scholarly journals Combined spinal epidural anaesthesia versus epidural anaesthesia: a comparative study

2020 ◽  
Vol 10 (2) ◽  
pp. 36-39
Author(s):  
Pramesh Sunder Shrestha ◽  
Ninadini Shrestha ◽  
Anil Shrestha ◽  
Roshana Amatya ◽  
Bigen Man Shakya ◽  
...  
Keyword(s):  
Comparative Study ◽  
Epidural Anaesthesia ◽  
Epidural Block ◽  
Spinal Block ◽  
Epidural Group ◽  
Hyperbaric Bupivacaine ◽  
Chi Square ◽  
Cross Sectional ◽  
Group B ◽  
Spinal Epidural

Background: Regional anaesthesia are widely utilized in surgical gynaecology practice. The Com­bined Spinal Epidural Anaesthesia (CSEA) technique and Continuous epidural anaesthesia both have been extensively used in elective gynaecological surgeries. This prospective cross-sectional comparative study was designed to compare the quality of anaesthesia between CSEA and Epi­dural anaesthesia. Methods: Sixty-four patients between age group 15- 65 years of ASA grade I, II were randomly di­vided into 2 groups. Group A patients received CSEA using “double needle double interspace tech­nique” and were given 2.5 ml of 0.5% hyperbaric bupivacaine for spinal block. Group B patients received epidural block with catheter using 10 ml of 0.5% plain bupivacaine. In all patients, subse­quent dosage of 2 ml per unblocked segment 0.5% plain bupivacaine was administered through the epidural catheter to achieve a block up to T4-5. Mean was calculated using t-test, median with Mann Whitney U test and Chi-square test where appropriate and the Statistical Analysis was done using SPSS program, version 11.0. Results: The surgical anaesthesia and motor blockade occurred significantly early in CSEA group. Duration of analgesia was significantly shorter in CSEA (84.1±40.6 min) as compared to epidural group (138.6±32.9 min). The total amount of bupivacaine required to attain the same target level was two times in epidural group (p<0.05). Haemodynamic changes were comparable in both the groups. No neurological side effects were observed. Conclusions: Sequential CSEA is superior alternative to epidural block, which combines the advan­tages of spinal and epidural while minimizing their drawbacks in elective gynaecological surgeries.

COMPARATIVE STUDY OF SEQUENTIAL COMBINED SPINAL EPIDURAL ANAESTHESIA VERSUS SPINAL ANAESTHESIA IN HIGH RISK GERIATRIC PATIENTS FOR MAJOR ORTHOPAEDIC SURGERY

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Sheetal .
Keyword(s):  
High Risk ◽  
Spinal Anaesthesia ◽  
Epidural Anaesthesia ◽  
Geriatric Patients ◽  
Hyperbaric Bupivacaine ◽  
Combined Spinal Epidural ◽  
Group A ◽  
Major Orthopaedic Surgery ◽  
Group B ◽  
Spinal Epidural

Sequential combined spinal epidural anaesthesia (Sequential CSEA) is probably the greatest advance in central neuraxial block in this decade for high risk geriatric patients because here the advantages of both spinal and epidural anaesthesia are summated avoiding the side effects. This study is designed to compare the clinical effects of sequential combined spinal epidural anaesthesia versus spinal anaesthesia in high risk geriatric patients undergoing major orthopaedic procedure. Sixty patients aged 65 to 80 years, ASA III were randomly allocated into two equal groups. Group A (n=30)  received sequential combined spinal epidural anaesthesia with 1 ml (5 mg) of 0.5% hyperbaric bupivacaine with 20  mg  fentanyl  through  spinal  route, and the expected incompleteness of spinal block was managed with small incremental dose  of  0.5%  isobaric bupivacaine  through epidural catheter, 1.5 to 2 ml for every unblocked segment to achieve T10 sensory level. Group B (n=30) received spinal anaesthesia with 2 ml (10 mg) of 0.5% hyperbaric bupivacaine and 20 mg of fentanyl. Both the groups showed rapid onset, excellent analgesia and good quality motor block. Group A showed a significantly less incidence of hypotension (p< 0.01) along with the provision of prolonging analgesia as compared to group B. So sequential combined spinal epidural anaesthesia is a safe, effective, reliable technique with stable haemodynamic along with provision of prolonging analgesia compared to spinal anaesthesia for high risk geriatric patients undergoing major orthopaedic surgery. Keywords: Sequential combined spinal epidural anaesthesia, Spinal anaesthesia, Fentanyl, Geriatric

scholarly journals A COMPARITIVE EVALUATION BETWEEN COMBINED SPINAL EPIDURAL BLOCK AND EPIDURAL BLOCK FOR LOWER ABDOMINAL SURGERIES

2021 ◽  
pp. 1-3
Author(s):  
Chandeshwar Choudhary ◽  
Praveen Kumar Singh ◽  
Debarshi Jana
Keyword(s):  
Epidural Anesthesia ◽  
Epidural Anaesthesia ◽  
Muscle Relaxation ◽  
Sensory Block ◽  
Epidural Block ◽  
Maximum Height ◽  
Randomised Study ◽  
Combined Spinal Epidural ◽  
Group B ◽  
Spinal Epidural

Introduction: Most of the lower abdominal surgeries are conducted under spinal or epidural anaesthesia. The purpose of this study is to evaluate combined spinal epidural anesthesia and epidural block in terms of efficacy, surgical analgesia and muscle relaxation in patients undergoing lower abdominal surgeries. Material and methods: This prospective randomised study was conducted at SKMCH, Muzaffarpur, Bihar where 60 patients of ASA I and II, aged 20-60 years of both sexes scheduled for elective lower abdominal surgeries were randomized into two groups. Group A – receiving epidural anaesthesia. 20ml of 0.5% plain bupivacaine was injected epidurally.1.5-2ml of 0.5% Bupivacaine was injected epidurally for every unblocked segment after the maximum height of block is reached so as to get the required T6 level. Group B – receiving combined spinal epidural anaesthesia. (2.5 ml) of 0.5% Bupivacaine (heavy) was deposited in the subarachnoid space.1.5-2ml of 0.5% bupivacaine was injected epidurally for every unblocked segment after 10 minutes to get required T6 height of block. Results: The changes in hemodynamic parameters observed between the two groups are statistically not significant. The time to achieve T6 sensory block was significantly shorter in CSE group when compared to epidural group. CSEA provided more degree of motor blockade and significantly good quality of analgesia compared to epidural anesthesia alone. The amount of bupivacaine required to produce the desired level of T6 blockade is 2.5 times less in CSEA compared to epidural anesthesia. Conclusion: Combined spinal epidural technique is effective, safe, with stable hemodynamics and superior to epidural anaesthesia in patients undergoing lower abdominal surgeries.

A Comparative Study between Ketamine and Lidocaine ro Decrease Propofol Injection Pain During Induction of Anesthesia

2021 ◽  
Vol 6 (1) ◽  
pp. 1304-1309
Author(s):  
Bikash Khadka ◽  
Nil Raj Sharma
Keyword(s):  
Comparative Study ◽  
Venous Occlusion ◽  
Verbal Response ◽  
Injection Pain ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Lidocaine Group ◽  
Mild Pain ◽  
Significant Difference

Introduction: Pain during the injection of anesthetic agents may be distressing and can reduce the acceptability of an otherwise useful agent such as propofol during daycare surgeries. Lidocaine and ketamine both are used as pre-treatment to decrease propofol induced pain. This study aims to compare the effectiveness of ketamine injection to decrease propofol-induced pain in comparison to lidocaine injection. Methodology: This is a prospective cross-sectional comparative study. Eighty-nine cases were divided into two groups where group K received ketamine 2 ml (0.2 mg/kg) whereas group L received lidocaine 2% 2ml (0.5 mg/kg) after venous occlusion with rubber tourniquet. One-fourth dose of propofol was injected 1 min after release of tourniquet and pain accessed at 0, 1, and 2 minutes of propofol injection with a verbal response and behavioral signs. Chi-square test and paired T-test were used and a p-value less than 0.05 was considered significant. Result: Regarding hemodynamic, oxygenation, and adverse effects there was no significant difference. Immediately after propofol injection, only 1 patient of the ketamine group had mild pain (2.22%) while 12 patients from the lignocaine group had mild pain (27.27%) with a p-value of 0.009. Also after 2 minutes of propofol injection, only 12 cases had mild pain i.e. 13.48% (1 from ketamine group i.e. 2.22% and 11 from lidocaine group i.e. 25%) with p-value of 0.002. Conclusion: Our study helps prove low-dose ketamine is more effective in reducing the incidence and severity of pain on injection of propofol in comparison to Lidocaine with better hemodynamic stability. 

scholarly journals Fetomaternal outcome in high-risk parturients receiving epidural analgesia using fentanyl with ropivacaine versus iv tramadol: a comparative study

2017 ◽  
Vol 6 (7) ◽  
pp. 2836
Author(s):  
Ashima Taneja ◽  
Kamaldeep Arora ◽  
Isha Chopra ◽  
Anju Grewal ◽  
Sushree Samiksha Naik ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
High Risk ◽  
Epidural Analgesia ◽  
Comparative Study ◽  
Satisfaction Score ◽  
Epidural Group ◽  
Patient Satisfaction Score ◽  
Vaginal Deliveries ◽  
Group A ◽  
Group B

Background: Labour analgesia has been recommended but sufficient data on use of labour epidural analgesia with ropivacaine and fentanyl combination during labour is not available.Methods: A comparative study was conducted on 40 high risk labouring partuirents, randomly allocated to group A (iv tramadol) and group B (epidural analgesia with ropivacaine plus fentanyl). Assessments were done for fetal heart rate abnormality, mode of delivery, duration of labour, and Apgar score. The VAS score, patient satisfaction score, and complications were recorded.Results: Group A had more number of instrumental deliveries compared to group B, the later had higher number of caesarean sections. No difference was observed in vaginal deliveries in both the groups. Pain relief was significant in patients of epidural group. The neonatal outcome was same in both the groups. Significant number of patients had a higher degree of satisfaction score in group B compared to group A.Conclusions: Tramadol and epidural analgesia in labour are safe and effective. Patient satisfaction is significantly higher in epidural group as compared to the tramadol group.

scholarly journals Prevalence and Serotype Determination of Streptococcus agalactiae Isolated From Non-Pregnant Women in Tehran, Iran

2020 ◽  
Author(s):  
Leila Goudarzi ◽  
Mohammad Bagher Khalili ◽  
Mahmood Vakili ◽  
Maryam Sadeh
Keyword(s):  
Pregnant Women ◽  
Streptococcus Agalactiae ◽  
Group B Streptococcus ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Specific Pcr ◽  
Pcr Method ◽  
Group B ◽  
Tehran Area

Consequence of Streptococcus agalactiae, Group B Streptococcus (GBS) relating infant’s diseases are well documented. Although many women carry this bacterium in their vagina, they may transfer to their infant during delivery and may result in different neonatal invasive diseases. The aim of this study was to determine the prevalence of GBS and serotyping the isolated species among un-selective non-pregnant women who attended two gynecology clinics in Tehran. In this cross-sectional study, a total of 560 vaginal samples collected from non-pregnant women. Following inoculation of the specimen on Blood Agar, the standard technology was applied for the final identification of GBS. Detected GBS species were further confirmed using specific PCR directed on dlts gene. Capsular serotyping was done by using the multiplex PCR method. The chi-square method was used for statistical analysis. Fifty (8.9%) out of 560 non-pregnant women were carriers of GBS. The most common types were III (36%), followed by type II (32%), Ia (26%), and Ib (6%), respectively. Results represent that the prevalence rate of GBS in non-pregnant women was reliable and similar to what obtained from pregnant women. In addition, the serotype III was found the most dominant types, as well as other investigations in the Tehran area. Therefore, vaccine designation based on type III is recommended.

Combined Spinal Epidural Anaesthesia versus Spinal Anaesthesia with Clonidine for Hip Surgeries: A Randomized Comparative Study

2017 ◽  
Vol 4 (4 (Part-2)) ◽  
pp. 1208-1214
Author(s):  
Pushpa Agrawal ◽  
◽  
Surekha Shinde ◽  
Rohit Jakhalekar ◽  
Pravin Jadhav ◽  
...  
Keyword(s):  
Comparative Study ◽  
Spinal Anaesthesia ◽  
Epidural Anaesthesia ◽  
Combined Spinal Epidural ◽  
Spinal Epidural

scholarly journals Burden among Caregivers of Person with Schizophrenia and Schizoaffective Disorder: A Comparative Study

2015 ◽  
Vol 2 (4) ◽  
Author(s):  
Jaya Bharti
Keyword(s):  
Comparative Study ◽  
Schizoaffective Disorder ◽  
Demographic Variables ◽  
Burden Of Care ◽  
Physical And Mental Health ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
Patient Groups ◽  
The Relationship

This is a cross-sectional comparative study with the aim to compare two patient groups of schizophrenia and schizoaffective disorder and their respective caregivers with the objectives to quantify and compare the burden in caregivers of person with schizophrenia and schizoaffective disorder and to study the relationship between them. In this study, 40 patients schizophrenia, 40 patients of schizoaffective disorder, along with their 80 respective caregivers were taken on the basis of inclusion and exclusion criteria. Subjects were assessed using Socio-demographic and clinical sheet &BAS. Appropriate statistics such as mean, standard deviation, chi-square test, unpaired t test, Pearson’s correlation were applied to analyze the data. The results of the study revealed considerable burden of care in families of the patients and a significantly greater burden of care in caregivers of patients with schizoaffective especially in the following domains: spouse related, caregivers’ routine, physical and mental health, taking responsibility, patient’s behaviour and caregiver’s strategy. Some of the demographic variables like age and education etc. were also found to have significant correlation with burden of care.

scholarly journals PERIOPERATIVE EFFECTS OF INTRATHECAL CLONIDINE AND FENTANYL WITH HYPERBARIC BUPIVACAINE IN SPINAL ANESTHESIA FOR VAGINAL HYSTERECTOMY

2016 ◽  
Vol 9 (5) ◽  
pp. 245
Author(s):  
Suman Chattopadhyay ◽  
Mallika Datta ◽  
Biswanath Biswas
Keyword(s):  
Placebo Group ◽  
Spinal Anesthesia ◽  
Low Dose ◽  
Mechanisms Of Action ◽  
Spinal Block ◽  
Hyperbaric Bupivacaine ◽  
Prolonged Duration ◽  
Group A ◽  
Group B ◽  
Intrathecal Clonidine

ABSTRACTObjectives: Intrathecal fentanyl and clonidine are effective analgesics with different mechanisms of action. This study compares 25 µg of both thesedrugs given intrathecally regarding onset, quality, and duration of hyperbaric bupivacaine-induced spinal block and side effects.Methods: A total of 90 patients of ASA I and II were randomly allocated into three equal groups. Group A received 0.5 ml of 0.9% normal saline(placebo), Group B and Group C received 25 µg fentanyl and clonidine intrathecally added to 2.5 ml of 0.5% hyperbaric bupivacaine, respectively. Theonset and regression time of sensory and motor blocks were recorded along with hemodynamic change, side effects, pain intensity (in terms of visualanalog score (VAS), and time to first rescue analgesic.Results: Intrathecal clonidine (25 μg) significantly prolongs sensory and motor blocks, with prolonged duration of analgesia in comparison withintrathecal fentanyl (25 µg) (325±15 minutes vs. 240±7.6 minutes). VAS score was similar, but sedation was more in clonidine group.Conclusion: We conclude that low-dose intrathecal clonidine is an effective adjuvant to bupivacaine for spinal anesthesia and provides betterpostoperative analgesia in comparison with intrathecal fentanyl.Keywords: Clonidine, Fentanyl, Bupivacaine, Regional, Spinal, Postoperative pain.

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