An Approach to Identify Imprints using Image Processing

Volume 1 Issue 4 (June 2013

Comparative study of fentanyl versus tramadol as adjuvant with low dose local anaesthetic ropivacaine (0.1%) for epidural labour analgesia

Background: Toxonomy committee of International Association defined pain as an unpleasant emotional and sensory experience associated with potential tissue damage. The present study was conducted to evaluate the effect of a combination of low dose ropivacaine with fentanyl and tramadol in epidural labour analgesia.Methods: This prospective randomized double blinded clinical study was conducted in 100 patients in labour after ethical committee approval. Inclusion criteria was patients who had ASA I and ASA II (American society of anesthesiologists physical status classification system), age above 18 years, height more than 150 cm, weight less than 110 kg, either primigravidae or gravid 2. Patients were allocated into two groups Group F (ropivacaine with fentanyl) and group T (ropivacaine with tramadol) by computer generated randomisation technique.Results: In the present study, mean age in group F (ropivacaine with fentanyl) was 22.54±2.5, mean age in group T (ropivacaine with tramadol) was 22.86±2.17, and weight in group F was 56.68±2.75 and group T was 56.58±2.58. Duration of labour in group F was 3.39±1.01 hrs and in group T was 3.42±0.70 hrs. There was no significant difference between the two groups at any time points for mean VAS score. There was no significant difference in the mean heart rate and arterial blood pressure among both the groups statistically (P>0.05). More side effects were seen in group F.Conclusions: Both fentanyl and tramadol in combination with ropivacaine provide similar analgesia with minimal motor block. Both have no adverse effects on cardiotocographic parameters. However side effects were relatively more common in fentanyl group. Thus tramadol is a safer alternative to fentanyl as an adjunct to epidural labour analgesia

Simulation of Borosilicate Crown glass Photonic Crystal Fibers with Flattened Chromatic Dispersion

Volume 1 Issue 10 (December 2013

Anesthetic management of parasitic conjoined twins' separation surgery

Parasitic twin is a rare form of conjoined twins with an incidence ranging from 1 in 50,000 to 1,00,000 live births. In thoracopagus type, both hearts are joined together and often are associated with underlying congenital cardiac malformations. The separation surgery is a challenging task for both the surgeon as well as anesthetist due to the complexity of the procedure and long duration of surgery, carrying mortality close to 100% in case of significant cardiac fusion. Here, we are sharing anesthetic management of successful separation of a rare type of parasitic male conjoined twins who had connected hearts and common liver

A Comparative Study to Assess the Efficacy and Safety of Intrathecal Bupivacaine Alone, Intrathecal Bupivacaine Plus Dexmedetomidine and Intrathecal Bupivacaine Plus Magnesium Sulphate for the Prevention of Post-Spinal Anaesthesia Shivering in Transurethr

Background: Preventing the post spinal shivering that occurs frequently in patients undergoing TURP would be beneficial. This trial aimed at evaluating the affect of intrathecal Mgso4 and dexmedetomidine in terms of incidence and intensity of shivering. Methods: This prospective randomized, double-blinded control study enrolled Seventy five patients randomized in three groups. All patients received standard spinal anaesthesia with 2.5ml of hyperbaric bupivacaine heavy 0.5% (12.5mg). Group A- received 0.5ml of normal saline, Group B- received 5μg dexmedetomidine in 0.5ml saline, and Group C- received 25mg MgSO4 in 0.5ml saline in addition to hyperbaric bupivacaine. The primary objectives of this study were incidence and intensity of shivering, while secondary objective were total dose of Pethidine required to control Shivering, Sedation score and Complications including Hypotension, bradycardia, Nausea, Vomiting. All data were summarized as mean ± SD for continuous variables, numbers and percentages for categorical variables. P <0.05 was accepted as statistically significant. Results: incidence of post spinal anaesthesia shivering was statistically significant in group A (56%) as compare to group B (12%) and group C (32%). The shivering grades of the groups A and C were statistically significant (P<0.001) and B was not significant (P>0.05). Nausea, vomiting, bradycardia and hypotension were comparable between the groups. All patients in group A, 22 patients in group B, and 21patients in group C had sedation score of 2. Three patients in group B and four in group C had a sedation score of 3. Conclusion: Intrathecal injection of dexmedetomidine and MgSO4 with bupivacaine were effective in reducing the incidence as well as intensity of post-SA shivering

Comparison of clinical performance of Ambu® AuraGain™ and BlockBuster® in anaesthetised preschool children-A randomised controlled trial

Background and Aims: Supraglottic airway (SGA) devices are a boon to paediatric airway management. The clinical performances of the BlockBuster® laryngeal mask airway (LMA) and Ambu® AuraGain™ in preschool children were compared in this study. Methods: After ethical approval and trial registration, this randomised controlled study was conducted on 50 children, aged 1–4 years, randomised into two groups. Appropriate sized Ambu® AuraGain™ (group A) and LMA BlockBuster® (group B) were placed as per the manufacturer's recommendation under general anaesthesia. Appropriate size of the endotracheal tube was then chosen and inserted through the device. Primary objective of the study was to compare the oropharyngeal seal pressure (OSP), and secondary objectives were the first attempt intubation success rate, overall intubation success rate, SGA insertion time, intubation time, haemodynamic changes and postoperative pharyngolaryngeal complications. The Chi-square test was used to analyse the categorical variables, while the intragroup comparison of mean changes in outcomes was evaluated by the unpaired t-test. The level of significance was set at P < 0.05. Results: Demographic parameters were uniformly distributed in both the groups. The mean OSP in group A was 26.6 ± 0.95 cm H2O and in group B was 29.08 ± 0.75 cm H2O. Both the devices were successfully inserted in all the patients. The success rate of blind endotracheal intubation through the device in first attempt was 4% in group A and 80% in group B. Postoperative pharyngolaryngeal complications were relatively less in group B. Conclusion: LMA BlockBuster® provides higher OSP and provides a higher success rate of blind endotracheal intubation in paediatric patients

Mortality predictors during the third wave of COVID-19 pandemic: A multicentric retrospective analysis from tertiary care centers of Western India

Background: The COVID-19 has a varied mode of presentation in different regions of the world. This multicentric study was planned to evaluate the survival outcomes in intensive care unit-admitted patients admitted during the third wave of the COVID-19 pandemic on the basis of clinicodemographic profile and vaccination status. Methodology: Data from 299 patients admitted to three tertiary care centers in Western India were collected and analyzed. Based on survival outcomes, all patients were divided into two groups: survivors and nonsurvivors. Univariate analysis of the demographic profile, comorbidities, vaccination status, and disease severity was performed, whereas multivariate analysis was performed to predict independent factors associated with mortality. Results: Among total 299 studied patients, 208 (69.5%) patients survived and 91 (30.4%) did not. The number of elderly patients and patients with comorbidities such as diabetes, tuberculosis, chronic obstructive pulmonary disease, cardiovascular and respiratory diseases, and malignancy were more prevalent among nonsurvivors. Patients who did not receive a single dose of vaccine were higher in the nonsurvivor group (P = 0.037); however, no significant difference in survival outcome was found if patients had received the first or both doses of vaccine. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score at 24 h after admission and Sequential Organ Failure Assessment (SOFA) score at admission were significantly higher in nonsurvivors compared to survivors (P < 0.0001). On multivariate analysis, APACHE II and SOFA scores were found to be independent predictors of outcome. Conclusions: Older age, presence of comorbidities, nonvaccination and higher disease severity scores affected mortality during the third wave of COVID-19