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Indian Journal of Anesthesia and Analgesia

Volume  4, Issue 2, April - June 2017, Pages 369-373
 

Original Article

Effects of Intravenous Dexmedetomidine on Bupivacaine Spinal Anaesthesia: A Placebo Controlled Randomised Trial

Anandlkumar Pande*, Sagar Bandiste**

*Associate Professor, **Assistant Professor, Dept. of Anaesthesia, B.J. Govt. Medical College, Jai Prakash Narayan Road, Near Pune Railway Station, Pune, Maharashtra 411001.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.1

Abstract

Background: Endotracheal intubation using an induction agent is usually facilitated by the use of depolarizingBackground: Endotracheal intubation using an induction agent is usually facilitated by the use of depolarizing neuromuscular blocking agents like succinylcholine however it may be associated with various side effects. Propofol and sevoflurane can be used for endotracheal intubation as both provides adequate intubating conditions but propofol is associated with several adverse effects when used alone. So this study was aimed to compare the intubating conditions, haemodynamic changes and side effects using combination of low dose of propofol and lower concentration of sevoflurane with propofol alone at its usual dose. Material and Methods: The present study was conducted on sixty patients of ASA grade I or II , aged 20-40 years of either sex scheduled for various elective surgeries under general anaesthesia. The patients were randomly allocated into two groups of 30 each: Patients in Group P were induced with 67% N 2O in O2 and propofol 3 mg/ kg given intravenously over 30 seconds while patients in Group PS were induced with sevoflurane 0.5-4% inhaled concentration with 67% N2O in O2 and propofol 1.5mg/kg given intravenously over 15 neuromuscular blocking agents like succinylcholine however it may be associated with various side effects. Propofol and sevoflurane can be used for endotracheal intubation as both provides adequate intubating conditions but propofol is associated with several adverse effects when used alone. So this study was aimed to compare the intubating conditions, haemodynamic changes and side effects using combination of low dose of propofol and lower concentration of sevoflurane with propofol alone at its usual dose.Material and Methods: The present study was conducted on sixty patients of ASA grade I or II , aged 20-40 years of either sex scheduled for various elective surgeries under general anaesthesia. The patients were randomly allocated into two groups of 30 each: Patients in Group P were induced with 67% N2O in O2 and propofol 3 mg/kg given intravenously over 30seconds while patients in Group PS were induced with sevoflurane 0.5-4% inhaled concentration with 67% N2O in O2 and propofol 1.5mg/kg given intravenously over 15 seconds. Endotracheal intubation was attempted at 4 minutes after the start of induction in both the groups.The intubating conditions, hemodynamic parameters (HR,SBP, DBP, MAP) and any side effects were observed and noted.Results: Intubating conditions were found to be significantly better in Group PS, (P<0.001). Intubating conditions were clinically accepted in 90% of patients in group PS compared to 73.3% in group P, which was highly significant, (P = 0.028). In Group P, HR, SBP, DBP and MAP were reduced significantly from their baselinevalues, (P<0.05). No significant difference in side-effects wasnoted between two groups,(P>0.05).Conclusion: The combination of sevoflurane and propofol seems to be a better alternative to propofol alone for endotracheal intubation in terms of better intubating conditions with minimal haemodynamic changes and side effects.


Keywords : Propofol;Sevoflurane; Intubating Conditions; Haemodynamics; Endotracheal Intubation.
Corresponding Author : Anandlkumar Pande, B-402, Felicita, Baener-Pashan link Road, Baner, pune – 411045, Maharashtra