Indira Gandhi Medical College and Mayo Hospital

Nāgpur, India

Indira Gandhi Medical College and Mayo Hospital

Nāgpur, India
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Patki A.,Indira Gandhi Medical College and Mayo Hospital | Shelgaonkar V.C.,Indira Gandhi Medical College and Mayo Hospital
Indian Journal of Anaesthesia | Year: 2010

Dextrans and hydroxyethyl starches produce signifi cant levels of free glucose residues following metabolism. The following study was designed to compare 6% hydroxyethyl starch-450 with Dextran 40, both used as preloading fl uids, for their potential to raise peri-operative blood glucose levels. After taking an informed consent, 180 non-diabetic adult patients, posted for elective surgery under spinal anaesthesia, were randomly divided into three groups, to receive Ringer's Lactate 20 ml/kg (group 1), Dextran 40,10 ml/kg (group 2) and Hestar 6%-450, 10 ml/kg (group 3), over half an hour, prior to the subarachnoid block, as preloading fl uid, and serial capillary blood glucose measurements were taken thereafter at regular intervals up to 240 minutes from the baseline reading. All the three preloading fl uids, including Ringer's Lactate used as control, were seen to signifi cantly increase the capillary blood glucose levels intra-operatively (P < 0.05), but the rise with Dextran-40 was seen to be sustained and highly signifi cant (P < 0.001). We thus conclude that, Dextran40 causes a sustained and signifi cant rise in peri-operative blood glucose levels.


Patki A.,Indira Gandhi Medical College and Mayo Hospital | Shelgaonkar V.C.,Indira Gandhi Medical College and Mayo Hospital
Journal of Anaesthesiology Clinical Pharmacology | Year: 2011

Background: Supplemental sedation with an intravenous agent is often required to allay fear and anxiety in patients subjected to spinal anaesthesia. We studied and compared the properties of propofol and midazolam as equisedative continuous infusions. Patients & Methods: 100, ASA grade 1 and 2 patients, 18 to 60 years of age, undergoing spinal anaesthesia, were randomly allocated to receive either propofol 1mg/ml or midazolam 0.1mg/ml in 50ml syringes through syringe pump. The infusion rates were titrated in order to maintain a desired sedation score of 4 on the Observer's assessment of alertness/ sedation scale. Anxiety score was assessed at regular intervals by a single observer in all cases, using a 100mm visual analog scale. Intraoperative and postoperative amnesia was assessed using visual task of recall of pictures and verbal task of recall of words. Results: Propofol infusion was found to be superior to that of midazolam as it showed a statistically significant faster onset in achieving the desired sedation score, significantly lower mean anxiety scores, a clear headed, rapid recovery and significantly lesser postoperative impairment of recall, but midazolam infusion was seen to be associated with deeper intraoperative amnesia over the former which was beneficial. Conclusion: Equisedatine infusion of propofol & midazolam as an adjunct & spinal anaesthesia offer good anxiolysis and cardio respiratory stability. Propofol her faster onset & recovery while midazolam provides better intraoperative annesia.


PubMed | Indira Gandhi Medical College and Mayo Hospital
Type: Journal Article | Journal: Journal of anaesthesiology, clinical pharmacology | Year: 2011

Supplemental sedation with an intravenous agent is often required to allay fear and anxiety in patients subjected to spinal anesthesia .We studied and compared the properties of propofol and midazolam as equisedative continuous infusions. PATIENTS #ENTITYSTARTX00026;100, ASA grade 1 and 2 patients, 18 to 60 years of age, undergoing spinal anesthesia, were randomly allocated to receive either propofol 1mg/ml or midazolam 0.1mg/ml in 50ml syringes through syringe pump. The infusion rates were titrated in order to maintain a desired sedation score of 4 on the Observers assessment of alertness/ sedation scale. Anxiety score was assessed at regular intervals by a single observer in all cases, using a 100mm visual analog scale.Intraoperative and postoperative amnesia was assessed using visual task of recall of pictures and verbal task of recall of words.Propofol infusion was found to be superior to that of midazolam as it showed a statistically significant faster onset in achieving the desired sedation score, significantly lower mean anxiety scores, a clear headed, rapid recovery and significantly lesser postoperative impairment of recall, but midazolam infusion was seen to be associated with deeper intraoperative amnesia over the former which was beneficial.Equisedatine infusion of propofol & midazolam as an adjunct & spinal anesthesia offer good anxiolysis and cardio respiratory stability. Propofol her faster onset & recovery while midazolam provides better intraoperative annesia.


PubMed | Indira Gandhi Medical College and Mayo Hospital
Type: Journal Article | Journal: Indian journal of clinical biochemistry : IJCB | Year: 2012

With the growing interest in the concept of free radicals in the pathogenesis of myocardial ischemia, it was thought worthwhile to study the changes in lipid peroxides and antioxidant enzyme glutathione peroxidase (GPx) in ischemic heart disease (IHD). The study was carried out on 76 patients of IHD-38 of acute myocardial infarction (AMI) and 38 of stable ischemic heart disease (SIDH). They were age and sex matched with 38 normal healthy controls. A significant increase (p<0.001) in lipid peroxides as malondialdehyde (MDA) (5.90.7 mmol/L) and a decrease in GPx (24.62.2 U/gmHb) was found in patients of AMI when compared with controls. There was no significant difference in these values in SIHD. Thus this study confirms the earlier findings that MDA and GPx are useful parameters in IHD and their magnitude is dependent on severity and/or duration of ischemia. We suggest that these tests would be of use in smaller institutions with limited facilities.


PubMed | Indira Gandhi Medical College and Mayo Hospital
Type: Journal Article | Journal: Indian journal of anaesthesia | Year: 2010

Dextrans and hydroxyethyl starches produce significant levels of free glucose residues following metabolism. The following study was designed to compare 6% hydroxyethyl starch-450 with Dextran 40, both used as preloading fluids, for their potential to raise peri-operative blood glucose levels. After taking an informed consent, 180 non-diabetic adult patients, posted for elective surgery under spinal anaesthesia, were randomly divided into three groups, to receive Ringers Lactate 20 ml/kg (group 1), Dextran 40,10 ml/kg (group 2) and Hestar 6%-450, 10 ml/kg (group 3), over half an hour, prior to the subarachnoid block, as preloading fluid, and serial capillary blood glucose measurements were taken thereafter at regular intervals up to 240 minutes from the baseline reading. All the three preloading fluids, including Ringers Lactate used as control, were seen to significantly increase the capillary blood glucose levels intra-operatively (P < 0.05), but the rise with Dextran-40 was seen to be sustained and highly significant (P < 0.001). We thus conclude that, Dextran40 causes a sustained and significant rise in peri-operative blood glucose levels.

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