Browsing by Author "Sandeep Khuba"

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Comparison of sedative efficacy of epidural bupivacaine 0.5% with lignocaine 2% plus adrenaline by measuring BIS guided propofol requirement in gynaecological surgery
(2012) Ghanshyam Yadav; Chandra Sekhar Pradhan; Surendra Kumar Gupta; Gaurav Jain; Sandeep Khuba; Dinesh Kumar Singh
Objectives: This study was conducted to compare the sedative efficacy of bupivacaine 0.5% with lignocaine 2% plus adrenaline in epidural anaesthesia by using BIS monitor. Study design: A randomized, double blind study. Methodology: Sixty patients, ASA physical status I or II, of age group 20-65 yrs, undergoing elective gynaecological surgery under epidural anaesthesia, were randomly but equally placed into two groups (group-B and group-L). Patients received (2ml/segment) bupivacaine 0.5% or lignocaine 2% with adrenaline in group-B and group-L respectively, to achieve a sensory block up to T8 level. After confirmation of sensory blockade, propofol infusion was started at a rate of 100 μg/kg/min to get a BIS value of ≤ 80 and the time was measured (onset time). Surgery was allowed to start immediately after the onset time. Propofol infusion was titrated to maintain the BIS value at 60-80. Infusion was stopped at the end of surgery. The time taken to reach the BIS of ≥90 was recorded as 'recovery time'. The amount of propofol consumed for onset of sedation and total amount consumed during the surgery were noted and compared. Results: There was no significant difference regarding demographic data and onset time in both groups (P>0.05). Recovery time was significantly prolonged in group-B than group-L 5.57+1.25 min and 4.38+0.94 min respectively (P<0.05). Dose of propofol consumed for onset of sedation was significantly low in group-B than group-L, 17.13+4.22 mg vs. 27.77+8.39 mg respectively (P<0.05). Total amount of propofol consumed was also significantly low in group-B than group-L, 140.33+34.59 vs. 184.80+38.21 respectively (P<0.05). Conclusion: We conclude that epidural block with 0.5% bupivacaine is associated with less propofol consumption as compared with 2% lignocaine with adrenaline to maintain BIS 60-80 and hence is more effective.
Evaluating the role of flupirtine for postcraniotomy pain and compare it with diclofenac sodium: A prospective, randomized, double blind, placebo-controlled study
(2014) Ghanshyam Yadav; Sujali Choupoo; Saurabh K. Das; Susanta K. Das; Shailaja S. Behera; Sandeep Khuba; Lal D. Mishra; Dinesh K. Singh
BACKGROUND:: Patients undergoing craniotomy, experience moderate to severe pain in postoperative period. Flupirtine does not have side effects like sedation and increase postoperative bleeding, so it may be a useful analgesic in neurosurgical patients. We designed this prospective, randomized, double blind, placebo-controlled study to evaluate the role of flupirtine for postcraniotomy pain and compare it with diclofenac sodium. MATERIALS AND METHODS:: A total of 390 adults (18 to 70 y), American Society of Anaesthesiologists I and II, of either sex, undergoing elective craniotomy, were randomly divided into 3 equal groups of 130 each. Group 1 (control) received placebo, group 2 (diclofenac) received tablet diclofenac 50 mg, and group 3 (flupirtine) received capsule flupirtine 100 mg. All medications were given 8 hourly on second postoperative day for 48 hours. Visual Analogue Scale score, level of sedation and incidence of side effects were observed. RESULTS:: Nineteen patients were dropped from the study and therefore subsequent analysis was carried out for 371 patients only. There was significant reduction of Visual Analogue Scale score in flupirtine and diclofenac group when compared to control (P<0.0001). Pain relief observed in control, flupirtine, and diclofenac group was 69.8%, 90.2%, and 90.5%, respectively. Need of rescue analgesia was significantly less in flupirtine and diclofenac group as compared to control (P<0.0001). No significant difference was observed among the groups in regards to adverse effects. CONCLUSION:: We conclude that oral flupirtine 100 mg is safe and as effective as oral diclofenac sodium 50 mg in reducing postcraniotomy pain. © 2013 by Lippincott Williams and Wilkins.
Evaluation of the efficacy of methylprednisolone, etoricoxib and a combination of the two substances to attenuate postoperative pain and PONV in patients undergoing laparoscopic cholecystectomy: A prospective, randomized, placebo-controlled trial
(Korean Pain Society, 2014) Sujeet Gautam; Amita Agarwal; Pravin Kumar Das; Anil Agarwal; Sanjay Kumar; Sandeep Khuba
Background: Establishment of laparoscopic cholecystectomy as an outpatient procedure has accentuated the clinical importance of reducing early postoperative pain, as well as postoperative nausea and vomiting (PONV). We therefore planned to evaluate the role of a multimodal approach in attenuating these problems. Methods: One hundred and twenty adult patients of ASA physical status I and II and undergoing elective laparoscopic cholecystectomy were included in this prospective, randomized, placebo-controlled study. Patients were divided into four groups of 30 each to receive methylprednisolone 125 mg intravenously or etoricoxib 120 mg orally or a combination of methylprednisolone 125 mg intravenously and etoricoxib 120 mg orally or a placebo 1 hr prior to surgery. Patients were observed for postoperative pain, fentanyl consumption, PONV, fatigue and sedation, and respiratory depression. Results were analyzed by the ANOVA, a Chi square test, the Mann Whitney U test and by Fisher's exact test. P values of less than 0.05 were considered to be significant. Results: Postoperative pain and fentanyl consumption were significantly reduced by methylprednisolone, etoricoxib and their combination when compared with placebo (P<0.05). The methylprednisolone + etoricoxib combination caused a significant reduction in postoperative pain and fentanyl consumption as compared to methylprednisolone or etoricoxib alone (P<0.05); however, there was no significant difference between the methylprednisolone and etoricoxib groups (P>0.05). The methylprednisolone and methylprednisolone + etoricoxib combination significantly reduced the incidence and severity of PONV and fatigue as well as the total number of patients requiring an antiemetic treatment compared to the placebo and etoricoxib (P>0.05). Conclusions: A preoperative single-dose administration of a combination of methylprednisolone and etoricoxib reduces postoperative pain along with fentanyl consumption, PONV, antiemetic requirements and fatigue more effectively than methylprednisolone or etoricoxib alone or a placebo. © The Korean Pain Society, 2014.
Pain management
(Springer India, 2016) V. Rastogi; Sandeep Khuba; Anand Vishal
[No abstract available]
Syringe swap and similar looking drug containers: A matter of serious concern
(2013) Ghanshyam Yadav; Surender Kumar Gupta; Alok Kumar Bharti; Sandeep Khuba; Gaurav Jain; Dinesh Kumar Singh
Medication error is a leading cause of morbidity and mortality in anesthesia and critical care unit. We present a case report of a 25 years old female patient, scheduled for emergency lower segment caesarean section (LSCS) under spinal anesthesia. Due to a syringe swap, inj. thiopentone sodium was injected inadvertently, instead of inj. ceftazidime. We had to administer general anesthesia to ventilate the patient, the patient which was otherwise unnecessary in this case. Patient was successfully extubated and shifted to postoperative anesthesia recovery room. We present a second case report of a 45 years old male patient with chronic obstructive pulmonary disease (COPD) admitted in Intensive Care Unit (ICU). This patient inadvertently received atropine instead of metronidazole and was successfully managed. These incidents highlight the importance of proper drug location, double checking of the drugs, and proper anesthesia resident education.