scholarly journals Comparison of the Effect of Lidocaine Adding Dexketoprofen and Paracetamol in Intravenous Regional Anesthesia

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ali Akdogan ◽  
Ahmet Eroglu
Keyword(s):  
Motor Block ◽  
Risk Group ◽  
Demographic Data ◽  
Hemodynamic Effects ◽  
Intravenous Anesthesia ◽  
Intravenous Regional Anesthesia ◽  
Significant Difference ◽  
Dexketoprofen Trometamol ◽  
Analgesia Requirement ◽  
Group D

Objective.Comparison of dexketoprofen and paracetamol added to the lidocaine in Regional Intravenous Anesthesia in terms of hemodynamic effects, motor and sensorial block onset times, intraoperative VAS values, and analgesia requirements.Method.The files of 73 patients between 18 and 65 years old in the ASA I-II risk group who underwent hand and forearm surgery were analyzed and 60 patients were included in the study. Patients were divided into 3 groups: Group D (n=20), 3 mg/kg 2% lidocaine and 50 mg/2 mL dexketoprofen trometamol; Group P (n=20), 3 mg/kg 2% lidocaine and 3 mg/kg paracetamol; Group K (n=20), 3 mg/kg 2% lidocaine. Demographic data, motor and sensorial block times, heart rate, mean blood pressure, VAS values, and intraoperative and postoperative analgesia requirements were recorded.Results.Sensorial and motor block onset durations of Group K were significantly longer than other groups. Motor block termination duration was found to be significantly longer in Group D than in Group K. VAS values of Group K were found higher than other groups. There was no significant difference in VAS values between Group D and Group P. Analgesia requirement was found to be significantly more in Group K than in Group P. There was no significant difference between the groups in terms of heart rates and mean arterial pressures.Conclusion.We concluded that the addition of 3 mg/kg paracetamol and 50 mg dexketoprofen to lidocaine as adjuvant in Regional Intravenous Anesthesia applied for hand and/or forearm surgery created a significant difference clinically.

A Comparative Study between Dexamethasone versus Paracetamol Added to Xylocaine in Local Intravenous Anesthesia in Upper Limb Minor Surgeries

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Reem Hamdy Elkabarity ◽  
Heba Abdel Azim Labib ◽  
Marwa Mamdouh Elfar ◽  
Mostafa Mohamed Mohamed Ibrahim Sharaf
Keyword(s):  
Regional Anesthesia ◽  
Motor Block ◽  
Intravenous Anesthesia ◽  
Full Stomach ◽  
Opioid Dose ◽  
Intravenous Regional Anesthesia ◽  
Significant Difference ◽  
Block Time ◽  
Recovery Times ◽  
Group D

Abstract Background Intravenous regional anesthesia (IVRA) is a technically simple, reliable and costeffective method of regional anesthesia for short operative procedures of the extremities. It is easy to be administered, of lower cost compared with general anesthesia, no need for deep sedation and can be used for emergency operations on extremities for patients with full stomach. Objective Comparison between the anesthetic and analgesic parameters in local intravenous anesthesia by adding Paracetamol and Dexamethasone to xylocaine. Patients and methods This study was carried out in Ain Shams University hospitals for six months (from August 2018 to February 2019) on 45 patients of both sexes aged 20-50 years belonging to ASA I & II undergoing forearm and hand surgeries using IVRA. Results There was no significant difference between group (P), Group (C) as regard sensory, motor recovery times, both had a shorter sensory and motor block time need to an opioid dose as an analgesic dose. Group (D) had the fastest sensory and motor block time and more prolonged recovery time than group (P) and group (C) need less opioid dose as analgesia for controlling pain. As regard postoperative analgesic requirements. Group (D) and group (P) needed less analgesic doses than group (C) but there was no significant difference between group (P) and group (C). Conclusion Addition of 8 mg Dexamethasone as adjuvant to xylocaine for intravenous regional anesthesia led to: Reduction the dose of xylocaine used for IVRA, Shortening the sensory and motor block onset times, Prolong the sensory and motor block recovery times, and Reduction the postoperative analgesic requirement with satisfaction for patient and surgeon.

scholarly journals Prospective study on standard and totally tubeless percutaneous nephrolithotomy

2019 ◽  
Vol 6 (11) ◽  
pp. 3972
Author(s):  
V. Vishnu Vardhana Reddy ◽  
Amar Kumar Repaka
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Elective Surgery ◽  
Demographic Data ◽  
Operation Time ◽  
Patient Comfort ◽  
Standard Group ◽  
Early Return ◽  
Significant Difference ◽  
Analgesia Requirement ◽  
Tubeless Percutaneous Nephrolithotomy

Background: With the improvement of instrumentation and experience of percutaneous nephrolithotomy (PCNL), several modifications to the procedure have taken place in order to reduce the morbidity and early return to normal lifestyle. This study aimed to compare the totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy techniques.Methods: It is a prospective randomized, clinical trial done on 60 patients was patients older than 20 years and younger than 60 years who were chosen for elective surgery of kidney stones via the PCNL technique. Patients were divided into two groups, standard PCNL (with a nephrostomy tube) and totally tubeless PCNL (no ureter stents or ureteric catheters).Results: Demographic data is matched in two groups of patients. The mean operation time was slightly longer in the standard group (108 minutes) than in the totally tubeless group (102 minutes), but there was no statistically significant difference. There was no significant difference between the two groups with regard to serum creatinine change or blood loss. Haemoglobin drop, hospital stay, Pain score and analgesia requirement was significantly less in the totally tubeless group. 4 patients in each group had bleeding postoperatively. Only five patients developed pyrexia in the postoperative period. The differences in the need for blood transfusion and postoperative pyrexia were not found to be statistically significant. 19 in standard group and 2 patients in totally tubeless group developed urine leak, found to be statistically significant.Conclusions: Author can conclude that the tubeless procedure has fewer complications, improved postoperative patient comfort, shorter hospitalization, and a reduced need for analgesics. 

scholarly journals The Effects on Sensorial Block, Motor Block, and Haemodynamics of Levobupivacaine at Different Temperatures Applied in the Subarachnoid Space

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Bahittin Nazli ◽  
Huseyin Oguzalp ◽  
Eyup Horasanli ◽  
Mehmet Gamli ◽  
Beyazit Dikmen ◽  
...  
Keyword(s):  
Side Effects ◽  
Motor Block ◽  
Room Temperature ◽  
Demographic Data ◽  
Sensory Block ◽  
Group I ◽  
Significant Difference ◽  
Different Temperatures ◽  
Group Ii ◽  
Transurethral Prostate Resection

Aim. To evaluate the effects of 0.5% levobupivacaine at 37°C preheated from room temperature, on sensorial block, motor block, and haemodynamics in patients undergoing transurethral prostate resection (TUR-P).Material and Method. The patients were randomly allocated to two groups: Group I patients were injected with 3 mL 0.5% levobupivacaine solution which had been kept at room temperature for at least 24 hours and Group II patients were injected with 3 mL 0.5% levobupivacaine solution which had been kept at 37°C for at least 24 hours. The patients were examined in terms of sensorial block, motor block, haemodynamic profile, and incidence of side effects.Results. No significant difference was found between the groups in terms of demographic data. The time to reachT10sensory block and the time of starting motor block were found to be significantly shorter in Group II . The duration of sensory block overT10andT6, the duration ofL1regression, the duration of the sensory block, and the regression time of the motor blocks from 3 to 2 were found to be longer in Group II.Conclusion. The use of 0.5% levobupivacaine spinal anaesthesia heated to 37°C accelerated the start of sensory and motor block.

scholarly journals Comparison of effect of intrathecal dexmedetomidine and clonidine as an adjuvant to hyperbaric bupivacaine in patients undergoing surgery for fracture femur and tibia

2017 ◽  
Vol 4 (12) ◽  
pp. 3833
Author(s):  
G. Praveen Chandra ◽  
Sampathi Shiva Krishna ◽  
Pooja Singh
Keyword(s):  
Motor Block ◽  
Elective Surgery ◽  
Onset Time ◽  
Hyperbaric Bupivacaine ◽  
Wound Infiltration ◽  
Nerve Blocks ◽  
Rescue Analgesia ◽  
Fracture Femur ◽  
Significant Difference ◽  
Group D

Background: Spinal anaesthesia with bupivacaine is administered routinely for lower abdominal and lower limb surgeries. The ensuing nerve block is sufficient to ensure patient’s wellbeing, while motor block facilitates the surgeon’s work. Post-operative pain relief can be achieved by various methods namely systemic opioid and non-opioid peripheral nerve blocks and local wound infiltration, each with their own merits and demerits. the present study was undertaken to compare the effect of intrathecal dexmedetomidine and clonidine as an adjuvant to hyperbaric bupivacaine in patients undergoing surgery for fracture femur and tibia.Methods: 80 patients between 20-60 years, undergoing elective surgery for closed fracture shaft of femur and tibia with ASA physical status of 1 and 2 were included in the study. All the subjects were randomly allocated to one of the two groups (Group C and Group D) by a computer-generated randomization chart. Group C received 2.5ml of 0.5% hyperbaric bupivacaine with 50mcg clonidine and group D received 2.5ml of 0.5% hyperbaric bupivacaine with 5mcg dexmedetomidine.Results: 30 of the 40 patients in group C were of ASA I and 10 were ASA II, while in group D, 25 were ASA I and 15 were ASA II. A significant difference was found in the onset time for sensory and motor block, receding time for sensory and motor block and the need of the first rescue analgesia between the two groups, showing that Dexmedetomidine was more potent than clonidine.Conclusions: Dexmedetomidine is a potent, highly selective and specific α2-adrenoreceptor agonist that has both sedative and analgesic effects and is also a valuable adjuvant when regional anaesthesia is incorporated.

Randomised Study Comparing the use of Propofol Versus Dexmedetomidine as a Sedative Agent for Patients Presenting for Lower Gastrointestinal Endoscopy

2020 ◽  
Vol 15 (1) ◽  
pp. 61-66
Author(s):  
Sameh A. Ahmed ◽  
Nehad Hawash ◽  
Fatma H. Rizk ◽  
Mahmoud Elkadeem ◽  
Mohamed Elbahnasawy ◽  
...  
Keyword(s):  
Maintenance Dose ◽  
Demographic Data ◽  
Loading Dose ◽  
Hemodynamic Parameters ◽  
Traditional Use ◽  
Randomised Study ◽  
Sedative Agent ◽  
Significant Difference ◽  
Group D ◽  
Positive Effect

Objectives:: Dexmedetomidine, the alpha 2 agonist sedative and an analgesic agent may be beneficial in sedation for endoscopic intervention. Our aim was to compare the use of dexmedetomidine versus the traditional use of propofol as a sedative agent for colonoscopies. Methods:: This study included 100 patients presenting for elective colonoscopy under sedation with random and equal allocation of patients into two groups; group P, in which patients received propofol in a loading dose of 1.5 mg/kg and maintenance dose of 0.5 mg/kg/hr, and group D, in which patients received dexmedetomidine at a loading dose of 1ug/kg and maintenance dose of 0.5 ug/kg/hr. In addition to the demographic data, time to recovery, time of discharge, and endoscopist rating were measured. Also, the hemodynamic parameters were recorded, and also the incidence of postoperative complications. Results:: The basic patients' characteristics, time to recovery, and time of discharge were comparable between the two groups. Moreover, the endoscopist did not significantly report more convenient procedure with one group over the other. Also, there was no significant difference in hemodynamic parameters or in the incidence of complications between the two studied groups. However the use of dexmedetomidine decreased the incidence of hypoxemia. Conclusion:: The use of dexmedetomidine seems to have a similar effect to the use of propofol as a sedative agent for lower GIT endoscopy with the positive effect of dexmedetomidine in decreasing the incidence of perioperative hypoxemia.

scholarly journals Comparison of the Effects of Low Volume Prilocaine and Alkalinized Prilocaine for the Regional Intravenous Anesthesia Technique in Hand and Wrist Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-9
Author(s):  
Ozlem Kapusuz ◽  
Guldeniz Argun ◽  
Murat Arikan ◽  
Guray Toğral ◽  
Aysun Basarir ◽  
...  
Keyword(s):  
Motor Block ◽  
Sensory Block ◽  
Intravenous Anesthesia ◽  
Future Studies ◽  
Tourniquet Pain ◽  
Patients Satisfaction ◽  
Significant Difference ◽  
Anesthesia Technique ◽  
Low Volume

Aim. Comparing the effectivity of prilocaine and prilocaine alkalinized with 8.4% NaHCO3in terms of sensory and motor block onset and termination durations in RIVA technique considering patients’ satisfaction and tolerance with application of tourniquet undergoing hand-wrist surgery.Materials and Methods. 64 patients were randomised into two groups. First group (Group P) was administered prilocaine and second group (Group PN) was administered prilocaine + %8.4 NaHCO3. Sensory and motor block onset and termination times and onset of tourniquet pain were recorded.Results. No significant difference was found between the two groups in terms of onset and termination of sensory block and the onset of motor block. The duration of the motor block was longer in Group PN than in Group P(P<0.05). Tourniquet pain was more intense in Group P(P=0.036). In Group PN, the use of additional drugs was recorded at a lower rate and patients’ satisfaction was higher than Group P.Conclusion. In the present study, it was established that alkalinization of prilocaine had no effect on the duration of sensory block and it prolonged the duration of motor block, increased patients’ satisfaction, and decreased tourniquet pain. It is our suggestion that future studies should be carried out on the issue by using different volumes.

scholarly journals Effect of dexmedetomidine as adjuvant in supraclavicular block for upper limb orthopedic surgeries

2017 ◽  
Vol 4 (5) ◽  
pp. 1510 ◽  
Author(s):  
Dixitkumar B. Modh ◽  
Manthan Parmar ◽  
Shilpin Solanki
Keyword(s):  
Upper Limb ◽  
Motor Block ◽  
Demographic Data ◽  
Total Duration ◽  
Hemodynamic Parameters ◽  
Physical Status ◽  
Analgesic Requirement ◽  
Respiratory Parameters ◽  
Supraclavicular Block ◽  
Group D

Background: Dexmedetomidine has anxiolytic, sedative, hypnosis, analgesic, antisialogogue and sympatholytic properties which render it suitable as an adjuvant. Hence this study was aimed to prove its efficacy as an adjuvant to lignocaine and bupivacaine for supraclavicular block in patients undergoing orthopedic upper limb surgeries. Other objectives of the study were to evaluate and compare the onset and duration of sensory and motor block as well as total analgesia, to compare effect on hemodynamic and respiratory parameters and to study any adverse effect associated with dexmedetomidine as adjuvant.Methods: Sixty patients of ASA physical status class I & II of elective upper limb forearm orthopedic surgeries were selected in our study. Patients in group NS (n=30) received 10 ml lignocaine 2% + 20 ml bupivacaine 0.5% + 1 ml normal saline for supraclavicular block and group D (n=30) received 10 ml lignocaine 2% + 20 ml bupivacaine 0.5% + 1 µg/kg of Dexmedetomidine for the same block. The onset and duration of sensory and motor block, total duration of analgesia, need of rescue analgesic postoperatively, postoperative VAS score was assessed and compared between the two groups.Results: Demographic data and surgical characteristics are comparable in both the groups. The onset of sensory and motor block was significantly lower (p <0.05) in group D than in group NS. The duration of sensory and motor block was significantly higher (p <0.01) in group D when compared to group NS. The duration of analgesic requirement postoperatively was significantly higher (p <0.01) in group D than group NS. No significant change in observations was made for hemodynamic parameters in both the groups.Conclusions: Dexmedetomidine can be considered as an adjuvant to lignocaine and bupivacaine mixture for excellent quality supraclavicular block without any side effects and provide good sedation in patients undergoing orthopedic upper limb surgeries.

scholarly journals Hemodynamic effects of carbetocin administered as an intravenous bolus or infusion during cesarean delivery

2020 ◽  
Vol 15 (2) ◽  
pp. 167-172
Author(s):  
Kihyug Kwon ◽  
Dohyung Kim ◽  
Hyunmin Jo ◽  
Ji Eun Park ◽  
Kyung Ok Kim
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Demographic Data ◽  
Elective Cesarean Section ◽  
Intravenous Bolus ◽  
Hemodynamic Effects ◽  
Duration Of Action ◽  
Left Lateral Decubitus Position ◽  
Significant Difference ◽  
Uterotonic Agent

Background: Postpartum hemorrhage is the leading cause of maternal mortality. Oxytocin being the most popular uterotonic agent, has been routinely administered after both vaginal delivery and cesarean section. Carbetocin is a newer uterotonic agent and provides the benefit of a longer duration of action without additional administration post-delivery.Methods: We recruited 34 women undergoing elective cesarean section under spinal anesthesia. All patient was received spinal anesthesia using 0.5% hyperbaric Marcaine 8–10 mg in conjugation with fentanyl 20 μg in the left lateral decubitus position. Hartmann’s solution 10–15 ml/kg was administered before carbetocin. The operation started as soon as sensory block at level T4–T6 was confirmed. A non-invasive hemodynamic monitoring cuff (Finometer®) was attached to the patient’s finger soon after the induction of spinal anesthesia. Using the Finometer, we recorded the heart rate and mean arterial pressure at every 15 s, starting from 15 s before the administration of carbetocin to 5 min after. After the removal of the placenta, the bolus group was administered intravenous bolus injection of carbetocin 100 μg and the infusion group was administered carbetocin 100 μg diluted in 50 ml normal saline, over 5 min using an infusion pump.Results: The demographic data showed no significant difference between the two groups. Furthermore, there were no significant hemodynamic differences between the two groups.Conclusions: The method of administration of carbetocin does not influence its hemodynamic effects.

scholarly journals A COMPARATIVE STUDY BETWEEN DEXMEDETOMIDINE AND MIDAZOLAM AS AN ADJUVANT TO INTRATHECAL BUPIVACAINE

2020 ◽  
pp. 1-4
Author(s):  
K.K. Arora ◽  
Neetu Gupta ◽  
Nidhi Sharma
Keyword(s):  
Side Effect ◽  
Motor Block ◽  
Local Anaesthetics ◽  
Efficacy And Safety ◽  
Significant Side Effect ◽  
Significant Difference ◽  
Haemodynamic Changes ◽  
The Common ◽  
Clinically Significant ◽  
Group D

Background: Subarachnoid block(SAB) is the common mode of anaesthesia. To prolong its action various adjuvants are being added to local anaesthetics(LA). In this study we compared the efficacy and safety of midazolam and dexmedetomidine as an adjuvant to intrathecal 0.5% hyperbaric (H) bupivacaine. Material & Methods: 80 ASA grade I or II patients of either sex scheduled for lower limb or lower abdominal surgeries were randomly allocated into two groups, Group D & Group M. In group D, patients received 3ml of 0.5% (H) bupivacaine + dexmedetomidine 5mcg in 0.5ml normal saline(NS). While group M received 3ml of 0.5% (H) bupivacaine + 2mg midazolam ( 0.4ml of 5mg/ml) + 0.1ml of NS. Onset of sensory & motor block and duration of sensory & motor block were recorded. Patients were monitored for any haemodynamic changes and side effect. Result: Duration of both sensory & motor blockade was significantly prolonged in group D as compared to group M. There was no clinically significant difference observed among both the groups in respect to hemodynamic parameters, sedation and side effect. Conclusion: Dexmedetomidine as an adjuvant to intrathecal bupivacaine (H) was better as compared to midazolam. It significantly prolongs the duration of analgesia postoperatively without any significant side effect.

scholarly journals COMPARISON OF CLONIDINE AND DEXMEDETOMIDINE AS AN ADJUVANT TO 0.5% BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: A RANDOMISED PROSPECTIVE DOUBLE-BLIND STUDY

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Kushal Jethani ◽  
Preeti Sahu ◽  
Seethal Ann
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Double Blind Study ◽  
Nerve Blocks ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block ◽  
Group D

Background and Objectives: Alpha-2 agonists are used as adjuvant with local anaesthetic agents to prolong the duration of spinal, epidural and peripheral nerve blocks as well as to prolong the duration of post operative analgesia. We performed a study to compare clonidine(1ug/kg) and dexmedetomidine (1ug/kg) as an adjuvant to 0.5% bupivacaine in supraclavicular brachial plexus block. Methods: Eighty ASA I and II patients scheduled for elective upper limb orthopaedic surgeries under supraclavicular brachial plexus block were divided into two  groups(n=25 each) in a randomized, double-blinded fashion. Group C received clonidine 1 μg/kg and Group D received dexmedetomidine 1 μg/kg added to bupivacaine 0.5% (30 cc). Onset and recovery time of sensory and motor block, as well as duration of analgesia were studied in both the groups. Results: Duration of sensory block and motor block was 220.12 ±50.3 and 280.1± 20.12 min respectively in group C, while it was 410.34± 60.12 and 460.4 ± 50.56 min respectively in group D and hence both were significantly prolonged in group D.  No statistically significant difference was seen in onset of sensory and motor block between the two groups. The duration of analgesia i.e. time to requirement of rescue analgesia was 270.4± 56.7 mins and 452.7 ±64.23 mins in group C and D respectively and  this difference was statistically significant (P=0.001). Conclusion: Addition of dexmedetomidine to bupivacaine 0.5% in supraclavicular brachial plexus block prolonged the duration of sensory and motor block as well as the duration of analgesia when compared with clonidine. Keywords: Clonidine, dexmedetomidine, supraclavicular block

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