SWARUPA ROYCHOUDHURY - Academia.edu (original) (raw)

Papers by SWARUPA ROYCHOUDHURY

Research paper thumbnail of Comparison of prophylactic dexmedetomidine and ketamine for the control of shivering under spinal anaesthesia

International Journal of Advances in Medicine, Apr 22, 2021

Post-anaesthetic shivering (PAS) is a common complication following general and regional anaesthe... more Post-anaesthetic shivering (PAS) is a common complication following general and regional anaesthesia. Various studies reported the incidence of shivering to be between 5% and 65% in patients recovering from general anaesthesia and 40 and 60% in patients recovering from regional anaesthesia. 1-3 Shivering is an involuntary, repetitive activity of skeletal muscles which occurs as a physiological response to combat hypothermia. Shivering increases oxygen requirement, basal metabolic rate, lactic acidosis and carbon dioxide production. Core body temperature is maintained within very narrow levels by the hypothalamus. This is known as the interthreshold range, sweating and vasodilation at one extreme and vasoconstriction and shivering at the other. Anaesthetic agents inhibit central thermoregulation by interfering with these hypothalamic reflex responses. Both general and regional anaesthesia increase the interthreshold range, though by different mechanisms. Spinal and epidural anaesthetics, like general anaesthetics, ABSTRACT Background: Shivering is a common problem during neuraxial block. Thermoregulatory control gets compromised by neyraxial block and as a result the incidence of shivering can go up to 56.7%. Aim of the current investigation was to evaluate the effectiveness of prophylactic use of intravenous dexmedetomidine and ketamine for the control of shivering and to note any side-effects of the drugs used during subarachnoid block. Methods: This randomised single blind study was conducted in 151 ASA grade I and II patients. SAB was performed with 3.0mL (15 mg) of 0.5% bupivacaine heavy in all patients. Patients were randomly allocated into two groups of 75 and 76each to receive dexmedetomidine (0.5 µg/kg) in group D and ketamine (0.5 mg/kg) in group K respectively. Temperature and hemodynamic parameters were recorded at every 15mins interval. Shivering was graded from 0 to 4 according to Tsai and Chu and if grade 3 shivering occurred, the study was stopped and pethidine 25 mg was given intravenously as rescue drug. Results: 2.67% of patients in group D had shivering whereas 38.16% patients in group K experienced shivering at the 5 th minute after spinal anaesthesia and it was statistically significant. However the difference in the incidence of shivering was not statistically significant between the two groups after the initial 5 minutes till the end of surgery. Conclusions: The prophylactic use of dexmedetomidine reduced incidences of shivering more effectively as compared to prophylactic use of ketamine. None of the drugs caused any untoward side effects.

Research paper thumbnail of Comparison of prophylactic dexmedetomidine and ketamine for the control of shivering under spinal anaesthesia

Post-anaesthetic shivering (PAS) is a common complication following general and regional anaesthe... more Post-anaesthetic shivering (PAS) is a common complication following general and regional anaesthesia. Various studies reported the incidence of shivering to be between 5% and 65% in patients recovering from general anaesthesia and 40 and 60% in patients recovering from regional anaesthesia. Shivering is an involuntary, repetitive activity of skeletal muscles which occurs as a physiological response to combat hypothermia. Shivering increases oxygen requirement, basal metabolic rate, lactic acidosis and carbon dioxide production. Core body temperature is maintained within very narrow levels by the hypothalamus. This is known as the interthreshold range, sweating and vasodilation at one extreme and vasoconstriction and shivering at the other.

Research paper thumbnail of Midline versus paraglossal laryngoscopic approach using the Miller blade in small children: A randomised, controlled, cross-over study

Airway, 2020

Background: Airway management in children is different from that of adults and needs special cons... more Background: Airway management in children is different from that of adults and needs special consideration. Laryngoscopy in children with the Miller straight blade can be performed via midline (MID) or paraglossal (PGL) approach. This study aimed to find out whether there was any advantage of one approach over the other in small children. Patients and Methods: After obtaining parental consent and approval from the Institutional Ethical Committee, this randomised, controlled, cross-over study was conducted in 110 children aged 2–24 months belonging to the American Society of Anesthesiologists Physical Status I or II. Children scheduled for elective surgeries under general anaesthesia were allocated randomly into one of the following two groups: A (PGL/MID) or B (MID/PGL) with 55 patients in each group. Following induction of anaesthesia and neuromuscular blockade, laryngoscopy was performed in a cross-over manner with either the PGL or MID approach first. The tip of the blade was placed at the vallecula. Intubation was performed following the second laryngoscopy. Glottic views with and without optimal external laryngeal manipulation (OELM) and ease of intubation were observed. Data were analysed, and P < 0.05 was considered statistically significant. Results: Both the approaches provided the same view in 81/110 children. In the remainder, a better view was obtained with the MID and PGL approaches in 14/110 and 15/110 children respectively. Laryngoscopy was easy in 93/110 children with both the approaches. OELM was required to improve the laryngoscopic view in 37/110 and 40/110 children with the MID and PGL approaches respectively. Conclusion: Using the Miller blade, both the MID and PGL approaches provided comparable laryngoscopic views and intubating conditions for young children in the age group between 2 and 24 months. When a restricted view is obtained, a change of approach may provide a better view.

Research paper thumbnail of Midline versus paraglossal laryngoscopic approach using the Miller blade in small children: A randomised, controlled, cross-over study

Airway, 2020

Background: Airway management in children is different from that of adults and needs special cons... more Background: Airway management in children is different from that of adults and needs special consideration. Laryngoscopy in children with the Miller straight blade can be performed via midline (MID) or paraglossal (PGL) approach. This study aimed to find out whether there was any advantage of one approach over the other in small children. Patients and Methods: After obtaining parental consent and approval from the Institutional Ethical Committee, this randomised, controlled, cross-over study was conducted in 110 children aged 2–24 months belonging to the American Society of Anesthesiologists Physical Status I or II. Children scheduled for elective surgeries under general anaesthesia were allocated randomly into one of the following two groups: A (PGL/MID) or B (MID/PGL) with 55 patients in each group. Following induction of anaesthesia and neuromuscular blockade, laryngoscopy was performed in a cross-over manner with either the PGL or MID approach first. The tip of the blade was placed at the vallecula. Intubation was performed following the second laryngoscopy. Glottic views with and without optimal external laryngeal manipulation (OELM) and ease of intubation were observed. Data were analysed, and P < 0.05 was considered statistically significant. Results: Both the approaches provided the same view in 81/110 children. In the remainder, a better view was obtained with the MID and PGL approaches in 14/110 and 15/110 children respectively. Laryngoscopy was easy in 93/110 children with both the approaches. OELM was required to improve the laryngoscopic view in 37/110 and 40/110 children with the MID and PGL approaches respectively. Conclusion: Using the Miller blade, both the MID and PGL approaches provided comparable laryngoscopic views and intubating conditions for young children in the age group between 2 and 24 months. When a restricted view is obtained, a change of approach may provide a better view.

Research paper thumbnail of Comparison of prophylactic dexmedetomidine and ketamine for the control of shivering under spinal anaesthesia

International Journal of Advances in Medicine, Apr 22, 2021

Post-anaesthetic shivering (PAS) is a common complication following general and regional anaesthe... more Post-anaesthetic shivering (PAS) is a common complication following general and regional anaesthesia. Various studies reported the incidence of shivering to be between 5% and 65% in patients recovering from general anaesthesia and 40 and 60% in patients recovering from regional anaesthesia. 1-3 Shivering is an involuntary, repetitive activity of skeletal muscles which occurs as a physiological response to combat hypothermia. Shivering increases oxygen requirement, basal metabolic rate, lactic acidosis and carbon dioxide production. Core body temperature is maintained within very narrow levels by the hypothalamus. This is known as the interthreshold range, sweating and vasodilation at one extreme and vasoconstriction and shivering at the other. Anaesthetic agents inhibit central thermoregulation by interfering with these hypothalamic reflex responses. Both general and regional anaesthesia increase the interthreshold range, though by different mechanisms. Spinal and epidural anaesthetics, like general anaesthetics, ABSTRACT Background: Shivering is a common problem during neuraxial block. Thermoregulatory control gets compromised by neyraxial block and as a result the incidence of shivering can go up to 56.7%. Aim of the current investigation was to evaluate the effectiveness of prophylactic use of intravenous dexmedetomidine and ketamine for the control of shivering and to note any side-effects of the drugs used during subarachnoid block. Methods: This randomised single blind study was conducted in 151 ASA grade I and II patients. SAB was performed with 3.0mL (15 mg) of 0.5% bupivacaine heavy in all patients. Patients were randomly allocated into two groups of 75 and 76each to receive dexmedetomidine (0.5 µg/kg) in group D and ketamine (0.5 mg/kg) in group K respectively. Temperature and hemodynamic parameters were recorded at every 15mins interval. Shivering was graded from 0 to 4 according to Tsai and Chu and if grade 3 shivering occurred, the study was stopped and pethidine 25 mg was given intravenously as rescue drug. Results: 2.67% of patients in group D had shivering whereas 38.16% patients in group K experienced shivering at the 5 th minute after spinal anaesthesia and it was statistically significant. However the difference in the incidence of shivering was not statistically significant between the two groups after the initial 5 minutes till the end of surgery. Conclusions: The prophylactic use of dexmedetomidine reduced incidences of shivering more effectively as compared to prophylactic use of ketamine. None of the drugs caused any untoward side effects.

Research paper thumbnail of Comparison of prophylactic dexmedetomidine and ketamine for the control of shivering under spinal anaesthesia

Post-anaesthetic shivering (PAS) is a common complication following general and regional anaesthe... more Post-anaesthetic shivering (PAS) is a common complication following general and regional anaesthesia. Various studies reported the incidence of shivering to be between 5% and 65% in patients recovering from general anaesthesia and 40 and 60% in patients recovering from regional anaesthesia. Shivering is an involuntary, repetitive activity of skeletal muscles which occurs as a physiological response to combat hypothermia. Shivering increases oxygen requirement, basal metabolic rate, lactic acidosis and carbon dioxide production. Core body temperature is maintained within very narrow levels by the hypothalamus. This is known as the interthreshold range, sweating and vasodilation at one extreme and vasoconstriction and shivering at the other.

Research paper thumbnail of Midline versus paraglossal laryngoscopic approach using the Miller blade in small children: A randomised, controlled, cross-over study

Airway, 2020

Background: Airway management in children is different from that of adults and needs special cons... more Background: Airway management in children is different from that of adults and needs special consideration. Laryngoscopy in children with the Miller straight blade can be performed via midline (MID) or paraglossal (PGL) approach. This study aimed to find out whether there was any advantage of one approach over the other in small children. Patients and Methods: After obtaining parental consent and approval from the Institutional Ethical Committee, this randomised, controlled, cross-over study was conducted in 110 children aged 2–24 months belonging to the American Society of Anesthesiologists Physical Status I or II. Children scheduled for elective surgeries under general anaesthesia were allocated randomly into one of the following two groups: A (PGL/MID) or B (MID/PGL) with 55 patients in each group. Following induction of anaesthesia and neuromuscular blockade, laryngoscopy was performed in a cross-over manner with either the PGL or MID approach first. The tip of the blade was placed at the vallecula. Intubation was performed following the second laryngoscopy. Glottic views with and without optimal external laryngeal manipulation (OELM) and ease of intubation were observed. Data were analysed, and P < 0.05 was considered statistically significant. Results: Both the approaches provided the same view in 81/110 children. In the remainder, a better view was obtained with the MID and PGL approaches in 14/110 and 15/110 children respectively. Laryngoscopy was easy in 93/110 children with both the approaches. OELM was required to improve the laryngoscopic view in 37/110 and 40/110 children with the MID and PGL approaches respectively. Conclusion: Using the Miller blade, both the MID and PGL approaches provided comparable laryngoscopic views and intubating conditions for young children in the age group between 2 and 24 months. When a restricted view is obtained, a change of approach may provide a better view.

Research paper thumbnail of Midline versus paraglossal laryngoscopic approach using the Miller blade in small children: A randomised, controlled, cross-over study

Airway, 2020

Background: Airway management in children is different from that of adults and needs special cons... more Background: Airway management in children is different from that of adults and needs special consideration. Laryngoscopy in children with the Miller straight blade can be performed via midline (MID) or paraglossal (PGL) approach. This study aimed to find out whether there was any advantage of one approach over the other in small children. Patients and Methods: After obtaining parental consent and approval from the Institutional Ethical Committee, this randomised, controlled, cross-over study was conducted in 110 children aged 2–24 months belonging to the American Society of Anesthesiologists Physical Status I or II. Children scheduled for elective surgeries under general anaesthesia were allocated randomly into one of the following two groups: A (PGL/MID) or B (MID/PGL) with 55 patients in each group. Following induction of anaesthesia and neuromuscular blockade, laryngoscopy was performed in a cross-over manner with either the PGL or MID approach first. The tip of the blade was placed at the vallecula. Intubation was performed following the second laryngoscopy. Glottic views with and without optimal external laryngeal manipulation (OELM) and ease of intubation were observed. Data were analysed, and P < 0.05 was considered statistically significant. Results: Both the approaches provided the same view in 81/110 children. In the remainder, a better view was obtained with the MID and PGL approaches in 14/110 and 15/110 children respectively. Laryngoscopy was easy in 93/110 children with both the approaches. OELM was required to improve the laryngoscopic view in 37/110 and 40/110 children with the MID and PGL approaches respectively. Conclusion: Using the Miller blade, both the MID and PGL approaches provided comparable laryngoscopic views and intubating conditions for young children in the age group between 2 and 24 months. When a restricted view is obtained, a change of approach may provide a better view.