Comparison of hemodynamic responses of intrathecally placed hyperbaric 0.75% bupivacaine hydrochloride in different height groups of patients undergoing caesarean section

To compare the Hemodynamic response of intrathecally placed 1.5 ml of 0.75% hyperbaric bupivacaine hydrochloric in different height groups of patients undergoing caesarean section in spinal anesthesia. Quasi experimental study. This study was carried out in the Department of Anesthesia, Sindh Govt, Lyari General Hospital, Dow Medical College, Dow University of Health Sciences from July 2009 to December 2009. In this study patients enrolled for elective caesarean section, were divided into two groups. In Group-A the height of the patients was equal or less than 60 inches [5 feet] and the height of the patients of Group-B was between 60 -66 inches [5 - 5.5 feet]. Hypotension was observed in 67 patients. 46 patients belonged to Group-A and 21 patients from Group-B. The study showed that height of the patients influenced the hemodynamic response of local Anesthetics given during spinal anesthesia

Comparison of haemodynamic responses between atropine and glycopyrrolate used with neostigmine during reversal of neuromuscular blockade

The aim of the study was to compare the haemodynamic responses between atropine and glycopyrrolate used with neostigmine during reversal of neuromuscular blockade. The experimental study was conducted in the Department of Anesthesia, Sindh Govt Lyari General Hospital over a period of 6 months from February 2009 to July 2009. In this study we included total sixty patients undergoing elective surgeries. These patients were allocated into two equal groups. The patients in group I received inj Neostigmine 0.04 mg/kg with inj atropine 0.4 mg/1 mg neostigmine and the patients in group II were given inj neostigmine 0.04 mg/kg with inj. Glycopyrrolate 0.2mg/1 mg neostigmine at the end of the surgery. In both the groups heart rate and blood pressures were recorded as a base line value prior to administration of reversal agents and then after 1, 5, and 10 minutes interval after giving the reversal agents. The comparison was made between groups I and group II. Out of 60 patients 37 [61.66%] were males and 23 [3 8.33%] were females with 1.6:1 male to female ratio. The base line mean heart rate, systolic and diastolic blood pressure readings in group I were 75.13 +/- 5.23, 130.18 +/- 7.1 and 75.22 +/- 4.37 respectively while in group II these readings were 71.19 +/- 4.21, 121.12 +/- 11.52 and 75.77 +/- 3.61 respectively. Mean heart rate and systolic blood pressure readings between groups at 1, 5 and 10 minutes were statistically significant while diastolic blood pressure readings between groups were significant only at 5 minutes. Glycopyrrolate, in comparison to atropine, is more effective in providing cardiovascular stability in antagonizing the muscarinic cardiovascular effects of neostigmine

Comparison of propofol and sevoflurane for laryngeal mask airway insertion [LMA] in adults

To compare the effects of Porpofol and Sevoflurane in Laryngeal Mask Airway insertion. This study was quasi experimental was carried out in the Department of Anesthesiology, Surgical Intensive Care and Pain Management, Dow Medical College and Civil Hospital Karachi, Dow University of Health Sciences. The duration of the study was six months. In this study 60 patients schedule for elective surgery were enrolled which were divided into two groups. The average age of the patients was 25.1 +/- 10.6 years [95% CI; 23.7-29.0]. Out of 60 patients, 28 [46.6%] were males and 32 [53.3%] were females with 1:0.8 male to female ratio. Gender difference was not statistically significant between the groups [Chi-Square= 0.601; P=0.44]. The average age, weight and LMA insertion time were not statistically significant between groups. Induction time was significant between groups. Induction time was significantly higher in porpofol group [B] than in the sevoflurane group [A]. Condition of LMA insertion of 24 [80%] patients were excellent [score = 18] and 6 [20%] patients were satisfactory [Score between 16 to 17] in group A while condition of LMA insertion of 28 [93.3%] were excellent and 2 [6.7%] were satisfactory in group B. This study concludes that porpofol is a better anesthetic agent for insertion of LMA as compared to sevoflurane by using loss of eye lash reflex as the end point for induction

Acid aspiration prophylaxis during anaesthesia for caesarean section: a survey among anaesthetists at Hyderabad

Pulmonary aspiration of gastric contents leading to acid aspiration syndrome [AAS] is a well recognized risk factor during general anaesthesia [GA] for Caesarean section [CS]. The cross sectional observational study was conducted during July 2008 to October 2008 at Department of Anaesthesiology and Intensive Care, Liaquat University of Medical and Health Sciences Jamshoro, Sindh, Pakistan. The objective was to assess anaesthetic practice patterns and measures to prevent aspiration of acid gastric contents in full term pregnant women undergoing anaesthesia for Caesarean section. A structured questionnaire regarding practice of anaesthesia for Caesarean section was distributed among anaesthetists working and practicing at Hyderabad. Results from the completed questionnaires were transferred to a Microsoft Excel spreadsheet and the responses represented as percentages. General anaesthesia was preferred by 75.4% anaesthetists for caesarean section, 83.6% anaesthetists used rapid sequence induction with cricoid pressure during general anaesthesia, 29.5% respondents restricted clear fluids for 2-3 hours. Antacids were used by 90% of the anaesthetists, while about 50% anaesthetists performed extubation when patients were fully awake. Recommended practice patterns and measures to prevent aspiration of acid gastric contents during anaesthesia for caesarean section are not observed by most of the anaesthetists working at Hyderabad

Recovery profile - a comparison of isoflurane and propofol anesthesia for laparoscopic cholecystectomy

To compare the recovery profile in terms of time of extubation, eye opening, orientation and mobility and frequency of Postoperative Nausea and Vomiting [PONV] between propofol and isoflurane based anesthesia in patients undergoing laparoscopic Cholecystectomy with prophylactic antiemetic. Quasi-experimental study. Department of Anesthesia, Civil Hospital and Dow University of Health Sciences, Karachi, from January to April 2007. After informed consent, a total of 60 ASA I-II patients scheduled for laparoscopic Cholecystectomy were divided in two equal groups I and P. Anesthesia in all patients were induced by Nalbuphine 0.15 mg/kg, Midazolam 0.03 mg/kg, Propofol 1.5 mg/kg and Rocuronium 0.6 mg/kg. Anesthesia was maintained with Isoflurane in group I and propofol infusion in group P, while ventilation was maintained with 50% N[2]O/O[2] mixture in both the groups. All patients were given antiemetic prophylaxis. Hemodynamics were recorded throughout anesthesia and recovery period. At the end of surgery, times of extubation, eye opening, orientation [by modified Aldrete score] and mobility [recovery profile] were assessed. PONV was observed and recorded immediately after extubation, during early postoperative period [0-4 hours] and late period [4-24 hours]. Antiemetic requirements were also recorded for the same periods in both the groups. Propofol provided faster recovery [extubation and eye opening times] and orientation in immediate postoperative period with statistically significant differences between the groups [p<0.0001]. Recovery characteristics were comparably lower in group I. More patients achieved full points [8] on modified Aldrete score at different time until 30 minutes in group P. Postoperative nausea and vomiting in early and late periods were significantly reduced in group P. Moreover, requirement of rescue antiemetic doses were significantly lower in group P in 24 hours [p<0.0001]. In this series, recovery was much faster with earlier gain of orientation with propofol anesthesia compared to isoflurane in the early recovery periods. Propofol is likely to be a better choice of anesthesia because of its better anti-emetic property that persists long into postoperative period and reduces the risk of PONV