scholarly journals Effect of Dexmedetomidine on Intraoperative Haemodynamics and Postoperative Analgesia in Laparoscopic Cholecystectomy

2018 ◽  
Vol 14 (1) ◽  
pp. 14-20
Author(s):  
Yojan Trikhatri ◽  
Satyendra Narayan Singh ◽  
Siddhartha Koirala ◽  
Jagat Narayan Prasad ◽  
Sailesh Adhikari
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Analgesia ◽  
Analgesic Effect ◽  
Diclofenac Sodium ◽  
Haemodynamic Effect ◽  
Analgesic Requirement ◽  
Dose Infusion ◽  
Analgesia Requirement ◽  
American Society

Background and objectives:Dexmedetomidine is an α2 agonist with sympatholytic, anxiolytic, sedative and analgesic effect used as adjunct during surgeries for its haemodynamic stabilizing effect and analgesic effect. Primary aims of the study were to evaluate the haemodynamic effect of intravenous dexmedetomidine and the duration and quality of analgesia in laparoscopic cholecystectomy. Secondary aims were sedation levels and occurrence of side effects.Materials and methods:Eighty four patients, American society of Anaesthesiologists physical status I and II, aged 18-60 years of either gender undergoing laparoscopic cholecystectomy in general anaesthesia were randomly allocated into two equal groups. Group C patient received Normal Saline and Group S patient received dexmedetomidine loading dose infusion of 1µg/kg over 10 minutes before induction and maintained with 0.4µg/kg/hr till the removal of gall bladder. Induction with propofol and fentanyl was done. Standard monitoring including Heart Rate, Mean arterial pressure, oxygen saturation were monitored perioperatively. Postoperative analgesia requirement and sedation score were assessed.Results: In Group S, the haemodynamic responses were significantly attenuated. During postoperative period, 24 hours analgesic requirement of diclofenac sodium was 141.43mg in group S as compared to 217.50mg in group C(p<0.001). Side effects were treatable. Sedation was better in Group S.Conclusion:Dexmedetomidine effectively attenuates haemodynamic stress response during laparoscopic surgery with reduction in postoperative analgesic requirements.

Intramuscular Diclofenac Sodium for Postoperative Analgesia After Laparoscopic Cholecystectomy

1994 ◽  
Vol 4 (5) ◽  
pp. 340???344 ◽  
Author(s):  
Y. G. Wilson ◽  
M. Rhodes ◽  
R. Ahmed ◽  
M. Daugherty ◽  
S. J. Cawthorn ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Analgesia ◽  
Diclofenac Sodium

scholarly journals Effect Intravenous Dexamethasone as an Adjuvant to Caudal Block on post operative analgesia:  Prospective Cohort study design

2020 ◽  
Author(s):  
Mohammed Suleiman Obsa ◽  
Meron ABrar Awol ◽  
Timsel Girma Simie
Keyword(s):  
Postoperative Analgesia ◽  
Categorical Variables ◽  
P Value ◽  
Anesthetic Techniques ◽  
Caudal Block ◽  
Chi Square ◽  
Analgesic Requirement ◽  
Duration Of Action ◽  
Dexamethasone Group ◽  
American Society

Abstract Introduction Caudal block is by far the most commonly employed regional anesthetic techniques to maintain postoperative analgesia in pediatric urogenital surgeries. However, its short duration of action can be prolonged by adding Adjuvants. The aim of this study was to compare the efficacy of dexamethasone administered through intravenous on post-operative analgesia in pediatric patients who underwent infra umbilical surgeries. Method In this prospective study, sixty American Society of Anesthesiologists Physical Status I and II patients aged 1–7 years were randomly allocated into two groups of thirty each. Both groups were compared for the duration of postoperative analgesia and analgesic requirement. Severity of postoperative pain was measured by FLACC score. Mann –Whitney U test was used to compare the pain severity and total analgesic consumption. Independent sample t test was used for analgesia duration as well as Chi-square test was used to analyze independent categorical variables between two groups and a p-value of less than 0.05 was considered as statistically significant. Result Analgesia duration was significantly prolonged in caudal block with IV dexamethasone group than caudal block with bupivacaine alone group ( P < 0.001). Total analgesia consumption was significantly lower ( P < 0.001) in caudal block with IV dexamethasone compared to with bupivacaine alone group. Postoperative severity of pain was significantly lower in caudal block with IV dexamethasone group at 4 th , 6 th and 12 th hours (P<0.001, P<0.001 and P<0.003) respectively. Conclusion Addition of intravenous dexamethasone as an adjuvant to caudal block with 0.25% Bupivacaine significantly reduced the intensity of post-operative pain and prolonged the duration of post-operative analgesia.

Clinical trial to assess role of ketamine in post operative analgesia after laparoscopic cholecystectomy

2021 ◽  
Vol 23 (05) ◽  
pp. 421-432
Author(s):  
Dr. Mohammad Kheiri Mahmod ◽  
◽  
Dr. Bashar Naser Hussein ◽  
Dr. Ammar Hamid Hanoosh ◽  
◽  
...  
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Analgesic Effect ◽  
Analgesic Requirement ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: The physiological consequences of post-operative pain including Stress response to surgery, Respiratory complications, cardiovascular complications, Thromboembolic complications, Gastrointestinal complications, Musculoskeletal complications and Psychological complications, all of which could delay or impair postoperative recovery and increase the economic cost of surgery as a result of the longer period of hospitalization. Inadequate post-operative pain control may also lead to the development of chronic pain after surgery .Aim of This study: is to evaluate the preemptive analgesic effect of intravenous ketamine in laparoscopic cholecystectomy. Patients and Methods: double blinded randomized clinical trial conducted at Al-Yarmouk teaching hospital, over a period of one year from March 2013 to March 2014 on a total of 120 adult patients scheduled for elective laparoscopic cholecystectomy, Patients were divided in to three groups of 40 patients each, the study drug administered intravenously during induction. Groups A and B received ketamine in a dose of 1 and 0.5 mg/kg, respectively, whereas group C received isotonic saline. The degree of pain at rest and deep breathing postoperatively were estimated using VAS, time of first analgesic dose, total opioid consumption, nausea, vomiting and hallucination were recorded for 24 h postoperatively. Results: postoperative pain scores were significantly low in group A when compared with the other groups at most times in the first 24 hours. Highest pain score was in group C at 0 h. Postoperative analgesic consumption was minimum in group A then group B and highest in group C. There was little significant difference in the pain scores between groups B and C. Group A had a significantly higher blood MAP than group B at 0, 0.5 and 1 h. 7.5% incidence of hallucinations were in group A. Conclusion: According to this study we conclude that preemptive ketamine in a dose of 1 mg/kg has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. A low dose of 0.5 mg/kg had little significant in preemptive analgesic effect and in reducing analgesic requirement.

scholarly journals A comparative study of different adjuncts to enhance the effects of intrathecal bupivacaine

2017 ◽  
Vol 5 (5) ◽  
pp. 2046
Author(s):  
Debajyoti Sur ◽  
Archana Agarwal ◽  
Ajay Kumar Chaudhary ◽  
Jaishri Bogra ◽  
Prithvi Kumar Singh ◽  
...  
Keyword(s):  
Comparative Study ◽  
Spinal Anaesthesia ◽  
Postoperative Analgesia ◽  
Magnesium Sulphate ◽  
Saline Group ◽  
Total Power ◽  
American Society ◽  
Group D ◽  
Single Blind

Background: Spinal anaesthesia is the commonly used technique for lower abdominal surgeries. Adjuvants to bupivacaine have been used to provide good quality of perioperative and postoperative analgesia. The aim of the study was to evaluate the effects of subarachnoid administration of bupivacaine with clonidine, magnesium, dexmedetomidine and saline group.Methods: The prospective, comparative single blind study included 120 patients in American society of anaesthesiologist (ASA) grade I and II, scheduled for lower abdominal surgeries were allocated in four groups. Each group included 15 mg bupivacaine with various adjuvants (30 µg clonidine, 50 mg magnesium sulphate and 3µg dexmedetomidine) were compared with saline group (group S).Results: Time of onset was earlier in groups D and C but delayed in group M. The total power regains (B0) in group D (250.8±18.87), group M (235.23±24.66) and group C (242.70±25.98) were significantly delayed (p<0.05) as compare with group S (180.07±18.53). Demand of analgesia was significantly earlier in group S as compared with groups C, M and D. Similarly, the time of two segment regression was significantly earlier in group S as compared with groups C, M and D (p<0.001). Patients were hemodynamically stable in groups D, C and M as compared to Group S.Conclusions: Dexmedetomidine and clonidine were equally effective and better as compared to magnesium as an adjunct to intrathecal bupivacaine.

Comparison of Ultrasound Guided Transversus Abdominis Plane Block versus Intraperitoneal and Perioportal Bupivacaine Infiltration in Post Operative Analgesia after Laparoscopic Cholecystectomy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mina Elia Haleem Eshak ◽  
Sherif Samir Wahba Rezk Allah ◽  
Hadeel Magdy Abdel Hameed Mohamed ◽  
Mohammed Abdel Mohsen Abdel Naeem Esmaeil
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anaesthesia ◽  
Postoperative Analgesia ◽  
Transversus Abdominis ◽  
Tap Block ◽  
University Hospitals ◽  
Post Surgery ◽  
Pain Scores ◽  
American Society ◽  
Incisional Pain

Abstract Background Laparoscopic cholecystectomy is one of the commonest elective laparoscopic surgeries done in our setup. We found that post-surgery most of the patients complain of incisional pain at port sites and right shoulder tip pain. Objectives The aim of this study has been to test the efficacy of TAP block versus intraperitoneal and periportal infilteration with local anesthetic agent specially to provide postoperative analgesia after laparoscopic cholecystectomy. Patients and Methods All patients were informed with the procedure US guided TAP block and were trained to use the visual analogue scale (VAS). The study was conducted on 50 randomly chosen patients aged 20 to 60 years, American Society of Anesthesiologists (ASA) class I or II scheduled for elective laparoscopic cholecystectomy in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 25 patients each: TAP block Group: received general anaesthesia and 20 ml of 0.25% bupivacaine on each side by midaxillary approach under ultrasound guidance. Intraperitoneal and periportal infiltration Group: received general anaesthesia and 20 ml of 0.25% bupivacaine was injected under the direct vision into the hepato-diaphragmatic space, near and above the hepato-duodenal ligament and above the gall bladder before removal of the probes, also 20ml of 0.25% bupivacaine was injected at the port sites at the end of operation. Results The Patients receiving TAP block had significantly lower pain scores at rest for 6 hrs and upon coughing for 6 hrs also after operation and decrease total need of analgesic in first 24 h post operative compared with patients who received Intraperitoneal and periportal infiltration. Conclusion Bilateral TAP block was effective in reducing postoperative pain scores at rest and upon coughing for 6-12 hours and lower total 24-h postoperative opioid and analgesic consumption after laparoscopic cholecystectomy under general anesthesia, compared to intraperitoneal and periportal infiltration. This technique can be a promising mode of postoperative analgesia where epidural catheter insertion is contraindicated.

scholarly journals Intrathecal clonidine added to small-dose bupivacaine prolongs

2013 ◽  
Vol 6 (1) ◽  
pp. 25
Author(s):  
Agreta Gecaj-Gashi ◽  
Hasime Terziqi ◽  
Tune Pervorfi ◽  
Arben Kryeziu
Keyword(s):  
Spinal Anesthesia ◽  
Postoperative Analgesia ◽  
Motor Block ◽  
Sensory Block ◽  
Analgesia Requirement ◽  
American Society ◽  
Group B ◽  
Double Blinded ◽  
Intrathecal Clonidine ◽  
American Society Of Anesthesiologists

Introduction: The aim of this prospective, double-blinded studywas to investigate the effects of clonidine in co-administrationwith bupivacaine during spinal anesthesia, regarding the onset and regression of motor and sensory block, postoperative analgesia and possible side effects.Methods: We randomly selected 66 male patients (age 35 to 70), from the American Society of Anesthesiologists (ASA) class I-II; these patients were scheduled for transurethral surgical procedures. These patients were randomly allocated into two groups of 33 patients each: group B (bupivacaine) only received 0.5% isobaric bupivacaine 7.5 mg intrathecally and group BC (bupivacaine + clonidine) received bupivacaine 7.5 mg and clonidine 25 μg intrathecally. We performed the spinal anesthesia at a level of L3-L4 with a 25-gauge needle. We assessed the sensory block with a pinprick,the motor block using the Bromage scale, analgesia with thevisual analog scale and sedation with the modified Wilson scale.We also recorded the hemodynamic and respiratory parameters.Results: The groups were demographically similar. The mean time of achievement of moto block (Bromage 3) and sensory block at level T9 was significantly shorter in the BC group compared with B group (p = 0.002, p = 0.000, respeectively). The motor block regression time was not significantly different between the two groups (p = 0.237). The postoperative analgesia requirement was significantly longer in group BC compared with group B (p = 0.000). No neurological deficit, sedation or other significant adverse effects were recorded.Conclusion: The intrathecal application of clonidine in combination with bupivacaine improves the duration and quality of spinal anesthesia; it also provides longer duration of postoperative analgesia, without significant side effects.

Role of Magnesium Sulfate in Postoperative Analgesia

1996 ◽  
Vol 84 (2) ◽  
pp. 340-347. ◽  
Author(s):  
Martin R. Tramer ◽  
Jurg Schneider ◽  
Rene-Andreas Marti ◽  
Kaplan Rifat
Keyword(s):  
Magnesium Sulfate ◽  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Peak Flow ◽  
Saline Control ◽  
Double Blind Study ◽  
Quality Of Sleep ◽  
Analgesic Requirement ◽  
Double Blind

Background N-methyl-D-aspartate antagonists may play a role in the prevention of pain. An assessment was made of the effect of the physiologic N-methyl-D-aspartate antagonist magnesium on analgesic requirements, pain, comfort, and quality of sleep in the postoperative period. Methods In a randomized, double-blind study, 42 patients undergoing elective abdominal hysterectomy with general anesthesia received 20% magnesium sulfate or saline (control) 15 ml intravenously before start of surgery and 2.5 ml/h for the next 20 h. Postoperative morphine requirement was assessed for 48 h using patient-controlled analgesia. Maximum expiratory flow (peak flow), pain at rest and during peak flow, and discomfort were evaluated up to the 48th postoperative hour, and 1 week and 1 month after surgery. Insomnia was evaluated after the first and second postoperative nights. Results Compared to control subjects, magnesium-treated patients consumed less morphine during the first 48h (P&lt;0.03), which was most pronounced during the first 6 h (P&lt;0.004), and experienced less discomfort during the first and second postoperative days (P&lt;0.05-0.005). The magnesium-treated group revealed no change in postoperative sleeping patterns when compared to preoperative patterns. Control patients showed an increase in insomnia during the first and second postoperative nights (P&lt;0.002 and P&lt;0.005, respectively) compared to preoperative values. Conclusions This is the first clinical study showing that the perioperative application of magnesium sulfate is associated with smaller analgesic requirement, less discomfort, and a better quality of sleep in the postoperative period but not with adverse effects. Magnesium could be of interest as an adjuvant to postoperative analgesia.

scholarly journals Comparison of Efficacy between Intramuscular Diclofenac and Transdermal Diclofenac Patch for Postoperative Analgesia in Patients Undergoing Lower Limb Surgery Under Sub Arachnoid Block in Jawaharlal Nehru Medical College, Wardha, India

2021 ◽  
pp. 113-120
Author(s):  
Anjali Modak ◽  
Harindanath S. Kumar
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Lower Limb ◽  
Diclofenac Sodium ◽  
Control Group ◽  
Study Group ◽  
Analgesic Requirement ◽  
Rescue Analgesia ◽  
Subarachnoid Block ◽  
Lower Limb Surgery

Background: To compare the analgesic efficacy of transdermal Diclofenac patch (100 mg) with intramuscular Diclofenac sodium (75 mg) for postoperative analgesia and to know the side effects of transdermal Diclofenac patch. Methods: 60 ASA I and II patients, of either sex, aged 15 and above, scheduled for lower limb surgery under subarachnoid block were included in the study. All were allocated randomly by computer generated randomization sheet into two groups of 30 each. Subarachnoid block was administered using 0.5% hyperbaric Bupivacaine. Participants in the study group were applied with a transdermal Diclofenac patch containing 100 mg of Diclofenac diethylamine at the beginning of the surgery. In the control group 75 mg of Diclofenac sodium was given intramuscularly half an hour before the end of surgery. Pain was assessed postoperatively using visual analogue scale. Injection Tramadol 2 mg was administered intramuscularly as rescue analgesia. The data obtained was analyzed using chi - square test and unpaired student’s ‘t’test. Results: The mean time at which rescue analgesia was administered in the control group was 7 hours 28 min and in study group was 20 hours 6min.The time at which rescue analgesics were required in the study group was significantly prolonged (p<0.0001). The amount of Inj. Tramadol required as rescue analgesia in the control group was 189.33 mg. ± 16.38 mg. and in study group it was 97 mg. ± 7.24 mg and this was found to be statistically significant (p<0.0001). When the side effects were compared they were not significant. Conclusions: Based on the results obtained we conclude that, the intraoperative application of 100 mg transdermal Diclofenac diethylamine patch significantly prolongs the time at which patient requires rescue analgesia without any significant side effects. Rescue analgesic requirement was also significantly lower in the study group.

scholarly journals Gabapentin a pre-emptive analgesic in post-operative pain: a randomised double blind placebo controlled study

2017 ◽  
Vol 6 (6) ◽  
pp. 1317
Author(s):  
Vikram Bhandari ◽  
Geeta Sharma ◽  
Dilip C. Dhasmana ◽  
Meenakshi Gupta ◽  
Jagdish P. Sharma ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Diclofenac Sodium ◽  
Controlled Study ◽  
Analgesic Requirement ◽  
Serious Adverse Events ◽  
Double Blind ◽  
Matching Placebo ◽  
Group I ◽  
Post Operative Pain ◽  
Elective Laparoscopic Cholecystectomy

Background: Conventional analgesics, used in peri-operative period cause numerous adverse effects and are not free from interactions with co-administered drugs. Gabapentin has been shown to be effective in various types of neuropathic pain. The primary aim of this study was to evaluate gabapentin as a post-operative analgesic. The study also evaluates the analgesic requirement and safety of gabapentin in post-operative period.Methods: Forty patients undergoing elective laparoscopic cholecystectomy were randomized to receive gabapentin or a matching placebo. The patients of group I received gabapentin 600mg orally 2 hrs before surgery and 12hrs after the first dose. The patients in group II received a matching placebo. Patients in both groups received diclofenac sodium 75mg i.m b.i.d for pain. Additional doses were given on demand and recorded.Results: The present study found that gabapentin significantly reduced pain score and analgesic consumption as compared to a placebo for a period of 24 hours.Conclusions: Gabapentin in the doses used was found to be effective in postoperative pain in patients undergoing planned laparoscopic cholecystectomy. It was found to be safe and no serious adverse events were reported.

scholarly journals Efficiency of Epidurally Injected lidocaine, lidocaine and Morphine or Lidocaine and Tramadol for Postoperative Analgesia in Dogs Following Orchiectomy and Ovariohysterectomy

2021 ◽  
Vol 10 (1) ◽  
pp. 13-18
Keyword(s):  
Postoperative Analgesia ◽  
Pain Scale ◽  
Surrounding Tissue ◽  
Epidural Administration ◽  
Single Male ◽  
Male Observer ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
The University

The objective of this study was to evaluate and compare the postoperative analgesia provided by epidural lidocaine, lidocaine and morphine or lidocaine and tramadol in dogs following elective orchiectomy or ovariohysterectomy. Thirty-six clinically healthy dogs, classified as class I and II according to the American Society of Anesthesiologists classification system, were randomly allocated into three groups of 12 each, with six females and six males. The dogs received 4mg/kg of lidocaine combined with 0.01ml/kg of 0.9% NaCl, 0.1mg/kg of morphine or 1.0mg/kg of tramadol epidurally. Postoperative pain was assessed 4, 8, 12, 18 and 24 hours after epidural anaesthesia using the University of Melbourne pain scale (UMPS), by a single male observer who was blinded to the epidural protocol. According to the obtained results, evaluated epidural protocols provided sufficient and comparable postoperative analgesia throughout the complete 24-hours observation period. The appearance of vocalization or painful reaction to palpation of the wound surrounding tissue were absolutely absent. Values of 10 points, or higher, indicating the presence of moderate to severe pain and the necessity of additional analgesia, were not recorded. However, established quality of postoperative analgesia is probably not the sole result of epidural administration of drugs, but also analgesic activity of drugs used for general anaesthesia (xylazine and ketamine), and their mutual synergistic or additive effects.

Sign in / Sign up

Export Citation Format

Share Document