Background: Postoperative shivering (POS) is one of the common problems following general anesthesia and with different unpleasant and stressful consequences for patients. Hence, its proper management is necessary for both prevention and treatment. Objectives: The aim of this study was to find out the prophylactic effect of intravenous dexamethasone in preventing postoperative shivering after general anesthesia. Materials and methods: Patients aged from 20 to 50 years were taken for study whohas been scheduled for elective surgery under general anesthesia and they were randomized into two equal groups. Group I (Dexamethasone group) received intravenous dexamethasone and group II received intravenous saline (Placebo group). Shivering was determined postoperatively and analyzed statistically. Results: Patients who had received intravenous dexamethasone, experienced a significantly lower incidence of postoperative shivering compared to placebo group (15% versus 55%, p<0.05). Conclusions: The result of this study showed that intravenous dexamethasone can reduce postoperative shivering which was significant statistically.

Background and Aims: We conducted a prospective, randomized, double-blind and controlled trial to compare the effects of oral clonidine and gabapentin as premedication in obtunding hemodynamic response to laryngoscopy and intubation in normotensive patients undergoing elective surgery. We also compared the preoperative anxiety and sedation status between these two drugs.Materials and Methods: A total of 60 patients of American Society of Anesthesiologists (ASA) physical status I, aged 20 -50 years of either sex enrolled in the study were randomly divided into two groups of 30 each. Group A patients received oral clonidine 200 mcg and Group B patients received oral gabapentin 900 mg, 90 minutes prior to induction of anesthesia. The heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were observed and recorded pre and post endotracheal intubation. Anxiety and sedation score were noted after 60 minutes of oral administration of drug as well as before induction of anesthesia.Results: Both groups were matched for age, sex, weight and intubation time. Anxiety score and sedation score before induction were significantly better in clonidine group as compared with gabapentin group. Also oral clonidine attenuated the increase in heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure better than oral gabapentin (p<0.05).Conclusion: Oral clonidine provided good attenuation of hemodynamic response to laryngoscopy and intubation as compared with oral gabapentin. Also clonidine is better agent as anxiolytic and sedative than gabapentin.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 131-136

Background: Postoperative sore throat (POST) though a minor sequel after general anaesthesia with endotracheal intubation, it can be distressing to the patient.Objective: The effectiveness of lubricating endotracheal tube with 0.05% betamethasone gel or intravenous dexamethasone in reducing the postoperative sore throat was compared.Materials and method: This was a prospective study carried out among ninety ASA I and II informed consenting patients aged 20-50 years undergoing elective surgery under general anaesthesia with endotracheal intubation. The patients were randomly divided into three groups with thirty subjects in each group. Betamethasone gel (0.05%) was applied over endotracheal tube over 15 cm mark from the tip in group I, intravenous dexamethasone was given in group II and group III was taken as control. In post-anaesthesia care unit, an anesthesiologist interviewed all patients on postoperative sore throat at 1 hour, 6 hours and 24 hours after operation.Results: At 24 hours following extubation, there was statistically significant lower incidence of post-operative sore throat (POST) in betamethasone group compared to other two groups (betamethasone group 3.33%, dexamethasone group 20% and control group 26.66%, p<0.05). When the groups were compared in pairs at 24 hours, there was statistically significant difference in the incidence of POST between betamethasone group and dexamethasone group and also betamethasone group and control group with lower incidence of POST in betamethasone group, p<0.05. It was also observed that there was no significant difference of POST between dexamethasone and control group at 1 hour, 6 hours or 24 hours, p>0.05.Conclusion: It can be concluded that the use of 0.05% betamethasone gel to lubricate widely the endotracheal tube prior to intubation effectively reduces postoperative sore throat, compared to intravenous dexamethasone administration.Delta Med Col J. Jan 2018 6(2): 73-77

Post-operative airway symptoms specially postoperative sore throat (POST) can be troublesome to patients following an uneventful general anesthesia with endotracheal intubation. Ninety ASA I and II informed consenting patients aged 20-50 years were recruited and randomly allocated into three groups of 30 each. The outer surface of the tracheal tubes used in intubating patients were lubricated with 0.05% betamethasone gel for group B, 2% lignocaine jelly for group L from the distal tip of the tube to the 15 cm mark and group C without lubrication. The incidence and severity of sore throat was then assessed at 1 hour, 6 hours and 24 hours during postoperative period. At 24 hours following extubation, there was a statistically significant lower incidence of POST in group B compared to other two groups. (group B= 6.66% vs group L= 33.33% vs group C= 40%, p<0.05). When the groups were compared in pairs, there was a statistically significant difference of POST between groups B and L also groups B and C with lower incidence of POST in group B at 24 hours, p<0.05. Significant difference in incidence of POST was, however, not found when group C was compared with group L separately, at different time of interval, p>0.05. It could be concluded that 0.05% betamethasone gel applied widely over endotracheal tube effectively reduces postoperative sore throat in comparison with 2% lignocaine jelly application.

Succinylcholine, a depolarizing muscle relaxant possesses a unique property of rapid onset and short duration of action, but is accompanied by side effects such as fasciculation and myalgia. The aim of this study was to investigate the prophylactic effect of intravenous lignocaine on the incidence and severity of succinylcholine-induced postoperative myalgia. This was a randomized controlled double blind study conducted at National Institute of ENT Dhaka, during September to December 2017. Eighty adult patients of American Society of Anesthesiologists status I and II of both sexes for elective surgery under general anesthesia were randomly allocated into two equal groups, lignocaine group and normal saline group. The patients of lignocaine group were pretreated with lignocaine 1.5 mg/kg body weight in 5 ml volume, while patients of normal saline group were given isotonic saline 0.9% in the same volume (5 ml) intravenously. Thereafter, anesthesia was induced in all patients, by injecting 1.5 mg/kg of fentanyl and 2 mg/kg of propofol intravenously. Following the loss of eyelid reflex, 1.5 mg/kg of succinylcholine was injected intravenously as a muscle relaxant and then the patients were intubated. The incidence and severity of myalgia were assessed by a blinded observer 24 hours after surgery. In terms of demographic data, the results of this study showed that there is no significant difference between patients in both groups (P>0.05). Overall, the incidence and severity of succinylcholine-induced myalgia in lignocaine group was significantly less, when compared with normal saline group (P<0.05). Pretreatment with intravenous lignocaine is effective in prevention of postoperative succinylcholine induced myalgia. Faridpur Med. Coll. J. Jan 2019;14(1): 13-15