scholarly journals Comparison of intravenous Magnesium Sulphate with intrathecal Magnesium Sulphate for post- operative analgesia in orthopaedic patients undergoing extracapsular hip fracture surgery

2016 ◽  
Vol 6 (1) ◽  
pp. 159
Author(s):  
Arvind Kumar ◽  
Usha Kumari Chaudhary ◽  
Dinesh Kansal ◽  
Shelly Rana ◽  
Vipin Sharma ◽  
...  
Keyword(s):  
Postoperative Analgesia ◽  
Normal Saline ◽  
Magnesium Sulphate ◽  
Control Group ◽  
Intravenous Route ◽  
Rescue Analgesia ◽  
Hip Fracture Surgery ◽  
Pain Scores ◽  
Intravenous Magnesium ◽  
Orthopaedic Patients

Background: Magnesium sulphate (MgSO4) N methyl D aspartate receptor antagonist has the potential to be an ideal adjuvant for postoperative analgesia via intrathecal or intravenous route. The aim of the study was, we compared the efficacy of two routes of MgSO4 (Intravenous vs intrathecal) as an adjuvant to bupivacaine in subarachnoid block (SAB).Methods: Ninety, American Society of Anesthesiologists physical status 1 or 2 patients, aged 20-60 years, scheduled for hip surgeries under SAB were recruited in department of Anaesthesia and Dept. of Orthopaedics. Patients in group 1 (n=29) received intrathecal 0.5% (H) bupivacaine 15 mg with 0.1 ml of normal saline and 250 ml 0.9% normal saline intravenous 30 minutes before giving SAB. Group 2 (n=30) patients received intrathecal 0.5% bupivacaine 15mg with 0.1 ml of normal saline and 50mg/kg of magnesium sulphate in 250 ml normal saline intravenous 30minutes before giving SAB. In Group 3 (n=30) patients received intrathecal 0.5% (H) bupivacaine 15 mg with 50mg (0.1ml) magnesium sulphate and 250 ml 0.9% normal saline intravenous 30 minutes before giving SAB. They were evaluated for block characteristics, visual analogue scale at various time intervals up to 24 hours and total rescue analgesic and duration of postoperative analgesia were noted.Results: Intravenous magnesium sulphate had maximum pain free interval, lower pain scores, longer sensory and motor blockade and less requirement of rescue analgesia as compared to the patients in intrathecal group or control group (P<0.05).Conclusions: Intravenous magnesium sulphate was more effective as compared to intrathecal route with regards to the pain scores and in providing postoperative analgesia.

scholarly journals Effect of Intravenous Dexamethasone in Combination with Caudal Analgesia on Post Operative Pain Control after Herniotomy in Children

2020 ◽  
Vol 35 (2) ◽  
pp. 145-149
Author(s):  
Md Jahirul Islam ◽  
Ismat Jahan ◽  
Aminul Islam
Keyword(s):  
Adverse Effects ◽  
Postoperative Analgesia ◽  
Control Group ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Pain Scores ◽  
Dexamethasone Group ◽  
Group I ◽  
Caudal Analgesia ◽  
Group Ii

Background: Dexamethasone has a powerful anti-inflammatory action and has demonstrated reduced morbidity after surgery. Objectives: The aim of this study was to examine the effects of a single i.v. dose of dexamethasone in combination with caudalblock on postoperative analgesia in children. Methods: This study was a randomized, double blind clinical trial, in which 77 children of ASA I and II, aged 3-10 years, undergoing elective unilateral herniotomy operation, was allocated in a double blind manner. Control Group I consist of 39 patients and Dexamethasone Group II consists of 38 patients. Group II received i.v. Dexamethasone 0.5 mg/Kg (Maximum 20 mg) and Group I received the same volume of i.v. saline after induction of anaesthesia. After inhalation induction of general anaesthesia, children received either dexamethasone 0.5-1 mg/Kg (maximum 20 mg) (n=39) or the same volume of saline (n=38) i.v. A caudal anaesthetic block was then performed using 1.5 ml/kg of Bupivacaine 0.25% in all patients. After surgery, rescue analgesic consumption, pain scores, and adverse effects were evaluated for 24 h. Results: Significantly, fewer patients in the dexamethasone group required fentanyl for rescue analgesia (7.9% vs38.5%, p<0.05) in the post-anaesthetic care unit or acetaminophen (23.7% vs 64.1%) after discharge compared with the control group. The time to first administration of oral acetaminophen was significantly longer in the dexamethasone group (646 vs 430 min). Postoperative pain scores were lower in the dexamethasone group and the incidence of adverse effects was similar in both groups. Conclusion: Intravenous dexamethasone 0.5-1 mg/Kg in combination with a caudal block augmented the intensity and duration of postoperative analgesia with out adverse effects in children undergoing herniotomy. DS (Child) H J 2019; 35(2) : 145-149

Evaluation of ultrasound-guided rhomboid intercostal nerve block for postoperative analgesia in breast cancer surgery: a prospective, randomized controlled trial

2020 ◽  
Vol 45 (4) ◽  
pp. 277-282 ◽  
Author(s):  
Başak Altıparmak ◽  
Melike Korkmaz Toker ◽  
Ali Ihsan Uysal ◽  
Özcan Dere ◽  
Bakiye Uğur
Keyword(s):  
Postoperative Analgesia ◽  
Radical Mastectomy ◽  
Opioid Consumption ◽  
Control Group ◽  
Axillary Lymph ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Quality Of Recovery ◽  
Pain Scores

Background and objectivesMastectomy has many potential sources of pain. Rhomboid intercostal block (RIB) is a recently described plane block. The primary hypothesis of the study is that ultrasound-guided RIB combined with general anesthesia would accelerate global quality of recovery scores of patients following mastectomy surgery. Secondary hypothesis is that RIB would reduce postoperative opioid consumption, pain scores, and the need for rescue analgesia.MethodsPatients aged between 18 and 70 years, with American Society of Anesthesiologists physical status I–II and scheduled for an elective unilateral modified radical mastectomy surgery with axillary lymph node dissection were enrolled to the study. Following endotracheal intubation, patients were randomly allocated into two groups. Patients in the first group (group R) received ultrasound-guided RIB with 30 mL 0.25% bupivacaine. In the control group (group C), no block intervention was applied. All patients received intravenous dexamethasone 8 mg, dexketoprofen trometamol 50 mg intraoperatively and tramadol 1 mg/kg 30 min before the end of surgery for postoperative analgesia. All patients received intravenous morphine patient-controlled analgesia device at the arrival to the recovery room.ResultsThe descriptive variables of the patients were comparable between group R and group C. Mean quality of recovery-40 score at 24 hours was 164.8±3.9 in group R and 153.5±5.2 in group C (mean difference 11.4 (95% CI 8.8 to 13.9; p<0.001). At 24th hour, median morphine consumption was 5 mg (IQR 4–7 mg) in group R and 10 mg (IQR 8–13 mg) in group C, p<0.001. Intraoperative fentanyl administration, pain scores and the need for rescue postoperative analgesia was similar between groups.ConclusionsIn the current study, ultrasound-guided RIB promoted enhanced recovery and decreased opioid consumption after mastectomy surgery.Trial registration numberACTRN12619000879167.

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.

scholarly journals Postoperative Analgesia for Haemorrhoid Surgery

1983 ◽  
Vol 11 (1) ◽  
pp. 27-30 ◽  
Author(s):  
D. A. Pybus ◽  
B. E. D'Bras ◽  
G. Goulding ◽  
H. Liberman ◽  
T. A. Torda
Keyword(s):  
Postoperative Pain ◽  
General Anaesthesia ◽  
Postoperative Analgesia ◽  
Normal Saline ◽  
Morphine Sulphate ◽  
Control Group ◽  
Treatment Groups ◽  
Number Of Patients ◽  
Caudal Analgesia ◽  
The Mean

Seventy patients undergoing haemorrhoidectomy under general anaesthesia were randomly allocated to one of five treatment groups in order to compare the effectiveness of various caudal agents in the control of postoperative pain. Four groups were given a caudal injection of either 2% lignocaine, 0.5% bupivacaine, 2% lignocaine + morphine sulphate 4 mg or normal saline + morphine sulphate 4 mg, while the fifth (control) group did not receive an injection. The number of patients requiring postoperative opiates was significantly higher in the lignocaine group than in the morphine (p <0.05) and morphine-lignocaine (p <0.05) groups. No agent significantly reduced the number requiring opiates. In those who received opiates, the mean analgesic period was 228 minutes in the control group, and was significantly longer following bupivacaine (577 min, p <0.01), morphine-lignocaine (637 min, p <0.05) and morphine (665 min, p <0.01). The mean analgesic period following lignocaine (349 min) was not significantly different from control. The incidence of catheterisation was lowest in those patients who did not receive caudal analgesia.

scholarly journals Comparing Intravenous Single Low Doses of Magnesium Sulphate versus Dexamethasone as Adjuvants to Ultrasound Guided Transversus Abdominis Plane (TAP) Block for Prolongation of Postcesarean Analgesia

2021 ◽  
Vol 15 (1) ◽  
pp. 22-29
Author(s):  
Tamer N. Abdelrahman ◽  
Rasha G. Abu-Sinna
Keyword(s):  
Magnesium Sulphate ◽  
Transversus Abdominis ◽  
Anesthetic Technique ◽  
Control Group ◽  
Time Interval ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Group D

Introduction: The TAP block is a regional anesthetic technique, which blocks neural afferents between T6 and L1, which provide anterior abdominal walls and therefore help to alleviate postoperative pain. Aim: The aim is to compare the efficacy of preoperative single low dose of intravenous MgSO4 versus intravenous dexamethasone as adjuvants to ultrasound guided TAP block for prolongation of postcesaren analgesia. Materials and Methods: A total 60 pregnant females were selected undergoing elective caesarean sections under general anesthesia with ultrasound-guided transversus abdominis plane (TAP) block done at the end of surgery. Patients were randomly and equally allocated into three groups of 20 patients each. The first group of patients were classified as magnesium sulphate group (M)who received 50 mg/Kg IV, the second group of patients were classified as dexamethasone group (D) who received 2 mg IV and the third group was classified as the placebo group (C) who received IV saline. Results: Comparison of the VAS at 6 and 12 hours postoperatively showed statistically significantly lower values in group (M) and group (D) compared to group (C) and also group (M) was significantly lower than group (D) as well. The time interval until first rescue analgesia (Nalbuphine) needed by the patients (VAS ≥ 50) was significantly longer in group (M) compared to group (D) and group (C) consecutively. Additionally, it was significantly longer in group (D) than in the control group(C). The total dose of rescue analgesia consumed during the first 24 hours postoperatively was significantly lower in groups (M) than in group (D) and both groups showed lesser doses compared to group (C) Conclusion: We concluded that both MgSO4 and dexamethasone could prolong the postoperative duration and analgesic efficiency provided by the TAP block in cesarean sections. This further reduced the demands for postoperative rescue analgesia, with MgSO4 found to be more efficient than IV dexamethasone. Clinical Trial Registration Number: NCT04223128

scholarly journals Circumcision in children: postoperative analgesic efficiency of transversus abdominis plan block vs caudal epidural block: a prospective observational study

2021 ◽  
pp. 1
Keyword(s):  
Postoperative Pain ◽  
Observational Study ◽  
Postoperative Analgesia ◽  
Prospective Observational Study ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Rescue Analgesia ◽  
Pain Scores ◽  
Significant Difference ◽  
Caudal Epidural

Background and objective: Circumcision is one of the most common operations and can cause postoperative pain, fear, and anxiety for children. This study aims to compare the effects of transversus abdominis plane (TAP) block and caudal epidural (CE) anesthesia on postoperative analgesia after circumcision in providing postoperative pain control. Methods: Eighty boys aged 1 to 14 years who underwent elective circumcision surgery under general anesthesia either with USG-guided TAP block or with CE block for postoperative analgesia were enrolled consecutively to this prospective observational study equally in each group. Postoperative pain scores and need for rescue analgesia were recorded and compared between the two groups. Results: There was no statistically significant difference between the groups in mean age and Aldrete scores (p > 0.05). Body mass index (BMI) of the caudal block group was statistically lower than the TAP group (p < 0.05). While there was no statistically significant difference between the groups in 30th-minute VAS values (p > 0.05), the CE block group's 1st, 2nd, 4th, 8th, 12th, 18th, and 24th hour VAS values were statistically lower than the TAP block group's (p < 0.05). Conclusion: USG-guided TAB block under general anesthesia was not associated with lower postoperative pain scores and delayed rescue analgesia need compared with CE block in patients who underwent elective circumcision surgery. CE block provided superior analgesia than the USG-guided TAP block after elective circumcision surgery in this study.

scholarly journals Pre-incisional epidural magnesium provides pre-emptive and postoperative analgesia in lower abdominal surgeries: a comparative study

2015 ◽  
Vol 1 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Ninadini Shrestha ◽  
Renu Gurung ◽  
Moda Nath Marhatta
Keyword(s):  
Epidural Analgesia ◽  
Postoperative Analgesia ◽  
Magnesium Sulphate ◽  
Opioid Analgesic ◽  
Controlled Study ◽  
Anesthetic Technique ◽  
Control Group ◽  
Double Blind Study ◽  
Double Blind ◽  
Comparable Group

Background: Magnesium sulphate has been used successfully as a non opioid analgesic adjuvant for postoperative pain management. This prospective controlled study was designed to evaluate the pre-emptive analgesic efficacy of adding magnesium to epidural analgesia in patients undergoing lower abdominal surgeries.Methodology: In a randomized, double- blind study sixty patients undergoing lower abdominal surgery under general anesthesia were assigned to three groups. Pre-magnesium (Group PI), post-magnesium (Group PO) and control (Group C) group. Anesthetic technique was standardized. Patients in pre-magnesium group received bolus of magnesium 50 mg via epidural before induction of anaesthesia followed by boluses of 10 mg h-1 until end of surgery. Post-magnesium group patients received epidural saline during the same time periods plus bolus epidural magnesium 50 mg at the end of surgery. Patients in control group received epidural saline during all three periods. Patients in the magnesium groups received bolus epidural analgesia with Fentanyl 8mcg, Bupivacaine 0.1%, and Magnesium 8mg in a volume of 8 ml after operation, when patient complained of pain and VAS score was more than 4. Patients in the control group received epidural analgesia with Fentanyl 8 mcg and Bupivacaine 0.1% in a volume of 8ml. Blood Pressure, pulse rate, respiratory rate, time to the first request for analgesic, visual analogue scale at rest, 24 hour, opioids consumption and side effect profiles were studied for 24 hours postoperatively.Results: The demographic parameters were comparable. Group PI had significantly lower VAS scores at all times 0,2,4,6,10,14,18 and 24 hours than those in the Group PO or Group C(P<0.05). The groups were similar with respect to haemodynamic, respiratory variables and side effects.Conclusion: Epidural Magnesium sulphate provided preemptive analgesia, and an a analgesic-sparing effect that improved postoperative analgesia without increasing the incidence of side-effects.Journal of Society of Anesthesiologists 2014 1(1): 22-28

scholarly journals Fentanyl versus midazolam as additive to local anesthetic mixture for peribulbar block during posterior segment surgery in adult patients a prospective randomized double-blind study

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Ahmed Abdalla Mohamed ◽  
Tamer Fayez Safan
Keyword(s):  
Postoperative Analgesia ◽  
Local Anesthetic ◽  
Posterior Segment ◽  
Adult Patients ◽  
The Other ◽  
Control Group ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Number Of Patients ◽  
Peribulbar Block

Abstract Objectives To evaluate analgesic and hemodynamic outcome of fentanyl or midazolam as additives to local anesthetic mixture (LAM) for peribulbar block (PBB) during posterior chamber surgery. Methods One hundred thirty-two ASA status I to III adult patients aged 50–75 years scheduled for posterior segment surgery (intraocular foreign body and elective vitrectomy) were enrolled in this prospective, randomized, double-blind trial from which 12 patients were excluded. After signing a written fully informed consent for study participation, patients were grouped into 3 groups (40 patients in each group); group C received local anesthetic mixture plus 1 ml plain saline, group F received local anesthetic mixture plus 25 μg fentanyl in 1 ml saline and group M received local anesthetic mixture plus 1 mg midazolam in 1 ml saline. The primary outcome was the onset time of eyelid and globe akinesia. Also, the duration of the block was assessed in the three studied groups. Intraoperative and postoperative hemodynamic measures were assessed. Postoperative analgesia was hourly-assessed using Visual analogue scale (VAS) and rescue analgesia was provided at visual analogue score of > 3. Results The number of patients who had fast eyelid and globe akinesia was significantly higher with significantly lower total 15-min score in group F than the other groups. Intraoperative and postoperative hemodynamic measures were non-significantly different between studied groups. Duration of the block was significantly longer in groups F and M than group C with significantly longer duration in group F. The number of patients who required postoperative rescue analgesia was significantly lower with significantly lower number of requests in group F than the other groups. Conclusion Additives to local anesthetic mixture during peribulbar block provided satisfactory anesthetic outcome than local anesthetic mixture alone. Fentanyl was superior to midazolam in terms of significantly speed up onset, longer block duration with significantly longer postoperative analgesia and lesser consumption of rescue analgesia. Both additives provided adjusted hemodynamic measures comparable to the control group. Trial registration Pan African Clinical Trials Registry (PACTR201708002496243) registered 03/08/2017 retrospectively.

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