ABSTRACT
Background: Laryngoscopy and tracheal intubation increase blood pressure [BP] and heart rate [HR]. The aim of the present study was to investigate the effect of gabapentin given before operation on the hemodynamic response to laryngoscopy and intubation in patients undergoing laparoscopic cholecystectomy. Methodology: 90 ASA I and II patients undergoing elective laparoscopic cholecystectomy were r and omly allocated to three groups of 30 each. Group C received placebo drug; group G6 received gabapentin 300 mg night before surgery and 300 mg at 6:00 AM on the day of surgery; group G9 received gabapentin 300 mg night before surgery and 600 mg at 6:00 AM on the day of surgery. Anesthesia was induced with inj. thiopentone and inj. rocuronium. Heart rate, systolic BP, diastolic BP and mean arterial pressure were recorded as baseline, after induction, at tracheal intubation [0 min.]; and then at 1, 3, 5, 10, 15 min following tracheal intubation. Results: MAP was significantly lower in G9 group as compared to the control group at 0, 1, 3, 5, 10 and 15 minutes. Heart rate did not differ amongst the three groups at any time interval. Conclusions: Gabapentin, under present study design, attenuates the pressor response but not tachycardia associated with laryngoscopy and intubation. Key words: Intubation; Laryngoscopy; Gabapentin Citation: Aggarwal S, Baduni N, Jain A. Attenuation of pressor response to laryngoscopy and intubation a comparative study between two doses of gabapentin in patients undergoing laparoscopic cholecystectomy. Anaesth Pain and Intensive Care 2015;19[1]:33-36
ABSTRACT
To ascertain the awareness regarding global warming and the anesthesia practices contributing to it in the city of Delhi. A questionnaire was circulated amongst the qualified anesthesiologists [consultants and senior residents] in the city of Delhi. The initial contact was made through e-mail and the questionnaire was required to be filled and returned electronically. The questionnaire was also made available online at http:/sites.google.com/site/surveydelhi. After 1 month, the forms were distributed physically. Assuming that at least 50% of the approximately 1200 practising anesthesiologists would be able to recognize the greenhouse gases correctly, the target number of responses was 150 with 99% confidence limit. Of the 831 anesthesiologists contacted, only 184 responded. Ninety-eight percent were aware of the greenhouse effect, but only 15.8% [29] could correctly identify all the greenhouse gases. However, 47.28% [87] could identify nitrous oxide and inhalational agents as a cause of greenhouse effect. Ninety percent of the respondents use circle system and 87% use low flows frequently. Ninety-three percent [171] of respondents routinely use nitrous oxide, and 32.1% [59] would, however, not use air even if made available. Seventy-nine percent [145] advocated total intravenous anesthesia as an alternative to reduce the menace. Only 22% were motivated enough to respond to the survey. More than half of these anesthesiologists were not aware about the anesthetic agents contributing to the greenhouse effect. However, their clinical practices inadvertently do not add to the environmental pollution
ABSTRACT
Intrathecal clonidine prolongs spinal anesthesia but the optimum dose to be used in cesarean delivery is not yet known. We evaluated the effect of addition of intrathecal clonidine to hyperbaric bupivacaine on postoperative pain after lower segment caesarean section. A total of 105 parturients carrying a singleton fetus at term, scheduled to undergo elective LSCS under spinal anesthesia were randomized in a double blind fashion to one of the three groups. Group BF [n=35] received 2 ml of 0.5% hyperbaric bupivacaine + 25 microg fentanyl, Group BC[50] [n=35] received 2 ml of 0.5% hyperbaric bupivacaine + 50 microg clonidine, Group BC[75] [n=35] received 2 ml of 0.5% hyperbaric bupivacaine + 75 microg clonidine. The duration of postoperative analgesia was 184.73 +/- 68.64 min in group BF, 360.71 +/- 86.51 min in group BC[50] and 760.50 +/- 284.03 min in group BC[75], P0<0.001. The incidence of hypotension was comparable, P =0.932, whereas the incidence of nausea and pruritis was significantly lower in groups BC[50] and BC[75] as compared to group BF, P <0.001. No other side effects of intrathecal clonidine were detected. Neonatal outcome was similar in all the three groups. Addition of 75 microg clonidine to hyperbaric bupivacaine in spinal anesthesia for LSCS significantly prolongs the duration of postoperative analgesia without any increase in maternal side effects. There was no difference in neonatal outcome