Academia Anesthesiologica International <p><strong class="pull-left">Academia Anesthesiologica International </strong>is a double-blinded peer-reviewed, open access, Bi-annual, online journal that publishes original research articles, review articles, case reports, brief communications and clinical studies in all areas/advances of anesthesia, pain and intensive care. <br> <strong>Online ISSN: 2456-7388 | Print ISSN:&nbsp;2617-5479</strong></p> Society for Health Care & Research Development en-US Academia Anesthesiologica International 2617-5479 Evaluation of Various Factors Affecting Emergency Intubation <p><strong>Background: </strong>Inadequate airway management is a major contributor to pre-hospital morbidity and mortality. The present study was conducted to evaluate various factors affecting endotracheal intubation. <strong>Subjects and Methods: </strong>This study was conducted on 474 patients requiring ETI. Informed consent was obtained from family members of all patients. Emergency intubation was performed as a ‘rapid sequence induction’ (RSI), with preoxygenation and cricoid pressure followed by an induction agent and then suxamethonium. Factors affecting ETI was recorded. <strong>Results: </strong>Out of 476 patients, males were 280 and females were 196. Indication of RTI was low GCS seen in 64, injury in 320, respiratory insufficiency in 10 and cardiac arrest in 82. The difference was significant (P&lt; 0.05). Method of ETI was RSI in 290, without relaxant in 81 and without any medication in 105. The difference was significant (P-0.05). Common difficulties in ETI were blood seen in 30%, vomit in 14%, hypersalivation in 28%, anatomical difficulties in 7%, patient position in 10% and technical problems in 11%. The difference was significant (P&lt;0.05). <strong>Conclusion: </strong>The presence of blood, vomit, hypersalivation, anatomical difficulties, patient position and technical problems are among various factors affecting ETI.</p> Meenakshi K. Moorthy ##submission.copyrightStatement## 2019-05-31 2019-05-31 4 2 1 3 A Comparative study of Agomelatine and Ramelteon for Attenuation of Haemodynamic response to Laryngoscopy and Endotracheal Intubation <p><strong>Background: </strong>Pressor response to laryngoscopy and endotracheal intubation is a well&nbsp; recognised clinical entity, and many medications have been used for its attenuation. Agomelatine and Ramelteon are analogues of Melatonin which have been recently used for preoperative anxiolysis and sedation with less known effects on pressor response. <strong>Subjects and Methods: </strong>60 ASA-I patients scheduled for elective surgeries under general anaesthesia were randomly allocated into 2 equal groups. Group-A (Tab.agomelatine 10 mg) and Group-R (Tab.ramelteon 8mg) were administered per oral 1 hour prior to induction of anaesthesia. Heart rate and blood pressure were assessed preoperatively and at 0,1,3,5,10,15 minutes. <strong>Results: </strong>Reduction heart rate and blood pressure were noted when compared to baseline in both the groups(p&lt;0.05). However there was no statistical difference between the two groups at various intervals of time and were comparable (p&gt;0.05). <strong>Conclusion: </strong>Oral agomelatine and ramelteon when administered 1 hour prior to induction of anaesthesia, resulted in comparable reduction of heart rate and blood pressure response to laryngoscopy and endotracheal intubation.</p> Pradeep Hosagoudar Arunashree S M. Venkateswara Pradeep ##submission.copyrightStatement## 2019-05-31 2019-05-31 4 2 4 7 Comparative Study of Attenuation of effects of Intubation on Blood Pressure Using IV Xylocard and IV Beta Blocker (Esmolol) <p><strong>Background: </strong>The occurrence of cardio vascular reactions to laryngoscopy and tracheal intubation has attracted the attention of anaesthesiologists and methods to avoid these potentially harmful responses even though transitory have been sought, particularly in critically ill patients, hypertensive patients. Tracheal intubation under light general anaesthesia is consistently accompanied by a pressor response, tachycardia and in some instances by cardiac arrhythmias. This pressor response, which was recognised early as 1951 is due to sympathetic reflex provoked by stimulation of the epipharynx and laryngopharynx. <strong>Subjects and Methods: </strong>Seventy five (75) patients belonging to ASA grade 1 &amp; 2 scheduled for general surgical, orthopaedic surgical, ENT, gynocological surgical producers were studied. <strong>Results: </strong>The age of the patients varied from 10 to 60 years. The MAP in group A decreased after induction. There was a highly significant raise to 109+/-11 mm Hg during laryngoscopy and intubation. This decreased to 105+/-9mm Hg after five minutes which is not significant. <strong>Conclusion: </strong>These responses are transitory, variable and are much more marked in a hypertensive patient than in the normotensive patient. Once the laryngoscopy and endotracheal intubation is completed, the increase in pulse and blood pressure subside, but the dysrhythmia persists for more than 2-3 minutes.</p> Mirza Afzal Baig ##submission.copyrightStatement## 2019-06-02 2019-06-02 4 2 8 12 Effects of Intubation on heart rate: Xylocard and Esmolol <p><strong>Background: </strong>Lignocaine is a local anaesthetic of moderate potency and duration with good penetrative power and rapid onset of action carbonated lignocaine has remarkable penetrative power, rapid onset of action a high incidence of motor block and a reduced incidence of missed segments (When used for epidural anaesthesia) when compared to hydrochloride of lignocaine. <strong>Subjects and Methods: </strong>Seventy five (75) patients belonging to ASA grade 1 &amp; 2 scheduled for general surgical, orthopaedic surgical, ENT, gynaecological surgical producers were studied. <strong>Results: </strong>The age of the patients varied from 10 to 60 years. In our study, the heart rate in controls (Group A) before induction was 86+/-10 rose to 93+/-12 and 107+/-13 after induction and after laryngoscopy + ETI respectively. The changes seen after endotracheal intubation alone was statistically very highly significant (&lt;0.001).&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; In Group B, the pre induction heart rate was 94+/-17, which increased to 99+/-13, after induction.This increase not significant (P&gt;0.05). There was an increases of 15 at laryngoscopy + ETI which was very highly significant (P&lt;0.001). <strong>Conclusion: </strong>In Group C, the pre induction heart rate of 96+/-15 increased to 97+/-11 at induction and to 108+/-15 following endotracheal intubation.</p> Mirza Afzal Baig ##submission.copyrightStatement## 2019-06-02 2019-06-02 4 2 13 16