Title: Utilization Pattern of Drugs in Neurosurgical Anaesthesia in a Tertiary Care Hospital in South Kerala

Authors: Dr Rejanigandha, Dr Resmi Douglas

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i2.147

Abstract

Objective: To analyse the pattern of use of anaesthetic drugs in patients undergoing neurosurgical procedures

Methodology: Data was collected retrospectively from case records of patients who underwent surgery in the Department of neurosurgery during the period January 1,2017 to January30,2017.

Data analysis was performed using SPSS Ver22.

Results: A total of 41 case records were analysed. The major indications of surgery were fracture [19.5%], cranioplasty [26.8%], tumour [24.4%], laminectomy [14.6%] and others include aneurysm clipping and VP shunt. Midazolam was the anxiolytic prescribed for all patients. Among the preoperative opioids, Fentanyl [70.7%] was the commonest followed by Morphine [22%] and Pethidine [7.3%]. All patients received Ondansetron as antiemetic and Glycopyrrolate as anticholinergic agent. Three patients received Dexmeditomedine infusion. Dexamethasone was given intravenously to relieve oedema in all patients. Thiopentone sodium along with Propofol in 92.7%, Thiopentone alone in 2.4% and Propofol alone in 4.9% were the inducing agents. General anaesthesia was maintained with Nitrous oxide, Oxygen and Isoflurane. Paracetamol intravenous infusion was given in 63.4% patients for postoperative pain relief while the rest were given Diclofenac injection intramuscularly.

Conclusion: Our study throws light into the current practice of anaesthetic medications in neurosurgery department of a tertiary care hospital. It also points out the areas of potential drug interactions.

Keywords: anaesthetic medication, neurosurgery, utilization pattern.

References

  1. Meadows WA,Hollowell BD.'Off-label 'drug use: An FDA regulatory term, not a negative implication of its medical use.Int J Impot Res 2008; 20:135-44.
  2. Patel P, Patel H et al. General anaesthetics and therapeutic gases. In:BruntonL, Chabner B, Knollman B, editors. Good-man and Gilman's The Pharmacological Basis of Therapeutics.12 th ed. China: Mc Graw Hill Inc;2011.p527-65
  3. Russel WJ, Morris RG et al. Changes in plasma catecholamine levels during endotracheal intubation. Br J Anaesth.1981 Aug;53(8):837-
  4. Catecholamine response to laryngoscopy and intubation. The influence of three different drug combinations commonly used for the induction of anaesthesia. Chraemmer Jorgensen B, Hertel et al. Anaesthesia.1992 Sep;47(9):750-6
  5. Messina AG, Wang M et al. Anaesthetic intervention for prevention of awareness during surgery. Cochrane Database of Systematic Reviews 2016,
  6. Patel AE, Shetty YC et al. Drug utilization and off-label use of medications in anaesthesia in surgical wards of a teaching hospital. Indian J Anaesth 2015;59:721- 7
  7. 4th Report of WHO Expert Committee: The use of essential drugs, WHO TRS 796, World Health Organisation,1990 [Internet] 2012.[Cited March 2013]
  8. Kain ZN, Caldwell-Andrews AA et al: Trends in the Practice  of Parenteral Presence During Induction of  Anaesthesia   and  the  use  of Preoperative Sedative Premedication in  the  United States, 1995 – 2002 : Results  of  a Follow  up National  Anaesth.Analg.2004 May; 98:1252-9.
  9. Kain ZN, Mayes LC et al: Premedication in the United States: A Status Report.  Analg  1997; 84: 427-32.
  10. K. Mirakhur: Preanaesthetic medication: a survey. J.R.Soc.Med. 1991;84(August ) : 481-3.
  11. Kongsrud F, Sponheim S: A comparison   of  atropine  and  glycopyrrolate in anaesthetic   Acta  Anaesthesiol. Scand. 1982 Dec ; 26 (6): 620 – 5.
  12. Eidi M ,  Kolahdouzan K H  et al: A comparison of  preoperative  ondansetron and dexamethasone  in  the  prevention  of post tympanoplasty nausea and   vomiting Iran J Med Sci. 2012; 37 :166  - 172.

Corresponding Author

Dr Resmi Douglas

Associate Professor, Department of Pharmacology,

Govt. Medical College, Alappuzha

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mob: 9495311466