Vaibhav Shahi

Abstract

Aims: Assessment of the degree of attenuation of pressor response to tracheal manipulation, with Esmolol and Dexmedetomidine as premedication, in patients posted for elective laparoscopic cholecystectomy. Settings and Design: The current randomised prospective study was designed and sixty patients of American Society of Anaesthesiologist class I and II undergoing laparoscopic cholecystectomy were included in the study. Methods and Materials: Sixty patients were randomised into two groups, Group E and Group D. Patients of group E (n=30) received Inj. Esmolol (0.50 mg/kg) in 10 ml normal saline two minutes before intubation and patients of group D (n = 30) received Inj. Dexmedetomidine (0.5mg/kg) in 10 ml normal saline over 10 minutes prior to intubation. In both the groups, at baseline and at various time intervals after study drug administration, hemodynamic parameters were recorded. Statistical analysis: SPSS software version 15.0 is used for statistical analysis. The values were represented as Mean SD. Student’s t-test was used for analysis of various parameters. Results: The demographic data and initial baseline hemodynamics were statistically similar. The sympathetic response to tracheal manipulation was significantly attenuated (p but dexmedetomidine blunts the pressor response more effectively. Conclusion: Among dexmedetomidine and esmolol, dexmedetomidine seem to be a promising drug to control the pressor response to tracheal manipulation. Keywords: Esmolol, Laparoscopic cholecystectomy, Dexmedetomidine.

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Abstract

Aims: To compare the efficacy of ropivacaine V/S levobuivacaine with fenatnyl as adjuvant for post operative analgesia in below umbilicus surgeries under combined spinal and epidural anaesthesia. Settings and Design: A prospective randomized double blind study was planned on 60 ASA grade I and II patients, admitted for elective surgeries. Materials and Methods: Patients were randomly divided into two Groups, Group I (n=30) received ropivacaine 0.1% (10ml of 0.2% ropivacaine) with 2µgm/ml of fentanyl (0.8 ml of fentanyl) & 9.2 ml of normal saline making a total volume of 20 ml, Group II (n=30) received 0.1% levobuivacaine (4 ml of 0.5% levobuivacaine) with 2µgm / ml of fentanyl (0.8 ml of fentanyl) & 15.2 ml of normal saline making a total volume of 20 ml. In both the groups, VAS score at different intervals of time, onset and duration of sensory block, and hemodynamic parameters and complications were assessed. Statistical Analysis Used: Data was expressed as either mean + standard deviation or numbers and percentages and analyses were performed using “Microsoft Excel 2007” for windows. The parameters were analyzed using Student’s Paired and Unpaired t-test. Results: The average duration of sensory block was 276±30.80 and 259±20.95 min for Group I and Group II respectively which were comparable for both Groups (p >0.05). The hemodynamic changes and complications have no significant differences between two groups, (p > 0.05). Conclusions: The combination of ropivacaine and levobupivacine with fentanyl as common adjuvant is equipotent for post-operative epidural anesthesia. Keywords: Ropivacaine, Levobupivacaine, Fentanyl, Epidural.

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