Naila Akhtar - Academia.edu (original) (raw)

Papers by Naila Akhtar

Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2006

INTRODUCTION: Laryngoscopy and tracheal intubation produce stress response in the form of tachyca... more INTRODUCTION: Laryngoscopy and tracheal intubation produce stress response in the form of tachycardia, hypertens ion and increased levels of catecholamines.1,2, As the control of blood pressure and heart rate is of utmost importance to prevent the detrimental effects; there is a need for a safe and effective drug to attenuate the cardiovascular response to laryngoscopy and intubation. Nalbuphine and midazolam are inexpensive and most commonly used in our community as a premedicant. Our aim was to compare the effects of nalbuphine and midazolam on haemodymanic responses to endotracheal intubation to help the selection of a better drug in this respect. METHOD: After approval from the hospital committee a study was carried out on ninety adult male patients of ASA I or II status, undergoing general surgery under standard general anaesthesia. After informed consent, three groups of 30 patients each were made by random allocation. On arrival in the theatre, E.C.G monitor, pulse oximeter and Noninvasive blood pressure monitor were applied. After 3 minutes of preoxygenation, all groups were induced with thiopentone 4mg/kg and suxamathonium 1mg/kg. Group I was control in which 3ml of saline was given. Group II received nalbuphine 75ug/kg and Group III received midazolam 30ug/kg before the induction agents. Following intubation, anaesthesia was maintained with O2+N2O+halothane (0.8%). Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded before induction, at laryngoscopy and intubation and after intubation every minute for three minutes. Concluding parameters were analysed statistically by ANOVA. p<0.05 was taken as significant. RESULTS: Demographic data showed similarity in age and weight between groups. Baseline values did not differ significantly between groups. A decrease in HR ,SBP, DBP, MAP was seen in Group II and III but the decrease was more pronounced in Group II.(p<0.05) DISCUSSION: The haemodynamic observations were noteworthy in our study. Significant attenuation of cardiovascular response to laryngoscopy and tracheal intubation was seen with nalbuphine and midazolam as compared to the control group. Analysis of haemodynamic response showed better suppression with nalbuphine than midazolam. The results of our study were consistent with previous study showing reduction in heart rate and systolic arterial pressure with nalbuphine as compared to other drugs.4 CONCLUSION: Our study results suggest that nalbuphine when used as premedicant, in dose of 75ug/kg is more effective than midazolam in blunting the stress response to laryngoscopy and intubation. We recommend its use in our settings before induction of anaesthesia. REFERENCES:

Background: Shivering is a frequently occurring complication of spinal anaesthesia. It is more co... more Background: Shivering is a frequently occurring complication of spinal anaesthesia. It is more common in patients undergoing abdomen surgery, procedures of long duration and extremes of age. It has deleterious consequences on patient recovery unless prophylactic steps are taken to prevent this complication. Aim: To compare the prophylactic use of I/V tramadol with I/V ketamine on thefrequency of intraoperative shivering inspinal anesthesia for patients undergoing caesarean section. Methods: A prospective randomized study was conducted in 400 parturients of ASA I and II status undergoing cesarean section. They were randomly divided into two groups n=200 each. Patients received prophylactic i/v 0.5mg Ketamine (K Group) and 2mg/kg i/v tramadol (T Group). Spinal anaesthesia was administered with injection bupivacaine. After assessment of adequacy of block, frequency of shivering was recorded. Results: In this study of 400 patients, shivering was seen in 111 patients (27.75%). Shivering ...

Anaesthesia, Pain & Intensive Care

Background & Objective: The augmentation of local anesthetics with various adjuvants to enhance t... more Background & Objective: The augmentation of local anesthetics with various adjuvants to enhance the quality and efficacy of subarachnoid block is clinically in practice since long. Comparative studies on effects of adding intrathecal tramadol and buprenorphine has never been studied before. Both drygs are esily available in our country. So, we conducted this study to evaluate and compare the characteristics of subarachnoid blockade, duration of postoperative analgesia, dose of recue analgesic postoperatively, and adverse effects of intrathecal buprenorphine (50 μg) and intrathecal tramadol (30 mg) as adjuvants to 0.5% hyperbaric bupivacaine for lower abdominal surgeries Methodology: This prospective randomized, single blind controlled trial was carried out at Services Hospital Lahore, from January to July 2018. 110 American society of Anesthesiologist I - II male patients, 35 to 45 y of age undergoing subarachnoid block for infra-umbilical surgery were randomized into two groups. Gr...

Pakistan Armed Forces Medical Journal, 2019

Objective: To compare the learning approach of final year and postgraduate students and assess th... more Objective: To compare the learning approach of final year and postgraduate students and assess the influence of gender and to explore with interviews if a change occurred at postgraduate level. Study Design: Concurrent mixed method. Place and Duration of Study: King Edward Medical University, Lahore, from Mar 2018 to Oct 2018. Methodology: Hundred final year MBBS and 100 postgraduate students were included in the study for quantitative analysis. “ASSIST” Questionnaire was used to identify student’s approach to studying as either “deep”, “surface”, “strategic” and also to find the correlation of gender with preference of study approach. Des-criptive statistics were calculated. Student’s t-test was used for statistical comparisons. Qualitative data was collected through in depth semi structured interviews of postgraduate students. Thematic analysis was done to interpret the data and triangulation method was used for validation. Results: The Mean age in undergraduate students was 23.24...

Ilioinguinal and iliohypogastric nerve blocks has been widely used in children undergoing inguina... more Ilioinguinal and iliohypogastric nerve blocks has been widely used in children undergoing inguinal herniorraphy. This technique may provide insufficient intraoperative analgesia as the inguinal region may receive innervation from genitofemoral nerve. We proposed that the addition of genitofemoral nerve block might improve the quality of analgesia. The objective was to find the efficacy of genitofemoral nerve block in addition to ilioinguinal and iliohypogastric nerve block for better intraoperative pain management in children under going inguinal hernia repair under general anaesthesia. After informed consent, 100 children of 1-10 yrs of age and ASA I or II status undergoing inguinal hernia repair were selected and divided in group I and II of 50 patients each. After induction of general anaesthesia, Group I patients received ilioinguinal and iliohypogastric block using bupivacaine 0.375% at a dose of 0.75 mg/kg, where as patients in group II were given genitofemoral in addition to ...

Introduction: Elective surgery is an important part of a hospital’s workload. Whenever a case is ... more Introduction: Elective surgery is an important part of a hospital’s workload. Whenever a case is put on list, it involves interaction of a number of people and in the same way its postponement affects many parties. The purpose of this study was to highlight the causes of such postponements, their impact on the hospital and to devise an approach to avoid preventable causes. Methods: This study was conducted in two operation theatres of Mayo Hospital Lahore over a period of one year i.e. from April 2009 to May 2010. All the patients scheduled to undergo elective surgical procedures in these operation theatres were included. Total number of cases, number of cancellations as well as causes of cancellation were noted. Results: A total of 252 lists were planned in both theaters and 2394 patients were put on list. Among this total number the operations of 179 patients (7.47%) were postponed. The highest proportion of postponements was due to time constraints (35.75%). Other main reasons we...

Background: Commonly used methods of performing peripheral nerve blocks include elicitation of pa... more Background: Commonly used methods of performing peripheral nerve blocks include elicitation of paresthesia and motor response to an electrical stimulus. The objective of this study was to compare the efficacy and reliability of these two methods in performing sciatic nerve block for lower limb surgery in elderly patients. Method: Sixty patients, 60 – 90 years of age were randomly divided into two groups in this observer blinded study. In Group I Sciatic nerve block was established with a nerve locator and in group II paraesthesia elicitation technique was used. 20 ml of 0.5% bupivacine was administered in both groups. Haemodynamic parameters were recorded before and after the sciatic nerve block. We recorded the time of onset and extent of both sensory and motor blocks. The severity of pain was also noted in both groups. Results: Statistically significant differences were seen in depth of sensory and motor blocks and degree of pain between groups (P < 0.05). The time of onset of ...

Aim: To compare the efficacy of crystalloids and colloids in preventing hypotension in spinal ane... more Aim: To compare the efficacy of crystalloids and colloids in preventing hypotension in spinal anesthesia in elective caesarean sections. Study Design: Randomized Control Trials. Setting: Department of Gynae & Obs Lady Willingdon Hospital/K. E. Medical University Lahore Duration of study: Six months Methods: A total of 200 patients were divided into two equal groups, group [RL] receiving 20ml/kg of ringer lactate as crystalloid and group [H] receiving 500 ml of 3% heamaccel as preloading fluid 15 min prior to administration of spinal anesthesia for elective C-section. Results: 200 pregnant females undergoing elective cesarean section under spinal anesthesia were included. The mean age of all the patients was 26.66±3.38years, 145 females were ASA class 1 while 55 females were ASA class 2. Mean drop in blood pressure was from 119.71±6.93mmHg to 87.66±10.19mmHg. BP was dropped from 119.37±7.02mmHg to 87.98±10.73mmHg in crystalloid group and in colloid group; it dropped from 120.04±6.85m...

Esculapio, 2021

Objective: To determine the effect of intravenous xylocaine and magnesium sulfate on attenuation ... more Objective: To determine the effect of intravenous xylocaine and magnesium sulfate on attenuation of hemodynamic response to laryngoscopy and intubation in patients undergoing general anaesthesia. Methods: This was a randomized controlled study carried out at operation theaters of services hospital lahore after obtaining approval from IRB of hospital. The data was collected over period of six month from 20.05.2020 to 20.12.2020 through electronic databases. 60 patients were divided into two groups of 30 each by lottery method in this randomized control trial. Intravenous magnesium sulphate 30 mg/ kg diluted in 50 ml normal saline 15 min before induction was administered in M group and 50 ml normal saline given in L group. Induction was done with propofol 2 mg/ kg, followed by suxamethonium 2 mg/ kg. I/V lignocaine 1.5 mg/kg diluted in N/S (5ml) was given as bolus in L group and 5 ml N/S IV bolus in M group 1 minute before intubation. Laryngoscopy was performed and the trachea was int...

Annals of King Edward Medical University, 2016

Objective: To compare the effects of nalbuphine and midazolam on cardiovascular response to laryn... more Objective: To compare the effects of nalbuphine and midazolam on cardiovascular response to laryngoscopy and intubation -during induction of anaesthesia. Method: Ninety adult male patients of ASA I or II status were included and divided into three equal g roups. Group I was control in which 3ml of saline was given. Group II received nalbuphine 75 ug/kg and Group III received midazolam 30 ug/kg. The cardiovascular response was evaluated at laryngoscopy and every minute after intubation for three minutes.The results were analysed statistically by ANOVA.p<0.05 was taken significant. Results: A decrease in HR, SBP, DBP, MAP was seen after three minutes in Group II and III but the decrease was more pronounced in Group II.(p<0.05) Conclusion: Premedication with nalbuphine 75gg/kg is more effective than midazolam in blunting the haemodynamic response to laryngoscopy and intubation.