Anesthesia, essays and researches
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Truview(PCD) laryngoscope is specially designed to aid positioning of the endotracheal tube as well as to record entry of the tube into glottis. Aim of the study is to compare the view of glottic opening and ease of intubation between Truview(PCD) laryngoscope and Macintosh laryngoscope in patients undergoing general anesthesia (GA). ⋯ Better visualization with lesser CLG was found with Truview(PCD) laryngoscope but it took longer time for intubation than Macintosh laryngoscope. The hemodynamic response to intubation was significantly less with the use of Truview(PCD) laryngoscope when compared to that of Macintosh laryngoscope.
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Cesarean section (CS) is the one of the most common surgical procedure in women. There is preoperative stress effect before the delivery of the baby as (intubation and skin incision). There is acute postoperative pain, which may be progressed to chronic pain. All these perioperative stress effects need for various approach of treatment, which including systemic and neuraxial analgesia. The different analgesia modalities may affect and impair early interaction between mother and infant. Preemptive intravenous (I.V.) paracetamol (before induction) may reduce stress response before the delivery of the baby, intraoperative opioids and postoperative pain. ⋯ Preemptive paracetamol and immediate postoperative opioid analgesia were more effective than preventive paracetamol.
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Vascular pain is a frequent and hypotension is most important complications of propofol administration. ⋯ Rapid propofol injection induced less vascular pain compared with slow injection, but 10 mg ephedrine was not more effective.
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Laryngoscopy and endotracheal intubation activates the sympathetic nervous system, causing tachycardia and hypertension. Dexmedetomidine has an affinity for alpha2 receptors 8 times greater than that of clonidine. It diminishes norepinephrine release and inhibits sympathetic activity leading to decreased heart rate (HR) and blood pressure. ⋯ It was found that attenuating response to hemodynamic changes were observed with dexmedetomidine and clonidine IV infusion. The early onset of dexmedetomidine makes it a promising choice. Hence premedication with IV infusion of dexmedetomidine can safely be recommended for attenuation of hemodynamic response to endotracheal intubation.
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Various techniques exist for gaseous induction in adults. Vital capacity induction (VCI) is a special technique for gaseous induction of anesthesia. ⋯ VCI provides an induction and recovery comparable to propofol induction.