Apollo Hospitals Bilaspur

Chhattisgarh, India

Apollo Hospitals Bilaspur

Chhattisgarh, India
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Srivastava V.K.,Apollo Hospitals Bilaspur | Agrawal S.,Himalayan Institute of Medical science | Nimbhorkar V.K.,Apollo Hospitals Bilaspur | Mishra A.,Apollo Hospitals Bilaspur | And 2 more authors.
Revista Brasileira de Anestesiologia | Year: 2016

Background: Succinylcholine is commonly used to achieve profound neuromuscular blockade of rapid onset and short duration. Objective: The present study compared the efficacy of pregabalin for prevention of succinylcholine-induced fasciculation and myalgia. Design: Prospective, randomized, placebo controlled, double blinded study. Materials and methods: Patients of both genders undergoing elective spine surgery were randomly assigned to two groups. Patients in Group P (pregabalin group) received 150 mg of pregabalin orally 1 h prior to induction of anesthesia with sips of water and patients in Group C (control group) received placebo. Anesthesia was induced with fentanyl 1.5 mcg/kg, propofol 1.5-2.0 mg/kg followed by succinylcholine 1.5 mg/kg. The intensity of fasciculations was assessed by an observer blinded to the group allotment of the patient on a 4-point scale. A blinded observer recorded postoperative myalgia grade after 24 h of surgery. Patients were provided patient-controlled analgesia with fentanyl for postoperative pain relief. Results: Demographic data of both groups were comparable (p > 0.05). The incidence of muscle fasciculation's was not significant between two groups (p = 0.707), while more patients in group C had moderate to severe fasciculation's compared to group P (p = 0.028). The incidence and severity of myalgia were significantly lower in group P (p < 0.05). Conclusion: Pregabalin 150 mg prevents succinylcholine-induced fasciculations and myalgia and also decreases the fentanyl consumption in elective sine surgery. © 2014 Sociedade Brasileira de Anestesiologia.


Srivastava V.K.,Apollo Hospitals Bilaspur | Nigam R.,Chhattisgarh Institute of Medical science | Agrawal S.,Himalayan Institute of Medical science | Kumar S.,Sanjay Gandhi Post Graduate Institute of Medical Sciences | And 2 more authors.
Minerva Anestesiologica | Year: 2016

BACKGROUND: Urinary catheterization during surgical interventions causes postoperative catheter-related bladder discomfort (CRBD). Antimuscarinic agents are the mainstay of treatment for overactive bladder (OAB). As the symptoms of CRBD mimic to OAB, so we designed this study to assess the efficacy of solifenacin and darifenacin for prevention of CRBD. METHODS: Ninety patients of either sex undergoing elective spine surgery and requiring urinary catheterization were randomly assigned into three groups to receive oral solifenacin 5 mg (Group S), darifenacin 7.5 mg (Group D) and placebo (Group C) 1 hour prior to induction of anesthesia. Anesthesia technique was identical in all the groups. Catheterrelated bladder discomfort (CRBD) was evaluated in 4-point scale (1 = no discomfort, 2 = mild discomfort, 3 = moderate discomfort, 4 = severe discomfort), on arrival (0 hour) and at 1, 2, and 6 hours postoperatively. Patients were provided patient-controlled analgesia with fentanyl for postoperative pain relief. RESULTS: There were no significant differences in demographic profile and fentanyl requirements (P>0.05). The prevalence and severity of CRBD were significantly less in the group D and group S compared with the group C at all time intervals (P<0.05). CONCLUSIONS: Pretreatment with oral solifenacin or darifenacin reduces catheter-related bladder discomfort with no clinically relevant significant side effects. © 2016 EDIZIONI MINERVA MEDICA.


Srivastava V.K.,Apollo Hospitals Bilaspur | Nagle V.,Apollo Hospitals Bilaspur | Agrawal S.,Himalayan Institute of Medical science | Kumar D.,Apollo Hospitals Bilaspur | And 2 more authors.
Journal of Clinical and Diagnostic Research | Year: 2015

Background: The advent of laparoscopic surgery has benefited the patient and surgeon; however creation of pneumoperitoneum for same has bearings during the perioperative period. These effects of pneumoperitoneum are associated with significant haemodynamic changes, increasing the morbidity of the patient. Aim: The present study compared the efficacy of dexmedetomidine and esmolol on hemodynamic responses during laparoscopic cholecystectomy Materials and Methods: A total of 90 patients aged 20-60 y, American Society of Anaesthesiologists (ASA) physical status I or II, of either sex, planned for laparoscopic cholecystectomy were included. The patients were randomly divided into three groups of 30 each. Group D received dexmedetomidine loading dose 1 mcg/kg over a period of 15 min and maintenance 0.5 mcg/kg/h throughout the pneumoperitoneum. Group E received esmolol loading dose 1 mg/kg over a period of 5 min and maintenance 0.5 mg/kg/h throughout the pneumoperitoneum. Group C received same volume of normal saline. Measurements: Heart rate (HR), systolic blood pressure, diastolic blood pressure and mean arterial pressure (MAP) were recorded preoperative, after study drug, after induction, after intubation, after pneumoperitoneum at 15 min intervals, post pneumoperitoneum and postoperative period after 15 min. Propofol induction dose, intraoperative fentanyl requirement and sedation score were also recorded. Results: In group D, there was no statistically significant increase in HR and blood pressure after pneumoperitoneum at any time intervals, whereas in Group E, there was a statistical significant increase in MAP after pneumoperitoneum at 15, 45, and 60 min only and HR during the whole pneumoperitoneum period. There was a significant decrease in induction dose of propofol and intraoperative fentanyl requirement in Group D and E, compared to Group C (p<0.0001). Conclusion: Dexmedetomidine is more effective than esmolol for attenuating the hemodynamic response to pneumoperitoneum in elective laparoscopic cholecystectomy. Dexmedetomidine and esmolol also reduced requirements of anaesthetic agents. © 2015, Journal of Clinical and Diagnostic Research. All rights received.


Urinary catheterization during surgical interventions causes postoperative catheter related bladder discomfort (CRBD). Antimuscarinic agents are the mainstay of treatment for overactive bladder (OAB). As the symptoms of CRBD mimic to OAB, so we designed this study to assess the efficacy of solifenacin and darifenacin for prevention of CRBD.Ninety patients of either sex undergoing elective spine surgery and requiring urinary catheterization were randomly assigned into three groups to receive oral solifenacin 5 mg (Group S), darifenacin 7.5 mg (Group D) and placebo (Group C) 1 hour prior to induction of anesthesia. Anesthesia technique was identical in all the groups. Catheter related bladder discomfort (CRBD) was evaluated in 4-point scale (1 = no discomfort, 2 = mild, 3 = moderate, 4 = severe), on arrival (0 hour) and at 1, 2, and 6 hours postoperatively. Patients were provided patient-controlled analgesia with fentanyl for postoperative pain relief.There were no significant differences in demographic profile and fentanyl requirements (P >0.05). The prevalence and severity of CRBD were significantly less in the group D and group S compared with the group C at all time intervals (P <0.05).Pretreatment with oral solifenacin or darifenacin reduces catheter-related bladder discomfort with no clinically relevant significant side effects.


PubMed | Apollo Hospitals Bilaspur and Himalayan Institute of Medical science
Type: Journal Article | Journal: Revista brasileira de anestesiologia | Year: 2016

Succinylcholine is commonly used to achieve profound neuromuscular blockade of rapid onset and short duration.The present study compared the efficacy of pregabalin for prevention of succinylcholine-induced fasciculation and myalgia.Prospective, randomized, placebo controlled, double blinded study.Patients of both genders undergoing elective spine surgery were randomly assigned to two groups. Patients in Group P (pregabalin group) received 150mg of pregabalin orally 1h prior to induction of anesthesia with sips of water and patients in Group C (control group) received placebo. Anesthesia was induced with fentanyl 1.5mcg/kg, propofol 1.5-2.0mg/kg followed by succinylcholine 1.5mg/kg. The intensity of fasciculations was assessed by an observer blinded to the group allotment of the patient on a 4-point scale. A blinded observer recorded postoperative myalgia grade after 24h of surgery. Patients were provided patient-controlled analgesia with fentanyl for postoperative pain relief.Demographic data of both groups were comparable (p>0.05). The incidence of muscle fasciculations was not significant between two groups (p=0.707), while more patients in group C had moderate to severe fasciculations compared to group P (p=0.028). The incidence and severity of myalgia were significantly lower in group P (p<0.05).Pregabalin 150mg prevents succinylcholine-induced fasciculations and myalgia and also decreases the fentanyl consumption in elective sine surgery.


PubMed | Sanjay Gandhi Post Graduate Institute of Medical Sciences, Apollo Hospitals Bilaspur and Himalayan Institute of Medical science
Type: Journal Article | Journal: Advanced pharmaceutical bulletin | Year: 2016

Dexmedetomidine and magnesium sulfate have been used in anesthesia as adjuvant to provide hemodynamic stability and anesthetic agents sparing effect. We compared these effects of dexmedetomidine and magnesium sulfate in spine surgeries.Ninety patients were randomly assigned to three groups. Group D received dexmedetomidine loading dose 1 g/kg over a period of 15 minutes and maintenance 0.5 g/kg/h throughout the surgery. Group M received magnesium sulfate loading dose 50 mg/kg over a period of 15 minutes and maintenance 15 mg/kg/h throughout the surgery. Group C received same volume of normal saline. Heart rate (HR) and blood pressure values were recorded at various intervals. The induction and maintenance doses of anesthetics and recovery parameters were also recorded.Heart rate in group D and group M were significantly decreased (p<0.05) during the whole intraoperative period compared to preoperative values. There was a significant difference in HR values between group C, D and M, during the whole intraoperaive period (p<0.05). Blood pressure values were statistically significantly lower in the group D and group M compared to group C after intubation and all time observations of surgery (p<0.05). Both drugs reduced the anesthetic agents requirement during surgery. However, the recovery parameters were statistically significant increase with magnesium sulphate compared to dexmedetomidine and control groups.Dexmedetomidine is more effective than magnesium sulfate for maintaining the hemodynamic stability in spine surgeries. Both these drugs also reduce the requirements of anesthetic agents. Recovery from dexmedetomidine is as rapid as control group compared to magnesium sulfate.


PubMed | Apollo Hospitals Bilaspur and Himalayan Institute of Medical science
Type: Journal Article | Journal: Brazilian journal of anesthesiology (Elsevier) | Year: 2016

Succinylcholine is commonly used to achieve profound neuromuscular blockade of rapid onset and short duration.The present study compared the efficacy of pregabalin for prevention of succinylcholine-induced fasciculation and myalgia.Prospective, randomized, placebo controlled, double blinded study.Patients of both genders undergoing elective spine surgery were randomly assigned to two groups. Patients in Group P (pregabalin group) received 150mg of pregabalin orally 1h prior to induction of anesthesia with sips of water and patients in Group C (control group) received placebo. Anesthesia was induced with fentanyl 1.5mcg/kg, propofol 1.5-2.0mg/kg followed by succinylcholine 1.5mg/kg. The intensity of fasciculations was assessed by an observer blinded to the group allotment of the patient on a 4-point scale. A blinded observer recorded postoperative myalgia grade after 24h of surgery. Patients were provided patient-controlled analgesia with fentanyl for postoperative pain relief.Demographic data of both groups were comparable (p>0.05). The incidence of muscle fasciculations was not significant between two groups (p=0.707), while more patients in group C had moderate to severe fasciculations compared to group P (p=0.028). The incidence and severity of myalgia were significantly lower in group P (p<0.05).Pregabalin 150mg prevents succinylcholine-induced fasciculations and myalgia and also decreases the fentanyl consumption in elective sine surgery.


PubMed | Apollo Hospitals Bilaspur and Himalayan Institute of Medical science
Type: Case Reports | Journal: Kathmandu University medical journal (KUMJ) | Year: 2015

Myasthenia gravis is a disease of great challenge to the anesthesiologist, because it affects the neuromuscular junction. Anesthetic management involves either muscle relaxant or non-muscle relaxant techniques. This case report documents the safe use of fentanyl, propofol and sevoflurane combination guided by bispectral index, without the use of muscle relaxants in a patient with myasthenia gravis who presented for meningioma surgery.


PubMed | Sanjay Gandhi Post Graduate Institute of Medical Sciences, Apollo Hospitals Bilaspur and Himalayan Institute of Medical science
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2014

Effective management of analgesia and sedation in the intensive care unit depends on the needs of the patient, subjective and/or objective measurement and drug titration to achieve specific endpoints.The present study compared the efficacy of dexmedetomidine, propofol and midazolam for sedation in neurosurgical patients for postoperative mechanical ventilation.Ninety patients aged 20-65 years, ASA physical status I to III, undergoing neurosurgery and requiring postoperative ventilation were included. The patients were randomly divided into three groups of 30 each. Group D received dexmedetomidine 1 mcg/kg over 15 minutes as a loading dose, followed by 0.4-0.7 mcg/kg/h. Group P received propofol 1 mg/kg over 15 minutes as a loading dose, followed by 1-3 mg/kg/h. Group M received midazolam 0.04 mg/kg over 15 minutes as a loading dose, followed by 0.08 mg/kg/h.Heart rate, mean arterial pressure, sedation level, fentanyl requirement, ventilation and extubation time were recorded.Adequate sedation level was achieved with all three agents. Dexmedetomidine group required less fentanyl for postoperative analgesia. In group D there was a decrease in HR after dexmedetomidine infusion (p<0.05), but there was no significant difference in HR between group P and group M. After administration of study drug there was a significant decrease in MAP comparison to baseline value in all groups at all time intervals (p<0.05), except postextubation period (p>0.05). Extubation time was lowest in group P (p<0.05).Dexmedetomidine is safer and equally effective agent compared to propofol and midazolam for sedation of neurosurgical mechanically ventilated patients with good hemodynamic stability and extubation time as rapid as propofol. Dexmedetomidine also reduced postoperative fentanyl requirements.

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