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All Journal Indonesian Journal of Anesthesiology and Reanimation (IJAR) Journal of Anaesthesia and Pain
Yadav, Rupesh
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Health Professions Medicine & Pharmacology

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Comparison of Lignocaine with Ondansetron for Attenuation of Propofol Induced Pain in Adult Patient Undergoing Laparoscopic Cholecystectomy: A Comparative Randomized Study. Kanojia, Akash; Sood, Rajesh; Kumar, Sandeep; Yadav, Rupesh
Journal of Anaesthesia and Pain Vol 4, No 2 (2023): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2023.004.02.02

Abstract

Background: Propofol is a non-opioid intravenous anesthetic agent and it is most commonly used for induction of anesthesia but it has a consistent side-effect of pain when it is injected intravenously. Aim of our study was to compare lignocaine and ondansetron for attenuation of pain on propofol injection in laparoscopic cholecystectomy.Methods: 100 patients planned for laparoscopic cholecystectomy were enrolled for this comparative randomized study. Group L (Lignocaine) – Patients received Inj. Lignocaine 0.5 mg/kg 1 minute before inducing with injection propofol. Group O (Ondansetron) – Patients received Inj. Ondansetron 0.1mg/kg 1 minute before inducing with injection propofol. The patient was evaluated for pain during injection using a four-point scale of 5 seconds and 15 seconds after the propofol injection. Chi-squared test, Fisher’s exact test, and Mann-Whitney test were used for data analysis.Result: Demographic data  in group L and group O were similar. The mean± SD pain score during the first 5 seconds in group O was 0.38 ± 0.57 while in group L was 0.02 ± 0.14  (p<0.001). The mean± SD post-operative nausea and vomiting (PONV) score during the first hour in group O was 0.08 ± 0.27 while in group L was 1.96 ± 1.160 (p<0.001).Conclusion: We concluded that lignocaine was found more effective than ondansetron for attenuation of propofol-induced pain and post-operative nausea vomiting was much lower than by ondansetron as compared to lignocaine.
Factors Affecting Outcome of Patients with Upper Gastrointestinal Haemorrhage Presenting to Emergency Department: A Prospective observational cohort study Lal, Devakrishna Bhavan; Ekka, Meera; Yadav, Rupesh; Yadav, Amlendu; Kumar, Sandeep
Journal of Anaesthesia and Pain Vol 4, No 3 (2023): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2023.004.03.04

Abstract

Background: Upper gastrointestinal bleeding (UGIB) is one of the most common presentations in an emergency department (ED). UGI endoscopy is the definitive diagnostic and therapeutic modality for UGIB. Aim of the study were look into the outcomes of UGIB and outcomes based on the timing of endoscopy (early endoscopy mean before 24 hours and late endoscopy mean after 24 hours).Methods: 180 patients presented in ED with UGIB and undergo Upper gastrointestinal (UGI) endoscopy. Socio-demographic profiles, with presenting signs and symptoms, co-morbidities, vitals, lab parameters, endoscopic diagnosis with the treatment of the patient were collected. They were followed up to day 7 of presentation to determine all-cause mortality, re-bleed, development of hemorrhagic shock, admission rate and length of ED stay, early endoscopy and late endoscopy.Result: The mortality difference in the early endoscopy (3.2%) and late endoscopy (16.1%) group was significant with a p-value of 0. 012. Late endoscopy (18.6%) was associated with a higher risk of development of hemorrhagic shock compared to the early group (4.8%) with a p-value of 0.011. The factors that had a significant association with mortality on univariate analysis were, late endoscopy, systolic blood pressure on presentation less than 90, variceal bleeding, blood transfusion requirement, AIMS 65 score greater than 0. Multivariate analysis showed that late endoscopy (OR 5.35(1.12-25.3)) and AIMS 65 score (OR 11.76(1.48-93.3)) were independent risk factors for mortality.Conclusion: We concluded that early endoscopy was associated with decreased mortality, decreased length of ED stay and decreased risk of development of hemorrhagic shock.
Bispectral Index Versus Minimum Alveolar Concentration Guided Anesthesia for Assessment of Intraoperative Awareness in Patients Undegoing Laparascopic Abdominal Surgery Shreya Garg; Vinod Bala Dhir; Jyoti Gupta; Yadav, Rupesh; Deepak Verma
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.V7I12025.12-21

Abstract

Introduction: Intraoperative awareness with explicit recall (AWR) occurs when an individual retains memory of intraoperative events after completion of anesthesia. It is an unpleasant feeling feared by both the patients and the anesthetists. Objective: This research aims to compare Bispectral Index (BIS) versus Minimum Alveolar Concentration (MAC) guided anesthesia for assessment of intra-operative awareness in patients undergoing laparoscopic abdominal surgery. Methods: This research is a prospective comparison involving 100 patients divided into two groups of 50 patients each. Group M (MAC): Desflurane concentration was maintained at a MAC value of 1. The BIS monitor was not to be applied to this group of patients at the time of induction, but in Group B (BIS), the BIS electrode was applied on the forehead immediately before induction. Hemodynamic parameters including heart rate and mean arterial blood pressure were recorded.  After the surgery, the patients were interviewed using the Modified Brice Awareness Questionnaire and Michigan Awareness Classification score for assessment of intra-operative awareness or consciousness at two intervals: in the post-anesthesia care unit and 48 hours after surgery. Results: Demographic data were comparable between groups M and B. No significant differences in the hemodynamic parameters, which include heart rate and mean arterial blood pressure (MAP) between the M group and the B group (p value>0.05). The patient’s awareness was compared based on a modified Brice awareness questionnaire. The distribution of awareness was comparable between groups M and B (0% vs. 4% respectively) (p value=0.495). The distribution of Michigan awareness classification scores was comparable between groups M and B. Class 0 (no awareness) was 98% vs. 96% respectively, and Class 1(isolated auditory perception) of 2% vs. 4% respectively with (p value=1). Conclusion: This research found that BIS-guided anesthesia works just as well as MAC-guided anesthesia at keeping patients from waking up and keeping an eye on changes in their blood pressure while they are under general anesthesia for laparoscopic abdominal surgery.
Comparison of Lignocaine with Ondansetron for Attenuation of Propofol Induced Pain in Adult Patient Undergoing Laparoscopic Cholecystectomy: A Comparative Randomized Study. Kanojia, Akash; Sood, Rajesh; Kumar, Sandeep; Yadav, Rupesh
Journal of Anaesthesia and Pain Vol. 4 No. 2 (2023): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2023.004.02.02

Abstract

Background: Propofol is a non-opioid intravenous anesthetic agent and it is most commonly used for induction of anesthesia but it has a consistent side-effect of pain when it is injected intravenously. Aim of our study was to compare lignocaine and ondansetron for attenuation of pain on propofol injection in laparoscopic cholecystectomy.Methods: 100 patients planned for laparoscopic cholecystectomy were enrolled for this comparative randomized study. Group L (Lignocaine) – Patients received Inj. Lignocaine 0.5 mg/kg 1 minute before inducing with injection propofol. Group O (Ondansetron) – Patients received Inj. Ondansetron 0.1mg/kg 1 minute before inducing with injection propofol. The patient was evaluated for pain during injection using a four-point scale of 5 seconds and 15 seconds after the propofol injection. Chi-squared test, Fisher’s exact test, and Mann-Whitney test were used for data analysis.Result: Demographic data  in group L and group O were similar. The mean± SD pain score during the first 5 seconds in group O was 0.38 ± 0.57 while in group L was 0.02 ± 0.14  (p<0.001). The mean± SD post-operative nausea and vomiting (PONV) score during the first hour in group O was 0.08 ± 0.27 while in group L was 1.96 ± 1.160 (p<0.001).Conclusion: We concluded that lignocaine was found more effective than ondansetron for attenuation of propofol-induced pain and post-operative nausea vomiting was much lower than by ondansetron as compared to lignocaine.
Factors Affecting Outcome of Patients with Upper Gastrointestinal Haemorrhage Presenting to Emergency Department: A Prospective observational cohort study Lal, Devakrishna Bhavan; Ekka, Meera; Yadav, Rupesh; Yadav, Amlendu; Kumar, Sandeep
Journal of Anaesthesia and Pain Vol. 4 No. 3 (2023): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2023.004.03.04

Abstract

Background: Upper gastrointestinal bleeding (UGIB) is one of the most common presentations in an emergency department (ED). UGI endoscopy is the definitive diagnostic and therapeutic modality for UGIB. Aim of the study were look into the outcomes of UGIB and outcomes based on the timing of endoscopy (early endoscopy mean before 24 hours and late endoscopy mean after 24 hours).Methods: 180 patients presented in ED with UGIB and undergo Upper gastrointestinal (UGI) endoscopy. Socio-demographic profiles, with presenting signs and symptoms, co-morbidities, vitals, lab parameters, endoscopic diagnosis with the treatment of the patient were collected. They were followed up to day 7 of presentation to determine all-cause mortality, re-bleed, development of hemorrhagic shock, admission rate and length of ED stay, early endoscopy and late endoscopy.Result: The mortality difference in the early endoscopy (3.2%) and late endoscopy (16.1%) group was significant with a p-value of 0. 012. Late endoscopy (18.6%) was associated with a higher risk of development of hemorrhagic shock compared to the early group (4.8%) with a p-value of 0.011. The factors that had a significant association with mortality on univariate analysis were, late endoscopy, systolic blood pressure on presentation less than 90, variceal bleeding, blood transfusion requirement, AIMS 65 score greater than 0. Multivariate analysis showed that late endoscopy (OR 5.35(1.12-25.3)) and AIMS 65 score (OR 11.76(1.48-93.3)) were independent risk factors for mortality.Conclusion: We concluded that early endoscopy was associated with decreased mortality, decreased length of ED stay and decreased risk of development of hemorrhagic shock.
Co-Authors Deepak Verma Ekka, Meera Jyoti Gupta Kanojia, Akash Kumar, Sandeep Lal, Devakrishna Bhavan Shreya Garg Sood, Rajesh Vinod Bala Dhir Yadav, Amlendu