Ayurveduniversity.edu.in2

Vacha (Acorus calamus) as an Ayurvedic Premedicant
D. N. PANDE *
Institute of Medical Sciences, Banaras Hindu University, Varanasi.
ABSTRACT : Previously many indigenous herbal drugs mentioned in Ayurvedic literature were experimentally
screened on the animals and were also studied clinically on the patients as pre-anesthetic medication drug such
as Brahmi, Sankhapushpi, Mandukparni, Jatamansi etc. Modern research workers had also proved their usefulness
in the treatment of nervous and mental diseases. In the same chain of research work, Vacha was selected for this
study and was used in the form of Ghanasatva. The clinical trial was carried on 40 healthy patients. The patients
were divided into two groups randomly. The control and trial groups included 20 patients each of narrow age and
weight distribution. The patients of group I (Control) were premedicated with Inj. Glycopyrrolate 0.2 mg IM and
Tab. Phenergan 50 mg orally with one ounce of plain water. The patients of group II (Trial) were premedicated
with Inj. Glycopyrrolate 0.2 mg I.M. and Vacha (Ghansatva) orally in recommended doses with one ounce of
plain water 90 minutes prior to induction of anaesthesia. A standard anesthetic technique with pre oxygenation
for 3 minutes & Nitrous oxide with Ether inhalation by spontaneous ventilation with Maggill’s open circuit
(Boyle’s apparatus) was used. The following parameters were used to see the efficacy of the drug : Psychophysical
effect before induction of anaesthesia, Cardio-respiratory and other reflex response during the course of subsequent
anaesthesia & Post operative sickness in immediate post operative period up to two hours. On the basis of
observations, it was concluded that Vacha controls the raised body temperature, produces good sedation and it may
be helpful in the patients with preexisting hyperthermia. It does not produce any C.V.S. & Respiratory depression.
Key word : Medhya, Phenergan, Glycopyrrolate , sedation, apprehension and induction.
INTRODUCTION
Till date many works had been done but no idealpremedicant is in hand.
Vacha1 - the drug under clinical study is being used since long in Ayurvedic practice2 for the treatment MATERIAL AND METHODS
of psychic disorders. Recently many works have beendone on Medhya,3,4,5,6 drugs e.g. Brahmi, Shankhapushpi, The crude drug (Vacha rhizome) was collected Ashwagandha etc. for the management of psychic from Ayurvedic Pharmacy, Institute of Medical disorders. Neuro-Pharmacological action of Vacha oil Sciences, Banaras Hindu University, Varanasi and it‘s revealed its sedative, tranqualizing action7 in rats, mice, validity was confirmed by Dravyaguna Department.
cats and dogs (Dhala and Bhattacharya, 1968).It inspired Coarse powder (churna) was prepared from Vacha us to carryout a clinical study on Vacha Ghanasatva in rhizome-dried completely under shade.
the field of Sangyaharan to explore an Ayurvedic The preparation of Ghanasatva was completed in two steps. In first step, one kg of Vacha rhizome Now a day the clinical trail of drugs has increased churna was mixed with 8 liters of water and boiled.
many fold11. The most important support in favour of When one-eighth of the initial content remained, it was the clinical trial is to confirm the observations and claims filtered. Thus a decoction was prepared. In the second made by previous workers 12, 13, 14, 15, 16, 17 in their step, the decoction was boiled again to change its experimental studies and also to find out any additional form from liquid to semisolid. Then dried under shade action and side effects which were some times not and thus the required Ghanasatva was prepared. The observed in experimental study but are observed in complete procedure was done in the Ayurvedic human being only. Therefore we planned to conduct a study on the efficacy of Vacha as premedicant.
Determination of the Dose of Drugs :
Aims and Objectives :
The dose for clinical study was calculated The aim of this study was to explore the possibility according to the dose of churna recommended for to provide a safe and effective Ayurvedic premedicant.
vacha in Ayurvedic literature by various authors. Foran adult weighing - 40-60 kg, the dose of the drug * Incharge, Section of Sangyaharan, Dept.of Shalya Tantra, was calculated according to yield of Ghanasatva, as ** Consultant Anaesthesiologist, Gopiganj, Bhadohi, (U.P.).
Grouping of the patients & Inclusion criteria :
observations could be missed. For evaluation of desirableand undesirable effects of the pre-medicaments, an Forty patients with a narrow age and weight assessment of the following signs and symptoms was difference scheduled for elective surgery were taken for the study and were randomly divided into two groupsconsisting of 20 patients in each group.
Exclusion criteria :
The following classes of patients were excluded premedication to ensure that no pathological conditions existed which could influence the various parameters of 1. Those who were beyond the range of 18 to 50 years this study. The drugs were given 60-90 minutes before 2. Those who were beyond A.S.A. GP. 1 & 2.
Group I : The patients of control group I received
inj. Glycopyrroglate 0.2 mg IM and Tab. Phenergan (Promethazine hydrochloride), 50 mg with an ounce of 4. Patients suffering from respiratory, cardiac, hepatic, renal,disorders, sensitive to aspirin, diclofenac sodium, Group II : The patients of group II (trial group)
bleeding disorders and peptic ulcer.
received inj. Glycopyrrolate 0.2 mg IM and cap. Vachaghanasatva 100 mg with an ounce of water 90 minutes The trial drug was clinically studied in following
three stages -
1. Psychophysical effect in pre-anaesthetic period Before giving the premedication, the B.P., P.R.,R.R., Temperature, G.C., C.V.S., R.S., G.I.T. werechecked and recorded on a porforma. After 90 minutes 2. Cardio-respiratory and other reflex responses during of administration of the drugs, the effects achieved were the course of subsequent anaesthesia.
also recorded before induction of anesthesia in calm andquiet surroundings. For recording the effects, a cyclostyled 3. Post-operative sickness in immediate post-operative Proforma was employed, so that none of the planned OBSERVATIONS & RESULTS
TABLE NO. 1 : GROUPING OF PATIENTS :
Premedication Drugs
of Patients
Inj. Glycopyrrolate 0.2 mg IM and Tab. Phenergan ( Promethazine hydrochloride) -50 mg. with an ounce of water 90 minutes before anaesthesia.
Inj. Glycopyrrolate 0.2 mg IM and cap. Vacha ghanasatva 100 mg with an ounce of water90 minutes before induction of anaesthesia.
TABLE NO. 2 : COMPARISON OF MEAN AGE AND WEIGHT :
Statistical Comparison
Vacha (Acorus calamus) as an Ayurvedic Premedicant : Pande D.N. & Mishra S.K. TABLE NO. 3 : EFFECTS ON PULSE RATE CHANGES PER MINUTE :
Statistical Comparison
premedication (A)
premedication (B)
The rise in mean pulse rate, observed within the both groups were found statistically significant.
TABLE NO. 4 : EFFECTS ON BLOOD PRESSURE CHANGES (M.B.P.) :
Statistical Comparison
premedication (A)
premedication (B)
A negligible rise in the mean of M.B.P. in group I and group II, 90 mnts after premedication carries no value.
TABLE NO. 5 : EFFECTS ON RESPIRATORY RATE CHANGES (PER MINUTE) :
Statistical Comparison
premedication (A)
premedication (B)
Change in respiratory rate was found insignificant at both the levels.
TABLE NO. 6 : EFFECTS ON BODY TEMPERATURE CHANGES (0F) :
Statistical Comparison
premedication (A)
premedication (B)
The rise in mean temperature after premedication level in both the groups were 0.29 and 0.15 respectively, which werestatistically significant in group I and insignificant in group II when compared within the groups.
TABLE NO. 7 : DESIRABLE AND UNDESIRABLE EFFECTS :
Incidence
Desirable Effects
Undesirable Effects
TABLE NO. 8 : MEAN INDUCTION TIME (IN MINUTES) :
Mean induction time (mnts)
Statistical Comparison
The difference in mean induction time between these two groups was found insignificant.
TABLE NO. 9 : MEAN RECOVERY TIME (IN MINUTES) :
Mean recovery time (mnts)
Statistical Comparison
The difference of mean recovery time is statistically insignificant.
TABLE NO. 10 : NATURE OF RECOVERY :
Nature of Recovery
The Nature of recovery is statistically identical.
DISCUSSION
with pre-existing hyperthermia due to its sweatinducing property.
Age and Weight is found identical in the study.
The rise in mean pulse rate/mnt, observed within the both 3. It is useful for quick and smooth induction.
groups (>0.01) as found statistically significant. A 4. It is a better drug for allaying apprehension than negligible rise in the mean of M.B.P. in group I and group II, 90 mnts after premedication carries no value (>0.05).
The psycho-physical response was evaluated 90 minutes 5. Incidences of complications during anaesthesia were after premedication in both the group. With regard to production of desirable effects both the groups were 6. It does not produce any cardiovascular and identical but the percentage was little higher in Vacha premedicated group, without producing any undesirableresponses.
REFERENCES
Vacha as premedicant helped in rapid induction of 1. Acharya P. V. Sharma, Dravyaguna Vigyan-2nd part, anaesthesia by reducing the induction time (4.5 ± 1.05).
Chaukhambha Bharati Prakahan, Varanasi, 8th edition, 1986,page 28.
The total anaesthetic requirement was also reduced. The 2. Sushruta Samhita, Ayurveda Tatwa Sandipika,Hindi percentage of smooth induction was found higher in trial Commentary-3rd edition by Kaviraj Dr. Ambika Dutt Shastri, group. Post operative recovery from anaesthesia was Chaukhambha Sanskrit Sansthan, Sharir Sthana 10/72-74, quicker after Vacha (5.68 ± 0.98) than Phenergan 3. Sushruta Samhita, Ayurved Tatwa Sandipika, Hindi Commentary- 3rd edition, by Kaviraj Dr. Ambika Dutt Shastri, Chaukhambha CONCLUSION
Sanskrit Sansthan, Chikitsa sthana, 28/19, page125.
On the basis of observation it can be concluded : 4. Gulati, P. K. & Pande S. B., Role of Jatamansi in Anaesthesia.
M.D. (Ayu.) Thesis -1984, IMS, BHU., Varanasi.
1. Vacha has capability to produce good sedation and 5. Athana R., Mishra L. D. and Pande D. N. Evaluation of Brahmi as preanaesthetic medication in relation to dehaprakriti, M.S.
(Ayu.) thesis, IMS, BHU, Varanasi,1995.
2. Vacha controls the raised body temperature induced 6. Barron, D. W. and Dundee J. W., Clinical studies of induction by Glycopyrrolate. It may be helpful in the patients agents British Journal of Anaethesia. 34 : 90, 1962.
Vacha (Acorus calamus) as an Ayurvedic Premedicant : Pande D.N. & Mishra S.K. 7. Bhatacharaya, et al. (1987), Antistress activity of sitoindosides 13. Dutta A. and Pande S.B., Comparative clinical study of Brahmi VII and VIII. New acylsterylgucosides from Withania Somnifera, and Ashwangandha as preanaesthetic medication, M.D. (Ayu.) 32 : Phytotherapy Research. Vol. 1, No. 1, 1987.
8. Bhusal C. P. (1997), Studies on Brahmi (Bacopa Monnierae) 14. Bhatt S. S. and Pande S. B. Study of Poorva Karma in relation as premedicant in ether anaesthesia in relation to deha prakriti, to Anaesthesia, M.D. (Ayu.) thesis, IMS, BHU, 1987.
M.S. (Ayu.) Thesis, IMS, BHU. Varanasi.
15. Pande, S. B. (1977), Evaluation of some indigenous drugs as 9. Asthana R., Mishra L. D. and Pande D. N., Evaluation of pre-adjuvants in anaesthesia (An experimental and clinical Brahmi as preanaesthetic medication in relation to Deha Prakriti, M.S. (Ayu.) thesis, I.M.S., B.H.U., Varanasi,1995.
16. Pande, D. N. (1986), Poorva-karma in relation to anaesthesia.
10. Chopra et al (1958). Indigenous drugs of India by R.N. Chopra, I.C. Chopra, Handa, N.L. and Kapoor, L.D. , U.M. Dhar and 17. Pandey, K. K. (1990), Evaluation of Ashwagandha (Withania Sons Pvt. Ltd., 15, 2nd ed. Bankim Chaterjee Street, Calcutta.
somnifera Dunal.) As preanasthetic agent. MD. (Ayu.) Thesis, 11. Churchill Davidson, Practice of anaesthesia. 5th ed. 1984.
12. Dixit, A., Studies of Role of Parsika Yavani (Hyocyamus retiulatus) as pre-anaethetic egent, M.D. (Ayu.) Thesis, 1979.
IMS, BHU.
ËÎ√ —wv G√fitË≤÷<Zwv Δ|Æ√Y}J …ÍË÷ G√§B<p s>]. —A. …√es>≤ —Ë| —Δ. w≤v. <Iπ√ Δ|Æ√Y}J …ÍË÷ wtv{> G√§B<pfi√V Δ|Æ√Y}J wv√≤ Δt«I lA√A≤ Y≤ot Z] √o] Y§* $ ÛΔ] wLvI I≤* I≤˙fi G√§B<pfi√≤* wv√ …Lfi√≤« Δ|Æ√Y}J …Lμ√« I≤* ™wvfi√ «fi√ $ ÛΔ wLvI I≤* ËÎ√ wv√ ÎfiA Δ|Æ√Y}J …ÍË÷ G√§B<p Y≤ot ™wvfi√ «fi√ oE√ 40 }√≤<«fi√≤* I≤* ÛΔw≤v …Lμ√Ë wv√ G˙fifiA ™wvfi√ «fi√ $ ÛA }√≤<«fi√≤* I≤* ËÎ√ —wv @…fitØv Δ|Æ√Y}J …ÍË÷ G√§B<p <ΔÙ Y¯Û÷ $ ÛΔΔ≤ _√}]™}wv o√…wLvI …} <Afi^⁄J …√fi√ «fi√ oE√ Δ|Æ√Y√}wv G√§B<pfi√≤* w≤v Δ√E wv√≤Û÷ <ËÔÙ …L<o™wLvfi√ AY]* …√fi] «fi] $

Source: http://www.ayurveduniversity.edu.in/newsletters/ayu/2009_3/30310.pdf