Indian Journal of Public Health Research & Development

Sharad Goel ¹, Ritu Goyal ¹, Sanjay Lal ¹, Shailja Sharma ¹

Affiliations
1 Department of Anaesthesia, Sarswathi Institute of Medical Sciences, NH-24 Anwarpur, Hapur, Ghaziabad 245304, IN

Abstract

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, Neostigmine

Full Text

     

Sanjay Kumar Lal ¹, Ritu Goyal ¹, Sharad Goel ¹, Saurabh Goel ²

Affiliations
1 Department of Anaesthesia, Saraswathi Institute of Medical Sciences, N. H.- 24 Anwarpur, Hapur, Ghaziabad, U.P.245304, IN
2 Department of Surgery, Saraswathi Institute of Medical Sciences, N. H.- 24 Anwarpur, Hapur, Ghaziabad, U.P.245304, IN

Abstract

In the present study, we aimed to compare the efficacy, tolerability, cardiovascular stability and recovery profile of propofol-thiopentone admixture with propofolketamine admixture in patient undergoing short surgical procedures. Sixty ASA grade I and II patients, age group 20-50 years of either sex scheduled for elective ambulatory surgical procedures were included. Patients were randomly allocated in two groups. Patients in group PT(n=30) were induced with admixture containing 10 ml of 1% propofol and 10 ml of 2.5% thiopentone and in group PK(n=30) were induced with admixture containing 10 ml of 1% propofol and 10 ml of 0.5% ketamine till loss of verbal response. Top up doses for maintenance were given as 2ml aliquots of the study drug. Induction dose and total maintenance dose of the drug, pain on injection, episode of apnoea, incidence of laryngospasm, bronchospasm, cough, hiccup and emergence phenomenon were recorded. Patients were monitored for pulse rate, non-invasive systolic and diastolic blood pressure through out the procedure. Recovery and discharge time was recorded. Induction and total maintenance dose of propofol was significantly high in group PT as compare to group PK. Patients in group PK have more stable haemodynamic profile as compare to patients of group PT. Incidence of side effects like apnoea and pain on injection were more in patients of group PT. The recovery and discharge time of the patients of both groups were comparable so it was concluded that combination of propofol and ketamine gives better efficacy and tolerability in terms of dose requirement, cardiovascular stability, less frequent side effects without affecting discharge profile as compare to propofol and thiopentone admixture.

Keywords

Anaesthetics, Intravenous, Propofol, Thiopentone, Ketamine, Ambulatory anaesthesia

Full Text

     

Shailja Sharma ¹, Arati Srivastava ¹, Sharad Goel ¹, Vikrant Sharma ², Ashutosh Niranjan ³

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

Abstract

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 Pressure

Full Text

     

Sharad Goel ¹, Sanjay Lal ¹, Ritu Goyal ¹

Affiliations
1 Department of Anaesthesia, Saraswathi Institute of Medical Sciences, Hapur, Ghaziabad 245304, IN

Abstract

Various modalities had been tried for optimum duration of post operative analgesia with minimal side effects. The present study was undertaken to evaluate the duration and quality of post operative analgesia by intrathecal bupivacaine alone, intrathecal bupivacaine12.5mg (0.5% heavy) with neostigmine (50μg) or intrathecal bupivacaine12.5mg (0.5% heavy) with morphine (100μg) in spinal block. 150 patients of ASA physical status 1&2, age 20-70 years of either sex, body weight 50- 100Kg were randomally assigned in three study groups. Group I - 0.5% bupivacaine (2.5ml bupivacaine+0.5ml normal saline), group II - 0.5% bupivacaine with 50μg neostigmine (2.5ml bupivacaine+0.5ml neostigmine) and group III - 0.5% bupivacaine with morphine100μg (2.5 ml bupivacaine+0.5 ml morphine). Onset of sensory and motor block of intrathecal neostigmine and intrathecal morphine group was much faster as compare to control group. Duration of post operative analgesia was also more in intrathecal neostigmine and intrathecal morphine group as compare to control group. Intrathecal neostigmine and intrathecal morphine groups were comparable in terms of onset of sensory and motor block and level of highest block. Nausea, vomiting and bradycardia were more in neostigmine group as compare to intrathecal morphine and control group. Patients in intrathecal morphine group had more incidence of pruritus. We concluded that intrathecal morphine 100μg is a better choice than intrathecal neostigmine during spinal block.

Keywords

Anaesthesia, Spinal Anaesthesia, Drugs, Bupivacaine, Neostigmine, Morphine

Full Text