The clinical study was designed to evaluate and compare single preoperative dose of pregabalin to a placebo regarding hemodynamic responses to laryngoscopy and endotracheal intubation, to assess perioperative fentanyl requirement and any side-effects. It was a randomized, double-blind, placebo-controlled, parallel assignment, efficacy study. The study was done at a tertiary university hospital. This study was a comparison between two groups of 30 adult patients scheduled for elective off pump coronary artery bypass surgery. In the control group, the patients were given placebo capsules, and in the pregabalin group, the patients were given pregabalin 150 mg capsule orally 1 h before surgery. The patients were compared for hemodynamic changes before the start of the surgery, after induction, 1, 3, and 5 min after intubation. Additionally, fentanyl requirement during surgery and the first postoperative day was also compared. The present study shows that a single oral dose of 150 mg pregabalin given 1 h before surgery attenuated the pressor response to tracheal intubation in adults, but the drug did not show any effect on perioperative opioid consumption and was devoid of side-effects in the given dose.
The history of cardiac pacing therapy must be viewed within the broader framework of electro-diagnosis and electro-therapy. Electro-therapy has a simple core concept: the use of an outside source of electricity to stimulate human tissue in various ways to produce a beneficial therapeutic effect. This has shown a prolonged, halting development through the ages, sometimes being looked upon as mysterious magic produced by complex machines. The field of paediatric open heart surgery gave a major impetus to the development of pacemakers since heart block often accompanied impeccably performed intra-cardiac repairs of congenital defects. This review deals various of aspects of pacemaker functioning, indications, contraindications and complications.
Total anomalous pulmonary venous connection becomes a totally different subset when associated with complex congenital anomalies. The combination of two separate life-threatening congenital heart defects complicates the management of these patients. Six patients with total anomalous pulmonary venous connection associated with complex congenital heart disease were studied. There were 2 girls and 4 boys. Three of them were less than 5 kg in weight, and the other 3 were more than 5 kg in weight. Four patients had severe pulmonary arterial hypertension and 2 patients had pulmonary stenosis. Three patients had supracardiac type with a right vertical vein, one had drainage to the right atrium superior vena cava junction, one patient had supra cardiac type but split flow to both the superior vena cava and one patient had cardiac type. Three patients had double outlet right ventricle. Three patients had atrioventricular canal defect and 2 patients had preoperative pulmonary vein obstruction. All patients underwent rerouting of pulmonary veins. Concomitant procedures included intraventricular tunnel repair of ventricular septal defect and infundibular resection in double outlet right ventricle. Atrioventricular canal repair was done for Rastelli type A atrioventricular canal. Superior vena caval plasty, atrioventricular canal repair and pulmonary artery banding were done in unbalanced atrioventricular septal defect and large double outlet right ventricle. Intracardiac repair through transatrial approach was done for tetralogy of Fallot. Right ventricle-pulmonary artery conduit was done for truncus arteriosus. Single ventricle repair was done for corrected transposition of great arteries. There were 2 hospital deaths.
Background: By lowering the oxygen fraction of the reperfusate, the reactive oxygen-derived free radicals can be reduced thus facilitating myocardial recovery during weaning from cardiopulmonary bypass and after surgery. Materials & Methods: Thirty patients undergoing mitral valve replacement were randomly exposed to an oxygen fraction of 0.7 (hyperoxic, n = 15) or 0.5 (normoxic, n = 15) during reperfusion. Hemodynamic variables, number of patients requiring additional inotropes and who developed new arrhythmia, duration of ventilation and intensive care unit stay, arterial blood gas and renal function were measured. Results: The demographic data, duration of cardiopulmonary bypass, aortic cross clamp time, duration of mechanical ventilation, intensive care unit stay, additional inotropes, arrhythmia after reperfusion and renal function were similar in both groups. Arterial blood gas analysis was not significantly different, except for the low oxygen partial pressure in the normoxic group during reperfusion. With regard to hemodynamic variables, mean arterial pressure of the hyperoxic group was higher one hour after the cross clamp release. Hemodynamic variables were comparable in all other time periods. Conclusion: By reducing the oxygen concentration during reperfusion, the clinical outcomes in terms of inotropes usage, new arrhythmia after reperfusion, renal function, duration of ventilation and intensive care unit stay were not significantly altered.
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