Sidharth Routray | Utkal University (original) (raw)
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Papers by Sidharth Routray
Innovative Publication, Jun 1, 2016
Ventilator Associated Pneumonia (VAP) refers to a type of pneumonia that occurs more than 48–72 h... more Ventilator Associated Pneumonia (VAP) refers to a type of pneumonia that occurs more than 48–72 hours after endotracheal intubation. Risk factors include prolonged mechanical ventilation, reintubation after extubation. Our aim was to find the incidence of VAP, total days of mechanical ventilation, days of ICU and hospital stay at our institution, proportion of various bacterial pathogens isolated from tracheal aspirate of patients with VAP and their antibiotic sensitivity pattern. Material &Methods: A prospective cohort study was conducted on 100 patients who were admitted to medical intensive care unit of SCB Medical college and on ventilatory support for two or more days and were not suffering from pneumonia prior to putting them on ventilator. Endotracheal aspirates were obtained under strict aseptic precautions using a 22-inch Romson's 12F suction catheter with a mucus extractor. Gram staining and biochemical tests for identification and antimicrobial susceptibility test were performed. The patients were classified into four groups named VAP, NON VAP, SURVIVORS and NON SURVIVORS. All the data collected were compiled and tabulated. Observation: The incidence of VAP in this study was 30%. The association between genders (p value-0.372), age (p value-0.929) and VAP infection was not found to be significant. There was no significant correlation between the primary disease and development of VAP (p value =0.24). Most common organism isolated was P. aeruginosa, (9 isolates) followed by MRSA (7 isolates) and most of them were resistant to commonly used antibiotics. Conclusion: VAP patients have higher mortality rate, longer duration of mechanical ventilation and duration of hospital stay than NON VAP patients. Early diagnosis of VAP and initiation of appropriate antibiotic treatment is vital to prevent the adverse outcomes.
International Journal of Biomedical and Advance Research, 2013
International Journal of Biomedical and Advance Research, 2013
The prevalence of obesity has increased significantly in developing countries like India in last ... more The prevalence of obesity has increased significantly in developing countries like India in last decade. More and more number of obese patients is posted for elective and emergency surgery. Although mild degrees of obesity poses few additional problems during perioperative management, morbid and super morbid obese patients require special consideration, equipment and handling. So proper pre operative assessment and preparation, choice of anaesthetic technique, patient positioning, handling and post operative management is necessary.
Cancer is beginning to outpace cardiovascular disease as the primary cause of death in the world.... more Cancer is beginning to outpace cardiovascular disease as the primary cause of death in the world. The quality and lifespan of patients with malignancies has improved with the newer and advanced chemotherapeutic agents. These patients are often posted for various types of elective and emergency surgeries. The anaesthesiologist faces a challenging task, as these patients have gross physiological derangements due to radiotherapy, toxicity of chemotherapeutic agents and potential drug interactions. Thorough preoperative assessment, optimization of physiological milieu, vigilant intraoperative monitoring, anticipation of potential complications and postoperative pain control plays important role in reducing perioperative mortality and morbidity in these patients.
Introduction: Endotracheal intubation may create a period of hemodynamic instability in normotens... more Introduction: Endotracheal intubation may create a period of hemodynamic instability in normotensive patients but more so in hypertensive patients. Endotracheal intubation produces stimulation of laryngeal and tracheal sensory receptors, resulting in a marked increase in the elaboration of sympathetic amines leading to hypertensive crisis. Objectives: The objective of study is to evaluate and compare the efficacy of fentanyl and fentanyl plus lidocaine in attenuating the stress responses to laryngoscopy and endotracheal intubation in hypertensive patients. Mterial and Methods: We conducted a prospective, randomized, double-blind study in 40 patients with controlled hypertension. All patients were randomly divided into two groups (fentanyl group and fentanyl plus lidocaine group). The fentanyl group received 2 mcg/kg and the fentanyl plus lidocaine group received 1.5mg/kg lidocaine and fentanyl 2mcg/kg, 3 min prior to intubation. Hemodynamic parameters were recorded at baseline, after giving induction agents, and 1, 3 and 5 minutes after endotracheal intubation. Results: There were no significant differences between the two groups regarding hemodynamic parameters like heart rate, systolic blood pressure and diastolic blood pressure before induction, 3 minutes before intubation and 1, 3 and 5 minutes after intubation. Conclusions: Both fentanyl and fentanyl plus lidocaine effectively decreased the stress response to endotracheal intubation.
Background: Percutaneous nephrolithotomy (PCNL) now a days is the treatment of choice for most re... more Background: Percutaneous nephrolithotomy (PCNL) now a days is the treatment of choice for most renal stones .Mostly PCNL is done under general anesthesia. However, it can be done under epidural anaesthesia which can have advantages like faster discharge, reduced cost and recovery time and most important patient satisfaction including postoperative pain relief. Aim: In the present study, we compared safety, efficacy surgical outcomes and complications between percutaneous nephrolithotomy under epidural and general anesthesia. Materials and Method: 60 patients were divided into two groups of 30 each (GA/EA), who were undergone percutaneous nephrolithotomy under epidural and general anaesthesia. Patient's general characteristics, stone features, surgical outcomes, and complications were compared between the two groups. All qualitative data and quantitative data were analyzed by chi square and student's t test respectively. P value <0.05 was considered statistically significant. Result: The two groups were similar in terms of mean age and stone size, number, and type. Furthermore, they did not differ significantly in terms of general characteristics, treatment outcomes or complications excluding postoperative fever. However, mean hospital stay was significantly shorter in the regional anaesthesia group than in the general anaesthesia group (8.2±1.6 days vs. 12.5±2.8) days, respectively, (p=0.0001), Also, the postoperative fever rate was significantly higher in the general anesthesia group (82.5% vs 50%, respectively, p=0.012). The treatment cost was 30$ in GA group and 10 $ in spinal group which was statistically significant. Also analgesia requirement on day 1 was more in GA group than EA group which was statistically significant. Conclusion: Regional epidural anaesthesia is as effective as general anaesthesia during percutaneous nephrolithotomy and is associated with shorter hospital stays, lower rates of postoperative fever, lower analgesic requirement and treatment cost.
Background: A lot of researches have been done to find an ideal adjuvant to ropivacaine in region... more Background: A lot of researches have been done to find an ideal adjuvant to ropivacaine in regional anaesthesia that inhibits intra and post operative pain and prolong the duration of anaesthesia without any side effects. was conducted to evaluate th dexmedetomidine when used as an adjuvant to ropivacaine in epidural anaesthesia in lower limb orthopaedic surgery. Materials and Methods: A prospective randomized stu anaesthesiologists' status I and II, posted for lower limb orthopaedic surgery. All patients were randomly allocated into two groups of 30 each; group I was ropivacaine group (RD). Group I (RC) patients received 16 ml of 0.75% ropivacaine and clonidine 2mcg/kg. Group II (RD) patients received 16 ml of 0.75% ropivacaine and dexmedetomidine 1.5mcg/kg. The onset, extent, duration of sens blocks, and side effects were recorded. earlier onset and longer duration of sensory and motor block. Sedation scores were statistically significant with RD group in comparison to RC group. RD group showed visible superiority over RC group in various post characteristics like the weaning of sensory and motor block, prolonged post Dexmedetomidine was a better alternative orthopaedic lower limb surgeries.
Innovative Publication, Jun 1, 2016
Ventilator Associated Pneumonia (VAP) refers to a type of pneumonia that occurs more than 48–72 h... more Ventilator Associated Pneumonia (VAP) refers to a type of pneumonia that occurs more than 48–72 hours after endotracheal intubation. Risk factors include prolonged mechanical ventilation, reintubation after extubation. Our aim was to find the incidence of VAP, total days of mechanical ventilation, days of ICU and hospital stay at our institution, proportion of various bacterial pathogens isolated from tracheal aspirate of patients with VAP and their antibiotic sensitivity pattern. Material &Methods: A prospective cohort study was conducted on 100 patients who were admitted to medical intensive care unit of SCB Medical college and on ventilatory support for two or more days and were not suffering from pneumonia prior to putting them on ventilator. Endotracheal aspirates were obtained under strict aseptic precautions using a 22-inch Romson's 12F suction catheter with a mucus extractor. Gram staining and biochemical tests for identification and antimicrobial susceptibility test were performed. The patients were classified into four groups named VAP, NON VAP, SURVIVORS and NON SURVIVORS. All the data collected were compiled and tabulated. Observation: The incidence of VAP in this study was 30%. The association between genders (p value-0.372), age (p value-0.929) and VAP infection was not found to be significant. There was no significant correlation between the primary disease and development of VAP (p value =0.24). Most common organism isolated was P. aeruginosa, (9 isolates) followed by MRSA (7 isolates) and most of them were resistant to commonly used antibiotics. Conclusion: VAP patients have higher mortality rate, longer duration of mechanical ventilation and duration of hospital stay than NON VAP patients. Early diagnosis of VAP and initiation of appropriate antibiotic treatment is vital to prevent the adverse outcomes.
International Journal of Biomedical and Advance Research, 2013
International Journal of Biomedical and Advance Research, 2013
The prevalence of obesity has increased significantly in developing countries like India in last ... more The prevalence of obesity has increased significantly in developing countries like India in last decade. More and more number of obese patients is posted for elective and emergency surgery. Although mild degrees of obesity poses few additional problems during perioperative management, morbid and super morbid obese patients require special consideration, equipment and handling. So proper pre operative assessment and preparation, choice of anaesthetic technique, patient positioning, handling and post operative management is necessary.
Cancer is beginning to outpace cardiovascular disease as the primary cause of death in the world.... more Cancer is beginning to outpace cardiovascular disease as the primary cause of death in the world. The quality and lifespan of patients with malignancies has improved with the newer and advanced chemotherapeutic agents. These patients are often posted for various types of elective and emergency surgeries. The anaesthesiologist faces a challenging task, as these patients have gross physiological derangements due to radiotherapy, toxicity of chemotherapeutic agents and potential drug interactions. Thorough preoperative assessment, optimization of physiological milieu, vigilant intraoperative monitoring, anticipation of potential complications and postoperative pain control plays important role in reducing perioperative mortality and morbidity in these patients.
Introduction: Endotracheal intubation may create a period of hemodynamic instability in normotens... more Introduction: Endotracheal intubation may create a period of hemodynamic instability in normotensive patients but more so in hypertensive patients. Endotracheal intubation produces stimulation of laryngeal and tracheal sensory receptors, resulting in a marked increase in the elaboration of sympathetic amines leading to hypertensive crisis. Objectives: The objective of study is to evaluate and compare the efficacy of fentanyl and fentanyl plus lidocaine in attenuating the stress responses to laryngoscopy and endotracheal intubation in hypertensive patients. Mterial and Methods: We conducted a prospective, randomized, double-blind study in 40 patients with controlled hypertension. All patients were randomly divided into two groups (fentanyl group and fentanyl plus lidocaine group). The fentanyl group received 2 mcg/kg and the fentanyl plus lidocaine group received 1.5mg/kg lidocaine and fentanyl 2mcg/kg, 3 min prior to intubation. Hemodynamic parameters were recorded at baseline, after giving induction agents, and 1, 3 and 5 minutes after endotracheal intubation. Results: There were no significant differences between the two groups regarding hemodynamic parameters like heart rate, systolic blood pressure and diastolic blood pressure before induction, 3 minutes before intubation and 1, 3 and 5 minutes after intubation. Conclusions: Both fentanyl and fentanyl plus lidocaine effectively decreased the stress response to endotracheal intubation.
Background: Percutaneous nephrolithotomy (PCNL) now a days is the treatment of choice for most re... more Background: Percutaneous nephrolithotomy (PCNL) now a days is the treatment of choice for most renal stones .Mostly PCNL is done under general anesthesia. However, it can be done under epidural anaesthesia which can have advantages like faster discharge, reduced cost and recovery time and most important patient satisfaction including postoperative pain relief. Aim: In the present study, we compared safety, efficacy surgical outcomes and complications between percutaneous nephrolithotomy under epidural and general anesthesia. Materials and Method: 60 patients were divided into two groups of 30 each (GA/EA), who were undergone percutaneous nephrolithotomy under epidural and general anaesthesia. Patient's general characteristics, stone features, surgical outcomes, and complications were compared between the two groups. All qualitative data and quantitative data were analyzed by chi square and student's t test respectively. P value <0.05 was considered statistically significant. Result: The two groups were similar in terms of mean age and stone size, number, and type. Furthermore, they did not differ significantly in terms of general characteristics, treatment outcomes or complications excluding postoperative fever. However, mean hospital stay was significantly shorter in the regional anaesthesia group than in the general anaesthesia group (8.2±1.6 days vs. 12.5±2.8) days, respectively, (p=0.0001), Also, the postoperative fever rate was significantly higher in the general anesthesia group (82.5% vs 50%, respectively, p=0.012). The treatment cost was 30$ in GA group and 10 $ in spinal group which was statistically significant. Also analgesia requirement on day 1 was more in GA group than EA group which was statistically significant. Conclusion: Regional epidural anaesthesia is as effective as general anaesthesia during percutaneous nephrolithotomy and is associated with shorter hospital stays, lower rates of postoperative fever, lower analgesic requirement and treatment cost.
Background: A lot of researches have been done to find an ideal adjuvant to ropivacaine in region... more Background: A lot of researches have been done to find an ideal adjuvant to ropivacaine in regional anaesthesia that inhibits intra and post operative pain and prolong the duration of anaesthesia without any side effects. was conducted to evaluate th dexmedetomidine when used as an adjuvant to ropivacaine in epidural anaesthesia in lower limb orthopaedic surgery. Materials and Methods: A prospective randomized stu anaesthesiologists' status I and II, posted for lower limb orthopaedic surgery. All patients were randomly allocated into two groups of 30 each; group I was ropivacaine group (RD). Group I (RC) patients received 16 ml of 0.75% ropivacaine and clonidine 2mcg/kg. Group II (RD) patients received 16 ml of 0.75% ropivacaine and dexmedetomidine 1.5mcg/kg. The onset, extent, duration of sens blocks, and side effects were recorded. earlier onset and longer duration of sensory and motor block. Sedation scores were statistically significant with RD group in comparison to RC group. RD group showed visible superiority over RC group in various post characteristics like the weaning of sensory and motor block, prolonged post Dexmedetomidine was a better alternative orthopaedic lower limb surgeries.