Comparing Bolus and Infusion administration of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty

<p><strong>Background and Aims: P</strong>ropofol is commonly used for providing sedation in endoscopic retrograde cholangio-pancreatography (ERCP). It’s simple to use and effective but presents cardiovascular and respiratory adverse effects. Recently, dexmedetomidine has been trie...

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Main Authors: Mohammadreza Moshari, Bahman Malek, Mohammadreza Minator-Sajjadi, Maryam Vosoghian, Mastaneh Dahi, Mahshid Ghasemi, Razieh Shekari
Format: Article
Language:English
Published: Shahid Beheshti University of Medical Sciences 2017-12-01
Series:Journal of Cellular and Molecular Anesthesia
Subjects:
Online Access:http://journals.sbmu.ac.ir/jcma/article/view/18502
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spelling doaj-9f68be0e43af4100a730264a64d3d80c2020-11-24T22:31:10ZengShahid Beheshti University of Medical SciencesJournal of Cellular and Molecular Anesthesia2476-51202017-12-012417117910.22037/jcma.v2i4.185029589Comparing Bolus and Infusion administration of Tranexamic Acid in Reducing Blood Loss in Total Knee ArthroplastyMohammadreza Moshari0Bahman Malek1Mohammadreza Minator-Sajjadi2Maryam Vosoghian3Mastaneh Dahi4Mahshid Ghasemi5Razieh Shekari6Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, TehranAnesthesiology Research Center, Shahid Beheshti University of Medical Sciences, TehranTaleghani Hospital Clinical Research Development Unit, Shahid Beheshti University of Medical Sciences, TehranAnesthesiology Research Center, Shahid Beheshti University of Medical Sciences, TehranAnesthesiology Research Center, Shahid Beheshti University of Medical Sciences, TehranAnesthesiology Research Center, Shahid Beheshti University of Medical Sciences, TehranAnesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran<p><strong>Background and Aims: P</strong>ropofol is commonly used for providing sedation in endoscopic retrograde cholangio-pancreatography (ERCP). It’s simple to use and effective but presents cardiovascular and respiratory adverse effects. Recently, dexmedetomidine has been tried but very little evidence exists to support its use. The aim of this study was to compare the efficacy and safety of combination of dexmedetomidine and lidocaine (DL) with the standard propofol-fentanyl (PF) regimen.<strong></strong></p><p><strong>Methods:</strong> After approval of the hospital ethics committee, 63 patients (18-60 years of age) were randomly divided into 2 groups. Thirty-one patients received a PF combination (group PF), and 32 patients received DL combination (group DL). The level of sedation was adjusted to achieve a Ramasy Sedation Scale (RSS) score of 3 (moderate sedation) in both groups of patients. Arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation (SpO<sub>2</sub>) during ERCP and recovery was continuously assessed.<strong></strong></p><p><strong>Results: </strong>The oxygen<strong> s</strong>aturation (SpO<sub>2</sub>) showed high statistical significant differences between both groups throughout the procedure with stability in DL group (P&lt;0.01). There was no statistical difference in HR and MAP between the two groups (P&gt;0.05). Post-procedural recovery time was significantly shorter in PF group (15.97±3.27 min) compared with (19.38±5.64 min) DL group (p&lt;0.01). PONV was 3.2% in PF group, while it was absent in DL group. No drug adverse effect or cardiovascular complications were observed in both groups.<strong></strong></p><p><strong>Conclusion:</strong> Dexmedetomidine and lidocaine combination as total intravenous anesthesia (TIVA) during ERCP not only did not reported any oxygen desaturation (SpO2&lt;90%) but also showed better stability of oxygen saturation (SpO<sub>2</sub>) and less PONV when compared with propofol and fentanyl combination.<strong></strong></p>http://journals.sbmu.ac.ir/jcma/article/view/18502Dexmedetomidine, Lidocaine, Sedation, ERCP, oxygen saturation
collection DOAJ
language English
format Article
sources DOAJ
author Mohammadreza Moshari
Bahman Malek
Mohammadreza Minator-Sajjadi
Maryam Vosoghian
Mastaneh Dahi
Mahshid Ghasemi
Razieh Shekari
spellingShingle Mohammadreza Moshari
Bahman Malek
Mohammadreza Minator-Sajjadi
Maryam Vosoghian
Mastaneh Dahi
Mahshid Ghasemi
Razieh Shekari
Comparing Bolus and Infusion administration of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty
Journal of Cellular and Molecular Anesthesia
Dexmedetomidine, Lidocaine, Sedation, ERCP, oxygen saturation
author_facet Mohammadreza Moshari
Bahman Malek
Mohammadreza Minator-Sajjadi
Maryam Vosoghian
Mastaneh Dahi
Mahshid Ghasemi
Razieh Shekari
author_sort Mohammadreza Moshari
title Comparing Bolus and Infusion administration of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty
title_short Comparing Bolus and Infusion administration of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty
title_full Comparing Bolus and Infusion administration of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty
title_fullStr Comparing Bolus and Infusion administration of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty
title_full_unstemmed Comparing Bolus and Infusion administration of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty
title_sort comparing bolus and infusion administration of tranexamic acid in reducing blood loss in total knee arthroplasty
publisher Shahid Beheshti University of Medical Sciences
series Journal of Cellular and Molecular Anesthesia
issn 2476-5120
publishDate 2017-12-01
description <p><strong>Background and Aims: P</strong>ropofol is commonly used for providing sedation in endoscopic retrograde cholangio-pancreatography (ERCP). It’s simple to use and effective but presents cardiovascular and respiratory adverse effects. Recently, dexmedetomidine has been tried but very little evidence exists to support its use. The aim of this study was to compare the efficacy and safety of combination of dexmedetomidine and lidocaine (DL) with the standard propofol-fentanyl (PF) regimen.<strong></strong></p><p><strong>Methods:</strong> After approval of the hospital ethics committee, 63 patients (18-60 years of age) were randomly divided into 2 groups. Thirty-one patients received a PF combination (group PF), and 32 patients received DL combination (group DL). The level of sedation was adjusted to achieve a Ramasy Sedation Scale (RSS) score of 3 (moderate sedation) in both groups of patients. Arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation (SpO<sub>2</sub>) during ERCP and recovery was continuously assessed.<strong></strong></p><p><strong>Results: </strong>The oxygen<strong> s</strong>aturation (SpO<sub>2</sub>) showed high statistical significant differences between both groups throughout the procedure with stability in DL group (P&lt;0.01). There was no statistical difference in HR and MAP between the two groups (P&gt;0.05). Post-procedural recovery time was significantly shorter in PF group (15.97±3.27 min) compared with (19.38±5.64 min) DL group (p&lt;0.01). PONV was 3.2% in PF group, while it was absent in DL group. No drug adverse effect or cardiovascular complications were observed in both groups.<strong></strong></p><p><strong>Conclusion:</strong> Dexmedetomidine and lidocaine combination as total intravenous anesthesia (TIVA) during ERCP not only did not reported any oxygen desaturation (SpO2&lt;90%) but also showed better stability of oxygen saturation (SpO<sub>2</sub>) and less PONV when compared with propofol and fentanyl combination.<strong></strong></p>
topic Dexmedetomidine, Lidocaine, Sedation, ERCP, oxygen saturation
url http://journals.sbmu.ac.ir/jcma/article/view/18502
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