Online ISSN: 2515-8260

Keywords : Pain Score

Efficacy Of Intraoperative Dexmedetomidine Infusion on Emergence Agitation and Quality of Recovery after Functional Endoscopic Sinus Surgery

Dr. Puspanjali Jena, Dr. Sudarshini M., Dr. Shashwathi Siddaramappa

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 602-609

Background: Emergence agitation has potential to harm both patients and caregivers. This is more often witnessed in patient undergoing otolaryngology operations under general anesthesia with volatile anesthetic used for maintenance.
Aim: We investigated the effects of intra-operative dexmedetomidine infusion on emergence agitation and quality of recovery after functional endoscopic sinus surgery in adult patients.
Materials and Methods: One hundred patients undergoing functional endoscopic sinus surgery were randomized into two groups. The dexmedetomidine group (Group D, n = 50) received dexmedetomidine infusion at a rate of 0.4 mcg/kg/hr from induction of anaesthesia until extubation, while the control group (Group C, n = 50) received volume-matched normal saline infusion as placebo. Propofol (2 mg/kg) and fentanyl (2 mcg/kg) were used for induction of anaesthesia, and sevoflurane was used for maintenance of anaesthesia. The incidence of agitation, haemodynamic parameters, and recovery characteristics were evaluated during emergence. A 40-item quality-of-recovery questionnaire (QoR-40) was provided to patients 24 hours after surgery.
Results: The incidence of agitation was lower in Group D than Group C (28 vs 56 %, P = 0.018). Mean arterial pressure and heart rate were more stable intra-operatively and during emergence in Group D than in Group C (P < 0.05). Time to extubation, nausea and vomiting, and pain scores were similar between the groups. Global QoR-40 score at 24 hours after surgery was higher in Group D (mean 174.7 ± 6.99) compared with Group C (mean 169.4 ± 9.91) (P < 0.05).
Conclusion: Intra-operative infusion of dexmedetomidine provided smooth and hemodynamically stable emergence. It also improved quality of recovery after nasal surgery.

Day Care Laparoscopic Cholecystectomy: A Prospective Study

Mohammed Arif, Shiv Kumar Bunkar, Rahul Yadav, Yogendra Singh Chundawat, Kalpana Agarwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2352-2359

Background: Laparoscopic cholecystectomy is a minimally invasive surgical procedure for removal of a diseased gallbladder. Rapid recovery after laparoscopic cholecystectomy and increasing experience with its post operative course has led to progressively shorter post operative period and the recent trend of day care surgery without an overnight stay at hospital. Now due to advances in anesthesia and surgical techniques, day surgery is the standard pathway of care for many complex patients and procedures traditionally treated through inpatient pathways. The purpose of present study is to evaluate feasibility and outcome of day care laparoscopic cholecystectomy in JLN Medical College & Hospital, Ajmer.
Material & Methods: This is a hospital based prospective study done on 50 patients undergoing laparoscopic cholecystectomy in Department of General Surgery at JLN HOSPITAL, Ajmer, Rajasthan from January 2020 to June 2021. Assessment of the post operative symptoms like nausea, vomiting, post operative pain was done in the recovery room itself. The discharged patients were followed up in surgical outpatient department on 2nd, 5th and 10th post operative day. Student’s t test, Fisher’s exact test were applied appropriately as per distribution of data. P-value<0.05 were considered statistically significant.
Results: Our study showed that the mean age of all the patients was 39.46 ± 10.06 years. 30% of all the patients were male, while 70% were female. Mean height was calculated to be 167.28 ± 6.89 cm. Mean weight was calculated to be 67.52 ± 10.47 kg and the mean BMI of the sample size was calculated to be 24.03 ± 2.69 kg/m2. It was found that the mean nausea & vomiting score was highest post-operatively than at discharge at least on 2nd day follow up (p value<0.05). The difference between the percentage of patients discharged and those not discharged was statistically significant (p value<0.05).
Conclusion: After undergoing the extensive research, collecting the data for the study purpose, analyzing the data, we could conclude that day-case laparoscopic cholecystectomy is feasible and safe and effective treatment for symptomatic gallstones