Hagen Herndon (detailquill9)

In laparoscopic cholecystectomy, pneumoperitoneum results in tachycardia, hypertension, and increased myocardial oxygen demand. These changes are more pronounced in hypertensive patients. ASN-002 concentration The intravenous administration of dexmedetomidine attenuates sympathoadrenal response and provides better hemodynamic stability intraoperatively. To evaluate the hemodynamic stabilizing and sedation properties of two different doses of dexmedetomidine including 0.7 μg.kg .h and 0.5 μg.kg .h in hypertensive patients undergoing laparoscopic cholecystectomy. This was a randomized, prospective, double-blind controlled trial. A total of 60 controlled hypertensive patients of either sex, aged 30-60 years, and ASA class 2 without any other serious comorbid conditions who were undergoing laparoscopic cholecystectomy under general anesthesia were randomly assigned into three groups of 20 each. Group A and B received loading dose of dexmedetomidine 1 μg.kg over 10 min and maintenance dose at 0.7 and 0.5 μg.kg .h , respectively. Group C received normal saline infusion only. Hemodynamic parameters (heart rate and systolic, diastolic, and mean arterial pressure) and sedation score were compared at different time intervals among groups. The Chi-square test, ANOVA, and Tukey Test. Fluctuations in the hemodynamics of hypertensive patients are effectively attenuated by dexmedetomidine and there is no difference in the attenuation of these hemodynamic changes by maintenance dose of 0.5 or 0.7 μg.kg .h . However, maintenance dose of 0.5 μg.kg .h causes lesser sedation. Dexmedetomidine administered as infusion in a maintenance dose of 0.5 μg.kg .h serves as an ideal anesthetic adjuvant in hypertensive patients undergoing laparoscopic cholecystectomy. Dexmedetomidine administered as infusion in a maintenance dose of 0.5 μg.kg-1.h-1 serves as an ideal anesthetic adjuvant in hypertensive patients undergoing laparoscopic cholecystectomy. Although the conventional awake fiber-optic nasal intubation is most commonly used in anticipated difficult tracheal intubation, it has several potential difficulties. The aim of this study is to compare another technique modified tube first (MTF) technique with the conventional one in terms of time taken, ease of glottis visualization, number of attempts needed, and complications. This was a prospective, randomized, open-label trial conducted on 60 patients with an anticipated difficult airway undergoing oromaxillofacial surgery at a tertiary care center. The patients were randomized into the MTF and conventional technique groups. Times from insertion of the fiber-optic scope into nares till vocal cord visualization (T1) and from T1 to complete intubation (T2) were measured and compared. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software version 21. Time taken to visualize glottis was significantly less in the MTF technique as compared to the conventional method (mean ± standard deviation = 108.6 ± 43.1 vs. 142 ± 49.2 s, respectively, = 0.007). Similarly, the total time taken for nasotracheal intubation with modified technique is significantly less as compared to the conventional technique ( = 0.004). Furthermore, there is significantly better ease of glottis visualization ( = 0.001), higher success in minimal attempts ( = 0.02) with significantly lesser incidence of desaturation in MTF technique ( = 0.026). The alternative technique (MTF) is a quicker, easier approach with higher success rate and lesser complications for the placement of an endotracheal tube in a difficult airway scenario. The alternative technique (MTF) is a quicker, easier approach with higher success rate and le