Indian Journal of Public Health Research & Development

Laveena Dabla ¹, Sapna Bansal ², Nalin Vilochan ¹, Vaishali Syal ³, Pankaj Kumar ¹, Sheenam Wadhwa ¹, Shikha Gulia ⁴

Affiliations
1 MBBS, Junior Resident, Amity College of Nursing, Amity University Haryana, IN
2 M.D Anesthesia, Associate Professor, Amity College of Nursing, Amity University Haryana, IN
3 M.Sc. Anesthesiology and Operation Theatre Technology, Department of Anesthesiology, Maharishi Markandeshwar (Deemed to be University) Mullana, Ambala, Haryana, IN
4 M.Sc. Neurosciences Nursing, Amity College of Nursing, Amity University Haryana, IN

Abstract

Background and Aims: Aim of this study was to compare the doses of Propofol and Etomidate using Entropy Monitor and per kilogram body weight doses and hemodynamic effects of both the drugs after induction and intubation. Material and Method: Hundred patients of ASA grade I and II in the age group of 18-60, scheduled for elective surgery under general anesthesia were randomly allocated in two groups. In group A: Induction dose of Etomidate was given till Entropy reached value of 40. In group B: Induction dose of Propofol was given till Entropy reached a value of 40. The doses given in ml were noted and calculated. Hemodynamic parameters like SBP, DBP, MAP, heart rate, oxygen saturation (SpO2), end tidal carbon dioxide were noted at baseline, induction, 1 min, 2 min, 3 min, 4 min, 5 min and 10 min thereafter. Data was subjected to statistical analysis. Results: There was reduction in induction doses using Entropy guided hypnosis level. The mean dose of Etomidate according to entropy was 16.9±2.8mg (0.27mg/kg) and per kilogram body weight dose was 18.61±3.4mg (0.3mg/kg). The mean dose of Propofol according to Entropy was 108.8±17.6 mg (1.72mg/kg) and per kilogram body weight dose was 124±23.1mg (2mg/kg). Incidence of hypotension and tachycardia was more with Propofol than Etomidate Conclusion: Use of Entropy resulted in decrease in the dose of Etomidate and Propofol. Etomidate provides more hemodynamic stability than Propofol after induction and intubation.

Keywords

Entropy monitor, hypnotic doses, hemodynamic response, Propofol, Etomidate.

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Sapna Bansal ¹, Laveena Dabla ², K.S. Bhatia ³, Becki ², Aiysha ²

Affiliations
1 Assosciate Professor, Department of Anaesthesiology, Maharishi Markandeshwar Deemed to be University, IN
2 Post Graduate Student, Department of Anaesthesiology, Maharishi Markandeshwar Deemed to be University, IN
3 Professor, Department of Anaesthesiology, Maharishi Markandeshwar Deemed to be University, IN

Abstract

Background: Continuous efforts are being taken to provide better postoperative quality of recovery especially in female patients in terms of both physical and emotional parameters after surgery and anaesthesia. Method: The present study was carried out in 70 female patients of ASA Grade I & II between the age group of 20-50 years scheduled to undergo lower abdominal surgery. They were randomly divided into two groups of 35 patients each to receive either table t duloxetine 60 mg or gabapentin 900 mg orally 3 hours prior to surgery and repeated 24 hours later with the same dose. Results: Both the groups were comparable regarding mean age and weight of the patients (Table I). There was highly significant difference in both mean and median values of quality of recovery in both the groups with better scores in the gabapentin group. The mean opioid requirement in group A was 2.83±1.20 and in group B was 1.90±1.04 which was also highly significant, p value 0.0009. Regarding patient satisfaction 54.28% patients in gabapentin group showed excellent satisfaction as compared to 28.50% patients in duloxetine group, p value 0.057. Side effects were observed more in Group A Conclusion: Gabpentin should be considered as an effective strategy for improving the postoperative quality of recovery and reducing the post-surgical narcotic consumption and related side effects.

Keywords

Duloxetine, Gabpentin, Postoperative Pain, Quality of Recovery.

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Divya Vijay ¹, Sapna Bansal ², Somika Aggarwal ¹, Priyam ¹

Affiliations
1 Postgraduate Student IIIrd Year, Maharishi Markandeshwar Deemed to be University, IN
2 Assosciate Professor, Department of Anaesthesiology, Maharishi Markandeshwar Deemed to be University, IN

Abstract

Background: Supraglottic airway devices have been widely used as an alternative to tracheal intubation during general anesthesia. Proseal Laryngeal Mask Airway (PLMA) is an effective alternative to ETT with inflatable cuff forming pressure seal around laryngeal inlet and permitting ventilation. In view of this, the present study was undertaken to compare the different insertion techniques to insert PLMA in adult patients undergoing elective surgeries. Methodology: Ninety patients scheduled for elective surgical procedures under general anesthesia belonging to ASA grade I and II were included in the study and were randomly divided into three groups with 30 patients in each group. In Group I (n=30), PLMA was inserted using introducer, in Group II (n=30) PLMA was inserted using digit and in group III (n=30) PLMA was inserted using stylet. Groups were compared in relation to number of attempts, insertion time, ease of insertion, orogastric tube insertion and, hemodynamic changes. Results: The success first attempt rate for placement of PLMA was highest with introducer as compared to digit or stylet and the results were statistically significant (p=0.029). The mean time of insertion for PLMA using introducer was 27.03±4.08 seconds which was shortest whereas with digit it was highest 35.27±4.97 (p=0.000) and by using stylet 31.33±3.12 seconds. There was no change in hemodynamic after the insertion of PLMA with either technique. Conclusion: To conclude introducer technique of PLMA insertion was best as compared to digit and stylet technique.

Keywords

Proseal Laryngeal Mask Airway; Supraglottic Airway Device

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Babita Ramdev ¹, Dinesh Kumar Sharma Sharma ², Sangita R. Sharma ³, Sapna Bansal ¹, T. Venugopal ⁴, Ritu Singh ⁴

Affiliations
1 Associate Professor, Department of Anaesthesia, MMIMSR, Mullana, Ambala, IN
2 Assistant Professor, Department of E.N.T.GMC, Patiala,, IN
3 ENT Consultant, Department of Anaesthesia, MMIMSR, Mullana, Ambala, IN
4 Post Graduate Student, MMIMSR, Mullana, Ambala, IN

Abstract

Introduction: Attenuation of stress response during laryngoscopy and intubation has been one of the major concerns of the anaesthetist. Various techniques have been used to suppress this response like deepening the level of anaesthesia and various drugs like β blockers,local anaestheticsetc. In this study Esmolol was used to suppress the stress response. Material and Method: 60 patients undergoing elective ENT surgery under general anaesthesia of ASA grade I and II were randomly divided into two groups of 30 each. Group I (n=30)-Control –no drug was given. Group II (n=30)-patients received pretreatment with Injection Esmolol 0.5mg/kg. Results: The results were tabulated and statistically analyzed with student t-test and Chi square test using ANOVA (analysis of variance). Conclusion: Esmolol attenuates the stress response to laryngoscopy and intubation in the form of increase in pulse rate and blood pressure and that esmolol given 3 minutes before induction provides stable cardiovascular conditions as compared to the control group and attenutates the pressor response but does not obliterate it completely.

Keywords

Esmolol, Stress Response, Laryngoscopy, Intubation.

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