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All Journal Bali Journal of Anesthesiology Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Verma, Indu
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Health Professions Medicine & Pharmacology Other

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Clinical profile comparison of cisatracurium and rocuronium in elective surgery Meena, Reema; Jain, Priyanka; Rana, Divya; Verma, Indu; Chauhan, Sunil
Bali Journal of Anesthesiology Vol 3, No 2 (2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (550.069 KB) | DOI: 10.15562/bjoa.v3i2.140

Abstract

Background:  Most surgeries are carried out with ease using neuromuscular blocking agents. This study was aimed to compare the intubating dose of cisatracurium and rocuronium regarding the onset of action, clinical duration, recovery index, intubating conditions, efficacy, and safety in elective surgery.Method: 60 adult patients of American Society Anesthesiology (ASA) grade I & II, underwent elective laparoscopic surgery were randomized to receive either cisatracurium 0.1 mg/kg (Group C) or rocuronium 0.6 mg/kg (Group R). Neuromuscular monitoring was done using STIMPOD Xavant NMS450. Relaxogram interpretation was carried out for the onset of action, clinical duration, and recovery index.Results: Cisatracurium had significant longer onset (233.33±62.31 vs. 86.66±28.62 seconds, p <0.001) and significant longer clinical duration (40±3.56 vs. 27.46±2.14 minutes, p <0.001) than rocuronium. Recovery index was significantly longer in the cisatracurium group (12.23±1.54 vs. 8.30±1.80 minutes, p <0.001). Clinically acceptable intubating conditions were achieved in 180 seconds (C group) compared to 60 seconds in the R group. No untoward or adverse response and complications were distinguished in either group.Conclusion: Cisatracurium 0.1 mg/kg exhibited a slower onset of action than rocuronium 0.6 mg/kg and provided excellent intubating conditions in the majority of patients after 180 seconds. The clinical duration and recovery index were significantly longer in cisatracurium compared to rocuronium. Both are potent and safe agents with excellent cardiovascular stability.
Cerebral Oxygenation Monitoring During Coronary Artery Bypass Grafting and Its Correlation with Hematocrit, Mean arterial pressure, and Partial pressure of Oxygen in Arterial Blood Sharma, Jai; Verma, Indu; Agarwal, Swati; Dagar, Nivedita
Indonesian Journal of Anesthesiology and Reanimation Vol. 7 No. 1 (2025): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V7I12025.1-11

Abstract

Introduction: Optimal cerebral oxygenation is vital during coronary artery bypass grafting (CABG) to prevent neurological complications like cognitive decline and stroke. Non-invasive monitoring methods include near-infrared spectroscopy (NIRS), electroencephalography (EEG), and transcranial doppler (TCD). It offers real-time rSO2 assessment, detecting critical thresholds and reducing risks during cardiopulmonary bypass (CPB). Objective: This observational study aims to investigates cerebral oxygenation changes during CABG and correlations with hematocrit, mean arterial pressure (MAP), blood oxygen levels, CPB flows, and temperature. Methods: Seventy-two elective CABG patients underwent CPB with parameters including rSO2, hematocrit, MAP, PaO2, temperature, and pump flows assessed at specific time points: T1: Baseline pre-anesthesia; T2: Post-anesthesia induction (FiO2 100%); T3: Post-anesthesia induction (FiO2 50%); T4: CPB initiation; T5: CPB at 35°C; T6: CPB at 32°C; T7: CPB rewarming (36°C); T8: Post-CPB weaning (FiO2 100%); T9: Post-CPB weaning (FiO2 50%). Results: The mean baseline values for rSO2 were 72.14 for the right side and 71.90 for the left side. Upon initiating CPB at 35°C, a significant maximum reduction in rSO2 of 10.5% was observed, which remained below baseline during the hypothermia phase. The rSO2 values began to increase during the rewarming phase, nearly reaching baseline levels after CPB. A post hoc analysis indicated that changes in rSO2 were correlated with variations in hematocrit (correlation coefficient = 0.518), MAP (correlation coefficient = 0.399), and PaO2 (correlation coefficient = 0.001). Conclusion: This study explored the fluctuations in rSO2 during CABG with CPB and examined its correlations with hematocrit, MAP, PaO2, CPB flows, and temperature. The findings highlight significant correlations among these variables, providing insights into factors influencing cerebral oxygenation during cardiac surgery.
Co-Authors Agarwal, Swati Chauhan, Sunil Dagar, Nivedita Jain, Priyanka Meena, Reema Rana, Divya Sharma, Jai