Comparative Study of Volume Controlled Ventilation Mode (VCV) and Pressure Controlled Ventilation Mode (PCV) Intra Operatively in Patient Undergoing Coronary Artery Bypass Graft Surgery

Introduction: Despite numerous advances in anaesthesia,surgical techniques, and postoperative care for coronaryartery bypass graft (CABG) surgery, postoperative pulmonarycomplications still account for postoperative morbidity.Primary aim of the study was to compare two modes ofventilation on gas exchange in form of PaO2/FiO2 ratio inintraoperative period at time of expected significant respiratoryalterations during CABG surgery. We compared VCV andPCV mode intra operatively as both ventilation modes arestandard of care. It was also intended to compare effectsof these modes on lungs to diagnose significant respiratorychanges with Chest X ray findings, and postoperative lengthof ICU stay.Material and methods: 60 patients posted for electivecoronary artery bypass graft surgery (CABG) were dividedinto two groups. Group 1 (VCV group) and group 2(PCV)group divided by sequentially numbered opaque sealedenvelope method. Baseline PaO2/FiO2 was observed beforeinduction, half hour after induction, post cardiopulmonarybypass (CPB) and at the end of surgery noted. Postoperativechest x ray findings, length of postoperative ICU stay alsocompared within two groups.Results: In terms of demographic data both modes werecomparable. After comparing both the modes it was observedthat PaO2/FiO2 ratio was better in PCV group half hour afterinduction and after CPB the end of surgery while no significantdifference between two modes on postoperative ray changesand length of ICU stay.Conclusion: Both the modes of ventilation can be used forCABG surgery with CPB which are standard of care wherePCV mode offers better oxygenation in terms of PaO2/FiO2at the end of the surgery after CPB.

Hemodynamic Response and Dose Requirement during Induction and Intubation with Propofol and Pentothal Sodium in Patients Undergoing Elective Coronary Artery Bypass Surgery

Introduction: The aim of the study was to observehaemodynamic changes during induction of patientsundergoing CABG with Propofol and Pentothal. It was alsointended to see if fixed dose combination of premedicationwith midazolam and fentanyl helps to reduce dose requirementof induction agents.Material Methods: 60 ASA grade II patients posted forelective Coronary Artery Bypass Surgery (CABG) weredivided into two groups. Group I (propofol group) and groupII (pentothal Group). All patients received premedication asInj.Midazolam 0.03 mg/kg and Inj.Fentanyl 4 µg/kg. Withcomputer generated randomization patient was allotted toeither propofol or Pentothal group. End point of inductiontaken as loss of eye-lash reflex or apnoea whichever appearsfirst. Hemodynamic parameters were recorded from baselinetill 7 minutes post intubation.Results: In both the groups SBP, DPB, MAP, HR and RPPwere found to be comparable. Both the drugs showed stablehemodynamic at various levels of observations. The meandose required for induction was found to be 1.7 mg/kg withpropofol and 1.07 mg/kg with Pentothal.Conclusion: Both propofol and Pentothal are equally ableto provide required stability even when standard doses ofbenzodiazepines and opioids are used in much lower dosesthan mentioned in literature