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Hemanshu Prabhakar, Gyaninder Pal Singh, Charu Mahajan, Indu Kapoor, Mani Kalaivani, Vidhu Anand
BACKGROUND: Brain tumour surgery usually is carried out with the patient under general anaesthesia. Over past years, both intravenous and inhalational anaesthetic agents have been used, but the superiority of one agent over the other is a topic of ongoing debate. Early and rapid emergence from anaesthesia is desirable for most neurosurgical patients. With the availability of newer intravenous and inhalational anaesthetic agents, all of which have inherent advantages and disadvantages, we remain uncertain as to which technique may result in more rapid early recovery from anaesthesia...
September 9, 2016: Cochrane Database of Systematic Reviews
Devashish Dhiren Vyas, Gopal Krishna Dash
A 28-year old female was admitted with recurrent seizures following 2 days of febrile illness, after which she developed status epilepticus. Midazolam and later thiopentone infusions were started after failure of regular intravenous antiepileptics. Burst suppression was achieved at doses of 3 mg/kg/hr for midazolam and 6 mg/kg/hr of thiopentone. Adjunctive medications included methylprednisolone, intravenous immunoglobulin and acyclovir. Imaging and biochemical parameters were normal. She required 3 cycles of midazolam and 2 cycles of thiopentone for complete cessation of seizures...
June 2016: Journal of Epilepsy Research
Tsukasa Kanchiku, Yasuaki Imajo, Hidenori Suzuki, Yuichiro Yoshida, Norihiro Nishida, Toshihiko Taguchi
STUDY DESIGN: A retrospective review. OBJECTIVE: The purpose of this study was to investigate the clinical outcomes in adolescents diagnosed with psychogenic low-back pain and hysterical paralysis and to evaluate the efficacy of differential diagnosis methods. SUMMARY OF BACKGROUND DATA: The incidence of low-back pain in adolescence is similar to that in adults, but the causes of low-back pain are difficult to determine in most cases. For these patients, a definitive diagnosis of psychogenic low-back pain and hysterical paralysis as well as adequate treatment are clinically important to avoid unnecessary surgical treatment...
June 28, 2016: Clinical Spine Surgery
Kanchan V Bilgi, Arumugam Vasudevan, Prasanna Udupi Bidkar
BACKGROUND: The objective of this study was to study and compare the effects of intravenous dexmedetomidine and fentanyl on intraoperative hemodynamics, opioid consumption, and recovery characteristics in hypertensive patients. METHODS: Fifty-seven hypertensive patients undergoing major surgery were randomized into two groups, Group D (dexmedetomidine, n = 29) and Group F (fentanyl, n = 28). The patients received 1 μg/kg of either dexmedetomidine or fentanyl, followed by 0...
May 2016: Anesthesia, Essays and Researches
Satyen Parida, Ramesh Varadharajan, Prasanna Udupi Bidkar, Sandeep Kumar Mishra, Hemavathi Balachander, Ashok Shankar Badhe, Pankaj Kundra
BACKGROUND AND AIMS: Evidence and utility of the individual steps of the rapid sequence induction and tracheal intubation protocols have been debated, especially in the setting of traumatic brain injury. The purpose of this survey was to determine preferences in the current approach to rapid sequence intubation (RSI) in head injury patients among a population of anaesthesiologists from South India. METHODS: A questionnaire was E-mailed to all the members of the Indian Society of Anaesthesiologists' South Zone Chapter to ascertain their preferences, experience and comfort level with regard to their use of rapid sequence intubation techniques in adult patients with head injury...
April 2016: Indian Journal of Anaesthesia
Verònica Gálvez, Phern-Chern Tor, Adriana Bassa, Dusan Hadzi-Pavlovic, Ross MacPherson, Mincho Marroquin-Harris, Colleen K Loo
Studies have reported that co-adjuvant remifentanil can enhance electroconvulsive therapy (ECT) seizure quality, putatively by allowing a reduction in the dosage of the main anaesthetic agents, as the latter have anticonvulsant properties. However, whether remifentanil also has direct effects on ECT seizure quality, and by implication, treatment efficacy, is unknown. This is the first study examining the effect of adjuvant remifentanil on ECT seizure quality when the dose of conventional anaesthesia remained unchanged...
April 1, 2016: European Archives of Psychiatry and Clinical Neuroscience
R MacPherson, M Marroquin-Harris, V Gálvez, P Tor, C Loo
In order to optimise outcome to Electro Convulsive therapy (ECT), there has been a trend to utilise remifentanil as an adjunct to standard intravenous induction agents. This has allowed a reduction in the dose of anaesthetic agent, and usually an improved response to stimulation. However there have been no previous studies to ascertain whether this improvement is simply as a result of the reduced dose of anaesthetic agent or whether remifentanil itself might possess epileptogenic properties. This retrospective case-controlled study examined ECT outcomes, determined by EEG quality analysis, in patients who received ECT with or without remifentanil, where there was no dose reduction in the anaesthetic agent...
March 2016: Anaesthesia and Intensive Care
Julia Tünsmeyer, Klaus Hopster, Sabine B Kästner
OBJECTIVE: To investigate the use of the Narcotrend electroencephalogram (EEG) monitor for the assessment of anesthetic depth in horses undergoing xylazine balanced isoflurane anesthesia. STUDY DESIGN: Blinded experimental study. ANIMALS: Seven healthy warm-blooded horses, aged 10.6 ± 5.9 years, weighing 535 ± 55 kg. METHODS: Horses were anesthetized for a terminal surgical trial with xylazine, thiopentone, and guaiphenesin for induction and isoflurane and xylazine continuous rate infusion for maintenance...
2016: Frontiers in Veterinary Science
Alen Mathew, Anish N G Sharma, P Ganapathi, P Shankaranarayana, M Nazim, D S Aiyappa
AIMS: The present study is undertaken to compare the hemodynamic effects using vecuronium versus rocuronium for maintenance in patients undergoing general surgical procedures. SETTINGS AND DESIGN: It is a prospective, randomized, and cohort study. SUBJECTS AND METHODS: 100 patients were randomly divided into two groups. All patients were induced with 5 mg/kg of thiopentone sodium, and intubation conditions were achieved with 1.5 mg/kg of suxamethonium, using a well-lubricated cuffed endotracheal tube of appropriate size...
January 2016: Anesthesia, Essays and Researches
Manee Raksakietisak, Chutimart Ngamlamiad, Thitiganya Duangrat, Suvit Soontarinka, Kasana Raksamani
OBJECTIVE: To study the changes in cortisol levels during and after cardiac surgery after an inductive dose of either etomidate or thiopentone and their consequences. MATERIAL AND METHOD: A prospective, randomized, double-blinded study was conducted in 26 patients undergoing elective cardiac surgery. They received either etomidate or thiopentone for induction. Serum cortisol levels were measured preoperatively, and then at 2-, 4-, 8-, and 24-hour All of the patients received standard anesthesia and surgery...
August 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Indu Bala, Neerja Bharti, Nanjangud P Ramesh
OBJECTIVE: This randomized, double-blind study was conducted to evaluate the effect of gabapentin pretreatment on the hemodynamic response to laryngoscopy and endotracheal intubation (LETI) in treated hypertensive patients undergoing surgery. METHODS: A total of 100 controlled hypertensive patients aged 35-60 years, undergoing elective surgery under general anesthesia with endotracheal intubation, were randomly allocated into three groups. Group 1 patients received placebo at night and 2 hours prior to induction of anesthesia...
September 2015: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
I Tully, E S Draper, C R Lamming, D Mattison, C Thomas, T Martland, R Appleton
AIMS: To obtain national epidemiological data on the aetiology, management and outcome of refractory convulsive status epilepticus (RCSE) in children. METHODS: Data on children admitted with RCSE between 01.01.2008 and 31.12.2009, to eight paediatric intensive care units (PICUs) were retrospectively collected using a standard proforma designed with and co-ordinated by PICANet. RESULTS: Data were collected on 245 (male, 179) patients aged between <1 month and 16...
July 2015: Seizure: the Journal of the British Epilepsy Association
Satyen Parida, Niyaz Channanath Ashraf, Jibin Sam Mathew, Sandeep Kumar Mishra, Ashok Shankar Badhe
BACKGROUND AND AIMS: We conducted a prospective, randomised, double-blind, controlled clinical trial to examine (1) whether a single preoperative dose of 800 mg gabapentin would be as effective as 2 μg/kg of intravenous (IV) fentanyl in blunting the haemodynamic response to tracheal intubation and (2) whether a combination of both would be more effective in this regard. METHODS: Seventy-five patients (American Society of Anaesthesiologists physical status I), aged 20-50 years were allocated into one of three groups: 2 μg/kg IV fentanyl, 800 mg oral gabapentin or a combination of both...
May 2015: Indian Journal of Anaesthesia
Priska Bastola, Hemant Bhagat, Jyotsna Wig
BACKGROUND AND AIMS: Both inhalational and intravenous anaesthetic agents are being used for neuroanaesthesia. Clinical trials comparing "propofol and sevoflurane" and "desflurane and sevoflurane" have been published. However, the comparison of all the three anaesthetics in neurosurgical patients has not been done. A randomised clinical study was carried out comparing propofol, sevoflurane and desflurane to find the ideal neuroanaesthetic agent. METHODS: A total of 75 adult patients undergoing elective craniotomy for supratentorial tumours were included in the study...
May 2015: Indian Journal of Anaesthesia
Hemani Ahuja, Valsamma Abraham, John Abraham, Dootika Liddle
BACKGROUND: Day-care gynecological procedures require the use of anesthetic agents, which ensure rapid induction and recovery. Although propofol is the gold standard drug in day-care procedures, it has its own side effects like apnea, cardiovascular instability, pain on injection, as well as its cost. The ideal drug combination to achieve this end remains elusive. Therefore, a combination of propofol, thiopentone, and ketamine may be a better alternative. MATERIALS AND METHODS: This prospective, double-blind, randomized study was conducted on 60 women, aged 18-50 years, American Society of Anesthesiologists (ASA) physical status 1 and 2, undergoing day-care gynecological surgeries...
2015: Advanced Biomedical Research
Rajeev Kumar Sharma, Bhavyesh Gupta, Bhawana Gupta
The present investigation was undertaken to explore the ulcer healing properties of three dosage schedules of different strengths of topically administered amiloride solution in thermally produced skin ulcers on the side of the midline on the back of the rabbits. Four circular thermal burns about 4.0 cm in diameter (two on either side of the midline) were made 4.0 cm apart on the pre shaved back of each anaesthetized (with thiopentone sod., 45 mg/kg, ip) rabbit with a heated template, applied for 30 sec. Three days later under anaesthesia, the burns were excised removing epidermis, dermis and subcutaneous tissue...
July 2014: Indian Journal of Physiology and Pharmacology
Kiran Shekar, Jason A Roberts, Charles I Mcdonald, Sussan Ghassabian, Chris Anstey, Steven C Wallis, Daniel V Mullany, Yoke L Fung, John F Fraser
INTRODUCTION: Vital drugs may be degraded or sequestered in extracorporeal membrane oxygenation (ECMO) circuits, with lipophilic drugs considered to be particularly vulnerable. However, the circuit effects on protein-bound drugs have not been fully elucidated. The aim of this experimental study was to investigate the influence of plasma protein binding on drug disposition in ex vivo ECMO circuits. METHODS: Four identical ECMO circuits comprising centrifugal pumps and polymethylpentene oxygenators and were used...
2015: Critical Care: the Official Journal of the Critical Care Forum
Vinod Bala Dhir, Anupama Gill Sharma, Mohandeep Kaur, Michell Gulabani
Here we present a case of high spinal blockade in a patient belonging to ASA Grade I which lead to need for endotracheal intubation. A 35 year old healthy male, weighing 59 kg, of height 165 cms presented with a post traumatic raw area over the left lower limb. A reverse sural graft along with skin grafting (from the thigh) was planned. In OR, the patient was placed in sitting position and the extradural space was identified by 'loss of resistance to air' technique at the L2-L3 intervertebral space. The catheter could not be threaded into the extradural space, hence 5ml of 0...
January 2015: Anesthesia, Essays and Researches
Dilip Kothari, Chetan K Sharma
BACKGROUND: Narcotic drugs have been used to attenuate laryngoscopy and intubation induced circulatory responses, but are not always available due to tough narcotics laws. Nalbuphine a synthetic opioid, free from restrictions has been in use for post-operative pain relief. Hence, we decided to compare nalbuphine and pentazocine for attenuation of hemodynamic effects during larygoscopy and endotracheal intubation in a randomized, double-blind clinical study. MATERIALS AND METHODS: A total of 60 patients (ASA I and II) of either sex, between 18 years and 50 years were given either nalbuphine 0...
September 2013: Anesthesia, Essays and Researches
Malti Agrawal, Vijay Dureja, Ananda Prakash Verma, Lakhwinder Singh Kang
AIMS AND OBJECTIVES: Laparoscopic surgery is the choice for gynaecological surgery these days, but pneumoperitoneum (PNO) and trendelenburg position increase the intraocular pressure (IOP) leading to decrease in perfusion of retina and at times the significant risk of ischemic retinopathy. Our present aim is to find out the suitable combination of induction and maintenance agent for combating the increase in IOP by PNO, lithotomy and trendelenburg position, and to study the changes in IOP at different time points and positions in gynaecological laparoscopic procedures...
September 2013: Anesthesia, Essays and Researches
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