scholarly journals A COMPARISION OF INTRATHECAL HYPERBARIC BUPUVACAINE WITH BUPRENORPHINE AND HYPERBARIC BUPIVACAINE ALONE IN GYNAECOLOGICAL SURGERIES FOR POSTOPERATIVE ANALGESIA

2021 ◽  
Vol 9 (06) ◽  
pp. 773-777
Author(s):  
Archana Jadhav ◽  
◽  
Rashmi Bengali ◽  
Keyword(s):  
Blood Pressure ◽  
Respiratory Rate ◽  
Spinal Anaesthesia ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Duration Of Surgery ◽  
Group B ◽  
Effective Analgesia

This study was performed at a tertiary care centre after the approval of the Institutional Ethical Committee and obtaining written informed consent from all patients. Sixty ASA I and II, aged 18- 65yrs, bodyweight 45-70kgs scheduled for gynaecological surgeries under spinal anaesthesia were chosen for the study and were divided into two groups named Group B and Group BN each comprising 30 patients. Group B received 3ml of 0.5% hyperbaric bupivacaine with 0.5 ml normal saline and Group BN received 3ml of 0.5% hyperbaric bupivacaine with 0.5ml (150mcg) of buprenorphine. Vital parameters like pulse rate, blood pressure, respiratory rate, SpO2 were recorded at 0 (basal) 15, 30, 45, 90 and 180 minutes. Postoperatively heart rate, blood pressure, respiratory rate and SP02 were monitored at 3 ,6 ,12 and 24 hrs. The mean age, height, weight, duration of surgery were comparable. Time of onset of sensory blockade and motor blockade were noted. The time for rescue medication was 909.0±216.9 min in group BN with a range from 690 min to 1500 min and in group B it was 412.0±89.28 min with a range from 130 min to 195 min. Comparing both groups duration of effective analgesia was significantly higher in group BN with P<0.0001.thus, it can be concluded that addition of buprenorphine as an adjuvant in spinal anaesthesia excellently prolongs duration of analgesia in postoperative period with minimal side effects.

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 COMPARISON OF TWO LOW DOSE REGIMENS OF SUBARACHNOID BLOCK ANESTHESIA FOR LOWER SEGMENT CAESARIAN SECTION

2020 ◽  
pp. 1-4
Author(s):  
Manoj Kumar Mishra ◽  
Sunny Eapen
Keyword(s):  
Spinal Anesthesia ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Fixed Dose ◽  
Gravid Uterus ◽  
Tertiary Care Centre ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Induced Hypotension ◽  
Perioperative Analgesia

Hypotension and bradycardia due to sympathetic blockade are two commonest complications of spinal anesthesia leading to maternal and neonatal morbidity and mortality. Aorto caval compression due to gravid uterus also contributes to the development of hypotension. Wedge under right buttock to provide 250 sideways tilt is used to prevent aortocaval compression by gravid uterus.Low dose bupivacaine heavy with intrathecal fentanyl is recommended as strategy to prevent spinal anesthesia induced hypotension and related complications. The present study was done in our tertiary care centre to compare the effects of fixed dose of Fentanyl 20μg (0.4ml) administered along with two low doses 1.6 ml(8mg) and 1.8 ml(9mg) of 0.5% hyperbaric bupivacaine (heavy) and assess the adequacy of surgical anaesthesia for caesarean section and hemodynamic changes intra operatively. There was faster onset of sensory blockade, better haemodynamic stability and prolonged postoperative analgesia in patients administered with1.6ml of 0.5% Bupivacaine heavy (8mg) & 20μg Fentanyl (Gp I) compared with patients administered with 1.8ml of 0.5% Bupivacaine heavy (9 mg) & 20μg Fentanyl (Gp II) . Perioperative analgesia was excellent in both the groups. No patient who developed bradycardia or hypotension in Gp I and only 2 patients in Gp II developed hypotension.Post-operative analgesia was for a longer period in Group II as compared to Gp I.

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.

scholarly journals Comparative study of hyperbaric 0.5% bupivacaine and hyperbaric 0.5% bupivacaine with low dose dexmedetomidine in spinal anaesthesia

2017 ◽  
Vol 6 (2) ◽  
pp. 410
Author(s):  
Shriganesh D. Kamat ◽  
Nitin N. Puram ◽  
Prakash R. Dhumal ◽  
Pushpa I. Agrawal ◽  
Jaiprakash B. Ramanand ◽  
...  
Keyword(s):  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Low Dose ◽  
Control Group ◽  
Spinal Block ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Group B ◽  
Randomised Controlled

Background: Spinal anaesthesia remains one of the basic techniques in the arsenal of modern anaesthesiology despite the waxing and waning of its popularity over last 100 years since its introduction into clinical practice.It avoids biochemical and metabolic changes consequent to the stress of general anesthesia for surgery as well as provides near optimal conditions for surgery. In present study, we tried to study effectiveness of intrathecal 0.5% heavy bupivacaine alone with Dexmedetomidine as an adjuvant to intrathecal 0.5% heavy bupivacaine for lower limb and lower abdominal surgeries.Methods: The present study was conducted in the department of anaesthesiology from December 2011 to September 2013.This study was a prospective, randomised controlled, single blind, study conducted in 100 patients of ASA grade I and II undergoing elective surgeries under spinal anaesthesia. The patients were divided randomly into two groups, containing 50 patients in each group. Dosages of drugs selected are divided as Group B: Patients received 3 ml of 0.5% hyperbaric bupivacaine (15mg) and Group BD: Patients received 3 ml of 0.5% hyperbaric bupivacaine (15mg) plus 10 µg Dexmedetomidine. Spinal block characteristics, Mean arterial pressure, Mean pulse rate, sedation and side effects were studied during intra-operative and postoperative period.Results: It was found from present study that in Dexmedetomidine group time to reach T10 sensory blockade and complete motor blockade was earlier and a higher level of sensory blockade compared to control group achieved. Duration of sensory, motor blockade and duration of analgesia was significantly prolonged in the Dexmedetomidine group compared to the control group. Hemodynamic parameters were preserved both intra-operatively and postoperatively. However there were a small percentage of patients who developed hypotension and bradycardia which were easily managed without any untoward effect. Hence Dexmedetomidine is a better neuraxial adjuvant for providing early onset of sensory and motor blockade, prolonged sensory blockade and post operative analgesia and adequate sedation.Conclusions: Intrathecal low dose Dexmedetomidine in a dose of 10µg along with 0.5% hyperbaric bupivacaine is an addition into anaesthesiologist's armamentarium for spinal anaesthesia in patients undergoing elective lower abdominal and lower limb surgeries.

scholarly journals Clonidine as an adjuvant to bupivacaine in spinal anaesthesia for infra-umbilical surgeries in children: a prospective randomized, double-blind trial

2021 ◽  
Vol 55 (2) ◽  
pp. 103-110
Author(s):  
Geeta Kamal ◽  
Raman Piplani ◽  
Anju Gupta ◽  
Nidhi Sehgal
Keyword(s):  
Spinal Anaesthesia ◽  
Randomized Study ◽  
Tertiary Care ◽  
Saline Group ◽  
Control Group ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Duration Of Action ◽  
Sensory Blockade ◽  
Group I

Objective: Spinal anaesthesia (SA) is a well-established technique for infra-umbilical surgeries but is underutilized in children. One important reason is the limited duration of action. Clonidine is a useful adjuvant in this regard but has not been studied in a dose of 1.5 μg/kg.Design: a prospective randomized study Setting: A single centre study conducted at a Super speciality paediatric tertiary care centre.Participants: Sixty children (5-12yrs) scheduled for lower abdominal surgery with duration <90min were included.Interventions: The participants were randomized into two groups to receive 0.4mg/kg of 0.5% hyperbaric bupivacaine with clonidine 1.5μg/kg (Group-I, n=30) or 0.4mg/kg of 0.5% hyperbaric bupivacaine with saline(Group-II, n=30) in the subarachnoid block.Main outcome measures: The sensory and motor block duration, time to two-segment regression, time to first rescue analgesic, and the number of rescue doses required were recorded.Results: Mean duration of sensory blockade (147.5±7.28 vs 310.33±10.17min; P<0.001) and motor blockade (132.5±10.06 vs 283.33±11.77min; P < 0.001) and duration of analgesia (172±9.61 vs 364.50±28.75min; P < 0.001) were significantly prolonged in the clonidine group. In the control group, most patients needed three analgesic doses over 24hr while in the clonidine group, the majority needed two doses. Adverse effects were infrequent in both groups.Conclusions: Clonidine as an adjuvant to 0.5% hyperbaric bupivacaine significantly prolonged the duration of analgesia with improved quality of anaesthesia while maintaining safety. We recommend the routine use of clonidine 1.5 μg/kg dose as an adjuvant to 0.5% bupivacaine in paediatric SA.

scholarly journals Effect of addition of intrathecal midazolam to 0.5% hyperbaric bupivacaine to prolong the post-operative analgesia in lower abdominal surgeries

2019 ◽  
Vol 6 (3) ◽  
pp. 790
Author(s):  
S. K. Adil Hasan
Keyword(s):  
Clinical Study ◽  
Statistical Significance ◽  
Mean Difference ◽  
Maximum Height ◽  
Motor Blockade ◽  
Medical Sciences ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Midazolam Group ◽  
Duration Of Surgery

Background: Bupivacaine when used alone produces analgesia for 2.5 to 3 hours, making it unsuitable in cases where the duration of surgery is longer and in cases which require further analgesia during post-operative period. Present study is intended to evaluate the effect of addition of intrathecal midazolam to bupivacaine to prolong the post-operative analgesia.Methods: Present clinical study was conducted in Kamineni Institute of Medical Sciences, Narketpally, Nalgonda District, Andhra Pradesh, India. After obtaining approval from institutional ethical committee, present clinical study was undertaken to evaluate the effects of addition of intrathecal midazolam to bupivacaine 0.5% (heavy). The study was conducted on 60 patients undergoing lower abdominal surgeries.Results: Mean onset of analgesia was 190.5 with SD 21.3 in group-C whereas in group-M, mean onset of analgesia was 185.3 with SD 26.81. Mean difference between the groups not showing statistical significance. In the present study the Maximum height of sensory blockade in control and midazolam group was T7 (T6-T8) compared to T7 (T6-T8) midazolam group. Mean duration of sensory blockade was 130.4 with SD 36.36 in group-C whereas in group-M, mean duration of sensory blockade was 191.9 with SD 36.4. Mean difference between the groups showing statistical significance. Mean duration of motor blockade was 176.3 with SD 23.7 in group-C whereas in group-M, mean duration of motor blockade was 208.1 with SD 18.21. Mean difference between the groups showing statistical significance.Conclusions: Midazolam is a useful adjuvant to bupivacaine in subarachnoid block. Intrathecal midazolam combined with intrathecal bupivacaine produces a longer and more effective anaesthesia and analgesia. It also prolongs post-operative analgesia without increasing adverse effects. 

scholarly journals Comparison of Effect of Intrathecal Fentanyl-bupivacaine and Tramadol-bupivacaine Combination on Postoperative Analgesia in Lower Abdominal Surgeries

2016 ◽  
Vol 1 (2) ◽  
pp. 35-40 ◽  
Author(s):  
Naina P Dalvi ◽  
Narendra Patil
Keyword(s):  
Blood Pressure ◽  
Postoperative Analgesia ◽  
Total Duration ◽  
Double Blind Study ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Sensory Blockade ◽  
Prolonged Duration ◽  
American Society

ABSTRACT Introduction This single-center, prospective, randomized, double-blind study compares the effect of intrathecal fentanylbupivacaine and tramadol-bupivacaine on the onset and duration of sensory and motor blockade, as well as postoperative analgesia in lower abdominal surgeries. Materials and methods Patients of either sex, aged 18 to 60 years, American Society of Anesthesiologists (ASA) grade I/II undergoing lower abdominal surgeries like appendicectomy, inguinal hernia repair surgery, and hydrocele surgery were administered either 2.5 mL of 0.5% bupivacaine + 0.5 mL (25 μg) of fentanyl citrate (group F) or 2.5 mL of 0.5% bupivacaine + 0.5 mL (25 mg) of tramadol (group T) intrathecally. Monitoring of the vital parameters, onset and duration of sensory and motor block, duration of postoperative analgesia, visual analog scale (VAS) score, sedation score, and any adverse drug reactions was done at predetermined intervals. Results Sixty patients were randomized to the group F (n = 30) and group T (n = 30). The duration of sensory blockade was significantly prolonged in group F (314.66 ± 49.25 minutes) as compared to group T (261.66 ± 27.92 minutes). Similarly, duration of motor blockade was longer in group F (263.66 ± 40.97 minutes) compared to group T (214.66 ± 26.61 minutes). The total duration of analgesia was significantly prolonged (p < 0.001) in group F (412 ± 97.888 minutes) compared to group T (301 ± 38.75 minutes). Hemodynamic parameters, such as pulse, systolic blood pressure, diastolic blood pressure and oxygen saturation were comparable in both the groups. Visual analog scores were significantly lower in the group F patients as compared to the group T patients. The group F patients had got significantly higher sedation scores as compared to Group T patients. Discussion Fentanyl 25 μg, when added to 2.5 mL of 0.5% hyperbaric bupivacaine, confers prolonged duration of sensory and motor blockade than 25 mg tramadol added to 2.5 mL of 0.5% hyperbaric bupivacaine. The bupivacaine-fentanyl combination prolonged duration of sensory and motor blockade, improved analgesia, as manifested by lower pain scores, and prolonged duration of postoperative analgesia. How to cite this article Dalvi NP, Patil N. Comparison of Effect of Intrathecal Fentanyl-bupivacaine and Tramadol-bupivacaine Combination on Postoperative Analgesia in Lower Abdominal Surgeries. Res Inno in Anesth 2016;1(2):35-40.

scholarly journals Evaluation of therapeutic effectiveness of vitamin D3 injections in common warts in a tertiary care centre

2019 ◽  
Vol 5 (3) ◽  
pp. 462
Author(s):  
Sushmalatha Banoth
Keyword(s):  
Vitamin D3 ◽  
Normal Saline ◽  
Tertiary Care ◽  
Treatment Session ◽  
Tertiary Care Centre ◽  
Cutaneous Manifestations ◽  
Multiple Modalities ◽  
Common Warts ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Warts or verrucae are the benign cutaneous manifestations caused by human papilloma virus. The treatment of wart possess a therapeutic challenge, as a result multiple modalities are existing for the treatment of cutaneous warts, which is cumbersome and may result in cosmetic disfigurement, chances of recurrences. The aim of the present study was to determine the resolution of common warts in response to vitamin D3 injections and to compare the resolution of common warts in the group receiving vitamin D3 with placebo group receiving normal saline.</p><p class="abstract"><strong>Methods:</strong> A total of 26 patients were enrolled and divided into Group A- received lesional injection of 0.2 ml vitamin D3 every 3 weeks for 3 months for the improvement in the size of warts. Group B- received 0.2 ml of normal saline injections as a control. The maximum of three sessions were carried in both groups. Clinical assessment was done by photographic evaluation at baseline, before each treatment session, and after completion of treatment.<strong></strong></p><p class="abstract"><strong>Results:</strong> In group A, 76.92% (10) of the patients showed complete clearance of wart with vitamin D3 injection, while in group B 8% (1) of patients with normal saline showed partial response. This therapy was well tolerated except for the minimal side effects like pain, redness and swelling at the site of injection.</p><p class="abstract"><strong>Conclusions:</strong> Intralesional Vit D3 injections may be a treatment option for warts, which has a good cosmetical acceptance and simple, well tolerated easily administrated in outpatient clinic rather than conventional treatment.</p>

scholarly journals Primary cemented bipolar hemiarthroplasty by transtrochanteric approach in unstable intertrochanteric fractures

2021 ◽  
Author(s):  
Thomas Angelo Skariah ◽  
Koshy George ◽  
Deny Mathew ◽  
James C. George ◽  
Samuel Chittaranjan
Keyword(s):  
Elderly Patients ◽  
Successful Treatment ◽  
Tertiary Care ◽  
Postoperative Outcome ◽  
Early Mobilization ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures ◽  
Tertiary Care Centre ◽  
Duration Of Surgery ◽  
One Year

<p><strong>Background:</strong> The successful treatment of unstable intertrochanteric fractures of the femur in elderly patients is a challenge. Due to complications associated with internal fixation, primary hemiarthroplasty is increasingly becoming an alternative treatment to achieve early mobilisation. A transtrochanteric approach could potentially decrease the complications associated with primary hemiarthroplasty. Aim of the study is to document the postoperative outcome and complications associated with this treatment.</p><p><strong>Methods:</strong> In this retrospective study, all elderly patients with unstable trochanteric fractures, treated by primary hemiarthroplasty through a transtrochanteric approach, in a tertiary care centre, from September 2017 to December 2019, were enrolled. Their data from hospital records were analysed and results compared to literature.</p><p><strong>Results:</strong> 48 patients underwent the procedure. Average age was 85 years. One year mortality was 31.25%. Average duration of surgery is 85 min. 58.3% were ambulant at one year. One case of dislocation secondary to surgical site infection was present.</p><p><strong>Conclusions:</strong> Primary hemiarthroplasty as a primary treatment in this group of patients enables early mobilization and prevents complications associated with prolonged immobilization. Transtrochanteric approach reduces the duration of surgery. Achieving early ambulation is the key to successful treatment.</p>

Sign in / Sign up

Export Citation Format

Share Document