ABSTRACT
BACKGROUND AND AIMS: Airway management is a key concern in trauma patients with cervical spine fracture. Application of manual inline axial stabilization (MIAS) has become the standard of care in these patients. Indirect laryngoscopy only requires alignment of the pharyngeal and laryngeal axis. Hence the primary objective of the study was to compare two indirect laryngoscopes, Airtraq (with adaptor) and Hansraj Video laryngoscopes based on its Intubation Difficulty Score. MATERIAL AND METHODS: Sixty anesthetized patients were divided into two groups using computer-based randomization, and tracheal intubation was performed using either Airtraq or Hansraj Videolaryngoscope with cervical spine immobilization. RESULTS: Both Airtraq and Hansraj groups were comparable in terms of percentage of glottic opening (POGO) scoring (92 ± 9.88% vs. 89.3 ± 10.4%.) and duration of intubation attempt (14.9 ± 4.36 sec vs. 16.97 ± 3.64 sec). Intubation difficulty scale (IDS) score was significantly shorter with Airtraq (1 ± 0.58 vs. 1.8 ± 0.805; P < 0.0001). The mean duration of time taken for laryngoscopy in Airtraq (12.9 ± 2.07 s vs. 19.06 ± 3.83 s; P < 0.0001)) was significantly shorter and also the duration of time taken to secure airway in Airtraq VL was significantly shorter (29.47 ± 4.75 s vs. 36.03 ± 5.80 sec; P < 0.0001). The heart rate and MABP changes were modest in both groups, but was significantly more in Hansraj VL as compared to Airtraq VL, post-intubation. CONCLUSION: Both Airtraq and Hansraj videolaryngoscope can be used as first-hand device in the scenario of cervical spine stabilization. Airtraq videolaryngoscope is better than Hansraj videolaryngoscope due to shorter IDS and lessor hemodynamic changes.
ABSTRACT
BACKGROUND: Post-operative nausea and vomiting (PONV) is common. 5HT 3 receptor antagonists are commonly used drugs for its prevention. A study was designed to compare the efficacy and safety of ramosetron and ondansetron in patients undergoing laparoscopic cholecystectomy (lap chole). MATERIALS AND METHODS: A prospective randomized case controlled study was conducted at J. N. Medical College Hospital, Aligarh Muslim University, Aligarh, India, in patients who underwent lap chole following intravenous administration of ondansetron (4mg) or ramosetron (0.3mg) at the end of surgery, and efficacy as well as side effects of ondansetron and ramosetron was documented and compared. RESULTS: One hundred and thirty adult females undergoing lap chole were studied - 65 patients in each of the two groups. In first 24 h after surgery, complete response (No PONV) was observed in 28 patients of the ondansetron group and in 32 patients of the ramosetron group (P>0.05). Complete response in the second 24 h after surgery was observed in 30 patients of the ondansetron group and in 45 patients of the ramosetron group (P<0.05). During the first and second 24 h, PONV requiring rescue antiemetic was significantly higher (P<0.05) in the ondansetron group as compared to the ramosetron group. Adverse drug effects in the post-operative period were observed in 11 and 8 patients in ondansetron and ramosetron groups respectively (P>0.05). CONCLUSION: Ramosetron was found safe and more effective antiemetic than ondansetron in patients undergoing lap chole.
