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Hemodynamic Responses at Intubation, Change of Position, and Skin Incision: A Comparison of Multimodal Analgesia with Conventional Analgesic Regime
BACKGROUND: Lumbar spine surgery is associated with hemodynamic variations at intubation, change of position, and skin incision. A balanced anesthesia with multimodal analgesia (MMA) is necessary to attenuate these changes. AIM: To assess the relative effectiveness of preemptive MMA compared with th...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2017
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490111/ https://www.ncbi.nlm.nih.gov/pubmed/28663613 http://dx.doi.org/10.4103/0259-1162.194556 |
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author | Savitha, Keelara Shivalingaiah Dhanpal, Radhika Vikram, M. S. |
author_facet | Savitha, Keelara Shivalingaiah Dhanpal, Radhika Vikram, M. S. |
author_sort | Savitha, Keelara Shivalingaiah |
collection | PubMed |
description | BACKGROUND: Lumbar spine surgery is associated with hemodynamic variations at intubation, change of position, and skin incision. A balanced anesthesia with multimodal analgesia (MMA) is necessary to attenuate these changes. AIM: To assess the relative effectiveness of preemptive MMA compared with the conventional analgesic regime in suppressing the hemodynamic response to endotracheal intubation, prone positioning, and skin incision. SETTINGS AND DESIGN: A randomized, prospective study involving 42 patients belonging to the American Society of Anesthesiologists Physical Status 1 and II scheduled to undergo elective lumbar spine surgery were allocated into two groups of 21 each. MATERIALS AND METHODS: Forty-two patients were randomly allocated into Groups A and B. Group A (study group) received diclofenac, paracetamol, clonidine, and bupivacaine with adrenaline skin infiltration and Group B (control group) injection paracetamol and saline with adrenaline skin infiltration. STATISTICAL ANALYSIS USED: Hemodynamic parameters (heart rate [HR], systolic blood pressure [SBP], diastolic blood pressure [DBP], and mean arterial pressure [MAP]) between the groups following intubation, prone position, and skin incision were noted and compared using repeated measure analysis of variance. One sample t-test was used to compare the standard mean concentration with the means of the study and control groups. P < 5% being considered statistically significant. RESULTS: In the study group, HR, SBP, DBP, and MAP were lower at intubation and change of position as compared to the control group and were statistically significant. CONCLUSION: Preemptive MMA with balanced anesthesia is effective in attenuating the hemodynamic responses to multiple noxious stimuli during lumbar spine surgery. |
format | Online Article Text |
id | pubmed-5490111 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-54901112017-06-29 Hemodynamic Responses at Intubation, Change of Position, and Skin Incision: A Comparison of Multimodal Analgesia with Conventional Analgesic Regime Savitha, Keelara Shivalingaiah Dhanpal, Radhika Vikram, M. S. Anesth Essays Res Original Article BACKGROUND: Lumbar spine surgery is associated with hemodynamic variations at intubation, change of position, and skin incision. A balanced anesthesia with multimodal analgesia (MMA) is necessary to attenuate these changes. AIM: To assess the relative effectiveness of preemptive MMA compared with the conventional analgesic regime in suppressing the hemodynamic response to endotracheal intubation, prone positioning, and skin incision. SETTINGS AND DESIGN: A randomized, prospective study involving 42 patients belonging to the American Society of Anesthesiologists Physical Status 1 and II scheduled to undergo elective lumbar spine surgery were allocated into two groups of 21 each. MATERIALS AND METHODS: Forty-two patients were randomly allocated into Groups A and B. Group A (study group) received diclofenac, paracetamol, clonidine, and bupivacaine with adrenaline skin infiltration and Group B (control group) injection paracetamol and saline with adrenaline skin infiltration. STATISTICAL ANALYSIS USED: Hemodynamic parameters (heart rate [HR], systolic blood pressure [SBP], diastolic blood pressure [DBP], and mean arterial pressure [MAP]) between the groups following intubation, prone position, and skin incision were noted and compared using repeated measure analysis of variance. One sample t-test was used to compare the standard mean concentration with the means of the study and control groups. P < 5% being considered statistically significant. RESULTS: In the study group, HR, SBP, DBP, and MAP were lower at intubation and change of position as compared to the control group and were statistically significant. CONCLUSION: Preemptive MMA with balanced anesthesia is effective in attenuating the hemodynamic responses to multiple noxious stimuli during lumbar spine surgery. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5490111/ /pubmed/28663613 http://dx.doi.org/10.4103/0259-1162.194556 Text en Copyright: © 2017 Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Savitha, Keelara Shivalingaiah Dhanpal, Radhika Vikram, M. S. Hemodynamic Responses at Intubation, Change of Position, and Skin Incision: A Comparison of Multimodal Analgesia with Conventional Analgesic Regime |
title | Hemodynamic Responses at Intubation, Change of Position, and Skin Incision: A Comparison of Multimodal Analgesia with Conventional Analgesic Regime |
title_full | Hemodynamic Responses at Intubation, Change of Position, and Skin Incision: A Comparison of Multimodal Analgesia with Conventional Analgesic Regime |
title_fullStr | Hemodynamic Responses at Intubation, Change of Position, and Skin Incision: A Comparison of Multimodal Analgesia with Conventional Analgesic Regime |
title_full_unstemmed | Hemodynamic Responses at Intubation, Change of Position, and Skin Incision: A Comparison of Multimodal Analgesia with Conventional Analgesic Regime |
title_short | Hemodynamic Responses at Intubation, Change of Position, and Skin Incision: A Comparison of Multimodal Analgesia with Conventional Analgesic Regime |
title_sort | hemodynamic responses at intubation, change of position, and skin incision: a comparison of multimodal analgesia with conventional analgesic regime |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490111/ https://www.ncbi.nlm.nih.gov/pubmed/28663613 http://dx.doi.org/10.4103/0259-1162.194556 |
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