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Article ; Online: Metabolic Profile of Lean/Non Obese NAFLD (Non Alcoholic Fatty Liver Disease) Subjects

Akash Jaiswal, / Kavita Jain / Nagendra Babu

Journal of Clinical and Diagnostic Research, Vol 15, Iss 11, Pp 01-

2021 Volume 05

Abstract: Introduction: Non Alcoholic Fatty Liver Disease (NAFLD) in the absence of overweight and obesity has been defined as ‘lean NAFLD’. Metabolic syndrome associated diseases in low and middle income countries have variable phenotypes and clinical outcomes. ... ...

Abstract	Introduction: Non Alcoholic Fatty Liver Disease (NAFLD) in the absence of overweight and obesity has been defined as ‘lean NAFLD’. Metabolic syndrome associated diseases in low and middle income countries have variable phenotypes and clinical outcomes. Hypothetically, ‘Lean NAFLD’ can be a part of the spectrum of classical obesity related NAFLD or separate entity with different pathophysiology. Aim: 1) To characterise the NAFLD in lean/non obese subjects; 2) To explore how it differs from classical ‘obese phenotype’ of the NAFLD; 3) To explore how these lean/non obese subjects with NAFLD are different from healthy lean/non obese subjects in terms of metabolic profile. Materials and Methods: The present study was a crosssectional observational study conducted over a period of six months. Forty subjects were categorised into four groups (1. Lean NAFLD without Diabetes; 2. Lean NAFLD with Diabetes; 3. Obese NAFLD with Diabetes; 4. Lean healthy subjects). Clinical history, examination, anthropometry, biochemical data including insulin resistance by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) were analysed. Results: Mean Body Mass Index (BMI), Fasting Blood Glucose (FBG) and HbA1c (Glycated haemoglobin) of group 2 and group 3 were significantly higher than that of group 1 and group 4 subjects (p<0.001). Mean HOMA-IR of the patients of group 2 and group 3 were significantly higher than that of group 1 and group 4 (p<0.001). No significant difference was seen in HOMAIR between patients of group 1 and group 4 (p>0.05) and also of group 2 and group 3 subjects (p>0.05). Conclusion: Lean NAFLD subjects have a different metabolic profile than overweight-obese patients with NAFLD, particularly in relation to diabetes. On the basis of all metabolic parameters and insulin resistance, authors propose a spectrum of insulin resistance ‘Non obese Control - Non obese NAFLD without Diabetes Mellitus (DM) - Non obese NAFLD with DM - Obese NAFLD with DM’.
Keywords	body mass index ; diabetes mellitus ; homeostatic model of insulin resistance ; insulin resistance ; Medicine ; R
Subject code	796
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	JCDR Research and Publications Private Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Role of Saroglitazar in Non Diabetic Non Alcoholic Fatty Liver Disease Patients

Akash Jaiswal / Kavita Jain / Amit Kumar Singh

Journal of Clinical and Diagnostic Research, Vol 15, Iss 12, Pp 21-

A Retrospective Observational Study

2021 Volume 23

Abstract: Introduction: Non Alcoholic Fatty Liver Disease (NAFLD) is a commonly encountered problem which affects one third of the general population. Saroglitazar, a Peroxisome Proliferator Activated Receptor (PPAR) alpha α and gamma γ agonist has been recently ... ...

Abstract	Introduction: Non Alcoholic Fatty Liver Disease (NAFLD) is a commonly encountered problem which affects one third of the general population. Saroglitazar, a Peroxisome Proliferator Activated Receptor (PPAR) alpha α and gamma γ agonist has been recently approved for treatment of NAFLD. Aim: To assess the efficacy of saroglitazar in non diabetic NAFLD patients. Materials and Methods: It was a retrospective observational study, conducted from October 2020 to March 2021 on 45 non diabetic NAFLD patients, at a tertiary care centre in north-eastern India. Liver enzymes, liver fibrosis and liver fat content were compared before and after receiving saroglitazar for 24 weeks. Multiple regression analysis was used to assess percent change in Alanine Transaminase (ALT), Aspartate Transaminase (AST), ALP, bilirubin, Liver Stiffness Measurement (LSM) and Controlled Attenuation Parameter (CAP). The p-values <0.05 were considered as statistically significant. Results: Mean age of the study population was 46±8.20 years, and there were 24 males and 21 females. Reduction in liver enzymes like Alanine Transaminase (ALT) and Aspartate Transaminase (AST) and fibroscan parameters like Liver Stiffness Measurement (LSM) and Controlled Attenuation Parameter (CAP) were seen. Mean values of ALT and AST at pretreatment status were 85.52±17.12 U/L and 70.02±19.10 U/L, and after treatment were 40.20±12.11 U/L and 37.32±8.31 U/L, respectively (p-value <0.0001 for both ALT and AST). Pretreatment and post-treatment mean values for LSM and CAP were 8.11±2.18 kPa (kilopascal), 365.84±56.22 d/m (decibel/ metre) and 7.20±1.80 kPa, 345.21±35.22 d/m, respectively (p-value=0.021 for LSM and 0.036 for CAP). Conclusion: Twenty four weeks saroglitazar was effective in treatment of non diabetic NAFLD. It not only reduces hepatocellular inflammation, but also liver fibrosis and liver fat.
Keywords	alanine transaminase aspartate transaminase ; controlled attenuation parameter ; fibroscan ; liver stiffness measurement ; peroxisome proliferator activated receptor ; Medicine ; R
Subject code	610
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	JCDR Research and Publications Private Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Bouveret’s Syndrome- An Uncommon Variant of Gallstone Ileus

Akash Jaiswal / Amit Singh / Kavita Jain

Journal of Clinical and Diagnostic Research, Vol 15, Iss 10, Pp PR01-PR

Case Series and Review of Literature

2021 Volume 04

Abstract: Bouveret’s syndrome is a rare form of gallstone ileus. It refers to gastric outlet or small bowel obstruction caused by the formation of a biliary enteric fistula with subsequent migration and impaction of a large gallstone into stomach or small ... ...

Abstract	Bouveret’s syndrome is a rare form of gallstone ileus. It refers to gastric outlet or small bowel obstruction caused by the formation of a biliary enteric fistula with subsequent migration and impaction of a large gallstone into stomach or small intestine. Its diagnosis is often delayed or overlooked. Diagnosis is based on the clinical manifestations, presence of pneumobilia, visualisation of stone and demonstration of small bowel obstruction on imaging. Enterotomy or gastrotomy with or without cholecystectomy and fistula repair is the most common surgical therapy. The aim of this case series was to analyse the presentation of Bouveret’s syndrome and strategise the optimum surgical approach based on the available literature and authors experience. Authors hereby report three cases of Bouveret’s syndrome encountered within last two years with clinical presentation, surgical approaches and operative findings. Computed Tomography (CT) scan is most commonly used to diagnose this rare entity. Early detection and optimum timing of surgery plays crucial role in outcome. It has high success rate, with acceptable surgical morbidity and mortality. Heightened awareness of this syndrome may lead to decreased morbidity and mortality.
Keywords	biliary enteric fistula ; enterotomy ; gastrotomy ; pneumobilia ; small bowel obstruction ; Medicine ; R
Subject code	610
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	JCDR Research and Publications Private Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A comparison of postoperative analgesic efficacy of opioid-free anesthesia using intravenous paracetamol (15 mg/kg), lignocaine (2 mg/kg), and magnesium sulfate (20 mg/kg) versus standard opioid anesthesia using intravenous tramadol (2 mg/kg) for preemptive analgesia in abdominal surgeries under general anesthesia

Neena Jain / Neha Surendran / Meera Kumari / Pradeep Kumar / Veena Patodi / Kavita Jain

Indian Journal of Health Sciences and Biomedical Research KLEU, Vol 16, Iss 2, Pp 219-

2023 Volume 224

Abstract: INTRODUCTION: Pain is an unpleasant sensory and emotional experience and is considered the fifth vital sign. Opioid-free anesthesia (OFA) is a technique where no intraoperative systemic, neuraxial, or intracavitary opioids are administered during the ... ...

Abstract	INTRODUCTION: Pain is an unpleasant sensory and emotional experience and is considered the fifth vital sign. Opioid-free anesthesia (OFA) is a technique where no intraoperative systemic, neuraxial, or intracavitary opioids are administered during the anesthesia. The prescription misuse/overuse has generated an opioid crisis which has led to the need for OFA. In this study, we will investigate the 24-h postsurgical analgesia and analgesic consumption with the use of OFA versus opioid anesthesia (tramadol) in patients undergoing abdominal surgery under general anesthesia. METHODOLOGY: Sixty patients of the American Society of Anesthesiologists Grade I-II scheduled for various abdominal surgeries were randomly assigned into two groups, with 30 patients in each group. Group A (opioid-free group): received IV lignocaine (2 mg/kg), IV magnesium sulfate (20 mg/kg), and V paracetamol (15 mg/kg) in 100 ml NS. Group B (opioid group): received IV tramadol (2 mg/kg) in 100 ml NS. Hemodynamic parameters, postoperative analgesic consumption, duration of analgesia, and any adverse effects were recorded. RESULTS: A very significant difference was observed between the study groups for mean values of mean arterial pressure at the last stages of surgery, with hemodynamics more stable in the opioid-free group (P < 0.01). In terms of mean values of minimum alveolar concentration throughout the surgery, the opioid group showed more anesthetic-sparing effect (P < 0.05). In terms of postoperative pain scores between the groups, the opioid-free group experienced less pain (P < 0.01). There was no difference between the groups in postoperative analgesic consumption and duration of analgesia. More side effects were noted in the opioid group. CONCLUSION: This study concludes that avoiding opioid use by preemptive administration of intravenous paracetamol, lignocaine, and magnesium sulfate provides safe, effective, and satisfactory analgesia in patients undergoing various abdominal surgeries under general anesthesia.
Keywords	lignocaine ; magnesium sulfate ; opioid-free anesthesia ; Medicine ; R
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Comparison of efficacy of intrathecal dexmedetomidine and magnesium sulfate as an adjuvant to 0.5% hyperbaric bupivacaine in patients undergoing infraumbilical surgeries under spinal anesthesia

Kavita Jain / Surendra K Sethi / Rahul Jain

Journal of Dr. NTR University of Health Sciences, Vol 9, Iss 2, Pp 116-

2020 Volume 123

Abstract: Background: Adjuvants in spinal anesthesia extends not only the duration of surgical anesthesia but also provides postoperative analgesia. This study aimed at comparing efficacy of intrathecal dexmedetomidine and magnesium sulfate as an adjuvant to 0.5% ... ...

Abstract	Background: Adjuvants in spinal anesthesia extends not only the duration of surgical anesthesia but also provides postoperative analgesia. This study aimed at comparing efficacy of intrathecal dexmedetomidine and magnesium sulfate as an adjuvant to 0.5% hyperbaric bupivacaine in various infraumbilical surgeries. Materials and Methods: 120 patients belonging to American Society of Anesthesiologists (ASA) physical status I or II aged 18 to 65 years of either sex were enrolled and randomly allocated into two groups. Group D (n = 60) received intrathecal bupivacaine (hyperbaric) 0.5%, 12.5 mg (2.5 ml)+dexmedetomidine 5 μg (0.5 ml) while Group M (n = 60) received bupivacaine (hyperbaric) 0.5%, 12.5 mg (2.5 ml) + magnesium sulfate 75 mg (0.5 ml) = 3 ml. Onset of sensory and motor block, time to reach peak level of sensory block, time to two segment regression, duration of sensory and motor block, duration of analgesia, sedation score, hemodynamic changes, and side effects were noted. Results: Onset of sensory and motor block were significantly faster in Group D (2.78 ± 0.34 min and 3.73 ± 0.43 min) compared to Group M (6.47 ± 0.43 min and 7.72 ± 0.48 min); (P < 0.05) Group D (131.70 ± 5.74 min) showed significantly prolonged time to two segment regression compared to Group M (102.78 ± 6.54 min); (P < 0.001). Duration of sensory and motor block were significantly prolonged in Group D (339.75 ± 23.57 min and 314.38 ± 14.93 min) when compared to Group M (248.18 ± 12.89 min and 228.81 ± 11.01 min); (P < 0.05). Duration of analgesia was significantly prolonged in Group D (348.26 ± 22.35 min) than Group M (268.01 ± 11.31 min); (P < 0.001). The patients remained hemodynamically stable in both groups without undue sedation and minimal side effects; (P > 0.05). Conclusion: Dexmedetomidine (5 μg) leads to faster onset as well as prolonged duration of both sensory and motor block, prolonged duration of postoperative analgesia in comparison to magnesium sulfate (75 mg).
Keywords	bupivacaine ; dexmedetomidine ; duration of analgesia ; magnesium sulfate ; spinal anesthesia ; Medicine ; R
Subject code	796
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical and histology features as predictor of severity of mucormycosis in post-COVID-19 patients

Kavita Jain / Akshay Surana / Tej Singh Choudhary / Sudhakar Vaidya / Shirish Nandedkar / Manju Purohit

SAGE Open Medicine, Vol

An experience from a rural tertiary setting in Central India

2022 Volume 10

Abstract: Background: An upsurge in cases of rhinosinusitis with or without associated orbital and/or cerebral involvement by mucormycosis has been observed in post-COVID-19 patients. Our objective is to evaluate the clinical and histopathology features of these ... ...

Abstract	Background: An upsurge in cases of rhinosinusitis with or without associated orbital and/or cerebral involvement by mucormycosis has been observed in post-COVID-19 patients. Our objective is to evaluate the clinical and histopathology features of these patients to determine the severity and develop a scoring on the extent on tissue invasion. Method: We prospectively enrolled and analyzed 95 post-COVID-19 patients who presented with the invasive mucormycosis of the head and neck region. Clinical and histology details were noted in predesigned forms. Various histology variables were graded from I to III to propose a scoring system for the severity of the disease. Results: Mucormycosis was common in males with a mean age of 46.8 ± 11 years. Facial pain was the most common presenting complaint and 77% of the patients were diabetic. Most cases (n = 59) showed a moderate degree of neutrophilic infiltrate with ⩾50% tissue necrosis and angioinvasion in three or more vessels with a fungal load of 2+/3+. Histology severity grade III was observed in patients who died from cerebral mucormycosis (n = 3) and septicemia (n = 2) and in patients who had undergone orbital exenteration (n = 6). Conclusion: The histopathology and severity score classification was directly correlated with the outcome of the patients. Further evaluation and a larger study will help to validate the proposed scoring for its clinical use in all forms and causes of mucormycosis.
Keywords	Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A comparative study to evaluate the efficacy of intraperitoneal instillation of 0.25% levobupivacaine with or without clonidine (0.75 μg/kg) for postoperative analgesia in patients undergoing laparoscopic cholecystectomy

Neena Jain / Surendra K Sethi / Bhupendra Soni / Veena Patodi / Kavita Jain / Deepak Kumar Garg

Journal of Dr. NTR University of Health Sciences, Vol 11, Iss 2, Pp 126-

2022 Volume 133

Abstract: Background: In recent years, the use of intraperitoneal instillation of local anesthetics with adjuvants has become popular for postoperative analgesia in laparoscopic cholecystectomy. This study aimed to compare the analgesic efficacy and safety of ... ...

Abstract	Background: In recent years, the use of intraperitoneal instillation of local anesthetics with adjuvants has become popular for postoperative analgesia in laparoscopic cholecystectomy. This study aimed to compare the analgesic efficacy and safety of levobupivacaine alone or with clonidine as an adjuvant given through intraperitoneal instillation in laparoscopic cholecystectomy under general anesthesia. Material and Methods: In this prospective randomized double-blind study, 100 patients, aged 18–60 years belonging to ASA physical status I or II, were randomly allocated into two groups. Group L (n = 50) received 0.25% levobupivacaine 28 ml + 2 ml normal saline, whereas Group LC (n = 50) received 0.25% levobupivacaine 28 ml + clonidine 0.75 μg/kg (diluted in 2 ml normal saline) as intraperitoneal instillation before removing trocar. The duration of analgesia, pain scores, total number of doses, and amount of rescue analgesic consumed in 24 h, sedation score, hemodynamics, and adverse effects was noted. Results: Duration of analgesia was significantly prolonged in Group LC (744.10 ± 96.72 min) compared to Group L (525.20 ± 67.91 min) (P < 0.05). Pain scores (VAS) were significantly lower in Group LC (P < 0.05). The total number of doses and amount of rescue analgesic consumption in 24 hours were less in Group LC as compared to Group L (P < 0.05). Sedation, hemodynamics, and side effect profile were comparable in two groups (P > 0.05). Conclusion: Clonidine (0.75 μg/kg) was found to be a safe and effective adjuvant to 0.25% levobupivacaine for intraperitoneal instillation in laparoscopic cholecystectomy in terms of prolonged postoperative analgesia, lower pain scores, reduced rescue analgesic consumption along with no significant sedation, hemodynamic changes, and adverse effects.
Keywords	clonidine ; duration of analgesia ; intraperitoneal instillation ; laparoscopic cholecystectomy ; levobupivacine ; rescue analgesic ; Medicine ; R
Subject code	796
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effect of Preoperative Ketamine Nebulisation on Attenuation of Incidence and Severity of Postoperative Sore Throat, Hoarseness of Voice and Cough

Veena Patodi / Naveen Kumar Jangid / Meera Kumari / Surendra Kumar Sethi / Neena Jain / Kavita Jain

Journal of Clinical and Diagnostic Research, Vol 16, Iss 1, Pp UC09-UC

A Randomised Double-blind Study

2022 Volume 13

Abstract: Introduction: Postoperative Sore Throat (POST) occurs in a majority i.e., upto 62% of patients who undergo endotracheal intubation under general anaesthesia. Ketamine nebulisation has been reported to reduce the incidence and severity of POST. Aim: To ... ...

Abstract	Introduction: Postoperative Sore Throat (POST) occurs in a majority i.e., upto 62% of patients who undergo endotracheal intubation under general anaesthesia. Ketamine nebulisation has been reported to reduce the incidence and severity of POST. Aim: To evaluate the effect of ketamine nebulisation on incidence and severity of POST, hoarseness of voice and cough. Materials and Methods: This prospective, randomised, double-blind study was conducted between September 2020 to February 2021 at J.L.N. Medical College, Ajmer, Rajasthan, India. Total of 100 American Society of Anesthesiologists (ASA) physical status I and II patients were enrolled, and randomly allocated into two groups of 50 each. The patients in Group K (n=50) were nebulised with ketamine (50 mg) with 4 mL normal saline (NS) and in Group S (n=50) were nebulised with 5 mL NS 15 minutes prior to endotracheal intubation. The incidence and severity of POST, hoarseness of voice and cough were assessed just after extubation (0 hour) and thereafter at 2, 4, 6, 12 and 24 hours postoperatively. Haemodynamic parameters {Heart Rate, (HR) Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP), and Oxygen Saturation (SpO2)} were noted before and after nebulisation, and just after intubation. Side-effect profile was also noted. The data from patients was analysed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA, version 21.0 for windows). Results: Mean age of Group S was 36.22±9.386 years and Group K was 37.40±9.604 years (p-value=0.534). The incidence and severity of POST was significantly lower in patients in Group K at 0 hours (p-value=0.003), at 2 hours (p-value=0.001), at 4 hours (p-value=0.003), at 6 hours (p-value=0.004) and at 12 hours (p-value=0.003), when compared to patients in Group S. The incidence and severity of cough was also significantly lower in patients in Group K at 0 hours, 2 hours, 4 hours and 6 hours (p-value <0.001). Incidence and severity of postoperative hoarseness of voice ...
Keywords	endotracheal intubation ; general anaesthesia ; haemodynamic parameters ; n-methyl d-aspartate receptor antagonist ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	JCDR Research and Publications Private Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effect of Dexamethasone as an Adjunct on Efficacy of Ropivacaine in Caudal Block for Postoperative Analgesia in Paediatric Infra-Umbilical Surgeries

VEENA PATODI / KAVITA JAIN / MUKESH CHOUDHARY / SURENDRA KUMAR SETHI / NEENA JAIN / VEENA MATHUR

Journal of Clinical and Diagnostic Research, Vol 15, Iss 5, Pp UC31-UC

A Randomised Double-blind Controlled Study

2021 Volume 35

Abstract: Introduction: Caudal block is a routinely performed analgesic and anaesthetic technique in paediatric population undergoing various infra-umbilical surgeries. Various adjuvants have been used along with local anaesthetics like ropivacaine in singleshot ... ...

Abstract	Introduction: Caudal block is a routinely performed analgesic and anaesthetic technique in paediatric population undergoing various infra-umbilical surgeries. Various adjuvants have been used along with local anaesthetics like ropivacaine in singleshot caudal block for enhancing postoperative analgesia in paediatric infra-umbilical surgeries. Aim: To evaluate the efficacy of dexamethasone used as an adjuvant to 0.2% ropivacaine in caudal block for postoperative analgesia in paediatric patients. Materials and Methods: This was a randomised doubleblinded controlled study conducted on 80 paediatric patients (8 months-8 years), with American Society of Anesthesiologists (ASA) physical status I or II undergoing various infra-umbilical surgeries,at a tertiary care teaching institute from April 2019 to September 2019. These total subjects were randomly allocated into two groups. Group R (n=40) administered 0.2% ropivacaine (1 mL/kg) while Group RD (n=40) administered 0.2% ropivacaine (1 mL/kg) with dexamethasone (0.1 mg/kg) in caudal block. The duration of analgesia, postoperative pain scores (Face Legs Activity Cry Consolability (FLACC) score), rescue analgesic consumption in 24 hours, haemodynamic changes and sideeffects were noted. The rescue analgesic (paracetamol 15 mg/ kg oral) was given whenever FLACC ≥4. Standard qualitative and quantitative tests (unpaired student t-test, Chi-square test) were used to analyse and compare the results obtained. Results: The mean duration of analgesia was significantly longer in Group RD (745.21±146.91 min) as compared to Group R (440.38±76.44 min); (p-value <0.001). The significantly lower FLACC pain scores were noted in patients in Group RD compared to Group R; (p-value <0.05). The rescue analgesic consumption was significantly lesser in Group RD in terms of requirement of number of doses of rescue analgesic than in Group R; (p-value <0.05). No significant haemodynamic changes or side-effects were observed in both groups; (p-value >0.05). Amongst postoperative ...
Keywords	adjuvants ; duration of analgesia ; face legs activity cry consolability scale ; local anaesthetics ; rescue analgesic ; Medicine ; R
Subject code	796
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	JCDR Research and Publications Private Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Dexmedetomidine with 0.5% lignocaine enhances postoperative analgesia in patients undergoing upper limb orthopedic surgeries under intravenous regional anesthesia

Neena Jain / Shilpi Tada / Surendra Kumar Sethi / Veena Patodi / Kavita Jain / Deepak Kumar Garg

Journal of Dr. NTR University of Health Sciences, Vol 10, Iss 1, Pp 8-

2021 Volume 14

Abstract: Background: Intravenous regional anesthesia (IVRA) is an effective technique to provide analgesia for upper limb surgeries of shorter duration. Various adjuvants are used with local anesthetics to prolong the duration of analgesia. This study was ... ...

Abstract	Background: Intravenous regional anesthesia (IVRA) is an effective technique to provide analgesia for upper limb surgeries of shorter duration. Various adjuvants are used with local anesthetics to prolong the duration of analgesia. This study was undertaken to establish the effect of dexmedetomidine with lignocaine for IVRA in upper limb orthopedic surgeries. Materials and Methods: Sixty patients aged 15 to 65 years of either sex belonging to the American Society of Anesthesiologists (ASA) physical status I and II undergoing upper limb orthopedic surgeries were enrolled. Group L (n = 30) received lignocaine 2%, 7.5 mL diluted to total volume of 30 mL using normal saline while Group LD (n = 30) received lignocaine 2%, 7.5 ml with dexmedetomidine 1 μg/kg dilu ted to total volume of 30 mL using normal saline in IVRA. The onset of sensory and motor block, recovery of sensory and motor block, duration of analgesia, hemodynamics, and adverse effects were noted. Results: The mean onset time of sensory block was significantly faster in Group LD (3.50 ± 0.41 min) than Group L (6.67 ± 0.65 min); P < 0.05. Group LD had significantly earlier motor blockade (8.83 ± 0.96 min vs 11.9 ± 0.75 min); P < 0.05. The recovery of sensory block was also significantly prolonged in Group LD (61.64 ± 5.18 min) when compared to Group L (12.76 ± 4.41 min); P < 0.05. The recovery of motor block was significantly prolonged in Group LD (67.40 ± 4.92 min vs 15.25 ± 4.44 min); P < 0.05. The duration of analgesia was significantly prolonged in Group LD (79.22 ± 4.84 min) as compared to Group L (22.07 ± 4.16 min); P < 0.05. No significant hemodynamic changes and side effects were noted; P > 0.05. Conclusion: Dexmedetomidine (1 μg/kg) in IVRA leads to faster onset of sensory and motor block, prolonged duration of analgesia with better hemodynamic stability and minimal side effects.
Keywords	dexmedetomidine ; duration of analgesia ; intravenous regional anesthesia ; lignocaine ; upper limb orthopedic surgery ; Medicine ; R
Subject code	796
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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