Indian journal of anaesthesia
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This study was conducted to determine the influence of colloid infusion on coagulation in patients undergoing off-pump coronary artery bypass grafting (OP-CABG). Thirty patients undergoing elective OP-CABG received medium molecular weight hydroxyethyl starch group I (MMW-HES 200/0.5), low molecular weight hydroxyethyl starch group II (LMW-HES 130/0.4) or gelatin group III (GEL) in a prospective randomized trial. Blood samples were assessed for hemoglobin (Hb), activated coagulation time (ACT), prothrombin time (PT), activated partial thromboplastin time (aPPT), platelet count, fibrinogen and von Willebrand factor (vWF) at specified intervals. ⋯ After the colloid infusion, vWF decreased significantly to 67% from baseline in group I as compared to 85 and 79% in group II and group III, respectively. vWF levels remained lower than the baseline value in the first 24 hours in group I, whereas this factor level increased above the baseline values in groups II and III, 6 hours postoperatively. Postoperative chest tube drainage in 24 hours was significantly higher in group I (856 +/- 131 ml) as compared to group II (550 +/- 124 ml) and group III (582 +/- 159 ml). LMW-HES 130/0.4 was superior to MMW-HES 200/0.5 and gelatin in patients undergoing OP-CABG, in terms of better preservation of coagulation associated with enhanced volume effect.
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A prospective, randomised, double-blind, placebo-controlled study was carried out to determine the effect of nitrous oxide (N(2)O) on the frequency and severity of pain and withdrawal reactions after injection of rocuronium. Eighty ASA physical status I and II patients undergoing general anaesthesia for elective surgery were enrolled. The patients were randomised to receive 100% oxygen (O(2)), or 50% N(2)O in O(2) for 3 minutes followed by a subparalysing dose of rocuronium 0.06 mg/kg. ⋯ Severe pain was reported by one patient in each group (P = 0.47). Withdrawal response after an intubating dose of rocuronium was observed in 6 (15%) and 18 (45%) patients in the N(2)O and O(2) groups, respectively (P < 0.05). Inhalation of 50% N(2)O in O(2) reduces the incidence and severity of pain and the withdrawal reactions associated with rocuronium injection.
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A one-year randomized placebo-controlled trial was conducted to study the effectiveness of intravenous lidocaine in the prevention of post extubation laryngospasm in children, following cleft palate surgeries. Children of age three months to six years were randomly assigned into two groups. Group P placebo (saline) and Group L (Lidocaine), 1.5 mg/kg. ⋯ The total reduction of laryngospasm and coughing was 29.9% and 18.92% with IV lidocaine. Significant alterations in haemodynamics and oxygen saturation were noted for 10 minutes, following extubation. Hence, intravenous lidocaine 1.5 mg/kg was effective in the prevention of post extubation laryngospasm in children undergoing cleft palate surgeries.