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1.
Artigo | IMSEAR | ID: sea-217969

RESUMO

Background: Intense sympathetic activity is linked to laryngoscopy and endotracheal intubation, which could lead to intraoperative problems. We undertook this study to compare the effects of preoperative nebulized Fentanyl and Dexmedetomidine on hemodynamic response to laryngoscopy and endotracheal intubation, taking advantage of their high bioavailability and better absorption through nasal mucosa. Aim and Objectives: The objectives of the study were (i) to compare the effect of preoperative nebulization on the hemodynamic response to laryngoscopy and intubation; and (ii) to assess intraoperative requirement of anesthetic agents. Materials and Methods: This prospective, randomized, and comparative study was conducted among 100 American Society of Anesthesiologists (ASA) I, II patients (of either gender) undergoing elective surgeries and requiring tracheal intubation, were randomized in two groups. Group A was given Fentanyl Nebulization (2 ?g/kg in 4 ml of 0.9% saline) and Group B was given Dexmedetomidine nebulization (1 ?g/kg in 4 ml of 0.9% saline) 10 min before anesthesia induction. Hemodynamic parameters were noted before and immediately after induction, 1 min, 5 min and 10 min after intubation. The main goal was to assess how Fentanyl and dexmedetomidine nebulization affect the laryngoscopy and intubation-induced stress response. The secondary outcome was to assess the intraoperative requirement of anesthetic agents, observe adverse effects of study drug and sedation score. Results: Dexmedetomidine nebulization was found to be more effective in blunting rise in heart rate post laryngoscopy compared to Fentanyl Nebulization (P < 0.0001) as well as in MAP after 10 min of intubation (P < 0.0001). Requirement of propofol was seen to be significantly reduced in Group B compared to Group A (P < 0.05). Sedation scores were significantly higher in Group B (P < 0.05). No evidence of side effects was observed in any group. Conclusion: Nebulisation of dexmedetomidine was found to be more effective in attenuation of stress response of laryngoscopy and intubation compared to nebulisation of fentanyl, with stable intraoperative hemodynamic and no significant side effects.

2.
Artigo | IMSEAR | ID: sea-184412

RESUMO

Introduction:- Fentanyl which is a short acting, synthetic opioid delivers cardiac stability at therapeutic doses and effectively blocks the sympathetic stress response to surgical stimulus. It also provides further hemodynamic stability. The Bispectral Index (BIS) is a derived electroencephalographic parameter. It has been widely validated as a monitor for depth of anesthesia. Methodology:- 99 patients of either sex, between age Group of 18 – 60 years, ASA Grade I and Grade II, scheduled for surgery under general anesthesia were randomly selected and included in this study. The duration of study was over a period of one year. This study was conducted in the Dept. of Anaesthesiology, Ananta Institute of Medical Sciences and Research Centre. Result:- In this study we were included two groups. 34% male & 66% female were included in Group I. While in Group 2 33% male & 67% female were included. Baseline characteristics of both the groups were not significantly different. There were no significant differences in age & sex& mean duration of surgery between two groups.(p>0.05 ) Conclusion:- This study colludes that, it was inferred that Fentanyl can also help to attenuate laryngoscopic stress response, as the rise in hemodynamics after laryngoscopy and intubation was within the normal limits of heart rate.

3.
Journal of Korean Neurosurgical Society ; : 139-143, 1993.
Artigo em Coreano | WPRIM | ID: wpr-60422

RESUMO

The simultaneous occurrence of one or more intracranial aneurysm and an intracranial arteriovenous malformation(AVM) in a patient is unusual. Four cases of intracranial aneurysm associated with cerebral arteriovenous malformation(AVM) were found in a total of 67 patients with cerebral malformation(AVM). The site of aneurysm was related anatomically to the arterial supplying arteriovenous malformation(AVM) in 3 cases and the bleeding source was aneurismal rupture in all four cases(100%). It is generally accepted that aneurysm is caused by hemodynamic stress result from the presence of an arteriovenous malformation(AVM). The management of the unusual problem is controversial which are surgical obliteration of both vascular lesion in one stage(2 cases) and surgical obliteration of both vascular lesion in two stages(1 case) were accomplinished with good surgical result.


Assuntos
Humanos , Aneurisma , Hemodinâmica , Hemorragia , Aneurisma Intracraniano , Malformações Arteriovenosas Intracranianas , Ruptura
4.
Journal of Korean Neurosurgical Society ; : 805-811, 1991.
Artigo em Coreano | WPRIM | ID: wpr-132796

RESUMO

We present two cases of traumatic aneurysms developing during aneurysmal surgery. The aneurysms were clipped without difficulty in both anterior communicating aneurysmal cases. To prevent the vasospasm, bypervolemic theraphy was begun and hypertension was induced postoperatively. The postoperative rebleeding occured within two weeks after initial aneurymal clipping in both cases. New aneursms developed near the clipped anterior communicating aneruysms ; A1 in one case, A2 in the other case. Minor arterial injury was considered to be the main cause of theses new aneurysmal formation and the hemodynamic stress induced by hypertension and hypervolemic therapy might contribute to the development of new aneurysms.


Assuntos
Aneurisma , Hemodinâmica , Hipertensão
5.
Journal of Korean Neurosurgical Society ; : 805-811, 1991.
Artigo em Coreano | WPRIM | ID: wpr-132793

RESUMO

We present two cases of traumatic aneurysms developing during aneurysmal surgery. The aneurysms were clipped without difficulty in both anterior communicating aneurysmal cases. To prevent the vasospasm, bypervolemic theraphy was begun and hypertension was induced postoperatively. The postoperative rebleeding occured within two weeks after initial aneurymal clipping in both cases. New aneursms developed near the clipped anterior communicating aneruysms ; A1 in one case, A2 in the other case. Minor arterial injury was considered to be the main cause of theses new aneurysmal formation and the hemodynamic stress induced by hypertension and hypervolemic therapy might contribute to the development of new aneurysms.


Assuntos
Aneurisma , Hemodinâmica , Hipertensão
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