Priya Kishnani
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A Comparative Study Between Effects Of Ketamine And Fentanyl As Co-induction Agents With Propofol For I-Gel Insertion In Minor Surgical Procedures. Jayshri Desai; Jayati Jain; Priya Kishnani
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 3 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i3.15323

Abstract

Background: The study aimed to compare and determine the success rate, ease of introducing I-gel and the hemodynamic effects of two adjuvant drugs ketamine and fentanyl, when used with induction agent propofol in minor surgical procedures.Methodology: The study comprised of 68 patients of ASA-I & II grading of either gender, aged between 18 to 60 years undergoing minor surgical procedures. Patients were distributed into two groups.Group K- inj. ketamine 0.5mg/kg & inj. propofol 2mg/kgGroup F- inj. fentanyl 1mcg/kg & inj. propofol 2mg/kgResults: Both groups K and F were comparable in terms of baseline clinic-sociodemographic variables such as age, gender, weight, ASA grade and Mallampatti grade. Attempt of insertion was more than one in 26.5% cases of group K and 8.8% cases of group F, showing statistically insignificant difference(p>0.05). Jaw relaxation was significantly good in group F than group K (p<0.01). Incidence as well as severity of coughing and limb movement was much higher in group K than group F (p<0.01). Overall excellent significantly higher condition was observed. Excellent conditions seen in 85.3% and 50% cases belonging to group F and group K respectively (p<0.01). Mean total requirement of propofol was 124±24.56 and 110.06±18.95 in cases belonging to groups K and group F respectively. Thus showing significant difference. Hemodynamic parameters such as heart rate(HR) and blood pressure(BP) were significantly higher in group K than in group F following induction(p<0.01).Conclusion: Fentanyl when used as co-induction drug with propofol provides ideal condition for I-gel insertion, decreases total requirement of propofol & stable hemodynamic response as compared to ketamine & propofol
An Observational Study of Intravenous Dexmedetomidine and Clonidine for Attenuating Haemodynamic Response to Laryngoscopy and Intubation in Patients Undergoing General Anaesthesia Priya Kishnani; Sanam Shah; Jayshri Desai; Anuja Agrawal
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 3 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i3.15898

Abstract

Background: Laryngoscopy and endotracheal intubation alters cardiovascular physiology causinghypertension and tachycardia. Dexmedetomidine, an alpha 2 adrenergic receptor produces analgesiaby direct activation of descending inhibitory pain pathway and inhibiting the release of substance P.Clonidine a centrally acting alpha 2 adrenergic agonist decreases central sympathetic nervous system in allhyperadrenergic situations. Hence we compare haemodynamic effects between dexmedetomidine 0.5 mcg/kg and clonidine 1mcg/kg during after laryngoscopy and tracheal intubation for patients undergoing generalanaesthesia.Method: Patients were allocated randomly into 2 groups of 30 each. Group D received dexmedetomidine0.5mcg/kg diluted in 10ml NS and group C- clonidine 1 mcg/kg diluted in 10ml NS intravenously andhemodynamic parameters were observed. Dexmedetomidine/ Clonidine according to groups is givenintravenously with premedication. After 5 minutes patients were induced with 2.5% thiopentone 5-7 mg/kgand succinyl choline 2mg/kg and intubated with appropriate sized cuffed ETT. Anaesthesia was maintainedwith O2, N2O, isoflurane and vecuronium bromide 0.08mg/kg.Results: Haemodynamic changes after laryngoscopy and intubation were recorded at baseline, premedication,induction, intubation, 1, 3, 5,10 and 15 minutes. The initial fall in HR is more in Group C compared to GroupD but the difference was insignificant, but since intubation till 10min post intubation HR was significantly(p<0.05) supressed more in Group D. Similarly fall in SBP and DBP is significantly (p<0.05) more in GroupD compared to Group C.Conclusion: Dexmedetomedine 0.5 mcg/kg intravenously 15 minutes prior to laryngoscopy and intubationattenuates the sympathetic response better as compared to clonidine without major side effects.