ABSTRACT
Background: The laryngeal mask airway (LMA) has reached ample popularity for the management of airway during surgery. Propofol, used as induction agent, causes change in blood pressure and heart rate (HR) while insertion of LMA. Sevoflurane, whereas, has the potential to be a good induction agent as propofol. We have compared propofol and sevoflurane for easy insertion of LMA among adults in minor surgeries. Aim and Objectives: The primary objective of the study was to compare the ease of insertion of LMA and its characteristics related to insertion among adults in minor elective surgeries using intravenous propofol or inhalational sevoflurane. While time taken to set induction and actual event of LMA insertion along with number of attempts, jaw relaxation time, LMA insertion time, apnea time, monitoring hemodynamic changes, and occurrence of complications were taken as secondary objectives. Materials and Methods: It was a prospective and observational study done in Department of Anesthesiology and Operation Theaters of Fortis Hospital, Kolkata, after getting ethical approval. Total 100 patients were recruited by consecutive sampling and divided into two groups - P (propofol) and S (sevoflurane) group. Anesthesia induction time, jaw relaxation time, LMA insertion time, etc. were noted. LMA insertion conditions were assessed by a 3-point scale using six variables, total score was calculated for each group. Hemodynamic parameters and induction complications were also recorded. Results: There was no significant difference in demographic parameters, American Society of Anesthesiologists class, Modified Mallampati Grading, and LMA size, between the groups. LMA insertion time was comparable between the two groups. Regarding complications, there was no incidence of coughing while minor gagging (4%) and laryngospasm (6%) were noted only with sevoflurane. Final summation of scores showed excellent insertion characteristics with propofol (94%) and sevoflurane (84%), respectively, with no significant difference. Conclusion: Inhalational sevoflurane may be regarded as a viable alternative to inj. propofol for insertion of laryngeal mask among adults in minor elective surgeries.
ABSTRACT
Background: Resistance to antibiotics is rising markedly. Factor which contributes to resistance is the rampant irrational use of antibiotics. The trend of prescribing antibiotics in intensive care units (ICUs) of eastern India is less explored. Aims and Objectives: The aim of the study was to describe and analyze the utilization of antibiotics as per the WHO/INRUD prescribing core indicators in an intensive and critical care unit (CCU) of a tertiary center in eastern India. Materials and Methods: A prospective observational study was carried out on prescription pattern of antibiotics. Case records of patients with restricted antibiotic therapy were reviewed and evaluated using descriptive statistics. A total of 353 prescriptions were evaluated and analyzed. Results: Among the total 353 patients most common age group admitted was 41–60 years. Males were more in numbers. Myocardial infarction and post-operative complications were the most common cause of admission in ICU and CCU, respectively. Ceftriaxone (44%) and meropenem (37%) were the drugs used rampantly in ICU and CCU. More than 90% of prescriptions had injections and drugs were written in generic names. Almost 90% of patients in CCU had antibiotics in their prescription. Adverse events occurred in 14.7% of patients and thrombophlebitis was the most common adverse event occurred. Conclusion: The study has given us an overall impression of the antibiotics usage pattern in ICU and CCU of this teaching institution. The study has shown that antibiotics should be used judiciously in ICU and CCU. Policy can be made on the basis of the result of this study.