Search

Background: Lung, oral, oesophageal, stomach and nasopharyngeal cancers are the most common cancers in men, whereas cancers of the breast, cervix and uterus are the most common cancers in women. Although systemic chemotherapy is the most common form of treatment for these cancers, the incidence of surgeries for the same have been on the increasing trend and therefore the need for oncoanesthesia has increased. Methodology- The study was conducted in Department of Anaesthesiology and Pain relief at Kidwai Memorial Institute of Oncology, Bangalore. duration of the study was from November 2019 to November 2021. 210 patients fulfilling the inclusion criteria were included in the study. Patients were divided into 3 groups and randomly allocated to each of them. Designated drug was administered via IV route. Oral intubation with proper cuffed endotracheal tube and its position was confirmed by bilateral five-point auscultation and was connected to volume controlled mode of mechanical ventilation. Monitoring of NIBP, continuous Ecg, Capnography and SpO2 was done. Result- In our study, there was no statistically significant difference in the mean baseline heart rates between the three groups. There is a decrease in mean heart rate after administration of study drug till the time interval before intubation when compared to the baseline heart rate. In our study, there was no statistically significant difference in the mean baseline SBP, DBP and MAP between the three groups. Conclusion-Dexmedetomidine is a better premedication when compared to lignocaine, as it completely attenuated the stress response to intubation. [ABSTRACT FROM AUTHOR]

Background: Laryngoscopy and endotracheal intubation is the commonest method of securing a definitive airway for administering anaesthesia. However, it is associated with tachycardia and hypertension and an increase in intraocular pressure. Various pharmacologic and non-pharmacologic methods have been tried to limit the pressure responses and intraocular pressure changes following the insertion of endotracheal tube. One such attempt is the use of laryngeal mask airway, which has been shown to be an effective means of securing a clear airway in fasting patients for elective surgery. Its insertion requires neither the visualization of cords nor the penetration of larynx, making the placement less stimulating than tracheal tube insertion and it may provoke less sympathetic response and catecholamine release Methodology: Sixty patients, of 18-60 years of age, of either sex undergoing elective surgical procedures at Kidwai Memorial Institute of Oncology, Bangalore requiring general anaesthesia were selected randomly. The study was conducted in our institute from December 2019 to February 2021. Patients were randomly divided into 2 groups. In Group 1, appropriate size of LMA was inserted blindly without laryngoscopy using standard technique whereas in Group 2, appropriate size of endotracheal tube was used to intubate trachea under direct laryngoscopy using macintosh laryngoscope. Results: There were no statistical significant changes in hemodynamic parameters and IOP following LMA insertion. Conclusion: There were no statistical significant changes in hemodynamic parameters and IOP following LMA insertion. There was statistically significant rise in hemodynamic parameters and IOP following laryngoscopy and intubation. [ABSTRACT FROM AUTHOR]

Background: Endotracheal extubation causes transient hemodynamic stimulation leading to increase in blood pressure and heart rate due to increase in sympathoadrenergic activity caused by epipharyngeal and laryngopharyngeal stimulation. Lignocaine, a Sodium channel blocker attenuates the hemodynamic response to tracheal extubation by inhibiting sodium channels in the neuronal cell membrane, decreasing the sensitivity of the heart muscles to electric impulses. Diltiazem, a Calcium channel blocker attenuates hemodynamic response by blocking voltage sensitive L type channels, and inhibiting calcium entry mediated action potential in smooth and cardiac muscle. It also has peripheral vasodilation property. Esmolol, a Beta blocker attenuates hemodynamic response by blocking sympathetic nervous system. Methodology-90 patients admitted for elective surgeries posted under general anaesthesia at Kidwai memorial institute of oncology, Bangalore during the duration of December 2018 to May 2019 were included in the study. Patients were randomly divided into 3 groups of 30 each. Randomization done by computer generated table. Group A: received Inj. Diltiazem 0.1mg/kg and preservative free lignocaine 1mg/kg. Group B: received Inj. Esmolol 0.5mg/kg and lignocaine 1mg/kg. Group C: received Inj. lignocaine 1mg/kg. Hemodynamic parameters HR, SBP, DBP, MAP were recorded before extubation (pre reversal) and 1min, 2mins, 3mins, 5mins and 10mins post extubation. In this study, the dosage was fixed based on previous studies. Results-Post extubation, the decrease in mean heart rate was statistically significant in Group B in comparison with Group C (control group) from 1 min post extubation till 10 min. There was increase in heart rate in Group A compared to Group C (control group) which is not statistically significant. Also there was slight decrease in heart rate in Group B compared to Group A (both study group) which is statistically significant at all the intervals. Conclusion-Smaller doses of esmolol when combined with lignocaine gives much better results when compared to Diltiazem + Lignocaine combination and lignocaine alone. [ABSTRACT FROM AUTHOR]