JPMA. The Journal of the Pakistan Medical Association
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Randomized Controlled Trial Comparative Study Clinical Trial
The effects of suxamethonium and pancuronium on the haemodynamic response to endotracheal intubation.
The pharmacological effects of suxamethonium and pancuronium on the cardiovascular system may vary and therefore alter the haemodynamic response to intubation. The arterial blood pressure, the heart rate and the rate pressure product were measured as parameters of haemodynamic change in forty adult ASA. I and II patients undergoing laryngoscopy and endotracheal intubation in a randomised controlled study. ⋯ Pancuronium, however, caused a significantly higher rise in the heart rate after endotracheal intubation compared to suxamethonium. In both groups the maximum rate pressure product occurred one minute after intubation, rising by 56% in the suxamethonium group and 64% in the pancuronium group compared to control values. In conclusion, there were significant and statistically similar increases in systolic and diastolic blood pressures and rate pressure product following intubation in both groups with values significantly above baseline until three minutes post intubation but the increase in heart rate in group A was significantly less than that in group B.
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Recovery from anaesthesia is a time of potential danger to the surgical patients. A retrospective audit of all recovery room admissions over a period of 18 months was carried out at the Aga Khan University Hospital. During this period 6978 patients were admitted to the recovery area and 695 had one or more complications. ⋯ The breakdown of complications according to different physiological systems is discussed. Several surveys have reviewed complications in the western population, but in contrast, no study is available in Pakistani patients. It is recommended that since one in ten patients is likely to have a problem in the early post-operative period, the local hospitals should provide adequate facilities meeting the criteria laid down for the recovery rooms in modern anaesthetic practice.
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Seventy patients were administered Atracurium, during six months from November, 1986 to April, 1987, for muscle relaxation during minor to major surgery. Age range was between 16-75 years with an average of 45. No premedication was used. ⋯ Major complications were bradycardia, eleven (15.7%) patients and bronchospasm (12.8%) nine patients. Sixty three (90%) had spontaneous recovery. Atracurium was found to be a safe muscle relaxant with an added advantage of elimination by Hoffman's reaction.