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Lalwani, Jaya
- The Effect of Low-Flow and High-Flow Sevoflurane Anaesthesia on Renal and Liver Function:A Comparative Study
Abstract Views :241 |
PDF Views:92
Authors
Affiliations
1 Department of Anaesthesia & Critical Care, Pt. JNM Medical College, Raipur, IN
2 Department of Anaesthesia & Critical Care Pt. JNM Medical College, Raipur, IN
1 Department of Anaesthesia & Critical Care, Pt. JNM Medical College, Raipur, IN
2 Department of Anaesthesia & Critical Care Pt. JNM Medical College, Raipur, IN
Source
Central Journal of ISA, Vol 1, No 1 (2017), Pagination: 26-30Abstract
Background and Aims: Sevoflurane degradation products can affect liver and renal functions. The study was undertaken to assess the safety of low- flow sevoflurane anaesthesia and high- flow sevoflurane anaesthesia by comparing their effects on renal and liver functions. Material and Methods: The study was conducted in 100 adult patients of American Society of Anaesthesiologists physical status I or II, who underwent elective surgery under general anaesthesia. Patients were selected randomly into two groups to receive either low-flow Sevoflurane (n=50) or high-flow Sevoflurane (n=50) anaesthesia. In all these patients, preoperative renal function tests (RFT)&liver function tests (LFT) were done. RFT included blood urea, serum creatinine, creatinine clearance, urinary protein&LFT included serum bilirubin, SGOT, SGPT, ALP. The patients were induced by intravenous thiopentone [4-7 mg/kg] and succinylcholine [1-2 mg/kg] was given to facilitate tracheal intubation. Trachea was intubated with appropriate size cuffed endotracheal tube. Anaesthesia was maintained with either highflow Sevoflurane with fresh gas flow of 4.5- 7 Liters/minute or low-flow Sevoflurane with fresh gas flow of 1- 3 L/min. Blood samples were collected before operation and at 0 hour, 06 hr, 24 hr, 48 hr&72 hr postoperatively to measure Blood urea, Serum creatinine, Creatinine Clearance (CL), serum bilirubin, Serum Glutamic Oxaloacetic Transaminases (SGOT), Serum Glutamic Pyruvic Transaminases (SGPT), Alkaline phosphatase (ALP). Urine samples were collected at 24 hrs preoperatively&every 24 hrs for up to 72 hrs postoperatively to measure urine protein. Results: This study shows alterations in renal&hepatic functions in low-flow sevoflurane anaesthesia as well as high-flow sevoflurane anaesthesia. However, the alterations in renal&hepatic functions were within upper normal limit in both groups as assessed using conventional measures of hepatic&renal functions. Conclusion: We conclude that there were no statistically significant differences in the hepato-renal function by the effect of low flow and high flow sevoflurane anaesthesia and both seem to be equally safe.Keywords
High-Flow, Kidney Function, Low-Flow, Liver Function, Sevoflurane.Full Text
References
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- Anaesthetic Management of Patient with Ellis Van Creveld Syndrome
Abstract Views :318 |
PDF Views:90
Authors
Affiliations
1 Pt. JNM Medical College and DR. BRAM Hospital, Raipur (C.G.), IN
1 Pt. JNM Medical College and DR. BRAM Hospital, Raipur (C.G.), IN
Source
Central Journal of ISA, Vol 1, No 2 (2017), Pagination: 78-80Abstract
Ellis van Creveld syndrome (EVC syndrome) also known as chondroectodermal or mesoectodermal dysplasia was first described by Richard W.B. Ellisand Simon Van Creveld in 1940. The name chondroectodermal is used because it affects the skeleton (chondro) and skin (ectoderm). In general population the incidence is reported as 7 per 1,000,000 live births. Due to multisystem involvement anaesthesia care is challenging during intraoperative as well as post-operative period. Here we describe the perioperative care of a 14 year old female with EVC syndrome who underwent corrective osteotomy of tibia for genu valgum. Patient was given anaesthesia fitness under American Society of Anesthesiologists as grade 1. We planned to give subarachnoid block to the patient as she had no anomalies involving any other system of body except skeletal system, moreover our patient had normal lumbosacral spine study but thoracic spine scoliosis. Perioperative period was without any adverse events. Postoperative management constitutes adequate analgesia and prevention of adverse cardiorespiratory events.Keywords
Ellis Van Creveld Syndrome, Genu Valgum.Full Text
References
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- Prakash M, Swain A, Mishra S, Badhe A. Bronchospasm in a case of Ellis Van Creveld syndrome in a patient posted for corrective osteotomy and elizarove surgery. The Internet Journal of Anesthesiology. 2008; 22(1).
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- Howard TD, Guttmacher AE, McKinnon W, Sharma M, McKusick VA, Jobs EN. Autosomal dominant postaxial polydactyly, nail dystrophy, and dental abnormalities map to chromosome 4p16, in the region containing the Ellis van Creveld syndrome locus. Am J Hum Genet. 1997; 61:1405–12. https://doi.org/10.1086/301643 PMid:9399901 PMCid:PMC1716089.
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- Ruize-Perez VL, Tompson SW, Blair HJ, et al. Mutation in two nonhomologous genes in a head-to-head configuration cause Ellis-van Creveld syndrome. Am J Hum Gen et. 2003; 72(3):728–32. https://doi.org/10.1086/368063.
- Tompson SW, Ruize-Perez VL, Blair HJ, et al. Sequencing EVC and EVC2 identifies mutations in two-thirds of Ellis-van Creveld syndrome patients. Hum Genet. 2007; 120(5):663–70. https://doi.org/10.1007/ s00439-006-0237-7 PMid:17024374.
- Shamim F, Minai F. Anaesthetic management of patient with Ellis-van Creveld syndrome. Journal of the Pakistan Medical Association. 2008; 58(8):460–2. PMid:18822649.
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- Intravenous Bolus Phenylephrine, Ephedrine and Mephentermine for Maintenance of Blood Pressure During Spinal Anaesthesia in Caesarean Section: A Comparative Study
Abstract Views :196 |
PDF Views:70
Authors
Affiliations
1 Professor, Department of Anaesthesia, Pt. JNM Medical College, Raipur (C.G.), IN
2 Balaji Multispecialty Hospital, Raipur (C.G.), IN
3 Associate Professor, Department of Anaesthesia, Pt. JNM Medical College, Raipur (C.G.), IN
4 Professor and Head, Department of Anaesthesia, Pt. JNM Medical College, Raipur (C.G.), IN
1 Professor, Department of Anaesthesia, Pt. JNM Medical College, Raipur (C.G.), IN
2 Balaji Multispecialty Hospital, Raipur (C.G.), IN
3 Associate Professor, Department of Anaesthesia, Pt. JNM Medical College, Raipur (C.G.), IN
4 Professor and Head, Department of Anaesthesia, Pt. JNM Medical College, Raipur (C.G.), IN
Source
Central Journal of ISA, Vol 2, No 1 (2018), Pagination: 8-13Abstract
Objective: To study the efficacy of intravenous bolus Phenylephrine, Ephedrine and Mephentermine for maintenance of Blood Pressure during Spinal Anesthesia in patients undergoing emergency Caesarean Section.
Materials and Methods: One hundred twenty, ASA type 1 and 2 patients scheduled for emergency caesarean section under spinal anaesthesia who developed hypotension were allocated into 3 groups of 40 each. Group P received Phenylephrine 0.1mg, Group E received Ephedrine 6 mg, and Group M received Mephentermine 6 mg in 1 ml as bolus IV.
Results: The rise of diastolic blood pressure at 2, 4, and 6 minutes post study drugs were significantly less in Ephedrine and Mephentermine group as compared to the Phenylephrine group (p<0.05). Similarly elevation of systolic blood pressure in Phenylephrine group was significantly higher as compared to other two groups for first 6 minutes. Thereafter the differences narrowed off. No significant differences were observed between changes in systolic and diastolic blood pressure of Ephedrine and Mephentermine group at any point of time. In Phenylephrine group, post study drug values of heart rate decreased significantly from the values at onset of the hypotension till the end of the surgery when compared to other two groups (p<0.001). Neonatal Apgar score at 1 and 5 min were >7 in all three groups.
Conclusion: Phenylephrine group had quicker control of blood pressure compared to the other two groups. However, as the time elapsed all drugs achieved comparable control of blood pressure. Phenylephrine did show some advantage over others with regard to reduction in heart rate.
Keywords
Bolus, Ephedrine, Mephentermine, Phenylephrine.Full Text
References
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- Clyburn P. Spinal anaesthesia for caesarean section: time for reappraisal? (Editorial) Anaesthesia 2005; 60:633-3. https://doi.org/10.1111/j.1365-2044.2005.04282.x PMid:15960712
- Parameshwara G. Spinal, epidural to combined spinal epidural analgesia. The history of central neuraxial block. Indian J Anaesth. 2001; 45(6):406.
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- Sahu D, Kothari D, Mehrotra A. Comparison of bolus phenylephrine, ephedrine, and mephentermine for maintenance of arterial pressure spinal anaesthesia in caesarean section – a clinical study. Indian J Anaesth. 2003; 47(2):125-8.
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- Ganeshavar AK, Shetty S, Shettar AE, Koppal R, Ravi R. Comparison of bolus phenylephrine, ephedrine and mephentermine for maintenance of arterial pressure during spinal anaesthesia in caesarean section. J. clin. diagn. res. 2011 October; Vol-5(5): 948-952.
- Anaesthetic Management of a Patient with Cornelia De Lange Syndrome
Abstract Views :465 |
PDF Views:111
Authors
Affiliations
1 Department of Anaesthesia, Pt. JN Medical College, Raipur (C.G.), IN
2 Department of Anaesthesia, Pt. JNM Medical College, Raipur (C.G.), IN
1 Department of Anaesthesia, Pt. JN Medical College, Raipur (C.G.), IN
2 Department of Anaesthesia, Pt. JNM Medical College, Raipur (C.G.), IN
Source
Central Journal of ISA, Vol 2, No 2 (2018), Pagination: 69-71Abstract
Cornelia De Lange syndrome (CdLS) is a very rare genetic disorder. Anaesthesiologists facing such type of syndromic patients is also rare and management of these patients with mental and growth retardation has always been challenging. We present successful anesthetic management in a child with CdLS posted for cataract surgery.Keywords
Anaesthesia, Cornelia De Lange Syndrome, Cataract.Full Text
References
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