scholarly journals Comparing the Analgesic Efficacy of Intrathecal Bupivacaine Alone with Intrathecal Bupivacaine Midazolam or Magnesium Sulphate Combination in Patients Undergoing Elective Infraumbilical Surgery

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Josef Attia ◽  
Amany Abo Elhussien ◽  
Mostafa Zaki
Keyword(s):  
Side Effects ◽  
Magnesium Sulphate ◽  
Lower Limb ◽  
Analgesic Efficacy ◽  
Motor Blockade ◽  
Sensory Blockade ◽  
Lower Limb Surgery ◽  
Group A ◽  
Group B ◽  
Limited Duration

Background. Spinal anaesthesia, which is one of the techniques for infraumbilical surgeries, is most commonly criticized for limited duration of postoperative analgesia. Aim of the Work. The aim of this study was to decrease bupivacaine dose used in spinal anesthesia in patients undergoing orthopedic lower limb surgery and reduce its possible side effects. Patient and Methods. Sixty adult patients of both sexes, divided into three. Group C received 2.5 mL bupivacaine and 0.5 mL saline 0.9%. Group A received 2.5 mL bupivacaine and 0.5 mL midazolam. Group B received 2.5 mL bupivacaine and 0.5 mL magnesium sulphate. Results. As regards onset of both motor and sensory blockade, there are a significant decrease in group A and a significant increase in group B as compared to group C, with a significant decrease in duration of motor blockade and significant increase in duration of sensory blockade in both group A and group B, respectively, as compared to group C, with a significant decrease in the duration of sensory blockade in group B as compared to group C. Conclusions. These results suggested that intrathecal midazolam as an adjuvant for bupivacaine increases the duration of both sensory and motor blockade more than that of magnesium sulphate.

scholarly journals A Comparison of Oral Gabapentin and Oral Pregabalin as Preemptive Analgesia for Orthopedic Surgery Under Spinal Anaesthesia

2021 ◽  
Vol 9 (1) ◽  
pp. 74-78
Author(s):  
Neena Jain ◽  
Rahul Bankapur ◽  
Preeti Lamba ◽  
saurav Singh
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Orthopedic Surgery ◽  
Lower Limb ◽  
Analgesic Efficacy ◽  
Double Blind Study ◽  
Group A ◽  
Group B

Background and Aims: Gabapentin and pregabalin, by decreasing noxious stimulus induced excitatory neurotransmitter release at central nervous system, may attenuate central sensitization and eventually decrease development of postoperative pain. We evaluated preemptive analgesic efficacy of single dose of oral gabapentin 600 mg and pregabalin 75mg for postoperative pain in patients undergoing lower limb orthopedic surgery under spinal anesthesia. Material and methods: A prospective, randomized, double blind study was conducted on 70 patients aged between 18 to 60 years with ASA grade 1 and 2 posted for lower limb surgeries under spinal anaesthesia. Patients were allocated into Group A and Group B receiving oral gabapentin(600mg) and oral pregabalin (75mg) respectively 1.5 hours before surgery. Primary objective was assessing duration and quality of analgesia by Visual Analogue Scale (VAS) score at 2,4,6,8,10,12,16,20 and 24 hours.Secondary objective was to assess total dose of rescue analgesic in first 24 hours, perioperative hemodynamic change and various side effects. Statistical Analysis used: Categorical data was compared using Chi- square test. Quantitative parametric data was analysed using unpaired student t-test. P value < 0.05 was considered statistically significant. Results: Mean duration of analgesia in Group A (10.53 ± 2.686 hours) was longer than Group B (7.943±3.199hr) (P = 0.0006).Mean number of analgesic dosesrequired in first 24 hourswere less in Group A (1.429 ± 0.5021) ascompared to Group B (1.771±0.6897) (P = 0.0202).All patients remained hemodynamically stable with no significant side effects noted in either group. Conclusion: We conclude that preemptive analgesic efficacy of oral gabapentin 600mg is better in comparison to oral pregabalin 75 mg for patients posted for lower limb orthopedic surgeries under spinal anesthesia.

Compare the Analgesic Efficacy of Dexmedetomidineand Fentanyl as an Adjuvant to Bupivacaine for Lower Limb Surgery

2021 ◽  
Vol 15 (6) ◽  
pp. 2153-2155
Author(s):  
Arshi Naz ◽  
Mirza Shahzad Baig ◽  
Vijai Kumar ◽  
Samita S Khan ◽  
Sidra Javed ◽  
...  
Keyword(s):  
Spinal Anaesthesia ◽  
Lower Limb ◽  
P Value ◽  
Hyperbaric Bupivacaine ◽  
Rescue Analgesia ◽  
Sensory Blockade ◽  
Significant Difference ◽  
Lower Limb Surgery ◽  
Group A ◽  
Group B

Objective: To compare the analgesic effectiveness of Dexmedetomidine and Fentanyl as an adjuvant to 0.5% Bupivacaine in spinal anaesthesia for patients undergoing lower limb surgery. Study Design: Randomized controlled trial. Place & Duration:The study was conducted at department of Anesthesia, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi for duration from 15thJuly2020 to 15thFebruary 2021. Methods: In this study 52 patients of both genders undergoing lower limb surgeries were included. Patient’s ages were ranging from 20 to 70 years. All the patients were divided into two Groups. Group A included 26 patients and received Inj. Dexmedetomidine 10 μg in 0.5ml normal saline with 12.5mg of 0.5% hyperbaric bupivacaine, Group B had 26 patients and received 25mg fentanyl with 12.5mg of 0.5% hyperbaric bupivacaine. Time to achieve T10 blockade, time to first rescue analgesia were examined and compare between both groups. All the statistical data was analyzed by SPSS 24.0. P-Value <0.05 was significantly considered. Results: Mean age of group A was 40.52±12.28 years and in group B it was 40.14±13.34 years. There were 18 (69.23%) male patients and 8 (30.77%) females in group A while in Group B 19 (73.08%) patients were male and 7 (26.92%) were females. No significant difference was observed between both groups regarding time to T10 blockade with p-value >0.05. A significant difference was found regarding time to rescue analgesia, in Group A it was 426.58±92.44 minutes and in Group B, it was 206.44±48.47 minutes (p-value <0.0001). Patients’ satisfaction was high in dexemedetomidine group as compared to fentanyl group. Conclusion: Dexmedetomidine 10 μg with 0.5% bupvicaine showed better effectiveness regarding time to first rescue analgesia as compared to fentanyl. No significant difference was observed regarding time to sensory blockade between both medications. Keywords: Dexmedetomidine, Fentanyl, Spinal Anaesthesia, Lower Limb Surgery, Sensory Block, Analgesia

scholarly journals Comparative Efficacy of Intrathecal Pethidine with Lignocaine 5% (Heavy) as Sole Anaesthetic Agent for Perineal Operations

2020 ◽  
Vol 5 (1) ◽  
pp. 78-83
Author(s):  
Jitta Sudershan Reddy
Keyword(s):  
Body Weight ◽  
Side Effects ◽  
Postoperative Analgesia ◽  
Anaesthetic Agent ◽  
Motor Blockade ◽  
Sensory Blockade ◽  
Motor Paralysis ◽  
Group A ◽  
Group B ◽  
Preservative Free

Background: The discovery of opioid receptors and ligand in the brain and spinal cord lead to the feasibility of their use intrathecally. Pethidine is the only narcotic that has been shown to be effective intrathecally for surgery. This is probably because it as a phenyl-piperidine derivative and has a structure and action similar to that of local anaesthetic.Subjects and Methods:50 patients belonging to ASA grade 1 and 2 physical status were randomly assigned to two groups A and B. Patients in group A received 1 ml of 5% lignocaine (heavy) intrathecally and those in group B gained intrathecal Pethidine (preservative-free) 0.5mg/kg body weight. The time for onset and level of sensory blockade, onset and degree of motor blockade, hemodynamic parameters, time for regression of sensory and motor blockade, duration of postoperative analgesia and side effects were noted and compared in both the groups.Results:Two groups were comparable with respect to age, sex, height and weight. The onset of sensory and motor blockade in-group A was 2.00±1.06min and 2.56±0.88 and in-group B it was 3.56±1.64 min and 7.22±1.11 min respectively, which was statistically significant. Grade I motor paralysis was seen in 2 cases (10%) in group A and 15 cases (75%) in groupB. Grade II motor paralysis was seen in 6 cases (30%) in group A and 5 cases (25%) in group B. Grade III motor paralysis was viewed in 12 cases (60%) in group A and 0 cases(0%) in group B. Grade I and III motor paralysis in the groups were statistically significant (p<0.05). Time for sensory regression at L1 was 65.12±4.83 min in-group A and 94.60±6.88 min in-group B that was statistically very significant (p<0.05). The time for regression of motor blockade was 60.40±3.85 in-group A and 60.20±5.02 in group B, which was statistically not significant (p>0.05). The duration of postoperative analgesia was 122.84±9.37 min in-group A and 320.60±23.02 in group B, which was statistically very significant. The incidence of side effects was comparable in both groups.Conclusion:Pethidine (preservative-free) 0.5mg/kg body weight can be used intrathecally as a sole anaesthetic agent to provide prolonged postoperative analgesia associated with hemodynamic stability and early ambulation in patients undergoing perineal surgeries.

COMPARATIVE STUDY BETWEEN EPIDURAL BUPIVACAINE WITH BUPRENORPHINE AND EPIDURAL BUPIVACAINE FOR POST-OPERATIVE ANALGESIA IN ABDOMINAL AND LOWER LIMB SURGERY

2021 ◽  
pp. 29-31
Author(s):  
Anant Prakash ◽  
Rahul Kumar ◽  
Chandeshwar Choudhary ◽  
Debarshi Jana
Keyword(s):  
Comparative Study ◽  
Lower Limb ◽  
Heart Beat ◽  
Epidural Administration ◽  
Visual Analogue Pain ◽  
Post Operative Period ◽  
Epidural Bupivacaine ◽  
Lower Limb Surgery ◽  
Group A ◽  
Group B

Background: Epidural administration of various analgesics gained increasing popularity following the discovery of opioid receptors in the spinal cord capable of producing potent analgesia. This effect seems to be greatest when epidural anaesthesia in continued in the post-operative period as epidural analgesia. It is now clear that epidural administration of opioids. Ours was a comparative study between epidural bupivacaine with buprenorphine and epidural bupivacaine for post-operative analgesia in abdominal and lower limb surgery. Methods: 60 patients undergoing lower abdominal and lower limb surgeries of either sex with ASA grade 1 and 2 aged between 20 and 60 years for divided into two groups. After completion of the surgery and when the effect of local anaesthetic wears of and the patients complains of pain the intended study drugs were given when visual analogue pain score touched 5 cm mark. Group – A: Patients received 8ml of 0.25% bupivacaine + 0.15mg of buprenorphine. Group – B: patients received 0.25% of bupivacaine alone. In the post-operative period the following parameters were studied, 1. Onset of analgesia, 2. Duration of analgesia, 3. Vital parameters such as heart beat, blood pressure, respiratory rate, sedation score and visual analogue score were recorded, 4. Side effects like nausea, vomiting, hypotension, respiratory depression, and pruritus allergic reaction were looked for. Results: It is observed that onset of analgesia in Group A (0.25% bupivacaine + 0.15mg buprenorphine) was 7.35 min. When compared to Group B which 15.5 min, which is statically signicant (P<0.05). Duration of analgesia in Group A is 17.23 hrs compared to Group B, which is 5.2 hrs, this is statically signicant (P<0.05). Visual analogue scale was reduced in Group A compared to Group B Conclusions: Addition of buprenorphine to bupivacaine by epidural injection for post-operative analgesia improves the onset, The duration and the quality of analgesia

scholarly journals Epidural butorphanol for post operative analgesia in lower limb surgeries: A comparative study with epidural tramadol

2017 ◽  
Vol 6 (3) ◽  
pp. 26-32
Author(s):  
G P Deo ◽  
S K Shrestha ◽  
I N Shrestha
Keyword(s):  
Patient Satisfaction ◽  
Side Effects ◽  
Lower Limb ◽  
Analgesic Efficacy ◽  
Epidural Injection ◽  
Double Blind ◽  
Duration Of Action ◽  
Number Of Patients ◽  
Group B

To compare the efficacy of epidural butorphanol and tramadol for post operative analgesia in lower limb surgeries. Randomized, controlled, double blind, prospective study conducted at Department of Anaesthesia and Critical Care, Chitwan Medical College from September 1st 2015 to August 31st 2016. 60 patients of ASA Grade I and II of either sex, aged between 18-65 years willing for epidural analgesia for post operative analgesia were included in the study. They were divided into two groups: Group B- Butorphanol group and Group T- Tramadol group. Subjects of Group B received 2mg of Butorphanol and 0.25% Bupivacaine making a total volume of 10 ml and that of Group T received 100mg of Tramadol and 0.25% Bupivacaine also making a total volume of 10 ml. Analgesic efficacy was assessed by Visual Analogue Scale (VAS). The onset and duration of analgesia along with side effects were also assessed. The quality of analgesia was studied using time to independent mobilization and overall patient satisfaction. Total number of patients was 60, of ASA Grade I and II, aged between 18-65 years. The mean age of patients in Group B was 42.6±11.7 years and 46.1±11.2 years in Group T. Time of onset of analgesia after epidural injection was 7.4±0.9 minutes in Group B and 12.7±1.5 minutes in Group T and the difference was found to be statistically significant. Duration of analgesia was 317.1±99.1 minutes and 438.8±136.6 minutes in Butorphanol and Tramadol groups respectively which was also statistically significant. Sedation was significantly higher in butorphanol group whereas nausea and vomiting was higher in tramadol group. Quality of analgesia in terms of patient satisfaction was better with epidural butorphanol. Both epidural tramadol and butorphanol were effective in relieving post operative pain however butorphanol had lesser side effects and greater patient satisfaction compared to tramadol but the duration of action was relatively short.

scholarly journals COMPARATIVE STUDY OF HAEMODYNAMIC CHANGES BETWEEN 6% HYDROXYETHYLSTARCH 130/0.4 AND RINGER LACTATE COLOADING IN ELDERLY PATIENTS UNDERGOING LOWER LIMB ORTHOPAEDIC SURGERY UNDER SPINAL ANAESTHESIA

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Jayanta Chakraborty ◽  
Uma Mandal
Keyword(s):  
Elderly Patients ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Orthopaedic Surgery ◽  
P Value ◽  
Ringer Lactate ◽  
Lower Limb Surgery ◽  
Group A ◽  
Group B ◽  
Lactate Solution

Background: Anaesthesia for the lower limb surgeries could be either general or regional. Studies had shown that regional anaesthesia for lower limb surgery results in better postoperative outcomes, including improved respiratory function, less nausea vomiting, less pain and lower incidence of deep vein thrombosis. Among all the regional anaesthetic techniques spinal anesthesia remained most preferred technique for its fast, predictable, profound, high quality sensory and motor block. However some complications like hypotension, bradycardia, post dural puncture headache, urinary retention were unavoidable and hypotension remained the most common one and found to be more in the elderly population with incidence of 25–82%. Treating spinal anaesthesia-induced hypotension included intravenous (IV) volume administration. IV Fluid infused before and at the time of spinal anaesthesia was referred to as preloading and coloading respectively. Although merit of coloading and the choice of fluid to be infused had remained  a matter of debate, till today no definitive study had indicated any superiority of colloids over crystalloids decisively  moreover large amount crystalloids to counter hypotensin  remained a threat to the cardiovascular overload for  elderly patients. Role of vasopressors in elderly remained controversial too. So this observational prospective study was  undertaken to compare  the effiicacy of coloading of infusion 6%HES 130/0.4 (colloid) and Ringer Lactate solution (crystalloid)  to maintain the intra operative haemodynamics in elderly patients undergoing lower limb orthopaedic surgery under spinal anaesthesia. Objectives: To assess and to compare the efficacy of infusion 6%HES 130/0.4 and infusion Ringer lactate solution coloading in preventing the intra-operative hypotension. Materials and method: On  approval of the Ethics Committee of Burdwan Medical College (BMC&H), 80 patients were included and equally divided into two groups group A and group B where groupp A received 6% HES  as coloading fluid and groupp B received RL as coloading fluid at the start of spinal anaesthesia. On entering Operation Theatre baseline parameters were noted for each patient and lumbar puncture for spinal anaesthesia was performed following strict aseptic precautions, in sitting position. Upon achieving adequate block episodes of hypotension were noted and treated according to the study protocol. Results: Statistical analysis for Continuous and categorical variables were done using Mann-Whitney U test and Pearson’s Chi Square test accordingly and p values less than 0.05 were considered significant. In group A, 17.5 % patients developed one episodes of hypotension whereas in group B, 37.5% patients developed one episodes of hypotension which was statistically significant with p value 0.0465.  In group A none of the patients developed further episodes of hypotension but in group B 5% affected patients developed one more episodes of hypotension and 2.5% affected patients developed two more episodes of hypotension. Average intravenous dose of mephentermine required to treat hypotension was 1.05 mg for group A and 2.70 mg for group B and found to be statistically significant with p value 0.039. Total fluid consumption In group A was 654.95 ml whereas in group B  was 976.73 ml and also  found to be statistically significant with p value <0.001. Conclusion:  The study found that coloading with 6% HES was significantly effective than Ringer Lactate solution in preventing episodes of hypotension in spinal anaesthesia induced elderly patients undergoing lower limb surgery without any noticeable adverse effect. Key Words: Spinal anaesthesia, lower limb surgery, elderly patients, coloading

scholarly journals EFFICACY OF INTRATHECAL BUPRENORPHINE WITH BUPIVACAINE 0.5% AND FENTANYL WITH BUPIVACAINE 0.5% IN LOWER ABDOMINAL SURGERIES – A COMPARATIVE STUDY

2021 ◽  
pp. 1-3
Author(s):  
Jobitta R ◽  
Harshavardhan K
Keyword(s):  
Side Effects ◽  
Comparative Study ◽  
Lower Limb ◽  
Intrathecal Administration ◽  
Sensory Blockade ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Baseline Characteristics ◽  
Group B ◽  
Operative Recovery

Introduction : Spinal anesthesia is one of the commonest and preferred mode of anesthesia for lower abdominal and lower limb surgeries because of its safety and faster post-operative recovery. Bupivacaine is the commonly used anesthetic for intrathecal administration. Drugs such as Fentanyl, Buprenorphine, Clonidine, Dexmeditomedine have been tried as adjuvants to increase the duration of Analgesia and decrease post-operative pain, but addition of these drugs is wrought with side-effects like hypotension and bradycardia. This study aims to compare the efficacy of Fentanyl and Buprenorphine as adjuvants to intrathecal Bupivacaine in lower abdominal surgeries. Methodology : A total of 112 patients undergoing lower abdominal surgeries where administered either the combination of Buprenorphine with Bupivacaine (56 patients, Group B) or Fentanyl with Bupivacaine (56 patients, Group F). Intraoperatively, patients’ vitals HR, NIBP, SpO2, ECG were monitored every 2 minutes once for the first 10 minutes, every 10 minutes once for the next 50 minutes, and 15 minutes once till the end of surgery. Motor and Sensory blockade, duration of Analgesia and Post-operative pain were also recorded. Results : There was no significant difference in the baseline characteristics and intra-operative vitals between the groups. Patients in Group B had a faster Motor and Sensory blockade, longer duration of analgesia and lesser post-operative pain as compared to Group F. None of he patients included in the study had significant intra-operative hypotension or respiratory depression. Conclusion : The addition of Buprenorphine to Bupivacaine is more efficacious than the addition of fentanyl to Bupivacaine and leads to better intra-operative and post-operative analgesia withourt significant side-effects.

scholarly journals Isobaric levobupivacaine a better and safer substitute for spinal anaesthesia in patients undergoing prolonged lower abdominal and lower limb surgeries

2018 ◽  
Vol 6 (9) ◽  
pp. 3111
Author(s):  
Wasimul Hoda ◽  
Abhishek Kumar ◽  
Priodarshi Roychoudhury
Keyword(s):  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Motor Block ◽  
Sensory Block ◽  
Double Blind Study ◽  
Double Blind ◽  
Sensory Blockade ◽  
Group A ◽  
Group B

Background: Bupivacaine being the drug of choice for spinal anaesthesia is associated with serious cardiac toxicity. Levobupivacaine and ropivacaine, both being the two S enantiomers of bupivacaine can be a safer alternatives with better cardiovascular safety. Hence, the clinical efficacy of both were assessed and compared in patients undergoing spinal anesthesia.Methods: A prospective randomized controlled double blind study was done in 68 adult posted for elective lower abdominal and lower limb surgeries under spinal anesthesia. They were randomized into 2 groups. About 3ml isobaric levobupivacaine 0.5% (15mg) was given in group A and 3ml isobaric ropivacaine 0.5% (15mg) was given in group B. Onset, duration of sensory and motor blocks, time for maximum sensory and motor block, time for 2 segment sensory regression and haemodynamic parameters were recorded and analyzed.Results: All patients achieved a sensory block of T10 dermatome. Onset of sensory blockade at T10 was similar in both groups, group A (5.71±1.31min) and group B (5.94±1.72min). Time from injection to two dermatomal regression was 129.68±15.54min in group A and 111.38±22.35min in group B. Onset of Bromage score of 1 in group A was 4.68±1.27min and in group B was 6.44±1.64min. The mean duration of motor and complete motor block was prolonged in group A patients (197.74±18.51min, 168.82±17.90 min) as compared to group B (131.88±20.41min, 106.71±10.85min).Conclusions: Isobaric levobupivacaine was found to be a better and safer substitute for spinal anesthesia in patients undergoing prolonged lower abdominal and lower limb surgeries.

scholarly journals Epidural tramadol improves the quality of pain relief during labor

2017 ◽  
Vol 6 (3) ◽  
pp. 14-19
Author(s):  
I N Shrestha ◽  
G P Deo ◽  
S K Shrestha ◽  
S Neupane ◽  
B S Regmi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Side Effects ◽  
Pain Relief ◽  
Total Dose ◽  
Analgesic Efficacy ◽  
Time Intervals ◽  
Group A ◽  
Group B

 To study the analgesic efficacy and side effects of Tramadol for painless labor in combination with Bupivacaine. Randomized, controlled, double blind, open prospective study conducted at Department of Obstetrics and Gynaecology, Chitwan Medical College from July 1st 2015 to June 30th 2016. 100 patients of ASA Grade I and II, aged between 20-35 years willing for epidural analgesia for labor pain were included in the study. They were divided into two groups: Group A- Control group and Group B- Study group. Subjects of Group A received 10 ml of 0.25% Bupivacaine and that of Group B received 10ml of 0.25% Bupivacaine with 1mg/kg body weight of tramadol. Analgesic efficacy was assessed by Visual Analogue Scale (VAS) and other vital parameters (Blood Pressure, Heart Rate and Respiratory Rate) before the administration of the drug and at different time intervals of 0, 5 min, 10 min, 15 min, 30 min, 45 min, 60 min and every hourly up to maximum of 5 hrs. Neonatal out comes were assessed by the use of APGAR scores and the side effects of the drugs in two groups were also evaluated. Total number of patients was 100, of ASA Grade I and II, aged between 20-35 years. The mean age of patients in Group A was 23.54 ± 3.74 years and 24.22 ± 3.64 years in Group B. Mode of delivery was spontaneous vaginal in 42 patients (84%) in group A and 45 patients (90%) in group B. Instrumental vaginal delivery was done in 1 patient (2%) of group A and none of group B. Cesarean section was done in 7 patients (14%) of group A and 5 patients (10%) of group B. There was no significant difference in heart rate, blood pressure and respiratory rate at various time intervals. Pain score of Group B was significantly less at 60th min and had lower values than Group A at various time intervals. Time for first top up was significantly delayed and the total dose of bupivacaine was significantly lower in Group B patients but the incidence of nausea and vomiting was significantly high among Group B patients. At one minute majority of the babies of group A had mean APGAR score 6.98 ± 0.55 versus 7.18 ± 0.60 in group B. At 5 minute, Group A had mean score of 8.02 ± 0.47 versus 8.22 ± 0.58 in Group B. There were no significant differences in 2 groups. In both the groups there was no significant effect on duration of second stage of labor and it wasn’t prolonged in any of the patients. Epidural anesthesia with bupivacaine and tramadol provided better pain relief and reduced the total dose of bupivacaine in majority of the patients with no adverse effects on mother and fetus. As tramadol is cheap, safe and effective, it can be considered as a better option to improve quality of pain relief during labor.

scholarly journals BRACHIAL PLEXUS BLOCK

2016 ◽  
Vol 23 (08) ◽  
pp. 980-984
Author(s):  
Muhbat Ali ◽  
Bashir Ahmed ◽  
Hamid Raza ◽  
Kamlaish Suchdev ◽  
Saqib Khan
Keyword(s):  
Body Weight ◽  
Brachial Plexus Block ◽  
Motor Blockade ◽  
Sensory Blockade ◽  
Elective Surgical Procedures ◽  
Significant Difference ◽  
Group A ◽  
Study Population ◽  
Group B ◽  
Plexus Block

Objectives: The aim of our study is to find out the efficacy of dexamethasone(8mg) on prolonging the duration of motor and sensory blockade as used in brachial plexusblock required for forearm and hand surgeries. Study Design: Prospective randomized doubleblind trial. Period: April 2013 to May 2014, for a period of 14 months. Setting: Tertiary carehospital in Karachi Pakistan. Method: The study population consisted of 42 patients belongingto ASA classification, grades I and II, who underwent elective surgical procedures involving theforearm and hand. The patients were divided in to three groups, group A consisted of patientswho were given 2% of prilocaine at 5mg per kg of body weight, group B consisted of patientswho were given 2% of prilocaine with dexamethasone (8mg as 2ml) at group C consisted ofpatients who were given 0.5% of levobupivacaine at 1.5mg per kg of body weight. The timeduration and onset of sensory and motor blockade was duly noted for all the three groups.Data was analyzed using SPSS version 20. Results: The time of onset of motor and sensoryblock in group A and B, were very similar, there was a difference of longer duration was dulynoted in group C, which was statistically significant (p<0.001). In terms of the duration of block,a statistically significant difference was found when compared in the three groups (p<0.001).The duration of sensory and motor blockade was longer in Group C when compared to theother two groups, and they were found to be longer in group B when compared with group A(p<0.001). Side effects were not found in the study population due to small number of patientsevaluated. Conclusion: According to our study the addition of dexamethasone to the prilocaineused in hand and forearm surgeries resulted in increased duration of the sensory and motorblockade achieved. While levobupivacaine was found to be a very potent anesthetic when usedlocally for post op analgesia requirements and during long procedures.

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