scholarly journals A COMPARATIVE STUDY OF CAUDAL BUTORPHANOL AND FENTANYL FOR ALLEVIATING POST-OPERATIVE PAIN IN INFRAUMBILICAL PROCEDURES IN CHILDREN BELOW 3 YEARS OF AGE

2019 ◽  
Vol 12 (1) ◽  
pp. 336
Author(s):  
Mohammed Irfanulla ◽  
Thrivikram Shenoy ◽  
Ranjan Rk
Keyword(s):  
Analgesic Efficacy ◽  
Anesthetic Technique ◽  
Caudal Block ◽  
Invasive Blood Pressure ◽  
Non Invasive ◽  
Post Operative Pain ◽  
The Mean ◽  
Group B ◽  
Fentanyl Group ◽  
Caudal Blockade

Objective: Caudal block is a common regional anesthetic technique used in children. However, it is limited by relatively shorter duration of analgesia. The objective of this study was to compare the analgesic efficacy of caudal blockade using butorphanol (1) and fentanyl in children below 3 years, undergoing infraumbilical surgeries.Methods: Patients were randomly allocated to two groups of 30 each. Without premedication, patients were induced with thiopentone, relaxed with atracurium for facilitation of LMA insertion, and maintained on O2, N2O, and halothane. Caudal block was then performed using an aseptic technique. One group received caudal butorphanol (25 μg/kg) with 0.25% bupivacaine (0.1 ml/kg) and the other received fentanyl (1 μg/kg). Incision was allowed after 15 min of block. After the completion of surgery, LMA was removed and patients were shifted to the PACU. Non-invasive blood pressure and heart rate were recorded; pain was assessed using modified objective pain score (MOPS) (2) at 2, 4, 6, 12, and 24 h, postoperatively. Oral paracetamol was given at a score >4.Results: The mean duration of analgesia in Group F was 12.47 (standard deviation [SD] 8.216) and 19.67 (SD 7.009) in Group B (p: 0.001, HS). Mean MOPS was 4.6 in the fentanyl group as compared to 2.6 in the butorphanol group at the end of 24 h (p=0.001, HS). Thus, butorphanol provided longer duration of analgesia compared to fentanyl.Conclusion: Caudal additives are safe in children and butorphanol provides significantly longer duration of analgesia as compared to fentanyl, thus avoiding caudal catheterization and intravenous analgesics.

scholarly journals A COMPARATIVE STUDY OF CAUDAL BUTORPHANOL AND FENTANYL FOR ALLEVIATING POST-OPERATIVE PAIN IN INFRAUMBILICAL PROCEDURES IN CHILDREN BELOW 3 YEARS OF AGE

2019 ◽  
Vol 12 (1) ◽  
pp. 336
Author(s):  
Mohammed Irfanulla ◽  
Thrivikram Shenoy ◽  
Ranjan Rk
Keyword(s):  
Analgesic Efficacy ◽  
Anesthetic Technique ◽  
Caudal Block ◽  
Invasive Blood Pressure ◽  
Non Invasive ◽  
Post Operative Pain ◽  
The Mean ◽  
Group B ◽  
Fentanyl Group ◽  
Caudal Blockade

Objective: Caudal block is a common regional anesthetic technique used in children. However, it is limited by relatively shorter duration of analgesia. The objective of this study was to compare the analgesic efficacy of caudal blockade using butorphanol (1) and fentanyl in children below 3 years, undergoing infraumbilical surgeries.Methods: Patients were randomly allocated to two groups of 30 each. Without premedication, patients were induced with thiopentone, relaxed with atracurium for facilitation of LMA insertion, and maintained on O2, N2O, and halothane. Caudal block was then performed using an aseptic technique. One group received caudal butorphanol (25 μg/kg) with 0.25% bupivacaine (0.1 ml/kg) and the other received fentanyl (1 μg/kg). Incision was allowed after 15 min of block. After the completion of surgery, LMA was removed and patients were shifted to the PACU. Non-invasive blood pressure and heart rate were recorded; pain was assessed using modified objective pain score (MOPS) (2) at 2, 4, 6, 12, and 24 h, postoperatively. Oral paracetamol was given at a score >4.Results: The mean duration of analgesia in Group F was 12.47 (standard deviation [SD] 8.216) and 19.67 (SD 7.009) in Group B (p: 0.001, HS). Mean MOPS was 4.6 in the fentanyl group as compared to 2.6 in the butorphanol group at the end of 24 h (p=0.001, HS). Thus, butorphanol provided longer duration of analgesia compared to fentanyl.Conclusion: Caudal additives are safe in children and butorphanol provides significantly longer duration of analgesia as compared to fentanyl, thus avoiding caudal catheterization and intravenous analgesics.

scholarly journals Comparison of single shot caudal Ropivacaine and Bupivacaine in paediatric patients undergoing herniotomy

2019 ◽  
Vol 1 (2) ◽  
pp. 73-76
Author(s):  
Rishabh Ravi ◽  
Bigen Man Shakya ◽  
Anil Shrestha
Keyword(s):  
Motor Block ◽  
Complete Recovery ◽  
Pain Scale ◽  
P Value ◽  
Single Shot ◽  
Caudal Block ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
The Mean ◽  
Group B

Background: Inguinal hernia repair is a common surgical procedure in children. Caudal block is an appropriate technique for the treatment of post operative pain in children undergoing herniotomy. This study compared the effects of Ropivacaine and Bupivacaine in caudal block in children undergoing herniotomy. Methodology: A total of 74 patients between 5-16 yrs undergoing herniotomy were randomized in two groups. In Group B, 0.75ml/kg of 0.25% caudal Bupivacaine was administered whereas Group R received 0.75 ml/kg of 0.25% caudal Ropivacaine. Pain score was assessed using Wong Baker pain scale in post operative period and motor power was assessed using modified Bromage scale till 6 hours. Results: The mean duration of post operative analgesia was found to be 253.51 ± 11.48 minutes in Bupivacaine and 258.1 ± 12.10 minutes in Ropivacaine group. The median duration of motor block was 180 (Q1 60- Q3 180) minutes in Bupivacaine and 30 (Q1 22.5- Q3 45) minutes in Ropivacaine group which was statistically significant. There was complete recovery of motor block by 2 hour in Ropivacaine and by 4 hour in Bupivacaine group. (p value< 0.001). Conclusion: From the current study, it is concluded that caudal Ropivacaine at 0.25% concentration and 0.75ml/ kg provides similar duration of post operative analgesia with less motor block in comparison to Bupivacaine.

Comparison of Analgesic Efficacy of Nalbuphine Versus Tramadol as Adjuvant to Local Anaesthetic in Caudal Block in Children

2021 ◽  
Vol 15 (11) ◽  
pp. 3458-3460
Author(s):  
Muhammad Sharif ◽  
Muhammad Arif Baloch ◽  
Nazeer Ahmed ◽  
Zafar ullah ◽  
Yasir Reda Toble
Keyword(s):  
Group Versus ◽  
Analgesic Efficacy ◽  
P Value ◽  
Caudal Block ◽  
Rescue Analgesia ◽  
Post Operative Pain ◽  
Group A ◽  
Male Patients ◽  
Group B ◽  
Mean Time

Objective: To compare the mean time of first analgesia with nalbuphine versus tramadol as adjuvant to bupivacaine for caudal block in children. Patients and Methods: In this randomized clinical trial, a total number of 60 children who were planned for caudal block after infra-abdominal surgeries having age 3-12 years were included. A caudal block was performed under general anaesthesia immediately after surgery for postoperative analgesia. Tramadol 2mg/kg body weight was given caudally to individuals in group A. Group B patients had 0.125 percent bupivacaine with 0.1mg/kg nalbuphine caudally. Time of requirement of first analgesia was noted in all patients. Paracetamol 10 mg/kg was given as rescue analgesic in all patients. Results: Mean age of patients was 8.30±3.03 years. Mean weight of patients was 23.33±6.92 Kg. There were 26 (43.33%) female patients and 34 (56.67%) male patients. There were 50 (83.33%) children who were having ASA status I, and remaining 10 (16.67%) children were having ASA status II. Mean pain score was 3.53±1.43 in tramadol group and 1.86±1.25 in Nalbuphine group (p-value <0.001. Mean time of first rescue analgesia was significantly prolonged in Nalbuphine group, mean time was 6.13±1.07 hours in Nalbuphine group versus 4.03±1.03 hours in tramadol group (p-value <0.001). Conclusion: Single dose of nalbuphine as an adjunct to bupivacaine is superior as compared to tramadol in reducing the post-operative pain, it also significantly prolongs the duration of analgesia in children. Keywords: Caudal Block, Nalbuphine, Tramadol, Post-operative pain, Time of first rescue analgesia.

scholarly journals Clinical outcome of the off-pump coronary artery bypass surgery- a comparison between combined high thoracic epidural anaesthesia with GA and GA alone

2014 ◽  
Vol 22 (2) ◽  
pp. 54-60
Author(s):  
Saiful Islam Azad ◽  
Abdul Khaleque Beg ◽  
AYF Elahi Chowdhury ◽  
IH Shahera Khatun
Keyword(s):  
Epidural Anaesthesia ◽  
Off Pump ◽  
Thoracic Epidural ◽  
Thoracic Epidural Anaesthesia ◽  
Arterial Blood ◽  
Post Operative Pain ◽  
Group A ◽  
The Mean ◽  
High Thoracic Epidural ◽  
Group B

Background: The common challenges for the cardiac anaesthesiologist during off pump coronary artery surgery (OPCAB) include haemodynamic stability during the different stressful surgical events and multiple cardiac manipulations, providing adequate myocardial protection, and obtaining effective postoperative analgesia leading to early discharge from the intensive care unit. Objective: This study has been undertaken with a view to find out whether a combined high thoracic epidural anaesthesia (HTEA) with general anaesthesia (GA) is safe and more efficient in providing overall cardiovascular stability as well as improving the parameters leading to a better outcome in terms of a shorter and more predictable road maps to recovery. Methods: Sixty patients aged within 40-70 years, without having any coagulopathy disorder, any emergency surgery or left main disease scheduled for CABG on beating heart were enrolled in prospective, randomized observational comparative study. Patients were divided in two groups. In group A patients received GA alone and in group B patients received high thoracic epidural anaesthesia with GA. The parameters including heart rate, SPO2, CVP, arterial blood pressure, ECG, and ABG analysis were recorded before induction, during induction, intubation and during different events of the surgery. Post operative pain score, sedation score, ventilator hour, duration in the ICU stay,  rescue analgesic need and post operative complications was assessed and recorded. Results: significant per-operative mean heart rate changes were observed all the events except at wound closure and during anastomosis with D1/D2 and the mean difference of mean arterial pressure at intubations, skin incision, sternotomy, pericardiotomy, during anastomosis of distal end of the graft with RCA, PDA, LCX and D1/D2 were observed statistically significant (p<0.05). No incidence of different arrhythmia occurred in group B, premature ventricular complex (PVC) was statistically significant (p<0.05) between two groups. No significant change was found in per-operative pH of arterial blood, PaCO2 and PaO2 changes at different times. Post operative pain score (VAS 0-100) in different time interval was found significant (p<0.05) change between two groups in all follow-up times. Status of rescue analgesics were observed statistically significant (p<0.05). The mean ventilator hours were 7.4±1.09 hours in group A and 5.3±0.81 hours in group B. The mean ICU stay was 72.9±9.2 hours in group A and 57.1±12.0 hours in group B. No post-operative complication was observed in both groups. The data were compiled and analyzed by using statistical software SPSS (ver. 12.0) and significance test performed by unpaired t test and Chi square test. P value <0.05 was considered as statistically significant. Conclusion: Both anaesthetic techniques are equally safe but better clinical outcome of the OPCAB surgery with the high thoracic epidural anaesthesia with GA. DOI: http://dx.doi.org/10.3329/jbsa.v22i2.18142 Journal of BSA, 2009; 22(2): 54-60

scholarly journals Comparison of Pre-emptive Use of Diclofenac, Ketorolac and Tramadol for Post-operative Pain in Laparoscopic Cholecystectomy

2009 ◽  
Vol 20 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Md Rafiqul Hasan Khan ◽  
Md Zohirul Islam ◽  
Md Sazzad Hossain ◽  
Lutful Aziz ◽  
SN Samad Choudhury
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Analgesic Efficacy ◽  
Prospective Clinical Study ◽  
The Poor ◽  
Post Operative Pain ◽  
Group A ◽  
Group B ◽  
Better Than

Under treatment of postoperative pain has been the topic of several recent editorials. The prevention, recognition, and management of postoperative pain in adults, as well as in children, have been receiving a great deal of interest. The poor outcome obtained with current regimens is primarily due to the inadequacies of drug administration techniques rather than the qualities of opioids themselves. In this prospective study comparison of preemptive use of diclofenac, ketorolac and tramadol was done for postoperative pain in laparoscopic cholecystectomy. 60 patients were divided into three groups. Group A received injection Diclofenac (3mg/kg) 75mg maximum at a time. Group B received injection Ketorolac (30 mg). And group C patients received injection Tramadol (100 mg). All drugs were given intravenous half an hour before induction. Analgesic efficacy was measured in VAS scale. In addition pulse, systolic blood pressure, diastolic blood pressure, mean blood pressure, total pethidine requirement and time of first pethidine requirement were recorded Patients received an increment of 10-20 mg of pethidine when pain score was 3-4. In this study, total pethidine consumption in group A is 56.5±5.14, in group B is 46.75±4.65 and in group C is 49±5.42. It shows that group B and group C have same analgesic effectiveness and which is better than group A. On the basis of present prospective clinical study postoperative pain can be managed by preemptive use of diclofenac, ketorolac and tramadol. The analgesic efficacy of ketorolac and tramadol is same and better than diclofenac. Key Words: Pre-emptive analgesia, Laparoscopic cholecystectomy. Journal of BSA, Vol. 20, No. 1, January 2007 p.24-29

Placental Transfer and Neonatal Effects of Epidural Sufentanil and Fentanyl Administered with Bupivacaine during Labor

1995 ◽  
Vol 83 (2) ◽  
pp. 300-308. ◽  
Author(s):  
John R. Loftus ◽  
Harlan Hill ◽  
Sheila E. Cohen
Keyword(s):  
Placental Transfer ◽  
Plasma Concentrations ◽  
Double Blind ◽  
Epidural Bupivacaine ◽  
Neurobehavioral Testing ◽  
Neonatal Assessment ◽  
The Mean ◽  
Blood Gas Analyses ◽  
Group B ◽  
Fentanyl Group

Background This randomized double-blind investigation was designed to study the placental transfer and neonatal effects of epidural sufentanil and fentanyl infused with bupivacaine for labor analgesia. Methods Healthy parturient women (n = 36) received epidural bupivacaine alone (group B) or with fentanyl (group B-F) or sufentanil (group B-S). Group B received a 12-ml bolus of 0.25% bupivacaine followed by a 10 ml/h infusion of 0.125% bupivacaine. Groups B-F and B-S received a 12-ml bolus of 0.125% bupivacaine with 75 micrograms fentanyl or 15 micrograms sufentanil, respectively, followed by 10 ml/h of 0.125% bupivacaine with fentanyl 1.5 micrograms/ml or sufentanil 0.25 micrograms/ml. Maternal venous (MV) and umbilical arterial (UA) and umbilical venous (UV) bupivacaine and opioid plasma concentrations were determined. Neonatal assessment included Apgar scores, umbilical cord blood gas analyses, and neurobehavioral testing at delivery and at 2 and 24 h of life using the Neurologic and Adaptive Capacity Score (NACS). Results The mean total dose of fentanyl was 136.6 +/- 13.1 micrograms (SEM), and of sufentanil, 23.8 +/- 1.8 micrograms. Although administered in a ratio of 5.7:1, fentanyl and sufentanil MV plasma concentrations were in the ratio of 27:1. UV/MV ratios were 0.37 for fentanyl and 0.81 for sufentanil. Fentanyl was detected in most UA samples, whereas sufentanil was present in only one sample. Neonatal condition was good and generally similar in all groups, with the exception of a lower NACS at 24 h in group B-F. Conclusions Although the degree of placental transfer of sufentanil appeared greater than that of fentanyl, lower MV sufentanil concentrations resulted in less fetal exposure to sufentanil. The lower NACS at 24 h in group B-F may reflect the continued presence of fentanyl in the neonate.

scholarly journals HEMODYNAMIC CHANGES AMONG PATIENTS UNDERGOING LOWER LIMB ORTHOPAEDIC SURGERIES UNDER HYPERBARIC BUPIVACAINE WITH CLONIDINE IN TWO DIFFERENT DOSES

2020 ◽  
pp. 38-40
Author(s):  
Preethi HN ◽  
Santhosh NV ◽  
Ravishankar BM
Keyword(s):  
Heart Rate ◽  
Local Anaesthetics ◽  
Baseline Heart Rate ◽  
Hyperbaric Bupivacaine ◽  
Duration Of Action ◽  
Invasive Blood Pressure ◽  
Non Invasive ◽  
Significant Difference ◽  
The Mean ◽  
Plexus Block

Introduction: Absorption of local anaesthetics is determined by site of injection, dosage and addition of a vasoconstrictor. Absorption is faster in regions of higher vascularity and also in some regions eg. Absorption of drug after inter-costal block is faster than after brachial plexus block. Higher dosage tends to be absorbed faster. Addition of vasoconstrictor does not prolong the duration of action of bupivacaine significantly but decrease its absorption. Methodology: Baseline heart rate, non Invasive blood pressure, spo2, respiratory rate was recorded every minute for 5 minute, then every 5 minutes till 1 hour of surgery, then every 15 minutes till the end of surgery postoperatively every 30 minutes till patients complain of pain. Results: Heart rate variability noticed and compared between the two groups in our study revealed a significant difference in the mean heart rate between Group BC30 and Group BC60 at 1,10,15,20,25 and 30 minute respectively. Otherwise the mean HR of the Groups are comparable at other time intervals. Conclusion: However, there was not statistical difference in the incidence of bradycardia noted between the two groups.

scholarly journals Ultrasonic cutting and coagulation device versus conventional diathermy dissection in thyroid surgery: prospective randomized trial

2018 ◽  
Vol 4 (2) ◽  
pp. 335
Author(s):  
Aditya Singhal ◽  
Dharma Kant Baskota ◽  
Kunjan Acharya
Keyword(s):  
Pain Score ◽  
Thyroid Surgery ◽  
Operative Time ◽  
Ultrasonic Device ◽  
Post Operative Pain ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Lottery System ◽  
Ultrasonic Cutting

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The objective of this study was to compare the operative time and postoperative outcomes in thyroid surgeries using the ultrasonic cutting and coagulation device with conventional diathermy dissection. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This study was a prospective, interventional, cohort study. The patients   were randomized in two groups by lottery system. The patients operated with ultrasonic device were labeled as Group A: UCCD and by conventional diathermy as Group B: CDD. The operative time, postoperative drain volume, pain score on VAS and complications were assessed and compared in between the two techniques of surgery.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Total of 18 males and 58 females underwent thyroid surgery with age ranging from 17 to 75 years. The operative time in UCCD group was less than CDD group (93.29 min vs. 106.59 min; p=0.06). The cumulative mean amount of drain was found to be less in UCCD group, this difference was statistically significant (77.86 ml vs. 138.05 ml; p=0.00018). The drain was removed earlier in UCCD group, this comparison was also statistically significant (2.49 days in UCCD group vs. 3.02 days in CDD group; p=0.000009). The mean pain score was found to be statistically significant on all the postoperative days in UCCD group. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The patients experienced less pain and complication while using UCCD as technique for surgery.  Hence, ultrasonic device using both cutting and coagulating mode at the same time is efficient in hemostasis and lesser post-operative pain, and found to be advantageous.</span></p>

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