scholarly journals Dexamethasone as a bupivacaine adjuvant for ultrasound-guided interscalene brachial plexus block: a prospective randomized study

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Maha Abd el Fattah Metawie Badran ◽  
Ayman Mokhtar Kamaly ◽  
Hadil Magdy Abdel Hamid ◽  
Raham Hassan Mostafa
Keyword(s):  
Postoperative Analgesia ◽  
Randomized Study ◽  
Shoulder Surgery ◽  
Interscalene Block ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Vas Score ◽  
Arterial Blood ◽  
Significant Difference ◽  
Group D

Abstract Background Finding adjuvants to local anesthetic used in interscalene block that could efficiently extend the analgesia duration has recently been the focus of researchers. The aim of the work was to determine whether the addition of perineural dexamethasone to bupivacaine in-ultrasound guided interscalene block would prolong the duration of sensory analgesia in patients undergoing shoulder surgery. Results This prospective, randomized, double-blinded study comprised 50 patients. They were randomly subdivided into 2 groups: group C [control] and group D [dexamethasone]. We noted a significant difference regarding the timing for the first rescue analgesia being shorter in group C than in group D with a P value < 0.001. Regarding postoperative analgesia, higher Ketolac consumption was noticed in group C than in group D. Patients from both groups showed excellent analgesic effects with VAS score less than 2 points up to 6 h postoperative then patients in group C had a higher VAS score compared to group D, and the difference was statistically significant (P value < 0.05). We also noticed an increase in the heart rate and mean arterial blood pressure in group C than in group D at 12 h and 24 h postoperatively. Conclusion We concluded that the addition of 8 mg of perineural dexamethasone to 30 ml of 0.5% bupivacaine showed improvement in the postoperative analgesia in shoulder surgery without obvious complications.

scholarly journals EFFICACY OF USG GUIDED FASCIA ILIACA COMPARTMENT BLOCK AS POSTOPERATIVE ANALGESIA IN PROXIMAL FRACTURE FEMUR

2020 ◽  
pp. 10-13
Author(s):  
Kulkarni Sanhita J. ◽  
Sahasrabuddhe Saumil S ◽  
Joshi Pradnya S ◽  
Bhale Pramod V ◽  
Sasturkar Vasanti M ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Femur Fracture ◽  
Proximal Femur Fracture ◽  
P Value ◽  
Ultrasound Guided ◽  
Total Consumption ◽  
Rescue Analgesia ◽  
Fracture Femur ◽  
Significant Difference

Background Fascia iliaca compartment nerve block (FICNB) has been reported to provide effective postoperative analgesia in patients with femur fracture. This study aimed to evaluate the effectiveness of FICNB with Bupivacaine and Dexamethasone for postoperative analgesia in proximal fracture femur. Methods Sixty-four patients of ASA grade 1 to 3, aged 50-80 years scheduled for proximal femur fracture femur were included and randomly assigned to two groups of 32 patients each Group F received ultrasound guided(FICNB) with 0.25% 40ml of Bupivacaine & Dexamethasone 4 mg & Group T received Tramadol 50mg at the end of surgery. Postoperative pain was assessed at 30 minutes, 2 hours, 4 hours, 6 hours, 8 hours, 12 hours and 24 hours using visual analogue scale (VAS). Injection Paracetamol 1gm was given intravenously as rescue analgesia in both the groups when VAS was more than four. Results Both the groups were comparable for demographic parameters. The mean duration of analgesia was 460.31±10.50 minutes in the FICNB group while it was only 263.72±12.85 minutes in the tramadol group, the difference being statistically significant (with a ‘p value’ of 0.001). The total consumption of paracetamol did not show a significant difference in either of the groups in the first 24 hours, the ‘p value’ being 0.406. Conclusion Ultrasound guided FICNB given postoperatively in patients undergoing proximal fracture femur can provide postoperative pain relief for longer duration than Inj. Tramadol.

scholarly journals A Comparison of effect of preemptive versus postoperative use of ultrasound-guided bilateral transversus abdominis plane (TAP) block on pain relief after laparoscopic cholecystectomy

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Poupak Rahimzadeh ◽  
Seyed Hamid Reza Faiz ◽  
Kaveh Latifi-Naibin ◽  
Mahzad Alimian
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Relief ◽  
Pain Score ◽  
Postoperative Analgesia ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Significant Difference

AbstractNowadays, there are various methods to manage pain after laparoscopic cholecystectomy. The aim of this study was to compare the effectof preemptive versus postoperative use of ultrasound-guided transversus abdominis plane (USG-TAP) block on pain relief after laparoscopic cholecystectomy. In this single-blinded randomized clinical trial, the patients who were candidates for laparoscopic cholecystectomy were randomly divided into the two groups (n = 38 per group). In the preemptive group (PG) after the induction of anesthesia and in the postoperative group (POG) after the end of surgery and before the extubation, bilateral ultrasound-guided transversus abdominis plane (TAP) block was performed on patients using 20 cc of ropivacaine 0.25%. Both groups received patient controlled IV analgesia (PCIA) containing Acetaminophen (20 mg/ml) plus ketorolac (0.6 mg/ml) as a standard postoperative analgesia and meperidine 20 mg q 4 h PRN for rescue analgesia. Using the numerical rating scales (NSR), the patients’ pain intensity was assessed at time of arrival to the PACU and in 2th, 4th, 8th, 12th, 24th h. Primary outcome of interest is NSR at rest and coughing in the PACU and in 2th, 4th, 8th, 12th, 24th h. Secondary outcomes of interests were the time to first post-surgical rescue analgesic and level of patients’ pain control satisfaction in the first 24 h. The USG-TAP block significantly decreased pain score in the POG compared to the PG, and also the pain was relieved at rest especially in 8 and 12 h (p value ≤ 0.05) after the surgery. Pain score after coughing during recovery at 2, 8 and 12 h after the operation were significantly decreased. (p value ≤ 0.05) The patient satisfaction scores in the POG were significantly higher in all times. There was a statistically significant difference between the two groups in terms of rate of postoperative nausea and vomiting (PONV), indicating that patients in the POG had significantly lower incidences of the PONV compared tothe PG. The time to first analgesic request was significantly shorterin the POG, which was statistically significant (p value = 0.089). There was no statistically significant difference between the two groups in terms of consumption of analgesics. The postoperative TAP block could offer better postoperative analgesia than preepmtive TAP block.

scholarly journals Study on the Effect of Different Doses of Hydromorphone on the Time Response and Postoperative Analgesia of Ropivacaine in Ultrasound-Guided Suprailiac Fascia Inguinal Block

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Baiyun Wang ◽  
Bingbing Hu ◽  
Huanhui Zhong ◽  
Chengda Zhao
Keyword(s):  
Postoperative Analgesia ◽  
Adverse Reactions ◽  
Incidence Rates ◽  
Time Effect ◽  
Ultrasound Guided ◽  
Analgesic Effects ◽  
Vas Score ◽  
Significant Difference ◽  
The Difference ◽  
Different Doses

Objective. To investigate the effects of different doses of hydromorphone under the guidance of ultrasound on ropivacaine blocking the superior inguinal iliac fascia and postoperative analgesia. Methods. From January 2020 to June 2021, 90 American Society of Anesthesiologists (ASA) I-II patients undergoing elective total hip arthroplasty (THA) were selected and randomly divided into 3 groups, 30 patients in each one. Ultrasound-guided superior inguinal iliac fascia block was performed in the patients of the 3 groups before operation. The L group: 0.3% ropivacaine 30 ml; the H1 group: 0.3% ropivacaine + 25 μg/kg hydromorphone 30 ml; the H2 group: 0.3% ropivacaine + 50 μg/kg hydromorphone 30 ml. The time until the occurrence of pain, pain intensity, sufentanil remedial dose, the number of PCIA presses, and effective times were compared among the 3 groups. The VAS and Ramsay scores of 3 groups were recorded at 12 h, 24 h, 36 h, and 48 h after operation. Results. The time from the end of surgery to the appearance of pain in the H2 group was higher than that in the H1 group and the L group, and the time in the H1 group was higher than that in the L group ( P < 0.05 ). The VAS score in the H2 group was lower than that in the H1 group and the L group, and the VAS score in the H1 group was lower than that in the L group ( P < 0.05 ). The VAS scores of 12 h, 24 h, 36 h, and 48 h after operation in the H2 group were lower than those of the H1 group and the L group, and the H1 group was lower than the L group ( P < 0.05 ). The Ramsay scores at 12 h, 24 h, 36 h, and 48 h after operation in the H2 group and the H1 group were higher than those in the L group ( P < 0.05 ), and the difference was not statistically significant in the H2 group and the H1 group ( P > 0.05 ). The remedial dosage of sufentanil, times of PCIA compression, and effective times in the H2 group were lower than those in the H1 group and the L group, and the level in the H1 group was lower than that in the L group ( P < 0.05 ). The incidence rates of adverse reactions in the L group, the H1 group, and the H2 group were 13.33%, 23.33%, and 30.00%, respectively. There was no significant difference in the incidence rate of adverse reactions among the 3 groups ( P > 0.05 ). Conclusion. 25 μg/kg and 50 μg/kg hydromorphone used in the ultrasound-guided superior inguinal iliac fascia block can enhance the time effect of ropivacaine and improve analgesic effects, with good safety. In addition, time effect and analgesic effect of 50 μg/kg hydromorphone in enhancing ropivacaine were more obvious.

scholarly journals Comparison of continuous interscalene block and subacromial infusion of local anesthetic for postoperative analgesia after open shoulder surgery

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668409 ◽  
Author(s):  
Semih Baskan ◽  
Deniz Cankaya ◽  
Hidayet Unal ◽  
Burak Yoldas ◽  
Vildan Taspinar ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Local Anesthetic ◽  
Shoulder Surgery ◽  
Interscalene Block ◽  
General Anesthetic ◽  
Continuous Interscalene ◽  
Significant Difference ◽  
Vas Scores ◽  
Double Blinded

Purpose: This study compared the efficacy of continuous interscalene block (CISB) and subacromial infusion of local anesthetic (CSIA) for postoperative analgesia after open shoulder surgery. Methods: This randomized, prospective, double-blinded, single-center study included 40 adult patients undergoing open shoulder surgery. All patients received a standardized general anesthetic. The patients were separated into group CISB and group CSIA. A loading dose of 40 mL 0.25% bupivacaine was administered and patient-controlled analgesia was applied by catheter with 0.1% bupivacaine 5 mL/h throughout 24 h basal infusion, 2 mL bolus dose, and 20 min knocked time in both groups postoperatively. Visual analog scale (VAS) scores, additional analgesia need, local anesthetic consumption, complications, and side effects were recorded during the first 24 h postoperatively. The range of motion (ROM) score was recorded preoperatively and in the first and third weeks postoperatively. Results: A statistically significant difference was determined between the groups in respect of consumption of local anesthetic, VAS scores, additional analgesia consumption, complications, and side effects, with lower values recorded in the CISB group. There were no significant differences in ROM scoring in the preoperative and postoperative third week between the two groups but there were significant differences in ROM scoring in the postoperative first week, with higher ROM scoring values in the group CISB patients. Conclusion: The results of this study have shown that continuous interscalene infusion of bupivacaine is an effective and safe method of postoperative analgesia after open shoulder surgery.

scholarly journals Comparitive evaluation of different concentrations of alcohol in ultrasound guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies

2021 ◽  
Vol 8 (4) ◽  
pp. 492-500
Author(s):  
Manish Kumar Singh ◽  
Pragya Verma ◽  
Sarita Singh ◽  
Gyan P Singh ◽  
Hemlata Verma
Keyword(s):  
Quality Of Life ◽  
Morphine Consumption ◽  
Rescue Analgesia ◽  
Vas Score ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Upper Abdominal

Patients suffering from advanced upper abdominal malignancies have pain as predominant symptom affects their quality of life and survival. USG guided coeliac plexus neurolysis become benevolence in these patients on part of their pain management and quality of life improvement. To compare the efficacy of USG guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies by using different concentration of alcohol (50% vs 75%).This Prospective, comparative, randomised double blinded study was conducted during Sep 2019 – Aug 2020 at our tertiary care centre. Total 60 cases were taken as per following inclusion and exclusion criteria and randomly divided into 2 groups i.e. 30 each group, we compare Visual Analogue Scale (VAS) score, quality of life (QOL) and need of rescue analgesia profile between the groups to know the efficacy of USG guided coeliac plexus block. In our study, we observed that the baseline mean VAS score in group I was 8.26±0.78 while in group II was 8.03±0.76. No significant difference was found in mean VAS score at this time between the groups (p=0.24). The baseline mean QOL score in group-I was 77.46±3.40 while for the cases of group II the mean QOL score was 77.36±3.33. No significant difference was found in mean QOL score at baseline between the groups (p=0.90). The baseline mean morphine consumption in group-I was 113.33±39.24 mg while for the cases of group-II the mean morphine consumption was 120.33±38.37mg. No significant difference was found in mean morphine consumption at this time between the groups (p=0.48).Both groups having 50% alcohol and 75% alcohol decreases the VAS score from baseline in patients having upper abdominal malignancies along with QOL and dosages of rescue analgesia whereas no significant difference in VAS score in patients of both groups.

scholarly journals Effectiveness of Transversus Abdominis Plane Block for Postoperative Analgesia in Obstetric Cases Undergoing Caesarean Section

2019 ◽  
Vol 4 (2) ◽  
pp. 755-758
Author(s):  
Roshan Pradhan ◽  
Seema Kumari Mishra ◽  
Lalit Kumar Rajbanshi ◽  
Kanak Khanal ◽  
Batsalya Arjyal ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Pain Score ◽  
Postoperative Analgesia ◽  
Transversus Abdominis ◽  
Control Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Rescue Analgesia ◽  
Visual Analogue Pain ◽  
Significant Difference

Introduction: Transversus abdominis plane (TAP) block is a regional anesthesia that involves the infiltration of local anesthetic in between the internal oblique and transversus abdominis muscle plane. This block provides post-operative analgesia and reduces the requirement of opioids consumption. Objective: To assess the effectiveness of TAP block in providing postoperative analgesia in women undergoing caesarean section. Methodology: This was a hospital based prospective, comparative, cross sectional study conducted in 70 patients from 17th September 2018 to 17th February 2019 undergoing caesarean section under spinal anesthesia. Patients were divided into two groups. Group A patients received TAP block with 0.5% Ropivacaine versus Group B patients received injection paracetamol 1gm intravenous every 8 hourly as a standard and routine analgesic. At the end of the surgery, TAP block was performed by anesthesiologist and assessment of postoperative pain using a visual analogue pain score at every 1 hour, 3 hour, 6 hour, 12 hour and 24 hour by trained staffs at postoperative ward. Then, depending upon the severity of the pain injection fentanyl 1mcg/kg intravenous was given as rescue analgesia. Short assessment of patient satisfaction (SAPS) score was also assessed 24 hours postoperatively. Results: Compared to control group, in women who received TAP block, there was statistically significant reduction in pain at 3 hr, 6 hr, 24 hrs. However at 12 hrs there was no significant difference in the pain score. The cumulative fentanyl requirement was also significantly less in the TAP block group at all the time points.  Conclusion: The TAP block provided highly effective postoperative analgesia following caesarean section and reduces the fentanyl requirement in the first 24 hour.

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