The Experts below are selected from a list of 45 Experts worldwide ranked by ideXlab platform
Manoj Panwar - One of the best experts on this subject based on the ideXlab platform.
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dexmedetomidine decreases requirement of thiopentone sodium and pentazocine followed with improved recovery in patients undergoing laparoscopic cholecystectomy
2014Co-Authors: Suchit Khanduja, Anil Ohri, Manoj PanwarAbstract:Background: Pain relief remains the most fundamental and consequential aspect of surgery for patients throughout perioperative period. Dexmedetomidine has created an interest in α2-adrenoceptor agonists in the management of pain and hence the aim of this study was to evaluate the effectiveness of the drug in hilly population of North India. Materials and Methods: Patients, irrespective of gender, were randomly allocated to two groups, control and test, each having 30 patients. Test group received an infusion of dexmedetomidine at a rate of 0.5 μg/kg/h 30 min before induction and 0.6 μg/kg/h after inducing anesthesia. Control patients received a volume-matched infusion of normal saline as placebo. Approximately 2 min before induction, analgesia was provided in the form of pentazocine, 0.5 mg/kg in control and 0.3 mg/kg in the test group. Induction was performed by 2 mg/kg thiopentone sodium supplemented with intravenous boluses of 25 mg thiopentone sodium every 15 s until loss of Eyelid Reflex (determined every 15 s). Induction dose of thiopentone sodium and total pentazocine dose were recorded. Recovery was assessed on the clinical recovery score (CRS) scale. Results: Infusion of dexmedetomidine decreased the induction dose of thiopentone approximately by 33% and of pentazocine dose by approximately 39% in patients undergoing laparoscopic cholecystectomy. Moreover, incidence of pain was also decreased significantly. Improved CRS from 4.33 to 6.87 was noticed immediately post-operatively in dexmedetomidine group of patients. Conclusion: Infusion of dexmedetomidine during the laparoscopic cholecystectomy decreases the requirement of thiopentone sodium and pentazocine and leads to early recovery of patients.
Suchit Khanduja - One of the best experts on this subject based on the ideXlab platform.
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dexmedetomidine decreases requirement of thiopentone sodium and pentazocine followed with improved recovery in patients undergoing laparoscopic cholecystectomy
2014Co-Authors: Suchit Khanduja, Anil Ohri, Manoj PanwarAbstract:Background: Pain relief remains the most fundamental and consequential aspect of surgery for patients throughout perioperative period. Dexmedetomidine has created an interest in α2-adrenoceptor agonists in the management of pain and hence the aim of this study was to evaluate the effectiveness of the drug in hilly population of North India. Materials and Methods: Patients, irrespective of gender, were randomly allocated to two groups, control and test, each having 30 patients. Test group received an infusion of dexmedetomidine at a rate of 0.5 μg/kg/h 30 min before induction and 0.6 μg/kg/h after inducing anesthesia. Control patients received a volume-matched infusion of normal saline as placebo. Approximately 2 min before induction, analgesia was provided in the form of pentazocine, 0.5 mg/kg in control and 0.3 mg/kg in the test group. Induction was performed by 2 mg/kg thiopentone sodium supplemented with intravenous boluses of 25 mg thiopentone sodium every 15 s until loss of Eyelid Reflex (determined every 15 s). Induction dose of thiopentone sodium and total pentazocine dose were recorded. Recovery was assessed on the clinical recovery score (CRS) scale. Results: Infusion of dexmedetomidine decreased the induction dose of thiopentone approximately by 33% and of pentazocine dose by approximately 39% in patients undergoing laparoscopic cholecystectomy. Moreover, incidence of pain was also decreased significantly. Improved CRS from 4.33 to 6.87 was noticed immediately post-operatively in dexmedetomidine group of patients. Conclusion: Infusion of dexmedetomidine during the laparoscopic cholecystectomy decreases the requirement of thiopentone sodium and pentazocine and leads to early recovery of patients.
Paul F White - One of the best experts on this subject based on the ideXlab platform.
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use of mivacurium during laparoscopic surgery effect of reversal drugs on postoperative recovery
1994Co-Authors: Yifeng Ding, Brian Fredman, Paul F WhiteAbstract:The authors studied the influence of mivacurium on the recovery profile following outpatient laparoscopic tubal ligation in 60 healthy nonpregnant women. After administration of midazolam 2 mg intravenously (IV) anesthesia was induced with fentanyl 2 mcg/kg and thiopental 4 mg/kg IV. When the patient became unresponsive (loss of Eyelid Reflex) either succinylcholine 1 mg/kg IV (Group 1) or mivacurium 0.2 mg/kg IV (Groups 2 and 3) was administered to facilitate tracheal intubation. Anesthesia was maintained with isoflurane (0.5%-2% inspired concentration) in combination with 67% N2 in oxygen. Muscle relaxation was maintained in all 3 groups with intermittent bolus doses of mivacurium 2-4 mg IV. In Group 3 residual neuromuscular block was reversed with a combination of neostigmine 2.5 mg and glycopyrrolate 0.5 mg IV at the end of the operation. In the postanesthesia care unit (PACU) patients in Group 3 had a significantly increased incidence of postoperative nausea and vomiting compared to Group 2. The use of succinylcholine (vs mivacurium) was also associated with more frequent postoperative nausea and vomiting. However these emetic sequelae did not delay postoperative recovery times. In addition a comparable number of patients in each treatment group required analgesic medication for postoperative pain. Although patients who received succinylcholine complained of significantly more neck pain during the 24 hour period after discharge nausea vomiting and shoulder pain were similar in all 3 groups during this period. The authors conclude that neostigmine and glycopyrrolate may contribute to the development of postoperative emesis when used for reversal of residual neuromuscular block. The use of mivacurium without reversal drugs was associated with a decreased incidence of nausea and vomiting in the PACU. (authors)
Anil Ohri - One of the best experts on this subject based on the ideXlab platform.
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dexmedetomidine decreases requirement of thiopentone sodium and pentazocine followed with improved recovery in patients undergoing laparoscopic cholecystectomy
2014Co-Authors: Suchit Khanduja, Anil Ohri, Manoj PanwarAbstract:Background: Pain relief remains the most fundamental and consequential aspect of surgery for patients throughout perioperative period. Dexmedetomidine has created an interest in α2-adrenoceptor agonists in the management of pain and hence the aim of this study was to evaluate the effectiveness of the drug in hilly population of North India. Materials and Methods: Patients, irrespective of gender, were randomly allocated to two groups, control and test, each having 30 patients. Test group received an infusion of dexmedetomidine at a rate of 0.5 μg/kg/h 30 min before induction and 0.6 μg/kg/h after inducing anesthesia. Control patients received a volume-matched infusion of normal saline as placebo. Approximately 2 min before induction, analgesia was provided in the form of pentazocine, 0.5 mg/kg in control and 0.3 mg/kg in the test group. Induction was performed by 2 mg/kg thiopentone sodium supplemented with intravenous boluses of 25 mg thiopentone sodium every 15 s until loss of Eyelid Reflex (determined every 15 s). Induction dose of thiopentone sodium and total pentazocine dose were recorded. Recovery was assessed on the clinical recovery score (CRS) scale. Results: Infusion of dexmedetomidine decreased the induction dose of thiopentone approximately by 33% and of pentazocine dose by approximately 39% in patients undergoing laparoscopic cholecystectomy. Moreover, incidence of pain was also decreased significantly. Improved CRS from 4.33 to 6.87 was noticed immediately post-operatively in dexmedetomidine group of patients. Conclusion: Infusion of dexmedetomidine during the laparoscopic cholecystectomy decreases the requirement of thiopentone sodium and pentazocine and leads to early recovery of patients.
Bertoloni William - One of the best experts on this subject based on the ideXlab platform.
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Effect of the genetics and the systems of electric and gaseous insensibilização (CO2) in well-being and quality of swine meat hybrid
2018Co-Authors: Bertoloni WilliamAbstract:Orientador: Nelson Jose BeraquetTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia de AlimentosResumo: Diversas pesquisas tem sido realizadas pela comunidade científica com o objetivo de avaliar o bem-estar de suínos durante o abate, entretanto, a maioria destes estudos não representam as condições de abate e constituição genética dos híbridos suínos produzidos e comercializados no Brasil. O presente estudo teve como objetivo principal, avaliar a influência da constituição genética de três híbridos suínos ( A, B e C) e dois sistemas de insensibilização (elétrico e gasoso) na qualidade da carne e bem-estar animal em condições de abate brasileiras. Um total de 956 suínos provenientes de três genéticas (A, B e C) amplamente comercializadas no Brasil com peso vivo de 100 a 120 kg foi aleatoriamente submetido ao sistema de insensibilização elétrico manual comercializado e produzido pela empresa Karl Schermer (220-230/250 volts, 45-60 HZ e 1,4 ¿1,5A) e ao sistema gasoso, modelo COMBI (90 % de CO2), coletivo do tipo compacto comercializado e produzido pela empresa dinamarquesa BUTINA no mesmo abatedouro. Mensurações de pH, cor (L, a*, b*), reflectância luminosa interna (HGP), perda por gotejamento (Drip Loss), capacidade de retenção de água (CRA), ¿umidade exprimivel¿ (Expressible Moisture), salpicamento muscular, escoriações da pele, contusões musculares, fraturas ósseas, Reflexos palpebral, níveis plasmáticos de creatina fosfoquinase (CPK), lactato, cortisol e presença de gene halotano foram realizadas em uma amostra dos suínos submetidos aos sistemas de insensibilização estudados. Comparando-se os sistemas de insensibilização, o elétrico demonstrou ser mais estressante, pois os submetidos a esse tratamento apresentaram níveis médios superiores de cortisol (12,23 e 18,55 mcg/dl , p= 0,001) e lactato (142,59 e 158,26 mg/dl , p= 0,0001) para os híbridos A e C em comparação ao sistema gasoso (9,22 e 12,57 mcg/dl ) e (118,09 e 109,68 mg/dl ) respectivamente, entretanto maiores níveis de CPK (p= 0,05) foram obtidos nos híbridos C, quando submetidos ao sistema gasoso (CO2). Variações dos indicadores sanguíneos de estresse entre os híbridos estudados também foram encontradas. Utilizando-se o sistema elétrico valores médios superiores de cortisol (18,55 mcg/dl, p= 0,0001) foram encontrados nos híbridos C quando comparados aos híbridos A (12,23 mcg/dl) e B (10,59 mcg/dl), entretanto, quando o sistema gasoso foi utilizado menores índices de cortisol e CPK foram observados nos híbridos A (9,22 mcg/dl e 1571,29 U/L, p= 0,001) comparativamente aos híbridos B (12,11 mcg/dl e 2641,69 U/L) e C (12,57 e 2789,60 U/L). A presença do genótipo (Nn) foi observada somente nos híbridos B onde níveis elevados de cortisol, lactato e CPK também foram encontrados quando estes animais foram submetidos ao sistema gasoso de insensibilização, entretanto, nas mesmas condições os híbridos C apresentaram elevados níveis de cortisol e CPK similares aos encontrados nos híbridos B, porem não se detectou a presença do genótipo (Nn) nestes animais. Diferenças significativas nos valores médios de luminosidade (L) (p= 0,05), valores (b*) (p= 0,0001), pH 24h pm no pernil (sm) (p= 0,05), pH 24 pm na sobrepaleta (sc) (p= 0,001), reflectância interna 1h pm (p= 0,0001) e reflectância interna 24h pm (p= 0,05) foram encontradas quando os sistemas de insensibilização gasoso e elétrico foram comparados. O sistema de insensibilização gasoso (CO2), apresentou ligeira vantagem em relação aos valores de pH 24h pm do pernil (sm) (5,76 ± 0,18) e sobrepaleta (sc) (6,09 ± 0,27) quando comparado ao elétrico (5,71 ± 0,17) e (6,24 ± 0,18) respectivamente, entretanto, nenhuma diferença significativa nos valores de capacidade de retenção de água, perda por exsudação e ¿umidade exprimível¿ foi observada quando os sistemas de insensibilização elétrico e gasoso foram comparados. A constituição genética dos híbridos avaliados influenciou os valores médios de luminosidade superficial (L) (p= 0,0001), valores (b*) (p= 0,05), pH 24h pm do pernil (sm) (p= 0,0001), reflectância interna 1h pm (p= 0,0001) e reflectância interna 24h pm (p= 0,0001) quando o sistema gasoso foi utilizado para todos os híbridos estudados. Em relação ao sistema de insensibilização elétrico a constituição genética dos híbridos influenciou significativamente os valores de pH do pernil (sm) 24h pm (p= 0,05), pH da sobrepaleta (sc) 24h pm (p= 0,05), reflectância luminosa interna 1h pm (p= 0,0001) e reflectância 24h pm (p= 0,0001). As diferenças nos valores de cor (L, a*, b*), ph 24h no pernil (sm) e sobrepaleta (sc), assim como os valores de reflectância luminosa interna obtidas entre os híbridos A, B e C, quando submetidos aos sistemas de insensibilização estudados não foram suficientes para influenciar significativamente os valores de perda por exsudação, capacidade de retenção de água e ¿umidade exprimível¿ entre os mesmos. Suínos submetidos ao sistema gasoso (híbridos A e B) apresentaram elevados valores médios (b*) (7,16 e 7,42, p= 0,0001) quando comparados aos híbridos insensibilizados com o sistema manual elétrico (5,52 e 5,61), respectivamente. Comparando-se os sistemas elétrico e gasoso de insensibilização independentemente da genética suína estudada, o sistema manual elétrico apresentou índices médios de salpicamento significativamente superiores nas regiões do coxão mole (0,477 e 0,26, p= 0,008), paleta / cranial (0,154 e 0,039, p= 0,003), paleta / central (0,261 e 0,052, p= 0,0002), paleta / caudal (0,180 e 0,030, p= 0,002), lombo / central (0,185 e 0,065, p= 0,01), lombo / caudal (0,06 e 0,207, p= 0,01) e lombo / lateral externa (0,061 e 0,013, p= 0,04). Considerando-se a extensão da musculatura atingida pelo salpicamento, comportamento similar ao encontrado nos índices de intensidade foi observado, ou seja, o sistema manual elétrico apresentou salpicamento mais difuso nas regiões do coxão mole (0,461 e 0,279, p= 0,03), paleta / cranial (0,154 e 0,039, p= 0,003), paleta / central (0,231 e 0,039, p= 0,00002) e paleta / caudal (0,185 e 0,026, p= 0,0008) quando comparado ao sistema gasoso coletivo. Pequena influência da genética suína foi observada tanto na intensidade como na área da musculatura atingida pelo salpicamento, quando o mesmo sistema de insensibilização foi utilizado. Maiores índices de escoriações da pele nas regiões da paleta (1,098 e 0,795, p= 0,0000001), corpo (1,04 e 0,948, p= 0,04) e pernil (0,84 e 0,68, p= 0,001) foram obtidos quando o sistema de insensibilização manual elétrico foi utilizado em comparação ao sistema coletivo gasoso. Nenhuma diferença significativa foi obtida quando se considerou a genética como efeito principal para os índices de escoriações da pele dos híbridos A, B e C insensibilizados como o mesmo sistema. Suínos insensibilizados com o sistema manual elétrico apresentaram maiores índices de Reflexo palpebral (11,57%) que os submetidos ao sistema gasoso coletivo (2,86%) de um total de 426 animais avaliados, demonstrando que o sistema manual elétrico foi menos eficaz e proporcionou um nível de narcose inferior ao sistema gasoso durante a sangria. Pequenos índices de fraturas ósseas (< 1%) e contusões musculares (< 2,5%) foram obtidos quando se utilizou ambos os sistemas de insensibilização para todas as genéticas estudadasAbstract: Several researchers have been accomplished by the scientific community with the goal of evaluating the swine welfare during the stunning, however, most of these studies doesn¿t represent the stunning conditions and genetic background of pigs produced and marketed in Brazil. The present study had as main goal, evaluate the influence of genetic background of three swine hybrids (A, B and C) and two stunning systems (Electric and Gaseous) in the meat quality and welfare animal under the Brazilian slaughterhouse conditions . A total of 956 pigs of three genetics (A, B and C) thoroughly marketed in Brazil with live weight from 100 to 120 kg was randomly submitted to the manual electric stunning system marketed and produced by the company Karl Schermer (220-230/250 volts, 45-60 HZ and 1,4 .1,5A) and to the gaseous collective system, model COMBI (90% of CO2), compact type marketed and produced by the company Danish BUTINA in the same slaughterhouse. Mensurations of pH, color (L, a*, b*), light scattering (HGP), drip loss, water holding capacity, expressible moisture, blood splashed, skin damage, muscular bruises, bones fracture, Eyelid Reflex, color and intramuscular fat, plasmatic levels of creatine phospokinase (CPK), lactate, cortisol and presence of gene halothane were accomplished in a sample of the swine submitted to the stunning systems studied. Comparing the stunning systems applied, the electric system demonstrated to be more stressful, therefore the pigs submitted to that treatment presented superior medium levels of cortisol (12,23 and 18,55 mcg/dl, p= 0,001) and lactate (142,59 and 158,26 mg/dl, p= 0,0001) for the hybrids A and C in relation to the gaseous system (9,22 and 12,57 mcg/dl) and (118,09 and 109, 68 mg/dl) respectively, although larger CPK levels (p= 0,05) were obtained when the hybrids C was submitted to the gaseous system. Variations of the blood indicators of stress among the hybrids studied were found. When the electric system was used superiors medium levels of cortisol (18,55 mcg/dl, p= 0,0001) were found in the hybrids C when compared to the hybrids A (12,23 mcg/dl) and B (10,59 mcg/dl), by the other hand, when the gaseous system was used the smallest levels of cortisol and CPK were observed in the hybrids A (9,22 mcg/dl and 1571,29 U/L, p= 0,001) comparatively the genetics B (12,11 mcg/dl and 2641,69 U/L) and C (12,57 mcg/dl and 2789,6 U/L) . The presence of the genotype (Nn) was only observed in the hybrids B where high levels of cortisol, lactate and CPK were also found, when stunned with the gaseous system, however, in the same conditions the hybrids C showed similar levels of cortisol and CPK but absence of the (Nn) genotype. Significant differences in the average brightness values (p= 0,05), (b*) (p= 0,0001), pH 24h pm in the ham (sm) (p= 0,05), pH 24h pm in the shoulder (sc) (p= 0,001), light scattering 1h pm (p= 0,0001) and light scattering 24h pm (p= 0,05) were found when the gaseous and electric systems of stunning were compared. The gaseous stunning system in comparison to the electric showed results slightly superiors, presenting better values of pH 24 in the ham (sm) (5,76 ± 0,18) and (5,71± 0,17) and in the shoulder (sc) (6,09 ± 0,27) and (6,24± 0,18), however any significant difference in the values of water holding capacity, drip loss and expressible moisture was observed when both systems were compared. The genetic constitution of the hybrids influenced the medium values of brightness (L) (p= 0,0001), (b*) (p= 0,05), pH 24h pm of the ham (p= 0,0001), light scattering 1h pm (p= 0,0001) and light scattering 24h pm (p= 0,0001) when the gaseous system was used for all the animals studied. In relation to the electric system of stunning, the genetic constitution influenced the pH values of the ham (sm) 24h pm significantly (p= 0,05), pH of the shoulder (sc) 24h pm (p= 0,05), light scattering 1h pm (p= 0,0001) and light scattering 24h pm (p= 0,0001). The significant differences in pH24 pm values of the ham (sm) and shoulder (sc), light scattering and color (L, a*,b*) among the hybrids submitted to the electric and gaseous systems obtained were not enough to influence the values of water holding capacity, drip loss and expressible moisture. Hybrids stunned with the gaseous system (A and B) showed high levels of (b*) values (7,16 and 7,42, p= 0,0001) when compared with other animals of the same genetic stunned with the electric system(5,52 and 5,61), respectively. Comparing the electric and gaseous systems of stunning independently of the breeds studied, the manual electric system presented blood splashed levels significantly superiors in the areas of the inside round (0,477 and 0,26, p= 0,008), shoulder / cranial (0,154 and 0,039, p= 0,003), shoulder / central (0,261 and 0,052, p= 0,0002), palette / caudal (0,180 and 0,030, p= 0,002), loin / central (0,185 and 0,065, p < 0,01), loin / caudal (0,06 and 0,207, p= 0,01) and loin / lateral external (0,061 and 0,013, p= 0,04). Considering the extension of the musculature damaged by the blood splashed the manual electric system also presented more diffuse blood splashed in the areas of inside round (0,461 and 0,279, p= 0,03), shoulder / cranial (0,154 and 0,039, p= 0,003), shoulder / central (0,231 and 0,039, p= 0,00002) and shoulder / caudal (0,185 and 0,026, p= 0,0008) when compared to the collective gaseous system. Small effect of genetic background was observed in the intensity (x) and extension of muscle damaged (y) by the blood splashed when the hybrids were stunned with the same system. Larger skin damage levels in the areas of the shoulder (1,098 and 0,795, p= 0,0000001), body (1,04 and 0,948, p= 0,04) and ham (0,84 and 0,68 , p= 0,001) were obtained when the electric manual system was used in comparison on the gaseous collective system. No significant difference was obtained when was considered the genetics as main effect for the skin damage levels of the hybrids A, B and C stunned with the same system. Pigs stunned with the manual electric system presented larger Eyelid Reflex levels (11,57%) in comparison the pigs submitted to the collective gaseous system (2,86%), from a total of 426 animal appraised, demonstrating that the manual electric system was less effective and provided a small narcosis level than the gaseous system during the bleeding. Small levels of bone fractures (
