rajiv gandhi university karnataka thesis topics

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SYNOPSIS OF DISSERTATION " A COMPARATIVE CLINICAL STUDY OF NITROGLYCERIN AND ESMOLOL FOR CONTROLLED HYPOTENSION IN ENT SURGERIES " Submitted by POST GRADUATE STUDENT IN

Although operative blood loss is dependant primarily upon bleeding from cut vessels, its extent may be influenced in several ways. Bleeding may be arterial, in which case it is related directly to the mean arterial pressure (MAP), capillary, when it is dependent upon local flow in the capillary bed, or venous, when it is related to venous tone. Arterial bleeding can only be abolished by the use of a tourniquet but it can be reduced considerably by a reduction in the MAP.3 Anaesthesia influences intraoperative bleeding in several ways and in the absence of regional blocks for the above surgeries, the role of an anaesthesiologist becomes very important.

Related Papers

The Eurasian Journal of Medicine

B. Yavascaoglu

Brazilian Journal of Otorhinolaryngology

Mehtap Honca

Endodontic Topics

The intra-operative control of pain and hemorrhage represents significant factors that are required for modern, effective, and efficient endodontic surgical procedures. This review focuses on these important issues and emphasizes the level of clinical evidence of various studies reporting on interventions to alter pain or hemorrhage. To accomplish this goal, the review will provide an overview of the fundamental properties of local anesthetics and hemostasis and then build upon this foundation to provide evidence-based recommendations for treatment considerations.

Journal of Applied and Advanced Research

sailesh mukul

Orthognathic surgery may be complicated by difficulty in achieving hemostasis because unlike soft tissue, the vessels traversing bone cannot be identified and isolated before osteotomy. In this study we evaluated the amount of blood loss and duration of surgery under deliberate hypotensive anesthesia in comparison to amount of blood loss and duration of surgery under normotensive anesthesia on patients undergoing orthognathic surgical procedures. A total of 16 cases undergoing orthognathic surgery were included in this clinical study.Patients were randomly grouped under normotensive (group I) or hypotensive group (group 2). Patients in hypotensive anesthesia group were given Esmolol to maintain mean arterial pressure in the range of 70-80 mm of Hg till osteotomy segments were fixed. There was more than 40% reduction in blood loss in orthognathic surgical procedures when induced hypotension was used, but there was not statistically significant (p=0.91) reduction in the operative time...

Reviews in Clinical Medicine

iman kashani

Introduction:Bleeding during ENT surgeries may contribute to impaired view. The less blood in surgical filed, the better quality and more surgeon’s satisfaction is expected. Deliberate hypotension is a technique to achieve this goal. Current study aimed to evaluate effects of Labetalol andNitroglycerinein deliberate hypotension. Methods: It is a double blind RCT,conducted on 68 septo-rhinoplastypatients in ENT ward, Imam Reza Hospital, Mashhad, during 2017 after obtaining written consent. Patients were assigned to receive Nitroglycerine (n=32) or Labetalol (n=36) randomly. Mean arterial pressure and HR monitored. Total blood loss was estimated and recorded at a Boezaart Surgical Field Grading Scale. Surgeon’s satisfaction with surgical field condition was measured after the procedures using a questionnaire at a 5-point Likert scale. Results: Two studied groups were similar in demographic characteristics. Heart rate was lower in Labetalol group (P <0.001) significantly, but there ...

Journal of international oral health : JIOH

ANUPAMA MUDHOL

Oral and maxillofacial surgeons are concern about the intraoperative bleeding because blood supply to face is very generous. Increased blood loss may lead to the need for transfusion of blood and blood products and hence patients are exposed to the risks associated with it. Hence, this study was undertaken to compare whether there is any significant difference in blood loss, surgical field and duration of surgery in patients undergoing maxillofacial surgeries with and without hypotensive anesthesia. The study was conducted on patients undergoing various maxillofacial surgeries. The patients were randomly divided into two groups, the study group and the control group. In the study group patients, induced hypotension was used in order to maintain systolic pressure of 80-90 mm Hg. In the control group patients, normotensive anesthesia was used. Estimation of blood loss (EBS), quality of the surgical field and duration of surgery was calculated for both groups in three types of surgical...

BMC Anesthesiology

Background Deliberate hypotension is used to provide a bloodless field during functional endoscopic sinus surgery; however, the impact of controlled hypotension during anesthesia on peripheral tissue perfusion has not been extensively evaluated. The aim of this study was to compare the impact of nitroglycerin- versus labetalol-induced hypotension on peripheral perfusion. Methods The present randomized, double-blinded, controlled trial included adult patients undergoing endoscopic sinus surgery. Patients were allocated to one of two groups according to the drug received for induction of deliberate hypotension: nitroglycerin (n = 20) or labetalol (n = 20). Mean arterial pressure was maintained at 55–65 mmHg in both groups. Both study groups were compared according to pulse oximeter-derived peripheral perfusion index (primary outcome), serum lactate level, mean arterial pressure, heart rate, surgical field score, and intraoperative blood loss. Results Forty patients were included in th...

IP Innovation Publication Pvt. Ltd

IP Innovative Publication Pvt. Ltd.

Aim: Is to find the effectiveness of dexmedetomidine versus nitroglycerin to provide hemodynamic stability during dental surgeries Methods: Forty ASA I and II patients undergoing dental surgeries were randomly allocated into two groups of 20 each: Nitroglycerine (Group NTG) and Dexmedetomidine (Group DEX). Group NTG received infusion of nitroglycerine at a rate of 1-10 μg/kg/min & group DEX received infusion of dexmedetomidine at a rate of 0.2-0.7 μg/kg/hr after a bolus dose of 1 μg/kg. Results: There was better control of hemodynamic variables during intraoperative period in dexmedetomidine group in comparison to nitroglycerine group. There was significant difference in mean changes of heart rate and blood pressure from baseline value at all points of study between both the groups except just before the intubation when both the groups were comparable. Conclusion: Dexmedetomidine was superior to nitroglycerin for maintenance of hemodynamic variables during dental surgeries.

International journal of oral and maxillofacial surgery

Hiroshi Fukayama

The purpose of this study was to determine the differences in endocrine responses, blood loss and arterial blood gas profiles between patients subjected to hypotensive anaesthesia or normotensive anaesthesia and those between patients given sodium nitroprusside (SNP) or nitroglycerin (NTG) as the hypotensive agent. 36 patients, who were scheduled to undergo mandibular osteotomy, were recruited for the study. Their hormonal responses, metabolic responses, arterial blood gas profiles and blood loss were determined during hypotensive anaesthesia induced by either SNP or NTG and normotensive anaesthesia induced by sevoflurane (SEV). Blood loss was smaller and the duration of surgery was shorter in the SNP and NTG groups than in the SEV group. The plasma levels of adrenocorticotrophic hormone, cortisol, vasopressin, norepinephrine and dopamine increased during surgery in all 3 groups. There were no significant differences in the hormone levels, among the 3 groups, or between the SNP and ...

hesameddin modir

In this blinded clinical trial, we attempted to compare the efficacy and safety of administering tranexamic acid, dexmedetomidine and nitroglycerin in preventing intraoperative bleeding and improving the quality of the surgical field during septorhinoplasty under general anesthesia. A total of 105 patients scheduled for septorhinoplasty were enrolled and randomly assigned into three groups based on the balanced-block randomization method. First group received 1 μg/kg intravenous injection dexmedetomidine, second group received 10 mg/kg intravenous injection tranexamic acid and third group received 0.5 μg/kg nitroglycerin, intravenously. The study sample was composed of 105 participants with the total mean age of 25.85 ± 6.52 years, and 59.05% of participants were female and the mean of body mass index was 24.34 ± 2.57 kg/m2. The results showed that there was no statistically significant difference in terms of arterial oxygen saturation, mean arterial pressure, heart rate, bleeding r...

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