ABSTRACT
Background- India, like many countries, has experienced two surges of the COVID 19 pandemic. Empirical data shows a difference in the effects of the virus between the two periods.We decided to compare the behaviour of the disease in its two major outbreaks in critically ill patients so as to obtain a better understanding and improve clinical outcomes. Methods- This was a retrospective study conducted by obtaining patients data from hospital records during the first st wave from 1 April 2020 to 30 June 2020 and comparing it to the records in second wave 15 March 2021 to 15 June 2021. Patient demographics, clinical presentation, mechanical ventilation and overall ICU outcomes were compared. Results- 89 patients admitted during first wave and 100 patients admitted during second wave during the chosen period were selected for the purpose of this study. Second wave predominantly involved the young and middle aged while majority of patients during first wave belonged to older age group with co morbidities. The most frequent signs and symptoms during both waves were fever, cough, pneumonia and tachypnea. Conclusion- The second wave was characterised by higher infectivity in a comparatively younger age group whereas first wave showed older age groups being primarily infected. However, the case fatality rate during first wave was higher than second wave.
ABSTRACT
The objective of current study was to compare the efficacy of three different anaesthesia induction approachesi.e. Inj propofol, Inj etomidate and admixture of Inj propofol and Inj etomidate in maintaining hemodynamicstability during induction and following Proseal LMA insertion in laparoscopic cholecystectomy. Patientswere randomly divided in to 3 groups with 90 patients each and received 2.5mg/kg of propofol(P), 0.3mg/kgof etomidate(E) and 1mg/kg of propofol+0.2mg/kg of etomidate which was mixed in a 20ml syringe. We alsostudied side-effects like PONV, myoclonus, pain on Injection, allergic reactions and thrombophlebitis. Wefound that the use of P-E admixture for induction of Proseal LMA provides hemodynamic stability as itprevents hypotension caused by propofol and also hypertension caused by etomidate when used alone. Admixturewas also associated with less incidence of other side effects like PONV, pain on Injection and myoclonus. Weconcluded that combination of propofol and etomidate for induction of anaesthesia for Proseal LMA issignificantly better than either drug used alone
ABSTRACT
The present study compares the effects of dexmedetomidine and esmolol on cardiovascular responseoccurring due to laryngoscopy and endotracheal intubation. A randomised controlled study was carried outon 90 healthy adult patients (ASA I and ASA II) under general anaesthesia. Patients were randomlyallocated into two groups i.e group E and group D. Group D received dexmedetomidine 0.6 µg/kg andgroup E received esmolol 1 mg/kg. Heart rate, systolic blood pressure and diastolic blood pressure wererecorded at baseline, at induction and at 1, 3, 5 and 10 minutes after intubation. This study showed thatdexmedetomidine (0.6 µg/kg) was more effective than esmolol (1mg/kg) for attenuating the cardiovascularresponse to laryngoscopy and intubation
ABSTRACT
In a prospective, double-blind, placebo-controlled, randomized trial one-hundred-sixty eight ASA I-II adults, undergoing laparoscopic cholecystectomy were randomly assigned into 3 groups of 56 each. Group L received lidocaine 2% (40 mg), Group B-1 received butorphanol 1 mg. and Group B-2 received butorphanol 2 mg. One min after pretreatment patients received one-fourth of the total calculated dose of propofol (2.5 mg/kg) over 5 s. In the lignocaine group 28 (50.00%) patients had pain during propofol injection as compared with 11 (19.64%) and 9 (16.07%) in the butorphanol 1mg and butorphanol 2mg groups, respectively (P < 0.05). Intergroup comparison revealed that although the incidence of pain at propofol injection was more in lignocaine group, the severity was primarily mild and comparable among the three groups (P > 0.05). Butorphanol decreased the frequency (P < 0.05) of propofol pain when compared with lidocaine. However severity of pain on injection of propofol was comparable among both the groups given pretreatment with butorphanol. (P > 0.05). No difference in complications, such as pain, edema, wheal, or flare response, were observed at the injection site within the first 24 h after the operation. Duration of analgesia was higher in Group-B-2 compared to other two groups. (142.5±33.96 minutes in Group-B-2, 76.07±23.56 minutes in Group-B-1 and 80.35±21.48 minutes in Group -L). However this was also associated with higher number of patients in deep sedation at 30 minutes. Pretreatment with butorphanol 1 mg or 2mg are equally effective in relieving pain on injection of propofol & more effective than lignocaine.
ABSTRACT
The objective of the present study was to compare the analgesic efficacy and side effects of butorphanol and tramadol.Equianalgesic doses of butorphanol (1mg) and tramadol (1mg/Kg) were compared in 50 adult patients (ASA-I) undergoing any kind of surgery requiring general anesthesia. The patients were divided into two groups of 25 each (n = 25). One of the study drugs (butorphanol/tramadol) was given intravenously just prior to induction of anesthesia in a double blind fashion. Following induction with standard doses of propofol/thiopentone Na and succinyl choline and intubation, anaesthesia was maintained with N2O/O2/Halothane. Heart rate and blood pressure were recorded from preoperative to post operative period in the recovery room and the frequency of side effects was noted by the trained nursing staff on duty following direct questioning of the patients. The proportion of patients with moderate to severe pain during postoperative period was significantly higher in tramadol group as compared to butorphanol group (p< 0.05). Time to first rescue analgesic was significantly prolonged in butorphanol group compared to tramadol group. The incidence of side effects was comparable in both the groups.To conclude according to our study, butorphanol is a very effective analgesic and contributes to balanced anaesthesia.