scholarly journals A comparison of epidural analgesia provided by Bupivacaine plus Pethidine, Bupivacaine plus Morphine, or Bupivacaine plus Morphine plus Midazolam for lower limb Orthopaedic surgery

2014 ◽  
Vol 4 (1) ◽  
pp. 19-21
Author(s):  
NR Sharma ◽  
U Rai ◽  
S Panthee ◽  
P Shrestha
Keyword(s):  
Epidural Anaesthesia ◽  
Lower Limb ◽  
Orthopaedic Surgery ◽  
Epidural Morphine ◽  
P Value ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
Good Patient Satisfaction

Epidural anaesthesia and analgesia in orthopaedic surgeries helps to prevent thromboembolic phenomenon by increasing venodynamics. Adequate post operative analgesia with good patient satisfaction has been observed with this technique. The objective of this study was to assess the duration of postoperative analgesia and complications in patients receiving epidural anesthesia with morphine, midazolam and pethidine in combination with bupivacaine. We prospectively studied 75 Patients who were scheduled for elective lower limb orthopaedic surgery with epidural anaesthesia. This study was conducted from March 2010 to March 2012 at Lumbini Medical College Palpa. They were randomly divided by lottery method into three equal groups. Group ‘A’ (BP) received 50 mg epidural pethidine (3 ml) with 0.5 % bupivacaine 13 ml. Group ‘ B’ (BM) received 5 mg (3 ml) epidural morphine with 13 ml of 0.5% bupivacaine and Group’ C’ (BMM) received 5 mg (1 ml) epidural morphine with 13 ml 0.5% bupivacaine and 2 mg (2 ml) epidural midazolam. All the patients were observed for 24 hours for quality of analgesia and other side effects like nausea vomiting, and pruritus. Data were analysed by SPSS-16.0 software. The result of the study shows the duration of analgesia was prolonged in BMM group than BM, and BP group and was statistically significant (P value <0.001). Incidence of nausea and vomiting in BMM group was lower than that of BP and BM group but was statistically insignificantly (P value 0.489). Pruritus was absent in BP group and was more with BM and BMM group (P value 0.007). In conclusion the use of epidural morphine and midazolam in combination with bupivacaine is the satisfactory method of post operative analgesia. By adding midazolam, duration of analgesia can be increased with decrease in incidence of nausea, vomiting and pruritus. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10842 Journal of Chitwan Medical College 2014; 4(1): 19-21

scholarly journals A comparison of epidural analgesia provided by Bupivacaine plus Pethidine, Bupivacaine plus Morphine, or Bupivacaine plus Morphine plus Midazolam for lower limb orthopaedic surgery

2014 ◽  
Vol 2 (3) ◽  
pp. 117-121
Author(s):  
Nil Raj Sharma ◽  
Pradip Timalsena ◽  
Sundip DC
Keyword(s):  
Epidural Anaesthesia ◽  
Lower Limb ◽  
Orthopaedic Surgery ◽  
Epidural Morphine ◽  
P Value ◽  
Medical College ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Epidural anaesthesia and analgesia in orthopaedic surgeries helps to prevent thromboembolic phenomenon by increasing venodynamics. Adequate post-operative analgesia with good patient satisfaction has been observed with this technique. Objective: To assess the duration of postoperative analgesia and complications in patients receiving epidural anaesthesia with Morphine, Midazolam and Pethidine in combination with Bupivacaine. Methods: We prospectively studied 75 patients who were scheduled for elective lower limb orthopaedic surgery with epidural anaesthesia at Lumbini Medical College, Palpa from 2010 March to 2012 March. They were randomly divided by lottery method into three equal groups. Group ‘A’ (BP) received 50 mg epidural Pethidine (3 ml) with 13 ml of 0.5% Bupivacaine. Group ‘B’ (BM) received 5 mg (3 ml) epidural Morphine with 13 ml of 0.5% Bupivacaine and Group ‘C’ (BMM) received 5 mg (1 ml) epidural Morphine with 13 ml 0.5% Bupivacaine and 2 mg (2 ml) epidural Midazolam. All the patients were observed for 24 hours for quality of analgesia and other side effects like nausea, vomiting and pruritus. Data were analysed by Statistical Package for Social Sciences (SPSS-16) software. Results: The result of the study shows the duration of analgesia was prolonged in BM group than BP group and even more so in BMM group (p value <0.001). Incidence of nausea and vomiting in BMM group was lower than in BP and BM group but statistically the difference was not significant (p value: 0.489). Pruritus was absent in BP group, less in BMM group while significantly higher in BM group. Conclusion: The use of epidural Morphine and Midazolam in combination with Bupivacaine is the satisfactory method of post operative analgesia. When Midazolam is added, duration of analgesia can be increased with decrease in incidence of nausea, vomiting and pruritus.Journal of Kathmandu Medical College Vol. 2, No. 3, Issue 5, Jul.-Sep., 2013 Page: 117-121DOI: http://dx.doi.org/10.3126/jkmc.v2i3.9961Uploaded date : 3/4/2014

scholarly journals COMPARATIVE STUDY OF HAEMODYNAMIC CHANGES BETWEEN 6% HYDROXYETHYLSTARCH 130/0.4 AND RINGER LACTATE COLOADING IN ELDERLY PATIENTS UNDERGOING LOWER LIMB ORTHOPAEDIC SURGERY UNDER SPINAL ANAESTHESIA

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Jayanta Chakraborty ◽  
Uma Mandal
Keyword(s):  
Elderly Patients ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Orthopaedic Surgery ◽  
P Value ◽  
Ringer Lactate ◽  
Lower Limb Surgery ◽  
Group A ◽  
Group B ◽  
Lactate Solution

Background: Anaesthesia for the lower limb surgeries could be either general or regional. Studies had shown that regional anaesthesia for lower limb surgery results in better postoperative outcomes, including improved respiratory function, less nausea vomiting, less pain and lower incidence of deep vein thrombosis. Among all the regional anaesthetic techniques spinal anesthesia remained most preferred technique for its fast, predictable, profound, high quality sensory and motor block. However some complications like hypotension, bradycardia, post dural puncture headache, urinary retention were unavoidable and hypotension remained the most common one and found to be more in the elderly population with incidence of 25–82%. Treating spinal anaesthesia-induced hypotension included intravenous (IV) volume administration. IV Fluid infused before and at the time of spinal anaesthesia was referred to as preloading and coloading respectively. Although merit of coloading and the choice of fluid to be infused had remained  a matter of debate, till today no definitive study had indicated any superiority of colloids over crystalloids decisively  moreover large amount crystalloids to counter hypotensin  remained a threat to the cardiovascular overload for  elderly patients. Role of vasopressors in elderly remained controversial too. So this observational prospective study was  undertaken to compare  the effiicacy of coloading of infusion 6%HES 130/0.4 (colloid) and Ringer Lactate solution (crystalloid)  to maintain the intra operative haemodynamics in elderly patients undergoing lower limb orthopaedic surgery under spinal anaesthesia. Objectives: To assess and to compare the efficacy of infusion 6%HES 130/0.4 and infusion Ringer lactate solution coloading in preventing the intra-operative hypotension. Materials and method: On  approval of the Ethics Committee of Burdwan Medical College (BMC&H), 80 patients were included and equally divided into two groups group A and group B where groupp A received 6% HES  as coloading fluid and groupp B received RL as coloading fluid at the start of spinal anaesthesia. On entering Operation Theatre baseline parameters were noted for each patient and lumbar puncture for spinal anaesthesia was performed following strict aseptic precautions, in sitting position. Upon achieving adequate block episodes of hypotension were noted and treated according to the study protocol. Results: Statistical analysis for Continuous and categorical variables were done using Mann-Whitney U test and Pearson’s Chi Square test accordingly and p values less than 0.05 were considered significant. In group A, 17.5 % patients developed one episodes of hypotension whereas in group B, 37.5% patients developed one episodes of hypotension which was statistically significant with p value 0.0465.  In group A none of the patients developed further episodes of hypotension but in group B 5% affected patients developed one more episodes of hypotension and 2.5% affected patients developed two more episodes of hypotension. Average intravenous dose of mephentermine required to treat hypotension was 1.05 mg for group A and 2.70 mg for group B and found to be statistically significant with p value 0.039. Total fluid consumption In group A was 654.95 ml whereas in group B  was 976.73 ml and also  found to be statistically significant with p value <0.001. Conclusion:  The study found that coloading with 6% HES was significantly effective than Ringer Lactate solution in preventing episodes of hypotension in spinal anaesthesia induced elderly patients undergoing lower limb surgery without any noticeable adverse effect. Key Words: Spinal anaesthesia, lower limb surgery, elderly patients, coloading

Association of Adverse Outcomes in Patients with Cirrhosis Presented with COVID-19

2021 ◽  
Vol 15 (5) ◽  
pp. 1134-1135
Author(s):  
M. A. Chhutto ◽  
A. H. Mugheri ◽  
A. H. Phulpoto ◽  
I. A. Ansari ◽  
A. Shaikh ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Adverse Outcomes ◽  
Chronic Liver ◽  
P Value ◽  
College Hospital ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
Disease Study

Objective: To determine the association of adverse outcomes in term of mortality in patients with cirrhosis presented with coronavirus disease. Study Design: Retrospective/observational study Place and Duration of Study: Department of Medicine, Chandka Medical College Hospital, Larkana from 1st March 2019 to 31st December 2020. Methodology: Two hundred and twenty covid-19 patients of both genders with or without chronic liver disease were enrolled in this study. Patients were categorized in to two groups. Group A (with cirrhosis 60 patients) and group B (without cirrhosis 60 patients). Outcomes in term of mortality between both groups were examined. Results: There were 38 (63.33%) males and 22 (36.67%) were females with mean age 46.14±8.44 years in group A while in group B, 40 (66.67%) and 20 (33.33%) patients were males and females with mean age 45.26±9.34 years. Patients with cirrhosis had high mortality rate as compared to patients without cirrhosis (33.33% Vs 13.33%) with p-value 0.0001. Conclusion: A significant association of adverse outcomes was found in cirrhotic patients with coronavirus disease. Keywords: Chronic Liver Disease, Corvid-19, Mortality

scholarly journals EFFECT OF PAIRED FORMATIVE ASSESSMENT ON STUDENTS’ LEARNING

2021 ◽  
Vol 71 (3) ◽  
pp. 976-79
Author(s):  
Qamar Zia ◽  
Nighat Arif ◽  
Tahira Sadiq
Keyword(s):  
Formative Assessment ◽  
Control Group ◽  
P Value ◽  
Medical College ◽  
Quasi Experimental ◽  
Group A ◽  
Group B ◽  
Methods Of Learning ◽  
And Control ◽  
Academic Scores

Objective: To determine the effect of paired formative assessment on students’ learning. Study Design: Quasi experimental study. Place and Duration of Study: Islamic International Medical College Rawalpindi, from Jan 2018 to Jun 2018. Methodology: A total of 160 students who attended otolaryngology module were included in the study. Randomized allocation was done by computerized software programme and students were divided into 2 groups i.e. experimental (group A) and control group (group B). Later on in group A, pairing of students was done by lottery method. Group A and B were dealt with paired and individual formative assessment respectively. Effectiveness of both methods of learning was calculated on the basis of academic scores obtained in tests consisting of 20 MCQs from predefined and taught syllabus. A p-value were obtained by applying independent sample t-test and considered statistically significant at 0.05. Results: Out of 160 participants, 94 (58.7%) were females and 66 (41.3%) were males. In individual testing phase mean scores of group A was 13.36 ± 2.22 and mean scores of group B was 13.24 ± 2.5 (p 0.861). In paired formative assessment phase, mean scores of group A was 16.70 ± 1.94 (CI 95% 2.16-4.55) and mean of scores of group B was 13.40 ± 2.23 (CI 95% 2.16-4.55) p=0.001. Conclusion: The effectiveness of paired formative assessment. This method provides students a conducive environment to achieve learning objectives.

scholarly journals Haematocrit Value in Preeclampsia

2016 ◽  
Vol 30 (2) ◽  
pp. 80-85 ◽  
Author(s):  
Sankar Kumar Basak ◽  
Kohinoor Begum ◽  
Maliha Rashid ◽  
Nahid Yasmin ◽  
Hasina Begum
Keyword(s):  
Pregnant Women ◽  
Strong Association ◽  
Cross Sectional Study ◽  
P Value ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Group A ◽  
The Mean ◽  
Group B

Objective(s): To assess the association between the haematocrit value and severity of preeclampsia.Materials & Methods: This cross sectional study was conducted in the department of Obstetrics & Gynaecology of Dhaka Medical College Hospital, Dhaka during the period of January 2012 to December 2013. Total of 100 patients were studied and they were divided into two groups – group-A and group-B. Fifty preeclamptic patients were included in the group-A and 50 normal pregnant women were included in the group-B.Results: Majority of preeclamptic women (68%) and normal pregnant women (76%) were in the age group of 20-30 years with the mean ages of group-A and group-B subjects were 26.50±5.71 and 26.26±4.91 years respectively. Eighty six percent of group-A and 70% of group-B women were of lower socioeconomic status. Majority of the study subjects (74% of group-A and 80% of group-B) were housewife. More than half (54%) of the preeclamptic women were primigravid and 60% of normal pregnant women were multigravid. Among the preeclamptic subjects 16 (32%) had mild hypertension (DBP<110mmHg) and 34 (68%) had severe hypertension (DBP ? 110 mmHg). Out of 50 preeclamptic subjects 45 (90%) had severe proteinuria (+++) and only 5 (10%) had moderate (++) proteinuria.The mean haematocrit value of preeclamptic patients was 34.881±3.03 and that of normal pregnant women was 31.94±1.2. It was statistically significant (P value 0.001). The mean haematocrit value of normal pregnant, mild and severe preeclamptic women were 31.94±1.2, 33.31±2.57 and 35.62±2.95 respectively. It was also statistically significant (P value 0.001).Conclusion: This study shows that haematocrit value of preeclamptic patients is significantly higher compared to that of the normal pregnant women (P<0.05). There is a strong association of increasead haematocrit and preeclampsia.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 80-85

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 Bier's block with Lidocaine versus Lidocaine plus Verapamil

2014 ◽  
Vol 2 (1) ◽  
pp. 12-17
Author(s):  
S Tabdar ◽  
S Lama ◽  
ER Kadariya
Keyword(s):  
Motor Block ◽  
Total Duration ◽  
Pain Tolerance ◽  
P Value ◽  
Fisher Exact Test ◽  
Time Duration ◽  
Sensory Blockade ◽  
Medical College ◽  
Group A ◽  
Group B

Background: General anaesthesia and regional anaesthesia both are used for upper extremity surgeries. Bier’s Blockusing local anaesthetic alone or in combination with other adjuvants provides effective analgesia intraoperatively as wellas postoperatively with fewer complications as compared to general anaesthesia.Objective: This study was designed to compare effectiveness, haemodynamic alterations and total duration of analgesiawith Lidocaine versus Lidocaine plus Verapamil in Bier’s Block.Methods: This is a prospective randomised double blind trial conducted in Kathmandu Medical College TeachingHospital from February 2012 to December 2012 after approval from the ethical committee and informed consent fromthe participants. Total 40 adult patients of age 20 to 50 years, weight 50 to 70 kg, of both gender, belonging to AmericanSociety of Anaesthesiologists Physical Status I and II undergoing elective distal upper extrimity surgery lasting at one toone and half hours with Bier’s Block were included in this study. They were randomly divided into two groups of twentyeach to receive either 40 ml of 0.5% Lidocaine alone (Group A) or 40 ml of 0.5% Lidocaine plus 2.5 mg Verapamil (GroupB). The two groups were compared in terms of onset and recovery from sensory and motor blockade, tourniquet paintolerance time, duration of analgesia, alteration of haemodynamics and major side effects. Data analysis was done byMicrosoft Offi ce Excel 2007 [Polystat, Microsoft Offi ce Excel worksheet.XLS] using student’s two tailed t test. Categoricalparamatres were tested by Fisher Exact test and p-value of <0.05 was considered statistically signifi cant.Result: Onset of sensory blockade was faster in group B (Mean± SD: 3.07± 0.25 minutes) as compared to group A (Mean±SD: 5.59 ± 0.41 minutes). The onset of motor block in group B was 10.4 ± 0.77 minutes versus 13.17 ± 1.45 minutes ingroup A. Recovery of sensory block in group B occurred at 29.95 ± 6.96 minutes versus 11.45 ± 2.16 minutes in groupA. Similarly recovery of motor block in group B occurred in 13.6 ± 1.79 minutes versus 7.65 ± 1.04 minutes in group A.Tolerance of fi rst tourniquet pain in group B was long 41.15 ± 3.82 minutes versus 22.00 ± 2.9) minutes in group A. Secondtourniquet pain tolerance time was again longer (48.25 ± 3.96 minutes) in group B versus 28.05 ± 4.84 minutes in groupA. Total duration of analgesia was more in group B (207.25 ± 21.1 minutes) versus 32.2 ± 5.78 minutes in group A. Totalconsumption of analgesic (Tramadol) in 24 hours in group B was lesser than group A (47.5 ± 38.0 mg versus 112.5 ± 35.8mg). All these differences were signifi cant statistically (p value <0.05). Both of the groups showed stable haemodynamicparameters intraoperatively as well as postoperatively without any signifi cant adverse effects.Conclusion: Addition of Verapamil to Lidocaine was more effective than Lidocaine alone in Bier’s block.DOI: http://dx.doi.org/10.3126/jkmc.v2i1.10513Journal of Kathmandu Medical College, Vol. 2, No. 1, Issue 3, Jan.-Mar., 2013, Page: 12-17

scholarly journals Comparative Study on Planned repeat Caesarean Section and Unplanned Repeat Caesarean Section

2016 ◽  
Vol 24 (1) ◽  
pp. 57-61
Author(s):  
Jinnatun Nur ◽  
Rashida Khanom ◽  
Sumaya Akter
Keyword(s):  
Caesarean Section ◽  
Subsequent Pregnancy ◽  
T Test ◽  
P Value ◽  
Retrospective Case ◽  
College Hospital ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
First Time

Repeat Caesarean section always carries more risk than first time caesarian delivery. In our country, antenatal care is always neglected. When this negligence occurs during subsequent pregnancy who had already goes on Caesarean section for the first pregnancy. In our study, we try to compare between the planned and unplanned repeat Caesarean section. The study was carried out at Mymensingh Medical College Hospital, Mymensingh and Amina Nursing Home at Charpara Mymensingh. This was a retrospective case control study, There were 100 patients in Group: A, (Planned repeat Caesarean section), Group B was also consisted with 100 patients (Unplanned repeat Caesarean section). Odd ratio was measured. Odd ratio between group; A and Group: B was 2.8. The two groups were compared by their age and independent t test was carried out. Group: A. Mean ± SD 25.76 ± 4.461Group: B. Mean ± SD = 26.12 ± 5.513. By pair independent t test: P value: .076ns. So we can conclude that regular antenatal Check up is mandatory for those whose 1st delivery was conducted by Caesarean section irrespective of age and economical status.J Dhaka Medical College, Vol. 24, No.1, April, 2015, Page 57-61

scholarly journals EPIDURAL ANAESTHESIA;

2012 ◽  
Vol 19 (06) ◽  
pp. 894-904
Author(s):  
CHOUDRY AMJAD ALI ◽  
RAHEEL AZHAR KHAN ◽  
AMJAD IQBAL ◽  
Tasadaq Khurshid
Keyword(s):  
Hospital Stay ◽  
General Anaesthesia ◽  
Urinary Retention ◽  
Epidural Anaesthesia ◽  
Recovery Time ◽  
Open Cholecystectomy ◽  
Length Of Hospital Stay ◽  
P Value ◽  
Group A ◽  
Group B

Objective: To compare the, post op analgesia, vomiting, shivering, length of hospital stay, peri-operative haemodynamicchanges and recovery time in patient under going open cholecystectomy under general anaesthesia versus those receiving epiduralanaesthesia. Study design: Quasi experimental study. Place and duration of study: Combined Military Hospital Rawalpindi from 15 October2007 to 15 April 2008. Methodology: American Society of Anaesthesiology (ASA) physical status (PS) I and II patient of either genderundergoing un-complicated open cholecystectomy were randomly divided into two groups, group A (n=30) received general anaesthesia (GA)and group B (n=29) received thoracic epidural anaesthesia (EA). Patients of both the groups were assessed for peri-operative haemodynamicchanges, recovery time, post op analgesia, vomiting and length of hospital stay. Chi-square test was applied to compare the two groups andobtain P-value. P-value of less than 0.05 was considered significant. Results: 9 out of 30 patients (30%) of group “A” (general anaesthesia) and4 out of 29 patients (13.79%) in group “B” (epidural anaesthesia) had vomiting. Shivering was seen in 3 out of 30 (10%) in group “A” (generalanaesthesia) and 1 out of 29 (3.44%) patient in group “B” (epidural anaesthesia). Urinary retention was seen in 1 out of 30 (3.33%) in group “A”(general anaesthesia) and 8 out of 29 (27.5%) in group “B” (epidural anaesthesia). Urinary retention was relieved by psychotherapy. None ofthe patient required catheterization. Post operative recovery from surgery was determined by gastrointestinal motility (passage of flatus andstart of oral sips). In group “A” (general anaesthesia) 6 patients (20%) started oral sips in first post operative day, 16 patients (53.33%) onsecond post operative day, 8 patients (26.66%) in third post operative day. In the group “B” (epidural anaesthesia) 13 patients (44.8%) startedoral sips on first post operative day, 15 (51.72%) on second post operative day and one patient (3.44%) on third post operative day. Regardingthe length of hospital stay 17 patient (56.66%) of group “A” (general anaesthesia) were discharge by third post operative day and 22 patient(75.77) were discharge by third post operative day in group “B” (epidural anaesthesia). Conclusions: The use of intra-operative epiduralanaesthesia combined with postoperative epidural analgesia was found to be associated with reduction in the post operative pain and vomitingin patients under going open cholecystectomy.

scholarly journals A Comparative Study of Efficacy of Clonidine and Dexmedetomidine As An Adjuvant to Ropivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block Vis-À-Vis Onset of Surgical Anaesthesia and Duration of Effect in Upper Limb Surgeries

2020 ◽  
Vol 8 (8) ◽  
pp. 513
Author(s):  
Sandeep Dubey ◽  
Rukhsana Najeeb ◽  
Arshid Ahmad Sofi
Keyword(s):  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
P Value ◽  
Ultrasound Guided ◽  
Supraclavicular Brachial Plexus Block ◽  
Group A ◽  
Group B ◽  
Plexus Block

Background: Supraclavicular block is a safe, reliable and cost effective technique of providing anesthesia for the upper limb surgeries. Objectives:  To evaluate the effect of Clonidine and Dexmedetomidine as an adjuvant to Ropivacaine in ultrasound guided supraclavicular block in upper limb surgeries with respect to: Onset of sensory and motor block, Duration of sensory and motor block, Quality of block and Duration of post-operative analgesia. Materials and methods: The purpose of present study was to compare the effect of addition of clonidine 1mcg/kg vs dexmedetomidine 1mcg/kg to 20ml of 0.5% ropivacaine in ultrasound guided supraclavicular brachial plexus block. A total of 90 patients of ASA I and II, aged 18-60 years, of either gender, undergoing upper limb surgery were allocated to three groups. Each group consisted of 30 patients. They received drugs as under: Group-A (dexmedetomidine group) received 20ml of 0.5% ropivacaine plus 1μg/kg of dexmedetomidine. Group-B (clonidine group) received 20ml of 0.5% ropivacaine plus 1mcg/kg clonidine. Group-C (placebo group) received 20 ml of 0.5% ropivacaine plus 2 ml normal saline. Results: Onset of sensory block was faster in Group-A as compared to Group-B and Group-C. The difference was statistically significant (p-value<0.05). Onset of motor block was faster in Group-A as compared to Group-B and Group C. The difference was statistically significant (p-value<0.05). Patients of Group-A had significantly longer duration of sensory and motor block when compared with Group-B and Group-C (p-value<0.05). Duration of post-operative analgesia was significantly longer in Group-A as compared to Group-B and Group-C (p-value<0.05). Quality of block was significantly better in Group-A as compared to Group-B and Group-C (p-value<0.05). Conclusion: Dexmedetomidine prolongs the duration of sensory and motor block, duration of postoperative analgesia and improves the quality of block much more as compared to clonidine when used as an adjuvant to ropivacaine in supraclavicular brachial plexus block.

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