scholarly journals Comparative study of ropivacaine with tramadol and ropivacaine with midazolam for post-operative epidural analgesia

2021 ◽  
Vol 8 (4) ◽  
pp. 527-531
Author(s):  
Selvam M ◽  
Karthik V J ◽  
Sangeeth Charles ◽  
Murugan Thalaiappan
Keyword(s):  
Epidural Analgesia ◽  
Comparative Study ◽  
Epidural Injection ◽  
Single Shot ◽  
Motor Blockade ◽  
College Hospital ◽  
Sensory Blockade ◽  
Significant Prolongation ◽  
Significant Difference ◽  
Sensory Motor

Epidural analgesia is the most commonly used method for surgical anesthesia, obstetric analgesia, post-operative pain control, and chronic pain management. These epidurals are used either as a single-shot technique or with the catheter that allows intermittent boluses or continuous infusion, or both. All of these variables are controlled by choice of drug concentration, dosage, and level of injections. To compare the onset and duration of sensory block, motor block, and post-operative analgesia duration using Ropivacaine with Tramadol and Ropivacaine with Midazolam in the Epidural technique. In this prospective, non-randomized, comparative study, the total of 160 patients who underwent surgeries below the umbilicus did under epidural technique at Govt. Kilpauk Medical college hospital a Govt. Royapettah hospital, Chennai, was screened. Patients were divided into two groups. Patients in Group R received an epidural injection of 0.5% Ropivacaine (30ml) with Tramadol 2 mg/kg, whereas patients in Group L received an epidural injection of 0.5% ropivacaine (30ml) with Midazolam (50mg/kg). On studying the comparison of the onset of sensory, motor blockade, and duration of the sensory-motor blockade in the two groups, the onset of sensory blockade, motor blockade, and duration of motor blockade was more among ropivacaine with midazolam group. In comparison, the duration of sensory blockade was more among ropivacaine with tramadol group. A statistically significant difference in onset of sensory, motor blockade, and duration of sensory blockade across the group was found (p<0.005). Tramadol or Midazolam's addition to caudal epidural block with ropivacaine showed significant prolongation of post-operative analgesia compared to ropivacaine alone. The mean duration of analgesia was more among ropivacaine with the Tramadol group.

scholarly journals A Comparative Study of Addition of Midazolam to Lignocaine—Bupivacaine vs only Lignocaine— Bupivacaine in Brachial Plexus Block

2016 ◽  
Vol 1 (1) ◽  
pp. 5-9
Author(s):  
Naina P Dalvi ◽  
Harshali Salunkhay ◽  
Shubha N Mohite
Keyword(s):  
Comparative Study ◽  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Control Group ◽  
Study Group ◽  
Motor Blockade ◽  
Peripheral Nerve Stimulator ◽  
Sensory Blockade ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

ABSTRACT Introduction This prospective, randomized, double-blind study compared the onset and duration of sensory blockade, motor blockade, and analgesia with lignocaine, bupivacaine, and midazolam combination vs only lignocaine, bupivacaine in brachial plexus block. Materials and methods Patients of either sex, aged 18–60 years, American Society of Anesthesiologists grade I/II, posted for upper limb surgeries to be performed under supraclavicular brachial plexus block with the help of peripheral nerve stimulator were administered either 10 ml 0.5% bupivacaine with 50 μg/kg midazolam (preservative free) + 20 ml 2% lignocaine with adrenaline (1:200,000) in Group lignocaine– bupivacaine–midazolam (LBM) or 10 ml 0.5% bupivacaine + 20 ml 2% lignocaine with adrenaline (1:200,000) in Group lignocaine–bupivacaine (LB). Onset and duration of sensory and motor blockade were monitored. Postoperative analgesia was graded with visual analog scale. Sedation was monitored with Ramsey sedation score. Results A total of 60 patients were randomized to the group LBM (n = 30) and group LB (n = 30). The analgesia was significantly prolonged in the study group, with a mean of 11.72 ± 1.924 hours as compared with a mean of 6.383 ± 1.031 hours in the control group. Sedation scores were higher in the study group, that is, group LBM compared to group LB postoperatively. Conclusion In conclusion, midazolam when added to bupivacaine and adrenalized lignocaine for supraclavicular brachial plexus block hastens the onset of sensory and motor blockade. This combination improves analgesia, as manifested by lower pain scores and prolonged duration of analgesia. How to cite this article Dalvi NP, Salunkhay H, Mohite SN. A Comparative Study of Addition of Midazolam to Lignocaine–Bupivacaine vs only Lignocaine–Bupivacaine in Brachial Plexus Block. Res Inno in Anaesth 2016;1(1):5-9.

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 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.

scholarly journals A Comparative Study of Bupivacaine 0.5 % and Ropivacaine 0.75 % for Supra-Clavicular Brachial Plexus Block Using Nerve Locator for Elective Upper Limb Orthopaedic Surgeries

2021 ◽  
Vol 10 (24) ◽  
pp. 1825-1829
Author(s):  
Amol Singam ◽  
Punith M. Sirige
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
General Nature ◽  
Motor Blockade ◽  
Sensory Blockade ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

BACKGROUND Regional anaesthesia has multiple advantages as compared to general anaesthesia for upper limb surgeries. Here in this study, we wanted to compare bupivacaine 0.5 %, commonly used anaesthetic with ropivacaine 0.75 % which has fewer side effects like cardiotoxicity for supraclavicular brachial plexus block. METHODS A study was performed on 60 ASA I & II patients aged between 18 and 75 years, undergoing upper limb elective surgeries under brachial plexus block using nerve locator. Beginning of sensory and motor block, general nature of block, and terms of sensory and motor blocks were assessed in the C5 to T1 dermatomes. RESULTS There was no statistically significant difference in the onset of sensory and motor blockade between ropivacaine 0.75 % and bupivacaine 0.5 %. Ropivacaine 0.75 % produced similar quality of motor and sensory blockade compared to 0.5 % bupivacaine. The time taken for maximum motor blockade with ropivacaine was comparable with that of bupivacaine 0.5 %. There was no statistically significant difference regarding the duration of analgesia with ropivacaine 0.75 % compared to bupivacaine 0.5 %. Duration of motor blockade with 0.75 % ropivacaine was comparable to that of 0.5 % bupivacaine. CONCLUSIONS Ropivacaine 0.75 % 0.4 ml / kg or 0.5 % bupivacaine 0.4 ml / kg for supraclavicular brachial plexus block produces satisfactory and comparable sensory and motor blockade. It is suggested that lower cardiovascular toxicity of ropivacaine with equal efficacy as bupivacaine in such circumstances may help in reducing the risks to the patient. KEY WORDS Bupivacaine 0.5 %, Ropivacaine 0.75 %, Brachial Plexus Block, Upper Limb Orthopaedic Surgeries

scholarly journals Comparative Study of Ketamine and Fentanyl When Added to Intrathecal Bupivacaine on Sensory and Motor Blockade in Patients Undergoing Total Abdominal Hysterectomy

2021 ◽  
Vol 8 (8) ◽  
pp. 420-426
Author(s):  
Saba Wani ◽  
Sadia Ali Wani ◽  
Salma Mariyam
Keyword(s):  
Comparative Study ◽  
Onset Time ◽  
Control Group ◽  
Sensory Level ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Sensory Blockade ◽  
Group I ◽  
Patient Consent

Introduction:- Ketamine and Fentanyl used intrathecally as adjuvant to 0.5% hyperbaric bupivacaine for patients undergoing TAH to shorten the onset of sensory and motor blockade and prolonging the duration of block. Aims and Objective:-We evaluated onset and duration of sensory and motor blockade and timing of regression of sensory blockade to T 12 and motor blockade to Bromage scale 3. Material and Methods:-This analytical Comparative Study was conducted in Department of Anaesthesiology, Era’s Lucknow Medical College and Hospital, Era University, Lucknow over a period of eighteen months from 2016 -2018 following approval from institutional ethical committee and written informed patient consent. The sample size of 162 female patient aged 40 to 60 years, belonging to ASA physical status 1 and 2 undergoing TAH were randomly allocated to three groups in double blind manner. Group I Received Inj. Bupivacaine (0.5% Heavy) 3.0ml + Inj. Ketamine (25 mg), Group II Received Inj. Bupivacaine (0.5% Heavy) 3.0 ml + Inj. Fentanyl (25 µgm), Group III (Control Group): Received Inj. Bupivacaine (0.5% Heavy) 3.0 ml + Normal saline 0.5 ml. Onset and Duration of Sensory and Motor Blockade and time taken for regression of sensory level to T12 and motor level to Bromage scale 3 noted. Results:- The present study showed that both Ketamine as well as Fentanyl shortened the onset time and prolonged the block duration. However, with respect to onset time, ketamine has shorter onset of blockade than fentanyl. Conclusion:- Both the modalities independently assured quicker onset and prolonged duration of block, thus suggesting that adjuvant use of either of two could be beneficial. Keywords: TAH, Ketamine, Fentanyl, Bupivacaine.

scholarly journals Comparative study of intrathecal nalbuphine versus clonidine as adjuvants to 0.5% isobaric levobupivacaine for elective infra umbilical surgeries

2020 ◽  
Author(s):  
Shalini A. ◽  
Kokila N. ◽  
Manjunatha H. G. ◽  
Supriya L.
Keyword(s):  
Adverse Effects ◽  
Comparative Study ◽  
Total Duration ◽  
Motor Blockade ◽  
Hemodynamic Changes ◽  
Perioperative Analgesia ◽  
Significant Difference ◽  
Recorded Data ◽  
To Receive ◽  
Effective Analgesia

Background and objectives: Various intrathecal adjuvants have been clinically tried for the prolongation of intraoperative and postoperative analgesia. This study aims at evaluating the effects of intrathecal nalbuphine and clonidine as adjuvants to isobaric levobupivacaine in subarachnoid block. Methodology: 60 patients scheduled for elective infra umbilical surgeries were allocated into two groups of thirty each to receive 15 mg of 0.5% isobaric Levobupivacaine with either 1 mg nalbuphine (Group LN) or 30 µg clonidine (Group LC) intrathecally. Characteristics of spinal anesthesia in terms of sensory analgesia and motor blockade were noted. Hemodynamic parameters and adverse effects if any were recorded. Data obtained was compiled and statistically analysed with appropriate tests. Results: Onset of sensory and motor blocks was faster in group LN (2.43 ± 0.93 and 2.2 ± 0.9 min) compared to group LC (3.26 ± 1.04 and 3.13 ± 1.0 min). However, time to two segment regression (186.8 ± 24.5 vs 146.5 ± 21.4), total duration of effective analgesia (384.1 ± 56.6 vs 292.1 ± 40.9) and total duration of motor block (345.3 ± 41.7 vs 235.6 ± 29.5 min) were significantly prolonged in group LC than in group LN. There was no significant difference in hemodynamic changes and adverse effects between the groups. Conclusion: The addition of 30 µg clonidine to intrathecal 0.5% isobaric levobupivacaine as adjuvant, is associated with prolonged sensory and motor blockade with better perioperative analgesia compared to 1 mg nalbuphine. Citation: Shalini A, Kokila N, Manjunatha HG, Supriya L. Comparative study of intrathecal nalbuphine versus clonidine as adjuvants to 0.5% isobaric levobupivacaine for elective infra umbilical surgeries. Anaesth pain & intensive care 2019;23(4)__ Received: 21 August 2019, Reviewed:  13 September, 22 November 2019, Accepted: 26 November 2019

scholarly journals Spinal Anesthesia for Knee Arthroscopy Using Isobaric Bupivacaine and Levobupivacaine: Anesthetic and Neuroophthalmological Assessment

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Monica del-Rio-Vellosillo ◽  
Jose Javier Garcia-Medina ◽  
Antonio Abengochea-Cotaina ◽  
Maria Dolores Pinazo-Duran ◽  
Manuel Barbera-Alacreu
Keyword(s):  
Spinal Anesthesia ◽  
Knee Arthroscopy ◽  
Demographic Data ◽  
Randomized Study ◽  
Sensory Block ◽  
Motor Blockade ◽  
Double Blind ◽  
Sensory Blockade ◽  
Sensory Motor ◽  
Surgeon Satisfaction

Introduction.The aim of the study was to compare the sensory, motor, and neuroophthalmological effects of isobaric levobupivacaine and bupivacaine when intrathecally administered.Materials and Methods.A prospective, double-blind, randomized study with 60 ASA grade I-II patients aged 18–65 years awaiting knee arthroscopy under spinal anesthesia. Patients received 12.5 mg of isobaric bupivacaine or levobupivacaine. Several features were recorded.Results.No significant intergroup differences were observed for ASA classification, time to micturate, demographic data, surgery duration, and patient/surgeon satisfaction. Similar hemodynamic parameters and sensory/motor blockade duration were found for both groups. There were no neuroophthalmological effects in either group. Sensory (P=0.018) and motor blockade onset (P=0.003) was faster in the bupivacaine group. T6 (T2–T12) and T3 (T2–T12) were the highest sensory block levels for the levobupivacaine and bupivacaine groups, respectively (P=0.008). It took less time to regain maximum motor blockade in the bupivacaine group (P=0.014), and the levobupivacaine group required use of analgesia earlier (P=0.025).Conclusions.Isobaric bupivacaine and levobupivacaine are analogous and well-tolerated anesthetics for knee arthroscopy. However, for bupivacaine, sensory and motor blockade onset was faster, and greater sensory blockade with a longer postoperative painless period was achieved.

scholarly journals Duration of analgesia, sensory and motor blockade and intra operative hemodynamic changes caused by intrathecal bupivacaine, bupivacaine plus clonidine and bupivacaine plus dexmedetomidine in spinal anesthesia: prospective, comparative study

2018 ◽  
Vol 6 (2) ◽  
pp. 493
Author(s):  
Sankaranand P. ◽  
Krishna Prasad G. V.
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Comparative Study ◽  
Spinal Anaesthesia ◽  
Motor Blockade ◽  
Sensory Blockade ◽  
Prospective Comparative Study ◽  
Group B ◽  
Group D ◽  
Mean Heart Rate

Background: This is comparative study to differentiate the effects of Dexmedetomidine and clonidine on duration of analgesia, motor and sensory blockade and the intraoperative hemodynamic profile when mixed with Bupivacaine.Methods: Patients aged 15-45 years having ASA 1 and ASA 2 scheduled for elective orthopedic surgeries under spinal anaesthesia were included and divided into 3 groups equally (50 patients each)’ i.e. Group B received only 3.0 ml of 0.5% Bupivacaine (Heavy); Group C received 3.0ml of 0.5% Bupivacaine (Heavy) mixed with Clonidine 30 µg; and Group D administered with 3.0 ml of 0.5% Bupivacaine (Heavy) mixed with 5µg Dexmedetomidine.Results: Majority of the cases enrolled in the study were knee disorders and the rest being fracture femur, tibia. At preoperative interval mean systolic blood pressure and diastolic blood pressure of Group B was slightly higher than Group C and Group D. At the time when spinal anaesthesia was given, a slight fall in DBP of patients was observed in all Group B, Group C and Group D. Mean heart rate of patients at preoperative interval in patients of Group B, Group C and Group D respectively, with Group C and Group D showing slightly lower mean heart rate as compared with that of the mean heart rate of Group B but the values were not statistically significant. There were no any significant changes in the hemodynamic status.Conclusions: Both of used combinations provide prolonged sensory and motor blockade, hemodynamic stability, minimal side effects, and excellent intraoperative and postoperative analgesia.

SIGNIFICANCE OF PLACENTAL HISTOPATHOLOGICAL FINDINGS IN PRETERM/TERM BIRTH

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Monika Kushwaha ◽  
Sanjeev Narang
Keyword(s):  
Preterm Birth ◽  
Comparative Study ◽  
Pregnancy Outcome ◽  
Neonatal Morbidity ◽  
Research Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Chorionic Villi ◽  
Term Birth ◽  
Medical College

Background: This study is cross-sectional, observational and comparative study, at Index Medical College, Hospital & Research Centre, Indore, Madhya Pradesh from July 2017 to July 2019 with sample size 100 placentae. Method: The placenta received was evaluated blinded of maternal pregnancy outcome. The pattern of morphology was evaluated both qualitatively (type of lesion) and quantitatively (number of lesions). Result: In Present study 79% of the deliveries were term deliveries and 21% were preterm deliveries. On placental macroscopy, placenta weight was significantly low among the neonates of preterm deliveries (370.00±60.49) as compared to term deliveries (440.89±55.22). Preterm placenta had higher number of abnormal placental lesion compared to term pregnancies. Conclusion: The uteroplacental insufficiency defined as placental infarct, fibrosis of chorionic villi, thickening of blood vessels, and poor vascularity of chorionic villi. Placental histopathological lesions are strongly associated with maternal under perfusion and uteroplacental insufficiency. These are the reasons for preterm birth. Thus, knowledge of the etiological factor can be use to reduce maternal and neonatal morbidity and mortility. Keywords: Placenta, Term & Preterm.

Comparative Study Between Clean Intermittent Self-Catheterization (Cisc) and Continuous Indwelling Catheterization (Cidc) in Relieving Acute Refractory Retention of Urine Due to Benign Enlargement of Prostate (Bep)

2020 ◽  
Vol 21 (2) ◽  
pp. 105-110
Author(s):  
Md Shawkat Alam ◽  
Sudip Das Gupta ◽  
Hadi Zia Uddin Ahmed ◽  
Md Saruar Alam ◽  
Sharif Muhammod Wasimuddin
Keyword(s):  
Comparative Study ◽  
Acute Urinary Retention ◽  
Bladder Capacity ◽  
Inclusion Criteria ◽  
College Hospital ◽  
Medical College ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Better Than

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110

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