Online ISSN: 2515-8260

Keywords : haemodynamics


An observational study of haemodynamics with etomidate as an induction agent in patients with coronary artery disease

Dr. Vishal Mallappa Kappattanavar, Dr. PG Raghavendra, Dr. Chandana MH, Dr.Jyoti Magar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 459-468

Etomidate has been widely used in western countries has now become available in India. Etomidate is
preferred in patients with CAD, especially with poor left ventricular (LV) function as it provides stable
cardiovascular profile but it has less inhibitory effect on pharyngolaryngeal reflex thus may cause less
blunting of response to laryngoscopy and intubation. After getting approval from institutional ethics
committee, study was carried out in all patients fulfilling the inclusion and exclusion criteria during the
study period. Patient diagnosed or known case of CAD either from history, investigations were
included in the study after obtaining written valid informed consent. There was no hypertension or
hypotension in group A (EF<45%) but in group B (EF>45%) hypertension was noted in just 1 patient
and no hypotension noted. Statistically they were non-significant (p value-0.077). There was no
occurrence any arrhythmias or significant ST changes in either group at any point of time from
induction to 10min after intubation.

EVALUATION OF EPIDURAL ROPIVACAINE FOR LOWER ABDOMINAL SURGERIES-A CLINICAL STUDY

Dr P. Nikhitha, Dr D. Jyothirmayee, Dr S. Manasa .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 782-792

Background: Different adjuvants are coadministered with local anesthetics to improve the speed of onset and duration of analgesia, and to reduce the dose, the selection of which is often left to the choice of an anesthesiologist.
Aims: Aim of the study is to evaluate the efficacy &safety of 0.75% Ropivacaine in epidural anaesthesia for lower abdominal surgeries.
Materials and methods: In the present clinical study, 0.75% preservative free ropivacaine is used through epidural route for patients undergoing elective lower abdominal surgeries belonging to ASA grade I and II with in the age group of 20 to 60 years.
We observed the time of onset , highest cephalad spread, two segment regression from highest cephalad spread and total duration of sensory block as well as degree of motor blockade and it's duration, haemodynamic changes, duration of post operative analgesia and side effects , if any.
Results: With 0.75% preservative free ropivacaine, the mean onset time of sensory block for S1, L1, T10, andT6 dermatomal levels are 22.9+/-5.01 mins, 8.48+/- 3.18 mins, 13.4+/-3.88 mins and 29.5+/-3.33 mins respectively. The maximum cephalad spread is T5 dermatomal level and mean time to reach maximum cephalad spread is 29.77+/-4.94 minutes.
The mean duration of sensory blockade and motor blockade are 406.25 +/- 23.22 minutes and 263.58 +/- 21.19 minutes respectively. The motor blockade time is far less than the sensory blockade. Only 6.66% of the total patients achieved the Modified Bromage scale3.
In our present study, the mean total duration of postoperative analgesia is 246.67+/- 42.86 minutes. There are not many changes in the haemodynamics and incidence of side effects and requirement of vasoactive drugs were minimal.
Conclusions: 0.75% ropivacaine has a longer duration of sensory blockade and the duration of motor blockade is for less than the sensory blockade, their by providing post operative analgesia for nearly more than four hours. It appears to be an ideal and safe local anaesthetic for these surgeries.

Comparison ofpremedication with oral pregabalin and i.v. Dexmedetomidine on hemodynamic changes in patients undergoing laproscopic surgery

Ashok Mittal, Vivek Tyagi , Pramod Chand3, Mahesh Verma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2144-2152

Background:The major problems during laparoscopic surgery are related to the
cardiopulmonary adverse effects of pneumoperitoneum, systemic carbon dioxide absorption,
and patient positioning. Due to the requirement of steep head-up position, the chances and
severity of unwanted hemodynamic responses such as hypertension and tachycardia are much
higher in laparoscopic cholecystectomy when compared with other laparoscopic
surgeries.Objective: The goal of anesthetic management in laparoscopic surgeries is to
minimize these hemodynamic responses along with adequate depth and pain control with the
target of minimal stress response and early discharge.
Materials & Methods:The present study was conducted in MLB Medical College and
hospital, Jhansi,UP.Participants of eithersex with ASA physical status grade I & II, aged 20
to 50 years and planned for elective laparoscopic cholecystectomy under general
anaesthesiawith tracheal intubationwere included in this study.This study was carried out in
100 participants. All selected participants under study were randomely divided into two
groups depending on the premedication used.Group A patients were given i.v.
dexmedetomidine in a dose of 1ug/kg over a period of 10 minutes, diluted with 100ml normal
saline,20minutes prior to induction of anaesthesia.Group B patients were given oral
pregabalin 75 milligrams with sips of water 1.5 hour before induction. Data was analysed in
SPSS 17.0 using unpaired students t test.
Result:We found that Systolic Blood Pressure and Heart Ratewere decreased after intubation
in both the groups but fall was significantly greater in group A when compared to group B
.There was also significant fall in Mean Arterial Pressure after intubation in group A as
compared to group B.

Haemodynamics of 2-chloroprocaine and bupivacaine for lower limb surgeries under spinal anaesthesia

Dr. Samatha Reddy Remata, Dr. Myakala Siddartha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1162-1167

The lipophilic portion is essential for anaesthetic activity and therapeutically useful local anaesthetics require a delicate balance between lipid solubility and water solubility. Addition of a butyl group to the Piperidine nitrogen of Mepivacaine results in bupivacaine, which is 35 times more lipid soluble and has a potency and duration of action three to four times that of Mepivacaine. Inclusion criteria were American Society of Anaesthesiologists (ASA) physical status I or II, either sex, age 18-60 years, presenting for lower limb surgeries. Exclusion criteria were patient allergic to drug, heart block/dysrhythmia. Hundred slips were made in such a manner that fifty slips had Group 1 written on it and the other fifty had Group 2. In the present study it was observed that there was no statistically significant difference in distribution of patients based on ASA grade in between the two groups p >0.05. In the present study it was observed that there was there no statistically significant difference in adverse events in between group.