European Journal of Molecular & Clinical Medicine

Background: In this study, we wanted to compare hemodynamic changes in patients receiving dexmedetomidine with those of patients receiving placebo.
Materials and methods: This was a hospital based randomized prospective comparative study conducted among 60 patients who presented to the Department of General Anaesthesia in Seth G S Medical College, KEM Hospital Mumbai from 2013 to 2014 after obtaining clearance from Institutional Ethics Committee and written informed consent from the study participants.
Results: The mean pre-operative heart rate in Group D was 79.83 ± 8.92 beats per minute (bpm) and in group C it was 76.97 ± 8.97 bpm and the difference was not statistically significant (p = 0.208). Immediately after turning the patient prone, the mean heart rate in group D was 79.83 ± 6.28 bpm and that in group C was 90. 25 ± 12.32 bpm and the difference was not statistically significant (p value = 0 784). The mean heart rate was significantly lower in group D compared to group C during rest of the intra operative period. At the time of reversal, the mean heart rate was 88.73 ± 6.24 bpm and 94.31 ± 6.21 bpm in group D and group C respectively. There is significant difference in the mean heart rate with p value 0.001. The pre-operative mean SBP in group D was 123.33 ± 14.15 and that in group C was 125.94 ± 11.45; the difference was not statistically significant with p value 0.244. In comparison of diastolic blood pressure (DBP) at various intervals between Group D and Group C, all the p values were statistically significant. Whereas the pre-operative mean DBP was 82.10 ± 2.11 mm of Hg and 82.63 ± 3.86 mm of Hg in Group D and Group C respectively. The difference was not statistically significant (p value 0.513). In Comparison of MAP at various intervals between Group D and Group C, all the p values were statistically significant. Whereas the pre-operative mean arterial pressure (MAP) in group D patients was 95.73 ± 2.60 mm of Hg and that in group C patients was 97 50 ± 6.53 mm of Hg there is no significant difference in mean MAP between two groups p value 0.172.
Conclusion: Dexmedetomidine provides good intra-operative hemodynamic stability in spine surgeries. The incidence of bradycardia and hypotension were less with the dexmedetomidine in prone position.

Aim and objectives: Hypertension and increased heart rate are prevalent during laryngoscopy and tracheal intubation. Acute LV failure, dysrhythmias, IC haemorrhage, pulmonary edoema and myocardial infarction are all possible complications. Patients with hypertension had a heightened pressor response, despite being preoperatively normalized with anti-hypertensive medication. The purpose of this research is to see if melatonin is more effective than a placebo at reducing the Haemodynamic reactions to laryngoscopy and endotracheal intubation. Research into the effects of melatonin on extubation response and intraoperative hemostasis is also a goal.
Materials and Methods: This study took place between June 2020 and May 2022 at Public Sector Tertiary care center and the Government Ear, Nose, and Throat Hospital. There were a total of 60 participants in the study. They split up into pairs. Melatonin 6 mg capsules (Group M) and a placebo (Vitamin D3) were given to Group C, both to be taken 120 minutes before to surgery.
Results: The melatonin group had a considerably lower increase in HR compared to the control group during laryngoscopy and intubation (P0.0029). The melatonin group also had considerably decreased heart rate variability during and after extubation compared to the placebo group. After induction, during laryngoscopy and intubation, and for the first 10 minutes after tracheal intubation, systolic blood pressure was considerably lower in the melatonin group. Systolic blood pressure was considerably lower in the melatonin group after surgery. Compared to the placebo group, the SBP of those receiving melatonin prior to, during, and after extubation dropped dramatically. The melatonin group had lower diastolic blood pressure than the placebo group throughout laryngoscopy and intubation, as well as after 1 minute, 5 minutes, and 10 minutes post-intubation. The intraoperative DBP in the melatonin group was substantially lower. DBP was likewise considerably lower in the melatonin group after extubation. As a result, the melatonin group had considerably lower mean arterial pressure (MAP) during the intraoperative time. There was a huge discrepancy
between the groups during the extubation process and immediately afterward.
Conclusion: The results of the study show that the hemodynamic reactions to laryngoscopy, intubation, and extubation can be reduced by giving the patient 6 milligrammes of exogenous melatonin orally 120 minutes before intubation. In addition, it aids in keeping intraoperative hemodynamics steady.

Background: Many anesthetic pre-medications are used to relieve this stress response. Of these premedications,
midazolam and dexmedetomidine are effectively used as sedatives. The present study was
planned to compare intranasal dexmedetomidine with intranasal midazolam as a pre-anesthetic
medication in children. Many anaesthetic pre-medications are used to relieve this stress response. Of
these pre-medications, midazolam and dexmedetomidine are effectively used as sedatives. The present
study was planned to compare intranasal dexmedetomidine with intranasal midazolam as a pre-anesthetic
medication in children. Fear of unpleasant and painful procedures, separation from parents and
unwillingness to breathe through an anaesthesia face mask may produce stormy anaesthetic induction in
unpremeditated patients. Because of this premedication should be an integral part of paediatric
anaesthetic practice.

Introduction: Spinal anesthesia is the most commonly performed anesthetic technique for
lower limb, abdominal, perineum surgeries. It has been seen that multiple drugs are being
added to the local anesthetics in subarachanoid blockade which results in better
haemodynamic stability, increased duration of surgical analgesia and even provide post
operative analgesia. Here we did a case series of adding intrathecal dexmedetomidine to
hyperbaric bupivacaine in cases which were posted for infraumbilical surgery and lasted for
more than 2 hours. Even two cases lasted for more than 5 hours were done comfortabily with
addition of dexmedetomidine.Dexmedetomidine is a selective alpha 2 adrenoceptor agonist
which can be used in low doses and it prolongs sensory block in a dose dependent manner
without major haemodynamic effects. Patient also had significant post operative analgesia
which reduced the requirement of rescue analgesia and also resulted in early recovery of the
patient.

Background&Method: The study was conducted with an aim to observe Haemodynamic changes
on Intubating the patients using Propofol and Fentanyl without the use of Muscle Relaxants on
50 normotensive patients of either sex between age 20-50 years. ASA grade I/II at Sanjay
Gandhi Medical College, Rewa, M.P.A detailed preanaesthetic assessment was done. Patients
seeming to have factors responsible for difficult intubation, (receding mandible, buck teeth, bull
neck, etc.) or contraindication to use of Propofol or Fentanyl were excluded from the study.
Weight of all patients was noted. Written consent was taken and patients were kept NPO
overnight.
Result:The patient is not totally paralysed, slight vocal cord movement was seen in 43 cases.
Slight diaphragmatic movement like a small hiccup was seen in 20 cases, mild cough was seen in
7 cases, moderate mandibular relaxation was seen in 14 cases. Limb movement was not
obtained in any patient. Therefore movement of vocal cords was the commonest factor which
was seen to lower the score from 8-9 to 6-7 (excellent to good conditions).However, slight
movement of partially abducted vocal cords was enough to allow placement of ETT in first
attempt in 41 cases with acceptable intubating conditions (89%) within 2 minutes of
administration of InjPropofol.
Conclusion: Acceptable intubating conditions were obtained in 92% patients i.e. 46 patients.
One patient had ideal intubating condition (score 9). 15 patients achieved excellent intubating
conditions. In these 15 patients, trachea could be intubated easily with cords showering slight
movement in partial abduction. These patients achieved a score of 8. Good intubating conditions
were obtained in 30 patients with intubating scores between 6-7, slight vocal cord movement of
partially abducted cords with slight diaphragmatic movement on placement of the tube was
observed. We conclude that Inj. Propofol 2.5 mg/kg preceded by Inj. Fentanyl citrate 2 mcg/kg 5
minute earlier provided good intubating conditions without the use of a muscle relaxant.