Comparison of 0.5% levobupivacaine and 0.75% ropivacaine in spinal anaesthesia for urological surgeries - Randomised double blinded study

2019 ◽  
Vol 9 (2) ◽  
pp. 113-116
Author(s):  
Vinod Selvin ◽  
◽  
U G Thirumaaran ◽  
Selva kumaran ◽  
◽  
...  
Keyword(s):  
Spinal Anaesthesia ◽  
Blinded Study ◽  
Double Blinded

Comparative study between the effect of intrathecal bupivacaine versus bupivacaine dexmedetomidine combination in spinal anaeshtesia for lower abdominal surgeries

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mervat M Marzouk ◽  
Wael R Thabet ◽  
Tarek M Ashoor ◽  
Ahmed Morsy Ahmed
Keyword(s):  
Blood Pressure ◽  
Spinal Anaesthesia ◽  
Primary Outcome ◽  
Sensory Block ◽  
University Hospital ◽  
Rescue Analgesia ◽  
Blinded Study ◽  
Hospital Patients ◽  
Block Level ◽  
Double Blinded

Abstract Study objectives We compared effect of intrathecal bupivacaine versus bupivacaine Design This is a prospective, randomized, double-blinded study. Setting The setting is at an operating room in Ain Shams University Hospital. Patients: 50 patients scheduled for general anesthesia were randomly allocated to the following 2 groups in equal numbers. Interventions Spinal anaesthesia will be performed in the sitting position at L3-L4 or L4-L5 level using a 25-gauge Quincke spinal needle by the most competent experts. The sensory block level will be assessed along the mid-clavicular line bilaterally. The motor block will be assessed according to Bromage scale Measurements Post operative (VAS) score and Time to first requested analgesia.(primary outcome), Systolic blood pressure, diastolic blood pressure, mean blood pressure and heart rate will be recorded every 5 minutes for 20 minutes then every 15 minutes till the end of surgery, Nausea and/ or vomiting as yes/no, Level of highest sensory block, Bromage score ≥3, Onset of sensory block and Two segment regression time (secondary outcomes) were recorded.. Main results Results of this study showed that the addition of dexmedetomidine to bupivacaine in spinal anaesthesia significantly prolonged both sensory and motor blockades duration compared with bupivacaine alone. They also prolonged the time of postoperative analgesia as evidenced by significantly longer time to first rescue analgesia and lower NRS scores with minimal adverse effects and haemodynamic stability. Conclusions We concluded that intrathecal dexmedetomidine increases the duration of analgesia and reduces postoperative pain without changes in the hemodynamic parameters and adverse side effects. It can be considered as an appropriate adjuvant to intrathecal local anesthetics for lower abdominal surgeries.

scholarly journals Effects of Nalbuphine and Fentanyl as Adjuvants to (0.5 %) Isobaric Levobupivacaine in Subarachnoid Block for Elective Transurethral Endoscopic Surgeries

2021 ◽  
Vol 10 (38) ◽  
pp. 3380-3386
Author(s):  
Dinesh G ◽  
Shilpa G.B ◽  
Greeshma N. Murdeshwar
Keyword(s):  
Adverse Effects ◽  
Spinal Anaesthesia ◽  
Motor Blockade ◽  
Male Adult ◽  
Hemodynamic Variables ◽  
Positional Variation ◽  
Blinded Study ◽  
Neurotoxic Effects ◽  
American Society ◽  
Double Blinded

BACKGROUND Isobaric levobupivacaine has minimal effect on positional variation of sensory and motor blockade given intrathecally. Also, it has lesser cardiotoxic and neurotoxic effects. Present study was done to compare efficacy, analgesia haemodynamic effects and any adverse effects after spinal anaesthesia with isobaric levobupivacaine with nalbuphine and fentanyl as adjuvants in transurethral endoscopic surgeries. METHODS 60 male adult patients of American Society of Anaesthesiologists (ASA class I-III) of age group 40 - 80 years were randomized into 2 groups (n = 30) in this prospective, double blinded study. 10 mg of 0.5 % levobupivacaine with 25 µg fentanyl in group LF and 10 mg of 0.5 % levobupivacaine with 0.8 mg nalbuphine in group LN. Parameters assessed were sensory and motor blockade characteristics and hemodynamic variables in both the groups. Adverse effects were recorded if any. RESULTS Onset of sensory and motor blockade were significantly faster in group LF compared to group LN. In both the groups, time for two segment regression was comparable. Statistically significant prolonged analgesic duration was noticed in group with nalbuphine than fentanyl as adjuvant to isobaric levobupivacaine. Difference in haemodynamic variation was not significant in both the groups. CONCLUSIONS Intrathecal nalbuphine 0.8 mg as an adjuvant with isobaric levobupivacaine 0.5 % 10 mg is as efficacious as fentanyl 25µg in transurethral endoscopic surgeries in elderly population with better hemodynamic stability. KEY WORDS Levobupivacaine; Fentanyl; Nalbuphine; Spinal anaesthesia.

scholarly journals A Comparative Study to Evaluate the Effect of Norepinephrine and Phenylephrine in the Treatment of Post Spinal Hypotension for Caesarean Section

2022 ◽  
Author(s):  
Archita Patil ◽  
Rashmee Chavan ◽  
Shwetha K. Mudalagirigowda ◽  
Sravya Adda
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Elective Caesarean Section ◽  
Fluid Loading ◽  
Time Intervals ◽  
Induced Hypotension ◽  
Cardiovascular Side Effects ◽  
Blinded Study ◽  
Spinal Hypotension ◽  
Double Blinded

Background: Maternal hypotension due to spinal anaesthesia in caesarean section is commonly seen. Alongwith fluid loading, phenylephrine is used to manage the hypotension. However, this drug is associated with cardiovascular side effects. Methods: This is a prospective double blinded study which was conducted on 100 term parturients scheduled from elective caesarean section under spinal anaesthesia, randomly assigned into two groups. After spinal anaesthesia patients of group N and P were treated with norepinephrine (5mcg) and phenylephrine (50mcg) respectively as an IV bolus for hypotension. Blood pressure, heart rate, number of bolus doses given, and neonatal APGAR score was noted. Results:  Patients of both groups were comparable with respect to haemodynamic parameters (HR, SBP, DBP, AND MAP). Incidence of bradycardia was higher in group P (22%, n=11) compared to group N (14%, n=7). Neonatal APGAR scores at different time intervals were similar in both groups. Conclusion: Intermittent boluses of norepinephrine were effective in the treatment of spinal anaesthesia induced hypotension during caesarean section and can be considered as an alternative to phenylephrine.

scholarly journals Robotics and the Airway Management

2022 ◽  
Author(s):  
Zahid Hussain Khan ◽  
Surender K. Malhotra
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Elective Caesarean Section ◽  
Fluid Loading ◽  
Time Intervals ◽  
Induced Hypotension ◽  
Haemodynamic Parameters ◽  
Cardiovascular Side Effects ◽  
Blinded Study ◽  
Double Blinded

Background: Maternal hypotension due to spinal anaesthesia in caesarean section is commonly seen. Alongwith fluid loading, phenylephrine is used to manage the hypotension. However, this drug is associated with cardiovascular side effects. Methods: This is a prospective double blinded study which was conducted on 100 term parturients scheduled from elective caesarean section under spinal anaesthesia, randomly assigned into two groups. After spinal anaesthesia patients of group N and P were treated with norepinephrine (5mcg) and phenylephrine (50mcg) respectively as an IV bolus for hypotension. Blood pressure, heart rate, number of bolus doses given, and neonatal APGAR score was noted. Results:  Patients of both groups were comparable with respect to haemodynamic parameters (HR, SBP, DBP, AND MAP). Incidence of bradycardia was higher in group P (22%, n=11) compared to group N (14%, n=7). Neonatal APGAR scores at different time intervals were similar in both groups. Conclusion: Intermittent boluses of norepinephrine were effective in the treatment of spinal anaesthesia induced hypotension during caesarean section and can be considered as an alternative to phenylephrine.

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