Comparison of two different doses of dexmedetomidine infusion on post-operative pain and sedation in patients undergoing laparoscopic surgery

Background: Effective attenuation of the sympathoadrenal stress responses is an important goal in anesthesiology. Dexmedetomidine (Dex) a new generation highly selective α2 adrenoreceptor agonist might permit sedation and analgesia without the unwanted vascular effects from activation of α1 receptors. In addition, it has been shown to induce a centrally mediated reduction of sympathetic nervous system activity and decrease hemodynamic and plasma catecholamine response to stressful events. These properties theoretically make it a suitable agent for use as part of the anesthetic regimen. The aim was to study the effect of Dex infusion at two different doses on sedation and post-operative pain using Ramsay sedation score and visual analog scale (VAS) during the post-operative period for first 24 hrs.Methods: In this study, the patients were randomly divided into three different groups (control, Dex 0.3, and Dex 0.6) using computer generated random table. Post-operatively patient’s sedation pain scores were compared using Ramsay sedation score and VAS, respectively.Results: It was observed that the duration of surgery, duration of infusion and use of fentanyl (μg) was statistically insignificant in all the three groups. The mean pain in subjects of both Dex 0.3 and Dex 0.6 just after surgery till 6 hrs post-surgery were found to be significantly (p0.05) between the three groups i.e., remains statistically the same. On comparing the mean Sedation in subjects of Dex 0.3 and Dex 0.6 just after surgery till 12 hrs post-surgery were found to be significantly (p0.05).Conclusion: The perioperative infusion of Dex may be an attractive option during laparoscopic surgery as it, offered better control of intraoperative and post-operative hemodynamics, and decreased post-operative pain level and better sedation scores, as compared with control

Use of nasogastric tube in emergency situation to prevent LMA ProSeal down folding: a simple method

Securing of airway and prevention of aspiration are of utmost importance during airway management in the field of anesthesia and emergency medicine. Now a days laryngeal mask airways are being very frequently used for securing airway in elective as well as emergency conditions. LMA-ProSeal™ (PLMA) (Laryngeal Mask Company, Henley-on-Thames, UK) has an added advantage over classical LMA (CLMA) as it has gastric port for insertion of Ryle’s tube which allows suctioning of gastric contents. PLMA also allows ventilation with higher pressures so it is preferred over CLMA, The design of the PLMA reliably allows positive pressure ventilation up to 30–40 cm H2O pressure. Use of PLMA is not always a smooth ride and may offer certain difficulties

Research Paper Evaluation of Anti-Inflammatory Activity of Cassia Angustifolia Seeds Extract in Rat

The present study was designed to perform evaluate antiinflamatory activity of seeds of Cassia angustifolia. Seed of Cassia angustifolia was extracted using methanol as solvent by soxhlet apparatus. The evaluation of antiinflamatory activity was done using carrageenan induced rat paw edema assay. The work entitled evaluation of antiinflamatory activity of seeds of Cassia angustifolia was to determine the efficacy and safety in experimental animals. Both aqueous and methanolic extract of seeds of Cassia angustifolia have shown significant reduction in inflamation in proliferative phase as indicated by decreased granuloma formation in the cotton pellet induced granuloma model in rats. The aqueous and alcoholic extract of seeds of Cassia angustifolia has shown significant decrease in preventing generation of collagen fibres, fibroblast and suppressing mucopolysaccharides

Comparative Study of Isobaric Levobupivacaine and Hyperbaric Bupivacaine for Lower Segment Caesarean Section Under Spinal Anaesthesia in Northen India

Background and Objectives: Central neuraxial blocks are the preferred technique for anesthesia for lower segment caesarean section. Local anesthesia drugs have been routinely used for spinal anesthesia to compare various block characteristics and hemodynamic changes in patients undergoing lower segment caesarean section using hyperbaric bupivacaine and isobaric levobupivacaine. Methods: After Institutional ethical committee approval, 100 patients scheduled for elective lower segment caesarean section were randomized into Group L and Group B. Group L (N = 50) received 2.5mL(12.5mg)0.5% isobaric levo-bupivacaine and Group B (N = 50) received 2.5 mL (12.5 mg) 0.5% hyperbaric bupivacaine as intra-thecal drugs for spinal anesthesia. The present study was conducted in Operation theaters and the Post-operative ward of LLRM medical college, Meerut. Difference in characteristics of onset of block, regression of block, hemodynamic profile, and side effects were recorded between groups. Results: Group L, in comparison to Group B, showed prolonged duration of sensory block (P = 0.01) with lesser duration of motor block (P = 0.0002). Hemodynamically hypotension was statistically significant in the bupivacaine group (P = 0.016). Conclusions: The current study validates that both isobaric levo-bupivacaine and hyperbaric bupivacaine in spinal anesthesia provide effective surgical anesthesia for lower segment caesarean section. Levo-bupivacaine can be a better alternative to bupivacaine in terms of reduced motor block time and a longer sensory block time with lesser incidence of hypotension and better hemodynamic stability

A clinical comparative study of ropivacaine versus ropivacaine with fentanyl by continuous epidural infusion for post-operative analgesia and ambulation in patients undergoing major gynecological surgery

Background: To compare the effect of continuous epidural infusion of ropivacaine versus ropivacaine-fentanyl for post-operative analgesia and ambulation in patients undergoing major gynaecological surgeries.Methods: A total of 60 patients of age 20 to 50 yrs of body mass index (BMI) within normal range (18.5to24.9 kg/m2) posted for major gynecological surgeries were divided into two equal groups (Group R and RF) in a prospective, randomized, double-blind fashion. In Group RF (n=30) 0.1% Ropivacaine with 2µg/ml Fentanyl and in Group R (n =30) 0.1% ropivacaine were used. General anaesthesia was given to all patients. Continuous epidural infusion using elastomeric pump was started at ‘0’ post-operative hours at 6ml/hour. Post -operative pain (Visual Analogue Scale Score), ambulation (James Modified Bromage Scale) and side effects were noted at 0, 2, 4, 6, 12, 18, 24, 36 and 48hrs.Results: The differences in VAS Score of subjects of both the groups were statistically significant(p<0.05) at 18 hrs, 24hrs, 36hrs and 48 hrs and the differences in Modified Bromage Scale of subjects of the groups were statistically similar at most of the time intervals. Also, the side effects were statistically similar between the groups.Conclusions: Author concluded that ropivacaine-fentanyl is better than ropivacaine alone by continuous epidural infusion for post-operative analgesia in major gynecological surgeries with no statistically significant side effects, effect on ambulation being similar in both the groups

Measurement of the top quark forward-backward production asymmetry and the anomalous chromoelectric and chromomagnetic moments in pp collisions at √s = 13 TeV

Abstract The parton-level top quark (t) forward-backward asymmetry and the anomalous chromoelectric (d̂ t) and chromomagnetic (μ̂ t) moments have been measured using LHC pp collisions at a center-of-mass energy of 13 TeV, collected in the CMS detector in a data sample corresponding to an integrated luminosity of 35.9 fb−1. The linearized variable AFB(1) is used to approximate the asymmetry. Candidate t t ¯ events decaying to a muon or electron and jets in final states with low and high Lorentz boosts are selected and reconstructed using a fit of the kinematic distributions of the decay products to those expected for t t ¯ final states. The values found for the parameters are AFB(1)=0.048−0.087+0.095(stat)−0.029+0.020(syst),μ̂t=−0.024−0.009+0.013(stat)−0.011+0.016(syst), and a limit is placed on the magnitude of | d̂ t| &lt; 0.03 at 95% confidence level. [Figure not available: see fulltext.

Measurement of t(t)over-bar normalised multi-differential cross sections in pp collisions at root s=13 TeV, and simultaneous determination of the strong coupling strength, top quark pole mass, and parton distribution functions

Peer reviewe

An embedding technique to determine ττ backgrounds in proton-proton collision data

An embedding technique is presented to estimate standard model tau tau backgrounds from data with minimal simulation input. In the data, the muons are removed from reconstructed mu mu events and replaced with simulated tau leptons with the same kinematic properties. In this way, a set of hybrid events is obtained that does not rely on simulation except for the decay of the tau leptons. The challenges in describing the underlying event or the production of associated jets in the simulation are avoided. The technique described in this paper was developed for CMS. Its validation and the inherent uncertainties are also discussed. The demonstration of the performance of the technique is based on a sample of proton-proton collisions collected by CMS in 2017 at root s = 13 TeV corresponding to an integrated luminosity of 41.5 fb(-1).Peer reviewe

MUSiC : a model-unspecific search for new physics in proton-proton collisions at root s=13TeV

Results of the Model Unspecific Search in CMS (MUSiC), using proton-proton collision data recorded at the LHC at a centre-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 35.9 fb(-1), are presented. The MUSiC analysis searches for anomalies that could be signatures of physics beyond the standard model. The analysis is based on the comparison of observed data with the standard model prediction, as determined from simulation, in several hundred final states and multiple kinematic distributions. Events containing at least one electron or muon are classified based on their final state topology, and an automated search algorithm surveys the observed data for deviations from the prediction. The sensitivity of the search is validated using multiple methods. No significant deviations from the predictions have been observed. For a wide range of final state topologies, agreement is found between the data and the standard model simulation. This analysis complements dedicated search analyses by significantly expanding the range of final states covered using a model independent approach with the largest data set to date to probe phase space regions beyond the reach of previous general searches.Peer reviewe

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe