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Anicase Study

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  A COMPARISON BETWEEN KETAMINE,CLONIDINE AND COMBINATION OF KETAMINE-CLONIDINE FOR THE PREVENTION OF POSTANAESTHETIC SHIVERING : AIMS AND OBJECTIVES To compare the efficacy of single dose intravenous ketamine (0.5mg/kg) and intravenous clonidine (1.5 mcg/kg) and combination of intravenous ketamine(0.25mg/kg) plus clonidine(0.75mcg/kg) in the prevention of shivering following general anaesthesia. Each of these parameters are being measured for Intra-operative periods   Prior Induction (Pre –  Operative) Immediately after intubation After 5 Mins After 10 Mins After 15 Mins After 30 Mins After 40 Mins After 50 Mins After 60 Mins End of Surgery Analysis    Heart Rate (HR)    Systolic Blood Pressure(SBP)    Diastolic Blood Pressure(DBP)    Mean Arterial Pressure(MAP) = DBP+1/3(SBP-DBP)    Peripheral oxygen saturation (SPO 2 )    Capnography (ETCO 2 ) Need to compare their variation across groups and from baseline separately for each group. Adverse events are also to be compared across groups. They are   Tachycardia happens when intra-operative Heart Rate rises above 100 Bradycardia happens when intra-operative Heart Rate falls below 60Hypertension happens when the Intra-operative MAP rises 20% or more from Baseline level Hypotension happens when the Intra-operative MAP falls 20% or more from Baseline level (Pre-operative) Nausea and Vomiting (N_V)   Also check the impact on Shivering and Sedation Score. a.   Need to compare Heart rate, Systolic blood pressure, diastolic blood pressure, mean arterial pressure, peripheral oxygen saturation variation across groups. ANS: Oneway anova was used to compare the variation of heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, peripheral oxygen saturation across groups. From the analysis, heartrate after 5, 10, 15, 30, 40, 50, 60, HR_EOS, HR_IND have significant variance across the groups. Therefore,the medicines which are given across the group has a significant effect on the heart rate of the patient. From the above analysis, diastolic blood pressure after 5, 10, 15, 30, 40, 50, 60, DBP_EOS, DBP_IND have significant variance across the groups. Therefore,the medicines which are given across the group has a significant effect on the heart rate of the patient. Again from the analysis, mean arterial pressure(MAP) after 5, 10, 15, 30, 40, 50, 60, MAP_EOS, MAP_IND have significant variance across the groups. Therefore,the medicines which are given across the group has a significant effect on the heart rate of the patient. Again from the analysis, SPO2(peripheral oxygen saturation) after 5, 10, 15, 30, 40, 50, 60 , SPO2_EOS, SPO2_IND don’t have significant variance across the groups. Therefore,the medicines which are given across the group has no significant effect on the heart rate of the patient.  Again from the analysis, we can see that ETCO2, after 5, 10, 15, 30, 40, 50, 60 , ETCO2_EOS, ETCO2_IND don’t have significant variance across the groups. Therefore,the medicines which are given across the group has no significant effect on the heart rate of the patient. b.   To compare the variation of HEART RATE, systolic pressure, diastolic pressure, mean arterial pressure, peripheral oxygen saturation with their baseline separately from each group. From the paired sample test, we have found that : SBP_IND-SBP_PREOP, SBP_5-SBP_PREOP. SBP_10-SBP_PREOP, SBP_15-SBP_PREOP, SBP_30-SBP_PREOP, SBP_40-SBP_PREOP, SBP_60-SBP_PREOP,DBP_EOS-DBP_PREOP,MAP_30-MAP_PREOP, MAP_EOS-MAP_PREOP have significant variation with their baseline separately from each group. HR_5-HR_PREOP, HR_10-HR_PREOP, HR_15-HR_PREOP, HR_30-HR_PREOP, HR_40-HR_PREOP, HR_50_HR_PREOP, HR_60_HR_PREOP, HR_EOS-HR_PREOP,SBP_50-SBP_PREOP,DBP_5-DBP_PREOP, DB_10-DBP_PREOP, DBP_15-DBP_PREOP, DBP30-DBP_PREOP, DBP_40-DBP_PREOP, DBP_50-DBP_PREOP,DBP_60-DBP_PREOP, MAP_5-MAP_PREOP,MAP_10-MAP_PREOP,MAP_15-MAP_PREOP,MAP_40-MAP_PREOP, MAP_50-MAP_PREOP,MAP_60_MAP_PREOP have insignificant variation with their  baseline separately from each group. 2. Comparison of adverse events across group. a.TACHYCARDIA AND BRADYCARDIA. Case Processing Summary  Cases Valid Missing Total N Percent N Percent N Percent GR * HEARTDESEASE 56 46.7% 64 53.3% 120 100.0%   GR * HEARTDESEASE Crosstabulation  Count HEARTDESEASE Total 1.00 2.00 GR 1 16 1 17 2 2 15 17 3 4 4 8 4 9 5 14 Total 31 25 56 Chi-Square Tests Value df Asymp. Sig. (2-sided) Pearson Chi-Square 23.951 a  3 .000 Likelihood Ratio 27.727 3 .000 Linear-by-Linear Association 1.088 1 .297 N of Valid Cases 56 a. 2 cells (25.0%) have expected count less than 5. The minimum expected count is 3.57. Heartdesease has significant variance across. groups. Therefore bradycardia and tachycardia has sigificant variance across groups. Hence the combination of medicines has significant variance on the heartdesease.
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