Title: A Retrospective Pharmacoepidemiological Study of the Utilization Pattern of Anesthetic medications in Surgical Gastroenterology Procedures in a Tertiary Care Hospital in South Kerala
Authors: Dr Rajani Gandha venkitachalam, Dr Raman Nareshkumar, Dr Resmi Douglas
DOI: https://dx.doi.org/10.18535/jmscr/v6i10.63
Abstract
Background: For Surgical Gastroenterolgy procedures, evidence suggests that optimal management includes, Thoracic epidural analgesia continued for 2 days postoperatively, no long acting benzodiazepines on the day of surgery and use of rapid, short acting opiods, short acting anesthetic medications may be beneficial. We examined retrospectively whether these strategies can be achieved in all patients undergoing surgical gastroenterology procedures irrespective of age, sex, associated comorbidities and duration of procedures.
Methods: Data was collected retrospectively from case records of patients who underwent surgical gastroengterology procedures in the Department of surgical gastroenterology during the period January 1,2017 to January 30,2017.
Results: Total of 38 case records were analysed.Major indications for surgery were Pancreatectomy (26.3%), Laparoscopic cholecystectomy (21.1%), Abdomino perineal resection (10.5%), Anterior resection (7.9%), Splenectomy (7.9%), and Others (7.9%) which include Fundoplication, Sigmoidectomy, Hepatectomy, Proctocolectomy). Female sex (63.2%) predominated over Male sex (36.8%) Most of the patients were in the age group between 50-70 years (52.6%).All Patients received Midazolam as anxiolytic, Glycopylorate as anticholinergic, Ondansetron as antiemetic. Preoperative opiod used are Pethidine (2.6%), Morphine (5.3%), Fentanyl (92.1%).50% of patients had no comorbidities,15.8% had hypertension alone,5.3% had hypertension and type 2 Diabetes mellitus,2.6% had hypertension, Diabetes mellitus type 2,2.6% had hypertension, Type 2 diabetes mellitus and coronary heart disease,2.6% had coronary heart disease alone.84.2% patients was induced with Thiopentone sodium and propofol,received thoracic epidural with buprenorphine as post operative analgesia.7.9% patients was induced with thiopentone sodium and propofol, post operative analgesia was managed with intravenous paracetamol,7.9% patients was induced with propofol and received thoracic epidural with buprenorphne for post operative analgesia.
Conclusion: The administration of thiopentone sodium and propofol as induction agents, Thoracic epidural with buprenorphine for postoperative analgesia is very common (84.2%) Ondansetron, midazolam, and Glycopylorate (>80% patients) as pre-anesthetic medication. Fentanyl is the opioid of choice in most patients(92.1%)
Keywords: drug utilization; Anesthetic medications; surgical gastroenterology procedures.
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