Online ISSN: 2515-8260

Keywords : Haemodynamic


Intranasal midazolam and dexmedetomidine as premedication on haemodynamic stability: A comparative study

Dr. Shilpa Agarwal, Dr. Neeti Agarwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 160-166

Background: Many anesthetic pre-medications are used to relieve this stress response. Of these premedications,
midazolam and dexmedetomidine are effectively used as sedatives. The present study was
planned to compare intranasal dexmedetomidine with intranasal midazolam as a pre-anesthetic
medication in children. Many anaesthetic pre-medications are used to relieve this stress response. Of
these pre-medications, midazolam and dexmedetomidine are effectively used as sedatives. The present
study was planned to compare intranasal dexmedetomidine with intranasal midazolam as a pre-anesthetic
medication in children. Fear of unpleasant and painful procedures, separation from parents and
unwillingness to breathe through an anaesthesia face mask may produce stormy anaesthetic induction in
unpremeditated patients. Because of this premedication should be an integral part of paediatric
anaesthetic practice.

A study on addition of 10mcg of dexmedetomidine to bupivacaine heavy intrathecally in infraumbilical surgeries: A Prospective Study

Dr. Kschitiz Agrawal, Dr. Hemant Subhash Dambale, Dr. Nitin Dagdu Waghchoure, Dr. Shrikant Mangalmurti Upasani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1824-1829

Introduction: Spinal anesthesia is the most commonly performed anesthetic technique for
lower limb, abdominal, perineum surgeries. It has been seen that multiple drugs are being
added to the local anesthetics in subarachanoid blockade which results in better
haemodynamic stability, increased duration of surgical analgesia and even provide post
operative analgesia. Here we did a case series of adding intrathecal dexmedetomidine to
hyperbaric bupivacaine in cases which were posted for infraumbilical surgery and lasted for
more than 2 hours. Even two cases lasted for more than 5 hours were done comfortabily with
addition of dexmedetomidine.Dexmedetomidine is a selective alpha 2 adrenoceptor agonist
which can be used in low doses and it prolongs sensory block in a dose dependent manner
without major haemodynamic effects. Patient also had significant post operative analgesia
which reduced the requirement of rescue analgesia and also resulted in early recovery of the
patient.

To Observe Haemodynamic Changes On Intubating The Patients Using Propofol And Fentanyl Without The Use Of Muscle Relaxants

Dr. Kuldeep Kumar Patel (Assistant Professor), Dr. Sanjay Kumar (Senior Resident), Dr. Vinod Kumar Singh Senger (PGMO)

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2014-2017

Background&Method: The study was conducted with an aim to observe Haemodynamic changes
on Intubating the patients using Propofol and Fentanyl without the use of Muscle Relaxants on
50 normotensive patients of either sex between age 20-50 years. ASA grade I/II at Sanjay
Gandhi Medical College, Rewa, M.P.A detailed preanaesthetic assessment was done. Patients
seeming to have factors responsible for difficult intubation, (receding mandible, buck teeth, bull
neck, etc.) or contraindication to use of Propofol or Fentanyl were excluded from the study.
Weight of all patients was noted. Written consent was taken and patients were kept NPO
overnight.
Result:The patient is not totally paralysed, slight vocal cord movement was seen in 43 cases.
Slight diaphragmatic movement like a small hiccup was seen in 20 cases, mild cough was seen in
7 cases, moderate mandibular relaxation was seen in 14 cases. Limb movement was not
obtained in any patient. Therefore movement of vocal cords was the commonest factor which
was seen to lower the score from 8-9 to 6-7 (excellent to good conditions).However, slight
movement of partially abducted vocal cords was enough to allow placement of ETT in first
attempt in 41 cases with acceptable intubating conditions (89%) within 2 minutes of
administration of InjPropofol.
Conclusion: Acceptable intubating conditions were obtained in 92% patients i.e. 46 patients.
One patient had ideal intubating condition (score 9). 15 patients achieved excellent intubating
conditions. In these 15 patients, trachea could be intubated easily with cords showering slight
movement in partial abduction. These patients achieved a score of 8. Good intubating conditions
were obtained in 30 patients with intubating scores between 6-7, slight vocal cord movement of
partially abducted cords with slight diaphragmatic movement on placement of the tube was
observed. We conclude that Inj. Propofol 2.5 mg/kg preceded by Inj. Fentanyl citrate 2 mcg/kg 5
minute earlier provided good intubating conditions without the use of a muscle relaxant.