Journal of clinical and diagnostic research : JCDR
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Response to experimental pain depends on the nature of the pain stimulus, as well as on gender, racial, cultural and socioeconomic factors. This study investigates the effect of age on pain sensitivity and cardiovascular reactivity produced by experimental pain. We have also compared the values of body mass index (BMI) and resting blood pressure of volunteers with the normal values. ⋯ The high numbers of volunteers with abnormal basal parameters (BMI and resting blood pressure) show an urgent need to educate the general public about the dangers and risk factors of obesity and hypertension. Less exposure of children to painful encounters may be responsible for their high pain sensitivity while higher values of resting blood pressure and decreased sensitivity of the sensory systems with advancing age may be responsible for the hypoalgesia observed in old adults.
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Laryngoscopy and endotracheal intubation can cause hypertension and tachycardia which can result in myocardial ischemia or stroke in vulnerable people. The objective of our study was to compare the efficacy of bolus dose of dexmedetomidine and fentanyl in attenuating haemodynamic stress responses following laryngoscopy and intubation. ⋯ Attenuation of rise in heart rate and blood pressure following laryngoscopy and endotracheal intubation was better with 1mcg/kg of dexmedetomidine when compared to fentanyl.
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Patients who survive cardiac arrest often develop severe neurological dysfunction due to the hypoxic brain injury and reperfusion induced cell death. Therapeutic hypothermia (TH) has become a standard therapy of cerebral protection following the successful return of spontaneous circulation in patients of out-of-hospital cardiac arrest, according to American heart association guidelines. This is a case report of a 30-year-old patient who developed in-hospital cardiac arrest and was revived after prolonged cardiopulmonary resuscitation (CPR) and also required primary angioplasty. ⋯ The patient was gradually and successfully weaned off from ventilator with no neurological impairment. There is an increasing evidence of TH and its protective mechanisms in patients with non-shockable arrest rhythms with particular emphasis on neurological outcomes. This article emphasizes the role of TH in every successful CPR irrespective of the cardiac rhythm.
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Continuous epidural infusion of Bupivacaine and Ropivacaine with or without the addition of Fentanyl has been evaluated by various researchers for effective postoperative pain relief. Studies however, depict significant variability in their results with regard to analgesic efficacy and adverse effects like hypotension, motor blockade etc. ⋯ It can be concluded that epidural analgesia using Ropivacaine 0.2% infusion is more effective than other study groups when used for postoperative pain relief in lower limb surgeries.
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Sepsis is one of the major causes of neonatal morbidity and mortality. Early recognition and diagnosis of neonatal sepsis are difficult because of the variable and non-specific clinical presentation of this condition. Hence, there is a need for early predictive screening method for neonatal sepsis. ⋯ The haematological scoring system using cord blood can be considered as an early predictive screening method for detection of early onset neonatal sepsis. Identifying the risk of developing sepsis early can prevent morbidity and mortality of the neonates.