European Journal of Molecular & Clinical Medicine

Epidural anesthesia have important role for surgeries of lower abdomen, pelvis and lower limbs as they offer excellent operating conditions and are relatively safe for patients. This is especially useful in patient who are at risk of pulmonary aspiration
Materials & methods: The  study  comprised  of  60  ASA grade  I and II patients,  of either sex,  age  group  20-70  years and weight  40-75 kg. undergoing elective  surgeries  on  lower  limbs,  pelvis  or  abdomen  with  no  contraindication to epidural  anesthesia were selected. All patients were admitted in Gynecology, Surgery and Orthopedics ward, was conducted in the Department of Anesthesiology ANMMCH Gaya.
Conclusion-: clonidine  will  definitely expand scope  and  improve  the reliability  and  efficacy  of  epidural  anesthesia.  The  major  clinical  place  of  clonidine  is  as  on  adjuvant  to other  analgesics and  local anesthestic  as shown  in  number  of  studies

Aim: To determine the hemodynamic effect of lumbar epidural anaesthesia in patients with Severe preeclampsia.
Material and methods: Following approval from the institutional ethics committee, 50 non-laboring ASA (physical status I or II, age 18-32 years, weight 44-68 kg) parturients carrying a singleton pregnancy and scheduled for elective caesarean section were included in our study, and written informed consent was obtained from each parturient in their own language. There were 25 normotensive women (Group I) and 25 severe pre-eclamptic women (Group II) with blood pressures of 160/110 who needed antihypertensive medication (either nifedipine, 10–20 mg BD or TDS, or labetalol, 800–1200 mg in 2 to 3 divided doses).
Results: Parturients in both groups were equivalent in terms of age, weight, height, and foetal gestational age. The pre-eclamptic group had greater baseline SBP, DBP, and MAP. The mean baseline HR was similar in both groups. Following SAB, SBP, DBP, and MAP all declined from baseline in both groups, but the lowest recorded SBP, DBP, and MAP in the normotensive group were lower than in the parturients with pre-eclampsia, which was statistically significant. The pre-eclamptic group consumed considerably less phenylephrine than the normotensive group. The percentage of decline in DBP and MAP estimated from the baseline was likewise lower in the pre-eclamptic group (34% and 32% in normotensive, respectively, against 30% and 32% in pre-eclamptics). Pre-eclamptics required considerably less phenylephrine to cure hypotension (150.99±61 g in normotensive patients vs 50.11±22.36 g in pre-eclamptics), which was statistically significant (P <0.0001).
Conclusion: In conclusion, hypotension after spinal anaesthesia for caesarean delivery was much lower in severe pre-eclamptics than in healthy pregnant women in the current research. Furthermore, pre-eclamptic parturients had lower phenylephrine needs, and newborn outcomes were equivalent across the two groups.

Background: Multiple agents are used for laparoscopic cholecystectomy since laparoscopic cholecystectomy is routinely performed surgery and desirable to have a stable intraoperative hemodynamic status by avoiding hypotension, hypertension or tachycardia. The search for ideal agent is still ongoing, alpha -2 adrenergic agonist have created interest in manner. So, the present study was conducted to compare the beneficial effect of clonidine and dexmedetomidine during laparoscopic cholecystectomy in maintain perioperative cardiovascular stability.
Methods: The present double blind randomized, prospective clinical study was carried out among patients scheduled for elective laparoscopic cholecystectomy under general anaesthesia for a duration of 2 years. The sample size was calculated as 90 using formula: n=4pq/d² and were divided equally into groups A (control), group B (clonidine) and group C (dexmedetomidine). Preanesthetic assessment of all the selected patients were done with complete history, general examination, airway assessment, systemic examination along with laboratory investigations. During perioperative period, hemodynamic parameters such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were recorded various intervals.
Results: Increase in heart rate was statistically insignificant in all the groups at baseline (B) and just after induction (D0).After infusion of drugs, increase in heart rate was significantly lower in all the intervals in Dexmedetomidine group and Clonidine group comparing with Control group.On comparing dexmedetomidine group with clonidine group, insignificant fall (p>0.05) in DBP were observed at all intervals except at 30 minutes after pneumoperitoneum (APN30) and after reversal(DBP_AR).While comparing Dexmedetomidine group with clonidine group, insignificant fall (p>0.05) in SBP and MAP were observed at all intervals except at 50 minutes after pneumoperitoneum (APN50).While comparing Clonidine with Dexmedetomidine, significantly decrease heart rate was observed in dexmedetomidine group.
Conclusion: Creation of pneumoperitoneum in laparoscopic abdominal surgeries produces significant increase of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP). During pneumoperitoneum in laparoscopic abdominal surgeries both intravenous clonidine and intravenous dexmedetomidine results to attenuate in all hemodynamic parameters (HR, SBP, DBP and MAP) During pneumoperitoneum in laparoscopic surgeries heart rate is better controlled by dexmedetomidine.

Background&Method: The study was conducted with aim to evaluate and compare the
efficacy of IV esmolol and IV lignocaine in blunting the hemodynamic response to
laryngoscopy and intubationsat Sanjay Gandhi Medical College, Rewa, M.P. In the operating
room the patients was transferred to the operating table. An intravenous infusion with saline
0.9% was started using 18 G cannula in a peripheral vein. Blood pressure monitored by
manual cuff. A pulse oximeter was placed on the finger. ECG monitoring was also
established. A central venous line placed in the cubital vein using a 375 cava fix and a 0.9%
normal saline was started. Baseline heart rate and blood pressure were recorded. Random
allocation of patients to each group was done lots drawn by a person not taking part in the
study. The investigator that is the person doing the study was unaware of the drug used.
Result: The difference between the groups in distribution of age (p=0.6), weight (p=0.7) and
sex ( p=0.8) were not statistically significant. In duration of laryngoscopy and intubations was
not statistically significant. (P=0.5).In grades of laryngoscope was not statistically significant
(P= 0.51). In experience of anesthetist was not statistically significant. (P=0.37).
Conclusion: Esmolol and lignocaine are both similar in their effectiveness in attenuating the
haemodynamic response to laryngoscopy and intubation’s, but they do not abolish it
completely. More studies need to be carried out to confirm the perception that esmolol in
combination with the newer narcotic agents like fentanyl may abolish the haemodynamic
response to laryngoscopy and intubations, particularly required in the patients in whom a
single hyper dynamic response may be catastrophic.

Abstract: Introduction: These injure result from contact with faulty electrical wiring g or
high voltage power lines passing over the residences. Lighting is also an electrical injure the
extent of injuring is influenced by the duration of contact, current-voltage, type of current
(direct or alternate) the path of current and the resistance offered by tissues. Case
Presentation: A case of a 25-year-old male admitted in the burn unit on the date 22 October
2019 with complaints about he came in contact with the electric pole due to electrical shock
on 12/10/2019. He had wound over left hand up the wrist, wound over over the left axilla,
inner part of both thighs, head and back. The wound over the left hand was associated with
pus discharge, which was foul-smelling and scanty in amount, blood-stained.Interventions:
Generally, the burn victims with major burns are hospitalized and care is providing the burn
unit or ward. The goals during this phase are saving a life, maintaining and protecting the
airway, restoring hemodynamic stability and promoting healing and preventing or correcting
the complication. Outcomes: Over the short course of treatment, the patient significantly
improved in functional mobility, transfers, ambulation, and bed mobility. Progress even
further towards his goal of returning home. Discussion: The patient responded well to
treatment, however additional interventions could be utilized in the future to aid in greater
improvements

A prospective, randomized study was performed after acceptance by the Ethics Committee and informed consent of 60 patients seeking elective surgery at the Krishna Hospital and the Medical Research Centre, Karad. The study objective is to evaluate haemodynamic consistency through attenuation of the pressure reaction during laryngoscopy and endotracheal intubation. Group A obtained pregabalin orally with water sips before induction and Group B served as control group, received multivitamin orally with sips of water 1hr before induction. Both groups were uniform in their distribution of age, weight and gender. They had similar physical status with no coexisting disease. Both groups were managed with same anesthetic protocol. It was concluded that the preoperative sedation before giving premedication in control and pregabalin groups are comparable, whereas pregabalin produced better preoperative sedation after one hour of premedication, as evidenced by higher Ramsay sedation score.