Dhanashree Dongare

Abstract

Background: Respiratory dynamics are significantly altered during laparoscopic surgeries. Anesthesiologists should be well versed with the benefits as well as limitations of positive end expiratory pressure (PEEP) during laparoscopy. They can then judiciously use the same in different patient populations. In this study we have compared the effects of ventilation with and without PEEP of 10 cm on blood gases, airway pressures and hemodynamic parameters during laparoscopy. Materials and Methods: 60 patients, from American Society of Anesthesiologists (ASA) physical status I and II, in the age group of 18 to 60, posted for laparoscopic cholecystectomy were enrolled. They were randomized into two groups of 30 each. Group P received PEEP of 10 cm during laparoscopy and group C did not receive any PEEP. The vital parameters, arterial blood gases, and airway pressures were compared in both groups. Results: The oxygenation, (PaO2/FiO2 ratio) was significantly higher in PEEP group (446. 4 ± 113.32 mm of Hg) as compared to the control group (404 ± 51.4 mm of Hg) after one hour of laparoscopy (P= 0.0037). The control group had higher arterial carbon dioxide tension (42.84 ± 2.38 mm of Hg) as compared to PEEP group (41.86 ± 2.33 mm of Hg), (P < 0> Conclusion: 10 cm of PEEP helped in better oxygenation with no significant hemodynamic alterations, in otherwise healthy patients undergoing laparoscopic cholecystectomy. Keywords: PEEP, Laparoscopy, Oxygenation.

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Abstract

Functional endoscopic sinus surgery (FESS) requires good intraoperative surgical field visualization for better identification of structures. Among the many modalities for improving visibility, antifibrinolytic agent like Tranexamic acid has shown good results in many other surgeries. In this study, we have evaluated the effect of a single bolus dose of 15mg/kg intravenous Tranexamic acid when used as an adjunct. Materials and Methods: We have studied group T (n=30), who received Inj. Tranexamic acid against group C (n=30) i.e. control group. They were compared for surgical field using Boezaart scale, surgical duration and blood loss. Statistical analysis was done by unpaired t test and chi square test as was appropriate. Results: T group showed significantly lower values of Boezaart scale score i.e. better visualisation for surgical field (p Conclusion: We found that Tranexamic acid has a beneficial role in functional endoscopic sinus surgeries by improving the quality of surgical field when used as an adjunct. Keywords: Tranexamic acid, surgical field, functional endoscopic sinus surgery.

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