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Shah, Nida Farooq
- A Randomized Controlled Study to Compare the Effectiveness of Intravenous Dexmedetomidine with Placebo to Attenuate the Haemodynamic and Neuroendocrine Responses to Fixation of Skull Pin Head Holder for Craniotomy
Authors
1 Department of Anaesthesiology and Critical care, Government Medical College, Jammu, Jammu and Kashmir, IN
2 Department of Neuroanaesthesiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, IN
3 Department of Anaesthesiology and Critical Care, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, IN
4 Department of Anaesthesiology and Critical care, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, IN
5 Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, IN
Source
Northern Journal of ISA, Vol 1, No 1 (2016), Pagination: 16-23Abstract
The stress response to an intense painful surgical stimulus is characterized by activation of the sympathetic nervous system and an increased secretion of the pituitary hormones. The ability of the alpha agonist dexmedetomidine was tested to decrease heart rate, arterial blood pressure, and neuroendocrinal responses to skull-pin head-holder. 60 patients undergoing craniotomy were randomly distributed to receive either saline (P group) or Dexmedetomidine (D group). The placebo group received saline, whereas the treatment group (D group) received a single bolus dose of dexmedetomidine (1 microgram/kg) intravenously over 10 minutes before induction of anaesthesia. Haemodynamic parameters as heart rate, arterial blood pressure, and serial levels of cortisol, prolactin, insulin, and blood glucose were measured. Both the groups were comparable with respect to age, weight, sex and duration of surgery. The arterial blood pressure and heart rate was found to be lower in the dexmedetomidine group when compared with the placebo group (P<0.05). In both groups there was an increase in the plasma cortisol, prolactin, and blood glucose levels. However, the values were significantly higher in the placebo group compared with the dexmedetomidine group (P<0.05). The insulin levels were not significantly changed because of the administration of the dexmedetomidine. Our study demonstrates that, a single bolus dose of dexmedetomidine before induction of anesthesia attenuated the hemodynamic and neuroendocrinal responses to skull-pin insertion in patients undergoing craniotomy.
Keywords
Craniotomy, Hemodynamic Effects, Neuroendocrine Response, Stress Response.References
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- Airway management in children with hydrocephalus: A case series
Authors
1 Department of Anaesthesiology and Critical care, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, IN
2 Department of Neuroanaesthesiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, IN
Source
Northern Journal of ISA, Vol 1, No 1 (2016), Pagination: 35-38Abstract
Anaesthetic induction and airway management in children with acute hydrocephalus for various procedures may be quite challenging. The large occiput, in these patients, places the neck in extreme flexion and the large forehead may obscure the line of sight in laryngoscopy, so elevating the body with pillows or towels is necessary in order to facilitate laryngoscopy.References
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