Decrease In Pulse Rate Research Articles

INTUBATING CONDITIONS: PROPOFOL WITH MUSCLE RELAXSANT AND PROFOFOL WITHOUT MUSCLE RELAXANT A STUDY IN TERTIARY CARE CENTRE

Introduction: Neuromuscular blocking drugs, particularly Succinylcholine, may cause serious side effects, but remain in clinical use to facilitate tracheal intubation due to a lack of suitable alternatives. Recent studies have suggested that propofol provides good intubating conditions without muscle relaxants, due to its relaxing action on upper air way.. A search for better and ideal intravenous induction agent has led to propofol, a 2, 6, di-isopropyl phenol which was developed following a series of investigations. Propofol reduces hypertension and tachycardia during intubation. The changes in blood pressure observed are due to both decrease in cardiac output and decrease in systemic vascular resistance. Increasing the depth of anaesthesia by administering supplementary increments of induction agent, opioids or lignocaine may improve conditions. These techniques also protect against the potentially adverse effects of tracheal intubation namely systemic, intra-cranial and intra-ocular hypertensions and tachycardia.
 Material and Methods: The study comprised of 100 adult patients of ASA grade I & II of either sex belonging to the age group of 18-60 years, drawn from various surgical specialties and undergoing surgery under general anaesthesia. Thorough pre anesthetic checkup was carried out in all patients and informed consent for surgery and general anesthesia was obtained. Routine investigations were carried out in all patients. 100 patients were randomly divided into two groups of 50 patients each.
 Results: Youngest patient was of 18 years in group I and 20years in group II. Eldest patient was of 59 years in group I and 60 years in group II. Maximum number of patients were in 20-30 years of age group. The pre induction mean pulse rate (base line) was 101.04±11.78 and 102.36±15.14 in group I and group II respectively. There was slight decrease in pulse rate initially after induction with mean 98.23±13.87 and 97.31±12.60 in group I and group II respectively. The pre induction mean arterial pressure (MAP) (baseline) was 91.47±7.64 and 92.45±9.21in group I and group II respectively. There was slight decrease in arterial pressure initially after induction with mean 80.48±6.29and 83.31±8.41in group I and group II respectively, but the difference was not statistically significant (P>0.05) from the baseline values. There was slight increase in mean arterial pressure just after intubation with mean 93.10±8.47 and 94.58±9.33 in group I and group II respectively, which was not statistically significant (p>0.05).
 Conclusion: In healthy adults, with normal airway, propofol 2.5mg/kg when used alone as inducing agent without the use of any neuromuscular blocking agents produced acceptable intubating conditions, when compared to propofol, 2.5mg/kg along with succinylcholine. It was also demonstrated that there was no significant cardiovascular changes when intubation was done without relaxant after induction with propofol.
 Keywords: Neuromuscular blocking drugs, cardiovascular, propofol

Electronic Fetal Monitoring to Prevent Fetal Brain Injury: A Ubiquitous Yet Flawed Tool

(JAMA. 2019;322:611–612) The practice of fetal cardiac rate monitoring began in the 1830s or earlier, and guidelines for intermittent auscultation came out in the 1920s and remained largely unchanged until the 1970s, when continuous electronic fetal monitoring (EFM) appeared. EFM generates a visual recording of fetal heart rate using either Doppler wave technology or a contact electrode on the fetal scalp. Fetal acidosis is associated with abnormal heart rhythms, including tachycardia, bradycardia and transient decreases in pulse rate, as well as diminished variability. Variability cannot practically be detected with auscultation.

Inter-annual decrease in pulse rate and peak frequency of Southeast Pacific blue whale song types

A decrease in the frequency of two southeast Pacific blue whale song types was examined over decades, using acoustic data from several different sources in the eastern Pacific Ocean ranging between the Equator and Chilean Patagonia. The pulse rate of the song units as well as their peak frequency were measured using two different methods (summed auto-correlation and Fourier transform). The sources of error associated with each measurement were assessed. There was a linear decline in both parameters for the more common song type (southeast Pacific song type n.2) between 1997 to 2017. An abbreviated analysis, also showed a frequency decline in the scarcer southeast Pacific song type n.1 between 1970 to 2014, revealing that both song types are declining at similar rates. We discussed the use of measuring both pulse rate and peak frequency to examine the frequency decline. Finally, a comparison of the rates of frequency decline with other song types reported in the literature and a discussion on the reasons of the frequency shift are presented.

Effect of Yogic Controlled Breathing Exercises on Cardiovascular Parameters

The study was conducted to evaluate the effect of pranayam (yogic controlled breathing exercises) &meditation on cardiovascular parameters in 1st year male medical students of GSVM Medical College,Kanpur. All the 60 students selected for the study were randomized into 3 groups of 20 students each:Group I–Anulom Vilom Pranayam, Group II–Kapalbhati Pranayam, Group III–Bhastrika Pranayam. Bloodpressure (systolic & diastolic) & pulse rate of all the students in each group were recorded at baseline & after3 months of training. Training programme included 10 min. meditation in padmasana followed by 5 min.practice of pranayam twice a day for 3 months. A significant (p< .001) decrease in pulse rate, systolic BP anddiastolic BP were observed after 3 months of training.. The relaxation & flexibility induced by meditation& pranayam help to stabilize the autonomic nervous system with a tendency towards parasympatheticdominance. So the meditation & pranayam should be encouraged to improve the performance ofcardiovascular system. Controlled pranayam breathing is also effective in improving the strength & tone ofmuscles involved in respiration.

COMPARISON OF INTUBATING CONDITIONS, FOLLOWING PROPOFOL WITH MUSCLE RELAXSANT AND PROFOFOL WITHOUT MUSCLE RELAXANT

Introduction: After induction of anaesthesia, tracheal intubation is usually facilitated by the use of muscle relaxants. Neuromuscular blocking drugs, particularly Succinylcholine, may cause serious side effects, but remain in clinical use to facilitate tracheal intubation due to a lack of suitable alternatives. Recent studies have suggested that propofol provides good intubating conditions without muscle relaxants, due to its relaxing action on upper air way. A search for better and ideal intravenous induction agent has led to propofol, a 2, 6, di-isopropyl phenol which was developed following a series of investigations. Propofol reduces hypertension and tachycardia during intubation. The changes in blood pressure observed are due to both decrease in cardiac output and decrease in systemic vascular resistance. Increasing the depth of anaesthesia by administering supplementary increments of induction agent, opioids or lignocaine may improve conditions. These techniques also protect against the potentially adverse effects of tracheal intubation namely systemic, intra-cranial and intra-ocular hypertensions and tachycardia.&#x0D; Material and Methods: 50 patients were randomly divided into two groups of 25 patients each. Group I: 2.5 mg/kg body weight of propofol injected slowly over 20 seconds. Group II: 2.5 mg/kg body weight of propofol injected slowly over 20 seconds. After loss of eye lash reflex, induction time was noted with stop watch and then injection succinylcholine 2mg/kg body weight was injected. Patients were monitored throughout the operation E.C.G. using cardiac monitor on lead II, PaO2 with Pulse Oxymeter. Pulse and blood pressure were recorded.&#x0D; Results: Youngest patient was of 20 years in group I and 22 years in group II. Eldest patient was of 56 years in group I and 60 years in group II. Maximum number of patients were in 20-30 years of age 15 (60%) in group I and 11 (44%) in group II. Excellent intubating conditions were seen in 15 (60%) patients of group I and 25 (100%) patients of group II. The pre induction mean pulse rate (base line) was 103.04±13.08 and 104.56±17.14 in group I and group II respectively. There was slight decrease in pulse rate initially after induction with mean 99.92±13.87 and 98.32±14.60 in group I and group II respectively, but the difference was not statistically significant from the baseline values. (p&gt;0.05). There was slight decrease in arterial pressure initially after induction with mean 80.88 ±6.59 and 85.31±8.71 in group I and group II respectively, but the difference was not statistically significant (P&gt;0.05) from the baseline values. There was slight increase in mean arterial pressure just after intubation with mean 94.10 ±8.07 and 95.58±9.46 in group I and group II respectively, which was not statistically significant (p&gt;0.05). These changes in M.A.P. values return to baseline values 5 minutes after intubation.&#x0D; Conclusion: Propofol 2.5mg/kg when used alone as inducing agent without the aid of any neuromuscular blocking agents produced acceptable intubating conditions, when compared to propofol, 2.5mg/kg along with succinylcholine. It was shown that there were no significant cardiovascular changes when intubation was done without relaxant after induction with propofol.

A study to compare the haemodynamic stability and side effects when using 0.5 percent levobupivacaine vs combination of 0.5 percent levobupivacaine and hyaluronidase, in ultrasound guided axillary brachial plexus block for forearm and hand surgeries

Background: One key component of enhanced recovery protocols is standardized analgesic and anesthetic regimens. Peripheral nerve blocks in particular help in enhanced recovery of the patient by the possibility of early mobilization of the patient. Local Anesthetics are drugs that prevent conduction of electrical impulses on the membranes of nerve and muscle. Adjutants are pharmacological drugs that when co- administered with local anaesthetic agents may improve speed of onset as well as the quality and duration of analgesia. Hyaluronidase drug works as a spreading factor by increasing tissue membrane permeability and reducing the viscosity. Objective: To find if there are any hemodynamic problems or any side effects when Levobupivacaine is used alone compared to Levobupivacaine when used with Hyaluronidase. Materials and Methods: After institutional ethical committee clearance 60 ASA PS class 1 and 2 adult patients in age group of 18 to 60 years who underwent elective upper limb surgeries in Sridevi Institute of Medical Sciences, Tumkur from October 2017 to October 2019 were included. Any patient with history of bleeding disorders, documented neuromuscular disorders, known allergy to Local anesthetics drugs, Psychiatric patients and if on anticoagulants were excluded from the study. Patients were alternately assigned to two groups Group A and Group B each containing 30 patients. Patients undergoing Ultrasound guided Axillary Brachial plexus block with. Group A: 20 ml of 0.5% Levobupivacaine and Hyaluronidase 300 Units (15U/ml of local anesthetic). Group B: 20 ml of 0.5% Levobupivacaine. The patients were given Ultrasound guided Axillary brachial plexus block. Hemodynamic parameters like pulse rate, non-invasive blood pressure, oxygen saturation was monitored. Mean arterial blood pressure (MAP) and pulse rate (PR), oxygen saturation was recorded before application of the block as well as immediately after block & 3 min intervals until the end of the operation. Any drop-in blood pressure more than 20% from the baseline signifies hypotension and was managed with Inj ephedrine 6 mg. Any decrease in pulse rate of less than 60 beats /min was managed with Inj. atropine 0.6mg. Any other complication other than this was noted. Results: Mean pulse rate was similar in both groups with Group A 81.87 and Group B 81.43. Mean arterial pressure between 2 groups was also similar MAP of Group A 105.3 and Group B 105.07. Conclusion: No significant hemodynamic changes were noted between both the groups. Hyaluronidase used as adjuvants along with local anaesthetics to improve the quality of block has no adverse effect on the hemodynamics, unlike other agents (adrenaline, dexmeditomidine, clonidine). It has a good safety profile.

Pulse Rate Change After Childhood Anxiety Management with Modeling and Reinforcement Technique of Children's Dental Care

Objective: To know the influence of handling child anxiety with modeling and reinforcement technique on changes in pulse rate in dental and oral care. Material and Methods: The sample consisted of 53 children aged 6-12 years who first came to pedodontic clinic in dental and oral hospital education of Hasanuddin University. Anxiety level was measured using objective parameters, measurement of radial pulse. Measurement of anxiety level was done before and after modeling and reinforcement was given through three treatments: I: dental models; II: game and III: video modeling and reinforcement. Data analysis was done using the Kolmogorov-Smirnov test and Friedman test. Results: There was a decrease before and after modeling and reinforcement. Before intervention, the average pulse rates in treatment I, II and III were 90.79, 88.00 and 88.38, respectively. After intervention, the average decrease in pulse rate of five beats per minute seen in the first treatment (85.15), a decrease of seven beats per minute on the second treatment (81.98), while in treatment III the average decrease was eight beats per minute (80.19) (p<0.001). Conclusion: Modeling and reinforcement technique effectively reduces children's anxiety levels for dental and oral care.

EFFECT OF ACUPRESSURE ON QUALITY OF SLEEP AND PULSE RATE IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Background: Patients with acute myocardial infarction have a change in sleep pattern. Acupressure is identified as a therapy with the principle of healing to deal with sleep changes.&#x0D; Objective: To analyze the effect of acupressure on sleep quality and pulse rate in patients with acute myocardial infarction.&#x0D; Methods: This study employed a quasi-experiment study with non-randomized pretest-posttest with control group design. There were 50 respondents selected in this study, with 25 assigned in the intervention and control group using consecutive sampling. Quality Sleep Questionnaire and bedside monitor were used to measure sleep quality and pulse rate. Acupressure in combination of Neiguan point (PC 6), Shenmen (HT7), Sanyinjiao (SP6), Yintang (EX3) and Tay (EX5) was given as the nursing intervention in this study. Data were analyzed using paired t-test and independent t-test.&#x0D; Results: There was statistically a significant increase of quality of sleep and significant decrease of pulse rate in the intervention group with p-value 0.000 (&lt;0.05).&#x0D; Conclusion: Acupressure has a significant effect on the increase of sleep quality and the decrease of pulse rate in patients with acute myocardial infarction. Thus, it is suggested that acupressure could be one of the nursing interventions for AMI patients to increase sleep quality and decrease of pulse rate.

EVALUATION OF THE EFFECT OF SECOND DOSE OF SUCCINYLCHOLINE ON THE PULSE RATE IN NON-ATROPINISED PATIENTS UNDER GENERAL ANESTHESIA

From the time when succinylcholine(scoline) introduced to clinical anesthesia, intravenous route of administration of the drug has been broadly practiced. Severe bradycardia and arrhythmias may from time to time produced by single or frequent doses. The mechanism of bradycardia caused by succinylcholine administration has not been completely explained, it has been found that succinylcholine produce a unpredictable effects on the sinoatrial node. In our hospital , a second dose of succinylcholine is usually used for short surgical procedures that required good relaxation like anorectal surgery and orthopedic manipulation under anesthesia. This study aimed to discuss the conditions under which bradycardia appear during general anesthesia with oxygen, propofol, scoline, halothane, along with the use of second dose of scoline and assess the need for atropine to prevent this effect. Fifty patients aged between 20-50 years of American Society of Anesthesiologists (ASA) class I were included in this study, anesthesia was induced with propofol, scoline, along with oxygen halothane mixture, then 2nd dose of scoline was given 10 minutes later. Frequent pulse rate were recorded. There was considerable decrease in pulse rate of the patients after the 2nd dose of succinylcholine, 36% of the patients developed bradycardia (pulse rate below 60), and the mean reduction in pulse rate was (23±13 beats/min). However there is no need for the use of atropine since all of the patients return to normal rates (60-100 beats/min) within 1 minute spontaneously. Conclusion: It has been found that the use of scoline in one dose produce decrease in pulse rate but not reach to the bradycardia level, while the uses of another dose will result in significant reduction in pulse rate that can reach to the level of bradycardia. All patients return to normal level of pulse rate within 1 minute, therefore, there is no need to use atropine neither preoperatively nor after developing of bradycardia since it's a self limiting phenomenon.

A Study on the Effect of Relaxation Techniques and Shavasana on Stress and Pulse Rates of Medical Students

Medical education is perceived as being stressful and a high level of stress may have a negative effect on cognitive functioning and learning of students in medical school. The present study was aimed at comparing the efficacy of two relaxation techniques on medical students and also to study the effects of the Jacobson’s technique of relaxation and Shavasana on pulse rate & stress levels in Medical students. 90 medical students were selected and randomly assigned to three groups (N=30 each) Group A receiving Jacobson’s Technique of relaxation, Group B receiving Shavasana and Group C control. The stress level was determined using Perceived Stress Scale. Pulse rate was measured before and after training of 1 month (sessions twice a week) and home programme of the same technique daily was asked to be followed for one month. Results indicate that both the techniques are significantly effective in inducing relaxation but objectively, on comparison of both techniques, Shavasana was observed to bring enhanced decrease in pulse rate & stress levels than Jacobson’s technique of relaxation.

Effects of progressive muscle relaxation on postmenopausal stress

Background: Menopause increases stress level among females and this may be a contributing factor in developing metabolic syndrome. Objectives: The objective of this study is to study the effects of progressive muscle relaxation on cardiorespiratory efficiency and autonomic functions in over weight and obese working stressed postmenopausal females. Materials and Methods: A total of 30 postmenopausal overweight or obese (body mass index [BMI]: 24.97 ± 1.28) females belonging to the age group 50-55 years were included. Stress level in the subjects was assessed according to the presumptive life event stress scale. The perceived stress scale (PSS) of Sheldon Cohen was used for measuring the perception of stress. Fasting blood samples were collected to exclude diabetic subjects and analyze lipid profile. BMI and waist/hip ratio were calculated. Resting pulse rate and blood pressure, respiratory rate were measured. VO 2 max, physical fitness index, breath holding time and 40 mm endurance test time were calculated for estimation of cardiopulmonary efficiency. Autonomic function tests were carried. Subjects were given progressive muscle relaxation training for 3 months and all parameters were reevaluated. Data was analyzed using SPSS version 16 (SPSS Inc., Chicago, USA). Results: PSS in pre-training session was 26.16 ± 1.7 and in post-training session was 14.33 ± 2.01 and the difference was statistically significant. There was a significant decrease in pulse rate, blood pressure, BMI, waist/hip ratio, cholesterol, low-density lipoprotein following preventive medicine residency training. Results of autonomic function tests and cardiopulmonary efficiency test improved significantly following relaxation training. Conclusions: Increased stress levels may increase BMI and waist/hip ratio, dyslipidemia and lead to autonomic dysfunctions and increase incidence of cardiovascular disease in postmenopausal females. Lifestyle modification with relaxation exercises decreases stress levels and improves autonomic functions, cardiopulmonary efficiency, and lipid profile.

A study on improving physiological and psychological personalities of the students by Vethathiri Maharishi′s nine-center meditation using electroencephalography

The Nine-center Meditation of Simplified Kundalini Yoga was formulated by Sage Vethathiri Maharishi to improve the functions of endocrine glands. It involves the following centers: Mooladhara, Swadhistana, Manipuraga, Anahatha, Visuddhi, Agna, Thuriya, Shakthi Kalam and Shiva Kalam. Meditation is done on all the nine centers, seven of which are endocrine glands located within the physical body and Shakthi Kalam, Shiva Kalam are Universal field and Absolute space, respectively. Meditation commences at Mooladhara Chakra; followed by meditation on each of other chakras and concludes when the mind merges with Absolute space. Mind is a magnetic wave with self-rotating movement. The speed of mind is measured in terms of mental frequency. Scientists have discovered through the use of Electro Encephalograph (EEG) that the mind works at frequencies ranging from 1–40 cycles/sec. To prove the research concept, forty four students of two different schools pursuing 11th standard were selected and chosen one as experimental group and another one as controlled group. The former group alone underwent and practiced the Nine-Centre Meditation for six months. The Mind frequencies of the students of both groups were measured by EEG test in Vethathiri Maharishi’s Kundalini Yoga research centre and their BMI (Body Mass Index), pulse rate, blood pressure were measured by a medical officer in the centre. After six month regular practice of the Nine-Centre Meditation, the former group of students progressed well compared to the later in the following: increase in BMI, academic marks, harmony in relation with parents, teachers, friends and decrease in pulse rate, blood pressure and mind frequencies. The Nine-Centre Meditation regulates and promotes the functions of the endocrine glands and mind so that streamline and uplift physiological and psychological functions of humans especially student community very rapidly. Keywords: Electroencephalograph, Chakras, Electroencephalography, Health, Wisdom

Safety and Effectiveness of Propofol Sedation during Endoscopic Retrograde Cholangiopancreatography

Objectives: Evidence of the safety and usefulness of propofol sedation during endoscopic retrograde cholangiopancreatography is presently insufficient; our study aimed to add such information. Methods: Patients were sedated using propofol or midazolam during endoscopic retrograde cholangiopancreatography. The safety and utility of the sedatives were compared. Safety parameters included examination cancellation rate, circulatory depression, and respiratory depression. Utility parameters included pain level, sedation tolerability rate, and bispectral index sedation level. Results: The propofol and midazolam groups contained 30 and 27 patients, respectively. No patient had an examination cancelled for sedation-related reasons. Blood pressure reduction (mmHg) was 24.1 ± 19.7 and 28.1 ± 20.7 in the midazolam and propofol groups, respectively, showing no significant difference. Pulse rate decrease (beats/min) was 2.4 ± 5.6 and 1.7 ± 4.5 in the propofol and midazolam groups, respectively, with no significant difference. Arterial carbon dioxide tension (mmHg) increased by 10.2 ± 6.5 and 10.8 ± 7.2 in the propofol and midazolam groups, respectively, showing no significant difference. Arterial oxygen saturation reduced by 2.9 ± 2.2% and 1.5±1.7% in the midazolam and propofol groups, respectively. The percentage of patients with <92% oxygen saturation showed no significant difference. The pain level was 0.9 ± 1.3 in the propofol group, and significantly lower than 2.4 ± 2.7 in the midazolam group. The sedation tolerability rate was 93.3% for propofol, and significantly higher than 74.1% for midazolam. The bispectral index (mean value/minimum value) was 75.1 ± 10.6/63.9 ± 12.1 for propofol, and significantly lower than 80.5 ± 4.2/72.0 ± 5.0 for midazolam. Conclusions: Propofol sedation had similar safety and superior efficacy to midazolam. Stepwise adjustments of propofol dosage likely result in safer sedation.

Changes in body weight and pulse: outcome events in overweight and obese subjects with cardiovascular disease in the SCOUT trial.

The Sibutramine Cardiovascular OUTcomes (SCOUT) trial showed a significantly increased relative risk of nonfatal cardiovascular events, but not mortality, in overweight and obese subjects receiving long-term sibutramine treatment with diet and exercise. We examined the relationship between early changes (both increases and decreases) in pulse rate, and the impact of these changes on subsequent cardiovascular outcome events in both the placebo and sibutramine groups. 9804 males and females, aged ⩾55 years, with a body mass index of 27-45 kg m(-)(2) were included in this current subanalysis of the SCOUT trial. Subjects were required to have a history of cardiovascular disease and/or type 2 diabetes mellitus with at least one cardiovascular risk factor, to assess cardiovascular outcomes. The primary outcome event (POE) was a composite of nonfatal myocardial infarction, nonfatal stroke, resuscitated cardiac arrest or cardiovascular death. Time-to-event analyses of the POE were performed using Cox regression models. During the initial 6-week sibutramine treatment period, the induced pulse rate increase was related to weight change (1.9±7.7 beats per minute (bpm) with weight increase; 1.4±7.3 bpm, 0-5 kg weight loss; 0.6±7.4 bpm, ⩾5 kg weight loss). Throughout the subsequent treatment period, those continuing on sibutramine showed a consistently higher mean pulse rate than the placebo group. There was no difference in POE rates with either an increase or decrease in pulse rate over the lead-in period, or during lead-in baseline to 12 months post randomization. There was also no relationship between pulse rate at lead-in baseline and subsequent cardiovascular events in subjects with or without a cardiac arrhythmia. Baseline pulse rate and changes in pulse rate may not be an important modifier nor a clinically useful predictor of outcome in an individual elderly cardiovascular obese subject exposed to weight management.

Repeated Dermal Paraphenylenediamine Exposure Induces Systemic Biochemical and Histological Changes in Adult male Albino Rats

Paraphenylenediamine (PPD) is a synthetic compound that is widely used as a hair dye. This study investigated biochemical and histological effects after repeated PPD dermal application. 30 adult male albino rats (200± 20gms) were classified into two groups; group I, (control group) included negative and positive control subgroups, each consisted of 10 rats and group II (tested group). Tested group was subjected to repeated topical PPD application in a dose of 10mg/kg for 90 days. All groups were investigated for these laboratory biochemical parameters: Serum creatine phosphokinase CPK-MB, aspartate (AST) and alanine transferases (ALT), serum creatinine (S. Creat.), blood urea nitrogen (BUN) as well as serum potassium. All the mentioned parameters showed significant increase when compared to control group. ECG was done and revealed significant decrease of pulse rate and significant prolongation of PR, QRS and QT intervals in tested group. In-addition, to biochemical and ECG investigations; histological examination was done for; cardiac, hepatic, renal and testicular tissues. Cardiac, hepatic, renal, and testicular tissues of tested group showed evident changes. These changes were more obvious in Cardiac, renal, and testicular tissues when compared to control.

Difference in Blood Pressure and Pulse Rate Pre- and Post-extraction of Teeth

Objective: To evaluate and compare blood pressure and pulse rate Pre- and Post-extraction of teeth. Materials &amp; Methods: The Systolic &amp; Diastolic blood pressure of 40 Indian patients in the age group of 20–50 years old were recorded using a Dial-type BP apparatus &amp; Stethoscope before and after dental extraction. The Pulse rate was also recorded pre- and post-extraction by palpating the radial pulse and recording it with a stopwatch for 1 minute. Results: 75 per cent of the patients had no significant change in blood pressure pre- and post-extraction, while 17.5 percent of the patients had an increase in blood pressure post-extraction. 7.5 per cent of the patients had a fall in blood pressure following dental extraction. Evaluation of pre- and post-extraction pulse rate shows no significant change in pulse rate in 92.5 per cent of the patients studied and 5 per cent of the patient had an increase in pulse rate post-extraction. 2.5 percent of the 40 patients studied had a decrease in pulse rate post-extraction. Conclusion: There’s no significant difference in blood pressure &amp; pulse rate pre- and post-extraction.

Anaesthetic effects in the ferret of alfaxalone alone and in combination with medetomidine or tramadol: a pilot study.

Alfaxalone is a neurosteroid with anaesthetic effects and it has been used successfully in several animal species. However, there are no data, to our knowledge, about its efficacy and safety in ferrets (Mustela putorius furo). We evaluated a variety of anaesthetic regimens in ferrets, namely, alfaxalone at 20, 10 and 5 mg/kg (n = 1, 10 and 9, respectively; intravenously); medetomidine at 20 µg/kg (n = 3; intramuscularly); medetomidine (20 µg/kg, intramuscularly) plus alfaxalone (2.5 mg/kg, intravenously; n = 7); and tramadol (5 mg/kg, intramuscularly) plus alfaxalone (5 mg/kg, intravenously; n = 2). Two animals treated with alfaxalone at 10 mg/kg and 20 mg/kg, respectively, died. At 5 mg/kg alfaxalone produced anaesthesia with a similar onset but a shorter duration of anaesthesia and analgesia than alfaxalone at 10 mg/kg. The medetomidine-alfaxalone combination produced anaesthesia and analgesia of a longer duration than alfaxalone administered alone at 5 mg/kg (P < 0.0001 and P < 0.001, respectively). Under this anaesthetic regimen, there was a progressive decrease in pulse rate during the first 30 min before the pulse rate stabilized. Respiratory parameters were maintained at acceptable levels. When tramadol was administered, all the animals exhibited a strong excitation reaction and in no case was the toe-pinch reflex clearly abolished. Thus, alfaxalone plus medetomidine provided safe and effective anaesthesia in ferrets. Alfaxalone, alone or in combination with tramadol, did not produce satisfactory results for use as an anaesthetic for this species.

Difference in Blood Pressure and Pulse Rate Pre- and Post-extraction of Teeth

Objective: To evaluate and compare blood pressure and pulse rate Pre- and Post-extraction of teeth. Materials & Methods: The Systolic & Diastolic blood pressure of 40 Indian patients in the age group of 20–50 years old were recorded using a Dial-type BP apparatus & Stethoscope before and after dental extraction. The Pulse rate was also recorded pre- and post-extraction by palpating the radial pulse and recording it with a stopwatch for 1 minute. Results: 75 per cent of the patients had no significant change in blood pressure pre- and post-extraction, while 17.5 percent of the patients had an increase in blood pressure post-extraction. 7.5 per cent of the patients had a fall in blood pressure following dental extraction. Evaluation of pre- and post-extraction pulse rate shows no significant change in pulse rate in 92.5 per cent of the patients studied and 5 per cent of the patient had an increase in pulse rate post-extraction. 2.5 percent of the 40 patients studied had a decrease in pulse rate post-extraction. Conclusion: There’s no significant difference in blood pressure & pulse rate pre- and post-extraction.

English

Fibreoptic intubation is a valuable modality for airway management. This study aimed to compare the efficacy and safety of dexmedetomidine and propofol infusion for sedation during fibreoptic nasotracheal intubation. Twenty patients of either sex aged between 18 to 60 years belonging to ASA I or ASA II grade were enrolled and randomly allocated into the dexmedetomidine group (1.0 μg/kg infusion over 10 min followed by 0.5 µg/kg/hr. during fibreoptic nasotracheal intubation) (n = 10) and the propofol group (100µg/kg/min body weight over 10 min followed by 50µg/kg/min during fibreoptic nasotracheal intubation) (n = 10). Intubating conditions and patient tolerance as graded by a scoring system were evaluated as primary outcomes. Intubation was successful in all patients. Satisfactory intubating conditions were found in both groups (10/10 in each group). In the evaluation of efficacy it was found that dexmedetomidine group had better patient tolerability according to 5 point fibreoptic intubation comfort score (3.0±1.05 and 1.8±1.03 in propofol and dexmedetomidine group respectively (p<0.05)). In the evaluation of safety it was found that in dexmedetomidine group better Spo2 is maintained during intubation (p<0.05), there was significant decrease in diastolic blood pressure in propofol group at the end of infusion (p<0.05) and there was significant decrease in pulse rate in dexmedetomidine group than propofol group at the end of infusion (p<0.05). Both drugs infusion are effective and safe to be used as sedative agent during fibreoptic nasotracheal intubation with same incidence of amnesia but better patient tolerance and Spo2 maintenance with dexmedetomidine.

Anaesthetic consideration during laparoscopic bilateral simultaneous nephrectomy

STUDY OBJECTIVE:To assess outcome from anaesthesia during laparoscopic bilateral simultaneous nephrectomy.DESIGN:Retrospective study.MEASUREMENTS:Preoperative Hb%, serum potassium, coagulation profile electrocardiography (ECG) changes, 2D Echography, x-ray chest, haemodynamic changes, end-tidal carbon dioxide (EtCO2), fluid management and postoperative analgesia.RESULTS:The mean age was 24.75 ± 14.35 years. The mean duration of surgery was 120 ± 80 minutes. The Hb%, serum creatinine and serum potassium were 9.4 ± 1.04%, 6.79 ± 4.91 meq/L and 3.61 ± 0.51 meq/L, respectively. Pulse rate mean blood pressure and EtCO2 were recorded after creation of pneumoperitoneum and at 15, 30, 45 and after exsufflation of pneumoperitoneum. After pneumoperitoneum, there was increase in pulse rate, systolic blood pressure, diastolic blood pressure and EtCO2. After 30 minutes and throughout the surgery, these variables remained stable. Four patients required nitroglycerine infusion for intraoperative hypertention. Only one patient required packed cell volume (PCV) transfusion and total intravenous fluid was 1 ± 0.5 L. At the time of exsufflation, there was decrease in pulse rate, systolic and diastolic blood pressure and EtCO2.CONCLUSION:Because of advancement in anaesthetic agents and muscle relaxant, there is safe outcome from anaesthesia during laparoscopic bilateral simultaneous nephrectomy.