Comparison Of Efficacy Of Propofol & Ketamine And Propofol & Fentanyl In Patients Undergoing Surgery

Introduction: An ideal anaesthesia always provides pleasant induction, minimal adverse conditions, inevitable loss of consciousness and rapid, smooth recovery of protective reflexes. The combination of Propofol, Fentanyl and Ketamine provides complete and balanced anaesthesia with advantages such as high potency, lower doses and fewer side effects. This study designed to compare the efficacy of propofol with fentanyl and propofol in combination with ketamine in patients undergoing surgeries. Materials and Methods: The present comparative study contains 120 cases undergoing various surgeries belonged to ASA grade I and II of both sexes and age between 2nd to 6th decades were recruited. Based on administered drug combinations cases were divided in to two groups i.e. group 1 administered with propofol & ketamine and group 2 administered with propofol and fentanyl. Oxygen saturation (SpO2), Heart rate, Systolic blood pressure (SBP), diastolic blood pressure (DBP) and respiratory rate was noted for all the participants before the surgical procedure and for every 5min after a surgical procedure. Results: The onset of induction was rapid in group 1 cases than group 2 cases. The mean pulse rate was significantly decreased after induction at 1 min, 5 min, 10 min, and 20 min. whereas in group 2, the mean pulse rate was decreased at 1 min and increased at 5 min, 10 min and 20 min. The mean respiratory rate and oxygen saturation also stable in both groups. Conclusion: The drug combination of propofol & ketamine and propofol & fentanyl are efficient in the maintenance of respiratory rate, oxygen saturation and haemodynamic stability. In this regard, drug combination of propofol & ketamine are best drug choice in surgical practice. Acceptance of propofol & ketamine is higher than propofol & Fentanyl.

Epidural anesthesia – Its efficacy, safety and cardiovascular stability in children

Background: A child awaking without pain is much easier to manage than one who wakes with pain. Regional anesthesia is also useful when general anaesthesia is technically difficult or is associated with an increased morbidity and mortality. Aim: The present study was conducted to identify the efficacy, safety and cardiorespiratory stability under anesthesia in children undergoing various lower abdominal and lower limb surgeries. Materials and methods: The study consisted of sixty patients of either sex, aged 1 to 12 years undergoing lower abdominal and lower limb surgeries under epidural block. Group A patients were premedicated with Inj. Glycopyrrolate I/V 0.1 mg to 0.2 mg, Inj. Ketamine I/V in the dose of 1 mg/kg. Group B patients were premedicated with Inj. Glycopyrrolate I/V 0.1 mg to 0.2 mg and Inj. Diazepam I/V 2.5 mg to 5.0 mg or Inj. Thiopentone sodium I/V 2-3 mg/kg body weight. After per medicating the child was preloded with isolute P/Ringer lactate (5-7 ml/kg body weight) Results: The mean duration of analgesia in group A patients was 151.2±10.84 minutes and in group B it was 149.8±5.74 minutes. There was no significant effect of epidural block on cardiovascular system. In this study none of the cases showed any significant change in respiratory rate and oxygen saturation in both groups. Conclusion: Epidural anesthesia in children is quite safe, economical and effective method for lower abdominal and lower limb surgery. Cardio respiratory Stability is excellent with this technique. Patient wakes pain free after surgery is over child is much easier to manage

Effect of simulated 400 m He-O2 saturation diving on oxidative-antioxidative system in lungs of rats / 军事医学

Objective To investigate the effect of simulated 400 m He-O2 saturation diving on the pulmonary oxidative-antioxidative system in rats.Methods SD rats were exposed to 4.1 MPa He-O2 mixture for 24 h in an animal chamber. Normal air pressure was used in the control group .The histopathology , contents of malondialdehyde ( MDA) , 8-hydroxy-2′-deoxyguanosine(8-OHdG),and glutathione(GSH) and activities of superoxide dismutase (SOD) and glutathione peroxi-dase( GSH-Px) in pulmonary tissues were determined .Results No difference was found during pathological examination or in MDA, 8-OHdG and SOD activity.GSH and GSH-Px activity were decreased significantly (P<0.05) after hyperbaric exposure.Conclusion Exposure to 4.1 MPa He-O2 for 24 h may promote oxidative stress and reduce antioxidative capacity rather than cause obvious oxidative damage in rat lungs .

Effect of PaCO_2 Modulating During Operation on Post-Operative Cognitive Function of Patients Undergoing OPCAB / 上海第二医科大学学报

Objective To observe the effect of PaCO_2 modulating during operation on post-operative cognitive function of patients undergoing off-pump coronary artery(OPCAB). Methods Thirty patients undergoing OPCAB were randomly divided into traditional group (G_ 1 , n=15) and modulated group (G_ 2 , n=15). During operation, PaCO_ 2 in G_ 1 maintained 35 mmHg to 39 mmHg with relatively fixed ventilation parameters setting, and PaCO_ 2 in G_ 2 ranged from 40 mmHg to 45 mmHg by adjusting ventilation parameters. Continuous cardiac output index (CCI), SvO_ 2 , regional cerebral O_ 2 saturation (rSO_ 2 ) and PaCO_ 2 were recorded before distal anastomosis(T_ 1 ), at 5 min of the first distal vessel anastomosis(T_ 2 ), second distal vessel anastomosis(T_ 3 ) and third distal vessel anastomosis(T_ 4 ), and 20 min after the completion of coronary artery anastomoses. HDS-R and ADL were used to examine the patients' cognitive function. Results There were no significant differences in pre- and post-operative HDS-R and pre-operative ADL scores between groups. The score of post-HDS-R in G_ 1 was obviously lower than that of pre-HDS-R (P

The effects of music therapy on vital signs and pulsatile oxygen saturation of pediatric intensive care unit children / 기본간호학회지

This study was attempted to prove the effect of emotional stability and vital signs applying music therapy program to the children admitted in the PICU. Data were collected from July to September, 1997. The subjects were 30 patients admitted in the PICU of 'S' University Hospital which were divided into two groups of experimental and control. Each group had 15 subjects. Method was nonequivalent control group pretest-postteset repeated design, observing vital signs and activity of subjects prior, during, and after the music intervention. The study tools were cassette tapes of "Mother's music whose babies want to listen" and Space-lab patient monitor. Data were analyzed using the SPSS/PC+; x2 test and t-test to analyze of the general characteristics; paired t-test to prove hypo-theses. Result were as follows; 1. Infants lower than seven months showed changing into stable vital signs from applying the music therapy, however infants from eight months to three-year old showed no change in vital signs. 2. Vital signs changed to stabilized condition in infants lower than seven months were heart rate and respiration rate. 3. The stability of vital signs during music therapy turned back to the previous state while terminating music therapy. 4. The effect of music therapy in the state of activity had on both infants group of lower than seven months and from eight months to three-year old, particularly more effective in the later group. I recommend follows on the base of above results; 1. As above results shows, listening to music is effective on infants and toddler, intervention with music therapy appropriate to chidlren's age is hot recommended. 2. Comparative study with noise blocking effect and music therapy effect within the ICU environment be recommended. 3. The repeated study on when the exact time is and how many repeat the music therapy to show the above mentioned effect be recommended. 4. We recommend this music therapy to be done in the recovery room, isolating room, operating room as well as ICU.

Indices for Assessing the Dynamic Severity of Mitral Stenosis

In order to obtain a useful parameter for dynamic quantification of mitral stenosis, hemodynamic data in 51 patients with pure mitral stenosis undergoing cardiac catheterization gas been statistically analyzed. As results, cardiac output was significantly correlated with mitral valve area(r=0.63), oxygen delivery(r=0.48), pulmonary vascular resistance(r=-0.46), oxygen delivery index(r=0.40) and mixed venous oxygen saturation(r=0.38), and was not significantly related to pulmonary artery pressures, pulmonary arterial wedge pressure and mitral pressure gradients. Whereas mixed venous oxygen saturation showed a significant correlation with pulmonary vascular resistance(r=-0.69), mean pulmonary artery pressure(r=-0.59), systolic pulmonary artery pressure(r=-0.59), diastolic pulmonary artery pressure(r=-0.59), mitral valve area(r=0.51), pulmonary arterial wedge pressure(r=-0.47), oxygen delivery index(r=-0.45), peak mitral pressure gradient(r=-0.41), oxygen delivery(r=-0.39), cardiac output(r=0.38) and mean mitral pressure gradient(r=-0.33). These results indicate that mixed venous oxygen saturation is a very useful parameter for dynamic quantification of advanced mitral stenosis.