Jodhpur, India
Jodhpur, India

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PubMed | Drsnmedical College and Netaji Subhash Chandra Bose Medical College
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2015

Sedation plays a pivotal role in the care of the critically ill patient. It is equally important to assess depth of sedation. The present study had been designed to compare dexmedetomidine and propofol for sedation in mechanically ventilated intensive care patients. It also intended to verify the clinical validity, reliability and applicability of objective assessment tool bispectral index (BIS) for monitoring sedation and observe for correlation with the commonly used subjective scale, Ramsay sedation score (RSS).This prospective randomized study was carried out in 60 haemodynamically stable patients, aged between 18 to 80 years, requiring sedation and mechanical ventilation. These were divided equally into two groups. Group A received dexmedetomidine loading dose (1g/kg) over 10 min followed by maintenance infusion of 0.5g/kg/hr (0.2-0.7 g/kg/hr). Group B received propofol loading dose (1mg/kg) over 5 min followed by infusion of 2mg/kg/hr (1-3mg/kg/hr). All patients received fentanyl 1 g/kg prior to the study drugs. Vital parameters and sedation levels (using RSS and BIS) were monitored for the study period of 12 hours with level 4 or 5 of RSS as target for sedation. Ramsay score was compared with the average of BIS values. Statistical analysis was done using SPSS VERSION 17 software.The study revealed statistically significant lower heart rates during sedation in dexmedetomidine group whereas fall in mean arterial pressure (MAP) following loading dose in propofol group. Patients sedated with dexmedetomidine were easily arousable. Need for rescue drug for achieving the desired RSS as well as incidence of bradycardia was more in dexmedetomidine group than other. Good correlation exists between Ramsay score and BIS values.Dexmedetomidine reduces heart rate while propofol transiently affects MAP. However, adequate sedation is achieved with both the drugs. The data obtained from the study validate BIS monitoring for ICU sedation.


Mahendra S.,Drsnmedical College | Suman B.,Drsnmedical College | Afzal H.,Drsnmedical College | Savitri S.,Drsnmedical College
Indian Journal of Public Health Research and Development | Year: 2015

Context: A large number of H1N1cases and deaths have been reported in Western Rajasthan during pandemic of H1N1 in year 2009-10. In year 2012 this Influenza A H1N1 virus once again resurfacing in western Rajasthan and reared its ugly head in the western Rajasthan.Once again H1N1 infection posed a serious threat to health community and was a cause of serious concerns in Western Rajasthan. Aims: To study the epidemiological profile of H1N1 cases in Western Rajasthan from January 2012 to December 2012. Settings and Design: Retrospective descriptive analysis Method and Material: Epidemiological characteristics of Influenza A H1N1 cases in Western Rajasthan from January 2012 to December 2012 were retrospectively, descriptively analyzed using data from the swine flu control room, Influenza A H1N1 screening center and isolation wards at the Dr.S.N. Medical College, Jodhpur. Dr.S.N. Medical College, Jodhpur is a largest multispecialty tertiary care teaching institution in Western Rajasthan. Data were Analyzed using MS Excel software. Results: At Dr. SNMC, from January 2012 to December 2012, a total of 817patients were tested for Influenza A H1N1, of which 21.8% (178) were found to be positive for the disease. Majority (71.3%, 127) of cases were females. Maximum cases (50%) were detected in the month of December and the patients >15-45 years of age accounted for 75.8% (135) of the cases. Influenza A H1N1 resulted in death of 12.9% (23) of the total cases, of which 65% (15) deaths occurred within 48 h of admission. Majority (69.6%,16) of deaths occurred in females. The patients >15-45 years of age accounted for 52.2% of the deaths. 40.4% (72) of cases and 52.2% (12) of deaths have occurred in pregnant and postpartum women. Conclusions: Influenza A H1N1 virus once again resurfacing in western Rajasthan and reared its ugly head in the western Rajasthan in year 2012. Similar to H1N1 pandemic 2009, the incidence and mortality in 2012 in western Rajasthan was higher in young. H1N1 influenza can cause severe illness and deaths in pregnant and postpartum women. © 2015, Indian Journal of Public Health Research and Development. All Rights Reserved.


Paliwal B.,Drsnmedical College | Rai P.,Drsnmedical College | Kamal M.,Drsnmedical College | Singariya G.,Drsnmedical College | And 4 more authors.
Journal of Clinical and Diagnostic Research | Year: 2015

Background and Aim: Sedation plays a pivotal role in the care of the critically ill patient. It is equally important to assess depth of sedation. The present study had been designed to compare dexmedetomidine and propofol for sedation in mechanically ventilated intensive care patients. It also intended to verify the clinical validity, reliability and applicability of objective assessment tool bispectral index (BIS) for monitoring sedation and observe for correlation with the commonly used subjective scale, Ramsay sedation score (RSS). Materials and Methods: This prospective randomized study was carried out in 60 haemodynamically stable patients, aged between 18 to 80 years, requiring sedation and mechanical ventilation. These were divided equally into two groups. Group A received dexmedetomidine loading dose (1μg/kg) over 10 min followed by maintenance infusion of 0.5μg/kg/hr (0.2-0.7 μg/kg/hr). Group B received propofol loading dose (1mg/kg) over 5 min followed by infusion of 2mg/kg/hr (1-3mg/kg/hr). All patients received fentanyl 1 μg/kg prior to the study drugs. Vital parameters and sedation levels (using RSS and BIS) were monitored for the study period of 12 hours with level 4 or 5 of RSS as target for sedation. Ramsay score was compared with the average of BIS values. Statistical analysis was done using SPSS VERSION 17 software. Results: The study revealed statistically significant lower heart rates during sedation in dexmedetomidine group whereas fall in mean arterial pressure (MAP) following loading dose in propofol group. Patients sedated with dexmedetomidine were easily arousable. Need for rescue drug for achieving the desired RSS as well as incidence of bradycardia was more in dexmedetomidine group than other. Good correlation exists between Ramsay score and BIS values. Conclusion: Dexmedetomidine reduces heart rate while propofol transiently affects MAP. However, adequate sedation is achieved with both the drugs. The data obtained from the study validate BIS monitoring for ICU sedation. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.

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