A Case Report of Hospital Acquired Resistant Bacterial Infections in a Rituximab Treated Patient with Lupus Vasculitis of Genitourinary Tract

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Manoj Kumar Ravilla
Shanmuganandan Krishnan
Sanjeevi Krishnan
Sujana Reddy


Background and Aims: Integral components of general anesthesia are endotracheal intubation and Laryngoscopy. However hemodynamic responses, such as tachycardia and hypertension, occur immediately and often lasts for 5 to 10 minutes. Hemodynamic responses are exaggerated in hypertensive patients. This study aimed to assess the efficacy of clonidine infusion as a premedication for attenuating hemodynamic reactions of hypertensive patients to laryngoscopy and endotracheal intubation.Methods: This prospective, randomized, controlled study enrolled 60 hypertensive patients of either sex scheduled for surgery under general anesthesia and endotracheal intubation.  Patients in clonidine group (C group, n = 30) received intravenous clonidine (4 μg kg-1), diluted in 50 ml normal saline, over 15 minutes by syringe pump pre-operatively, at rate of 200 ml / hr and those in the control group (NS group, n = 30), were given 50 ml normal saline as a placebo in the same manner. The Sedation score of each patient was recorded 15 min after infusion completion. General anesthesia was subsequently given to the patients in both groups in accordance with a prescribed protocol. Hemodynamic parameters were recorded before induction, during laryngoscopy, and at various intervals after laryngoscopy, and statistical analyses were performed. Results: Compared to the control group, the study group had a significantly lower heart rate in all of the recorded readings. There was a significant attenuation of systolic blood pressure and mean arterial pressure in group C compared to those in the NS group. The sedation score after 15 min was significantly higher in Group C than Group NS (p< 0.001). There were no significant variations noticed between the two groups regarding complications that occurred after the operation. Conclusion: Intravenous 4 μg kg-1 clonidine infusion is effective in preventing exaggerated hemodynamic responses during laryngoscopy and tracheal intubation in patients with hypertension.

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Kumar Ravilla, M. ., Krishnan, S. ., Krishnan, S. ., & Reddy, S. . (2023). A Case Report of Hospital Acquired Resistant Bacterial Infections in a Rituximab Treated Patient with Lupus Vasculitis of Genitourinary Tract. Journal of Coastal Life Medicine, 11(1), 874–877. Retrieved from https://www.jclmm.com/index.php/journal/article/view/442


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