Comparison of lidocaine vs lidocaine + ketorolac in intravenous regional anaesthesia [bier's block]

To compare the duration of anaesthesia and degree of analgesia during intravenous regional anaesthesia using Lidocaine alone and Lidocaine with Ketorolac. An international quasi experimental study. This study was carried out in Nishtar Hospital Multan from 01/01/2006 to 30/06/2006 [6 Months]. Results: Patients were divided into two groups A and B. In group A injection Lidocaine 0.5% 40ml was given whereas in group B injection Ketorolac 30mg was add to Lidocaine 0.5% 40ml. The degree of anaesthesia and duration of analgesia were compared in both groups. Haemodynamics were also recorded to see any systemic effects of drugs. We conclude that 30mg Ketorolac added to Lidocaine in IVRA increases degree of anaesthesia and also provide prolonged postop analgesia

Comparison of Lidocaine and magnesium sulfate on hemodynamic changes in response to endotracheal intubation

Laryngoscopy and endotracheal intubation may produce adverse hemodynamic effects such as hypertension and tachycardia. To attenuate these stimulating responses, various methods and drugs were recommended. The objective of this study was to compare the effect of lidocaine and magnesium sulfate on hemodynamic changes in response to endotracheal intubation. In this study, 100 patients [ASA class I-II] were selected and divided randomly into two groups [50 patients in each group]. Premedication and induction drugs were the same in both groups according to weight. In case group, magnesium sulfates 40mg/kg [50%] and in control group, lidocaine lmg/kg [1%] was used before induction of anesthesia. In both groups, BP and HR checked in all patients and recorded before and after premedication after induction and in the 1st, 3rd, 5th minutes after endotracheal intubation. Data were analyzed by SPSS. T-test was used to compare the mean heart rate and systolic and diastolic blood pressure in different time and p<0.05 was considered significant. Two groups were equal in ASA class, frequency distribution of gender and age, HR, systolic and diastolic BP before and after premedication. But decrease in BP and HR after inducation of anesthesia in control group was more than study group [p<0.05]. There were no significant differences between two groups in mean BP and HR in the 1st, 3rd, 5th minutes after endotracheal intubation. Magnesium sulfate and lidocaine have the same effect on attenuating cardiovascular responses to endotracheal intubation

Fast tracheal intubation with adminstration of ephedrine before atracurium

The most important duty of anesthesiologist is to maintain a secure airway that in emergency patients by injection of intravenous anesthetic drugs such as nesdonal and succinylcholine, tracheal intubation is performed with a 30-45 second delay. But in cases that succinylcholine is contraindicated, nondepolarizing muscle relaxant like atracurium is injected and tracheal intubation is performed with a 3-5 minute delay. The aim of this study was to compare the effect of atracurium and ephedrine with atracurium alone for shortening the time of tracheal intubation. One hundred patients [ASA class I] were randomly divided into two groups of 50 cases. Induction of anesthesia was performed in both groups with nesdonal and then atracurium with dose 0.6mg/kg was administered in both groups. After premedication in case group, ephedrine with dose 70 micro g/kg was performed. In control group, tracheal intubation was performed 3-5 minutes after injection atracurium. Systolic and diastolic blood pressure and heart rate were measured and recorded at different times and also intubaion condition was recorded and data was compared. The mean age was 26.3 +/- 10 years in case group and 31.4 +/- 10 years in control group. In case group, tracheal intubation was performed in all patients during 2 minutes. After anesthesia induction, systolic and diastolic blood pressure decreased and heart rate increased in both groups, but there was a significant difference after intubation at minute 1 and 5 [p<0.05]. Quality of tracheal intubation was seen in 88% of subjects in case group and 96% of subjects in control group, this difference was not statistically significant. Ephedrine can cause a decrease in the onset time of atracurium and faster intubation without adverse hemodynamic effect