Online ISSN: 2515-8260

Author : Anand, Dr. Abhijeet


A randomised comparative trial assessing the postoperative pain with transdermal buprenorphine and intramuscular diclofenac for analgesia

Dr. Abhijeet Anand

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 3551-3557

Aim: to compare the effectiveness and safety of transdermal buprenorphine with the widely used parenteral analgesic, diclofenac, for postoperative analgesia in the setting of major upper abdominal surgery under general anesthesia (GA).
Material and Methods: This was prospective, controlled clinical trial done in the Department of Anesthesia,ICARE Institute of Medical Science and Research &Dr.Bidhan Chandra Roy Hospital, Haldia,West Bengal, India. Patients were allocated to two parallel study groups by simple, balanced randomization using a computer-generated random number list. One group received buprenorphine patch releasing 20µg/h. The other group received diclofenac sodium intramuscular (IM) injection, in aqueous solution, 75 mg in the deltoid region. The primary outcome measure was postoperative pain assessed by VAS scoring at 4-h intervals for the first 12 h and then 12 hourly till the end of 72 h. For VAS scoring, a 10 cm vertical line was used, marked out in millimeters. The number of episodes of nausea-vomiting (despite postoperative ondansetron 4 mg 8-hourly for 48 h) was noted. Changes in vital parameters and other potential treatment-emergent adverse events were recorded The target sample size was 50 evaluable patients in each group.
Results: In the buprenorphine group, although the VAS score declined over time, the reduction attained statistical significance in comparison to the baseline (4 h) VAS score only at 72 h. In contrast, in the diclofenac group, VAS score achieved a statistically significant reduction in comparison to baseline from 8 h onwards, and this was maintained until the end of the observation period. In the buprenorphine group, 31 patients (62%) required rescue analgesia within the 72 h observation period, in contrast to 12 (24%) in the diclofenac group. This difference was statistically significant (P = 0.012).
Conclusion: we concluded that the primary outcome measure was comparable between the groups, the pattern of rescue analgesia use suggests that postoperative analgesia experience with buprenorphine patch was less satisfactory than diclofenac injection in this study. 

A prospective observational analysis of antimicrobial drug resistance trends in bacteria isolated from ICU patients admitted with respiratory tract infections

Dr. Abhijeet Anand

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 3849-3854

Aim: The aim of this study to analyzed antimicrobial Resistance Pattern of Bacteria Isolated from ICU Patients with Respiratory Tract Infections.
Materials and Methods: This was a prospective, observational study conducted in the Department of Anaesthesia ,ICARE Institute of Medical Science and Research &Dr.Bidhan Chandra Roy Hospital, Haldia,West Bengal, India.  A total of 200 samples (Sputum, Pleural fluid, Pus, IT-Tube sample, Bronchial swab, Respiratory swab) of RTI patients were collected from Respiratory ICU. For identification of different microorganisms selective media were used in this study. Isolate the microorganisms with the help of primary and secondary identification and antibiotic sensitivity were performed. 
Results: Majority of the patients was male 62.5% and rest 37.5% was female. Gram negative organisms are detected in (67%), Gram positive organisms detected (22%), and no organism detected (11%) of the swab samples.
Conclusion: Piperacillin-tazobactam was the most common antibiotic prescribed to patients with respiratory infection admitted to ICU. More than half of patients had resistance to the empirical antibiotic used in our ICU, highlighting the need for antibiogram for each ICU. Most of the patient had prior antibiotic use and had mainly gram negative organisms with high resistance to commonly used antibiotics.