Anesthesia, essays and researches
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The use of intravenous sedation during cardiac surgery to reduce awareness has been practised routinely during past few years and the two most commonly used drugs include propofol and dexmedetomidine, but their effects on hemodynamics and postoperative outcomes in cardiac surgery is continually being evaluated. ⋯ HR and MAP were significantly less in dexmedetomidine group compared to propofol group (P < 0.05). Both the groups had a similar requirement of vasopressors and inotropes. The duration of postoperative ventilation and length of stay in the ICU were significantly shorter in the dexmedetomidine group (P < 0.05). The risk of delirium was significantly less in dexmedetomidine group (P < 0.05). From our study we concluded, that the perioperative infusion of dexmedetomidine produces better hemodynamic stability, reduces the risk of postoperative delirium, and leads to shorter ICU stay.
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The spread of local anaesthetics during spinal anaesthesia is affected by various factors and can be unpredictable especially in parturients undergoing caesarean section. Factors like abdominal girth, symphysis fundal height etc have to studied to know their impact on level of sensory blockade. We hypothesized a study to find any correlation between weight of the baby and the level of sensory blockade. ⋯ There is no statistically significant correlation between weight of the baby and the level of sensory blockade.
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Several video laryngoscopes had demonstrated their superiority over conventional oral and nasal intubation techniques. King Vision video laryngoscope has fewer studies supporting its suitability for oral intubations. However, its suitability as a nasal intubating device has not been yet evaluated. We evaluated the suitability of King Vision video laryngoscope for nasotracheal intubation comparing with TruviewPCD. ⋯ King Vision video laryngoscope is just as effective as TruviewPCD video laryngoscope for successful nasotracheal intubation.
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Positioning fracture femur cases for sub arachnoid block (SAB) is challenging. Fascia iliaca compartment block (FICB) is low skilled, helps positioning, and provides analgesia. Dexmedetomidine as an adjuvant prolongs analgesia. ⋯ FICB ensures patient comfort during positioning for SAB and provides postoperative analgesia. Dexmedetomidine significantly prolongs postoperative analgesia.
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The hemodynamic response associated with laryngoscopy and tracheal intubation is a common concern for the anesthesiologist, especially in high-risk patients. The use of dexmedetomidine has found favor in obtunding this response, in addition to providing better intubating conditions and reducing the dose of other anesthetic drugs. Most of the current literature states a loading dose of 1 μg/kg dexmedetomidine to be superior to lower doses in this regard. However, using a lower dose may be advantageous by reducing incidence of adverse effects such as hypotension and bradycardia which are likelier with the use of higher dose, in addition to being more cost-effective. ⋯ Dexmedetomidine when used as infusion in the loading dose of 0.5 μg/kg is therapeutically as effective as when used in the dose of 1.0 μg/kg not only in reducing the induction dose of propofol but also in providing good intubating conditions and blunting the hemodynamic response to intubation. A lower dose is associated with a lesser incidence of adverse effects such as hypotension and bradycardia.