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Sharma, Shailja
- A Pilot Study of the Efficacy of Intrathecal Neostigmine for Postoperative Analgesia in Lower Abdominal and Lower Limb Surgery at SIMS, Ghaziabad, Uttar Pradesh
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Authors
Affiliations
1 Department of Anaesthesia, Sarswathi Institute of Medical Sciences, NH-24 Anwarpur, Hapur, Ghaziabad 245304, IN
1 Department of Anaesthesia, Sarswathi Institute of Medical Sciences, NH-24 Anwarpur, Hapur, Ghaziabad 245304, IN
Source
Indian Journal of Public Health Research & Development, Vol 3, No 1 (2012), Pagination: 136-138Abstract
Intrathecal neostigmine had been used in various doses to produce analgesia without neurotoxicity in both animal and human studies. The present study was conducted using 50μg intrathecal neostigmine methylsulphate with 12.5mg bupivacaine (0.5% heavy) for optimum duration of post-operative analgesia with minimal side effects. In this study 100 patients belonging to ASA physical status I and II, age 20-70 years of either sex scheduled for elective lower abdominal and lower limb surgeries under spinal anaesthesia were included. Patients were randomly allocated in two groups: group I (n=50, control) received 2.5ml bupivacaine + 0.5ml of normal saline and group II (n=50, test) received 2.5ml bupivacaine +0.5ml of neostigmine (50μg). Time of onset of sensory and motor block, highest level of block, duration of analgesia and side effects like hypotension, bradycardia, nausea, vomiting, etc were recorded. Onset time of sensory and motor block was much faster In bupivacaine and neostigmine group as compared to bupivacaine group. Patients were pain free for average 6-7 hours with bupivacaine and neostigmine as compared to 3-4 hours with bupivacaine. It was concluded that intrathecal neostigmine in the dose of 50μg provide post-operative analgesia for a period of 6-8 hours with lesser incidence of side effects of nausea and vomiting.Keywords
Anaesthesia, Spinal Anaesthesia, Drugs, Bupivacaine, NeostigmineReferences
- Hood DD, Eisenach JC, Tuttle R. Phase I safety assessment of intrathecal neostigmine methylsulfate in humans. Anaesthesiology 1995:82:331-343.
- Yaksh TL, Dirksen R, Harty GJ. Antinociceptive effects of intrathecally injected cholinomimetic drugs in the rat and cat. Eur J Pharmacol 1985 117: 81-8.
- Krukowski JA, Hood DD, Eisenach JC and et al. intrathecal neostigmine for post caesarean section analgesia: Dose response. Anesth Analg 1997; 84: 1269-75.
- Eisenach JC, Detweiler DJ, Tong Cy and et al. Cerebrospinal fluid norepinephrine and acetylcholine concentrations during acute pain. Anesth Analg 1996; 82: 621-6.
- Hood D.D., Eisenach J.C., Tong C., Tommasi E., Yaksh T.L.Cardio respiratory and spinal cord blood flows effects of intrathecal neostigmine methy1sulphate, clonidine and their combination in sheep. Anesthesiology 1995; 82: 428-435.
- Chung CJ, Kim JS, Park HS, Chin YJ. The efficacy of intrathecal neostigmine, intrathecal morphine and their combination for post cesarean section analgesia. Anesth Analg 1998; 87: 341-6.
- Mainvsky J.M., Renaud G., Le Corre P.Intrathecal bupivacaine in humans: effects of volume and baricity on spinal effects. Anesthesiology 1999; 91:1260-1266.
- Krukowski J.A., Hood D.D., Eisenach J.C. and et al. Intrathecal neostigmine for post cesarean section analgesia; dose response. Anesth Analg. 1997; 84: 1269-1275.
- Batra YK, Rajeev S, Panda NB and et al. Intrathecal neostigmine With bupivacaine for infants undergoing lower abdominal and urogenital Procedures dose response.Acta Anaesthesiol Scand 2009;Apr,53(4);470-5
- Tan PH, Kuo JH, Liu K, Hung CC. Efficacy of intrathecal neostigmine for the relief of post inguinal herniorrhaphy pain. Acta Anaesthesiol Scand 2000; 44:1056-60.
- Liu SS, Hodgson PS, Moore JM, Trautman WJ. Dose response effects of spinal neostigmine added to bupivacaine spinal anesthesia in volunteers. Anesthesiology 199; 90: 710-7.
- Saini S, Sethi S, Malhotra N Evaluation of Intrathecal Neostigmine for postoperative Analgesia J Anaesth Clin Pharmacol 2006; 22(1) : 35-40
- Gupta S.Postoperative Analgesia With Intrathecal Neostigmine; Two Different doses Of 75 µgms And 50 µgms With Heavy Bupivacaine. The Internet journal of Anaesthesiology ISSN 1092-406X
- Lauretti GR, Hood DD, Eisenach JC. A multicenter study of intrathecal neostigmine for analgesia following vaginal hysterectomy. Anesthesiology 1998; 89: 913-8.
- Klamt JG, Slullitel A, Garcia IV, Prado WA. Postoperative analgesic effect of Intrathecal neostigmine and its influence on spinal anaesthesia. Anaesthesia s1997; 52: 547-51.
- Comparative Analysis of Variation in Intraocular Tension with Vecuronium Bromide and Atracurium Besylate: a Prospective Study
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Authors
Affiliations
1 Department of Anaesthesiology, Saraswathi Institute of Medical Sciences, Hapur, IN
2 Department of Ophthalmology, Saraswathi Institute of Medical Sciences, Hapur, IN
3 Department of Surgery, Saraswathi Institute of Medical Sciences, Hapur, IN
1 Department of Anaesthesiology, Saraswathi Institute of Medical Sciences, Hapur, IN
2 Department of Ophthalmology, Saraswathi Institute of Medical Sciences, Hapur, IN
3 Department of Surgery, Saraswathi Institute of Medical Sciences, Hapur, IN
Source
Indian Journal of Public Health Research & Development, Vol 3, No 2 (2012), Pagination: 151-153Abstract
Intraocular pressure is the pressure exerted by the contents of the eye against its containing wall. During general anaesthesia, the intraocular pressure can increase, rendering problems in ophthalmic surgery especially surgery on the eye bulb. Pre-treatment with non-depolarising muscle relaxant prevents fasciculation and so the intraocular pressure does not rise. This is a prospective randomized study of 100 patients divided into two equal groups, where we have compared the effect of vecuronium bromide and atracurium besylate on intraocular pressure. The intraocular pressure was measured before surgery, at the time of intubation and at every 10 minutes interval during surgery. All the data were analysed statistically using unpaired student t test. We concluded that vecuronium bromide has better control over intraocular pressure as compared to atracurium besylate.Keywords
Vecuronium Bromide, Atracurium Besylate, Intraocular PressureReferences
- Gold Smith E. An evolution of succinylcholine and gallamine as muscle relaxants in relation to intraocular tension.Anaesth. Analog.1967.46:557.
- Hollyoway KB. Control of eye during general anaesthesia for intraocular surgery. Br J Anaesth 1980,52:671
- Mirakhur RK, Shepherd WFI, Lavery A, Elliot P. The effect of vecuronium on intraocular pressure. Anaesthesia 42.1987:944- 46.
- Al-Albarek MH, Samuel JR. Further observation on the effect of general anaesthesia on intraocular pressure in man. Br J Anaesth. 1974,46:756-59.
- Samuel JR, Beaugie A. Effect of CO2 on intraocular pressure in man during general anaesthesia. Br. J Ophthal.1974:58:62.
- James N, Mc Galliard, Gavin G, Lavery FFARCS, William FI, Shepherd FRCS. The effect of atracurium on intraocular pressure during steady state anaesthesia and rapid sequence induction: a comparison with succinylcholine. Can. Anaesth Soc J.1986.33(4):437-42.
- Jantzaj JP, Hackett GH, Eradmannk, Earnshow G. Effect of vecuronium on intraocular pressure.Br J Anaesth. 1986:59:433-6.
- Payne JP, Hugas R. Evolution of atracurium in anaesthetized man. Br J Anaesth.1981,53:45.
- Mayer EF, Singer P, Otto A. A controlled study of the effect of succinylcholine on intraocular pressure. Anaesthesiology. 1980,53:72.
- Maharaj RJ, Humphery D, Kaplon N. Effect of atracurium on intraocular pressure. Br J Anaesth. 1980,52:459-63.
- Murphy DF, Eustace P, Unwin A, Magner JB. Atracuriun and intraocular pressure. 1985,69:673-75.
- Nontuberculous Mycobacterium in Pulmonary & Extrapulmonary Tuberculosis: Stilla Neglected & Underdiagnosed Pathogen in Developing Countries
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Authors
Pankaj Saini
1,
Varsha A. Singh
2,
Kunal Sharma
3,
Gunjeet Singh
3,
Abhishek Chauhan
4,
Shailja Sharma
5
Affiliations
1 Junior Resident, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
2 Professor, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
3 Junior Resident, Department of Pharmacology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
4 Junior Resident, Department of Respiratory Medicine, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
5 General Physician, Baghpat, Uttar Pradesh, IN
1 Junior Resident, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
2 Professor, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
3 Junior Resident, Department of Pharmacology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
4 Junior Resident, Department of Respiratory Medicine, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
5 General Physician, Baghpat, Uttar Pradesh, IN