scholarly journals Intrathecal Magnesium Sulfate as Analgesic and Anaesthetic Adjunct to Bupivacaine in Patients Undergoing Lower Extremity Orthopaedic Surgery

2018 ◽  
Vol 4 (2) ◽  
pp. 74-80 ◽  
Author(s):  
Prakash Maden Limbu ◽  
Sindhu Khatiwada ◽  
Birendra Prasad Sah ◽  
Satyendra Narayan Singh ◽  
Krishna Pokharel ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Lower Extremity ◽  
Magnesium Sulfate ◽  
Spinal Anaesthesia ◽  
Orthopaedic Surgery ◽  
Motor Block ◽  
Sensory Block ◽  
P Value ◽  
Hyperbaric Bupivacaine ◽  
Group B

Background: Subarachnoid block is a popular mode of anesthesia for lower limb surgeries. Studies of Magnesium Sulfate (MgS04 ) as an adjuvant to intrathecal local anaesthetic are limited. The objective was to find out the analgesic and anaesthetic effect of intrathecal MgS04 added to bupivacaine for spinal anaesthesia in patients undergoing lower extremity orthopaedic surgery.Methods: Sixty ASA I or II adult patients undergoing lower extremity orthopaedic surgery were randomly allocated in a double blinded fashion into two groups of thirty each. Group A received 3.0 ml of 0.5% hyperbaric bupivacaine with 0.15 ml of 50% MgSO4. Group B received 3.0 ml of 0.5% hyperbaric bupivacaine with 0.15 ml of NS. Onset of sensory and motor block as well as time to attain highest level of sensory block were recorded. Duration of sensory and motor block along with duration of spinal anaesthesia were also assessed. Any adverse effects were noted and treated.Results: Duration of sensory and motor block along with duration of spinal anaesthesia were prolonged in patients of MgSO4 but were not statistically significant with p-value of 0.33, 0.23 and 0.68 respectively. Onset of anaesthesia, requirement of rescue analgesics, haemodynamic parameters and adverse effects were comparable between two groups.Conclusion: In patients undergoing lower extremity orthopaedic surgery the addition of 75mg of MgSO4 to intrathecal bupivacaine did not prolong the duration of sensory block, spinal anaesthesia nor decreased postoperative analgesic consumption without any additional side effects. Journal of Society of Anesthesiologists of NepalVol. 4, No. 2, 2017, Page: 74-80

scholarly journals Comparison of Intrathecal Fentanyl and Butorphanol as an Adjuvant to Intrathecal Bupivacaine 0.5% in Infraumbilical Surgeries- A Randomised Double Blind Study

2020 ◽  
Author(s):  
Sandip Roy Basunia ◽  
Prosenjit Mukherjee ◽  
Md Bakir Hossain Munshi
Keyword(s):  
Spinal Anaesthesia ◽  
Motor Block ◽  
Controlled Trial ◽  
Sensory Block ◽  
P Value ◽  
Double Blind Study ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Group A ◽  
Group B

Introduction: Neuraxial opioids are widely used as adjuvants to local anaesthetic as they improve quality and duration of block. Neuraxial opioids like Butorphanol and Fentanyl allow prolonged analgesia in the postoperative period and faster recovery from spinal anaesthesia. Aim: To compare the safety and efficacy of Butorphanol and Fentanyl combined with bupivacaine for spinal anaesthesia in infraumbilical surgeries. Materials and Methods: The present study was a randomised controlled trial in which 110, ASA I and II patients of either sex who underwent elective infraumbilical surgeries under spinal anaesthesia were selected. Patients were allocated randomly into two groups A (n=55) and B (n=55). Group A (F) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with fentanyl 25 microgram (0.5 mL) to make it total 3.5 mL. Group B (B) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with butorphanol 250 microgram (0.25 mL) and Normal Saline (NS) 0.25 mL to make it total 3.5 mL. Heart Rate (HR), Systolic and Diastolic Blood Pressure (SBP, DBP), two segment regression time of sensory block, motor block were assessed at preset intervals. Chi-square test or Fischer’s-exact test were used and a p-value ≤0.05 was considered as statistically significant. Results: Mean of two segment sensory regression time of Group A was 41.94±1.73 minutes and Group B was 50.56±4.43 minutes (p<0.0001). Time to onset of motor block in Group A was 5.28±.32 minutes and Group B was 5.27±.32 minutes (p=0.96). Mean duration of motor block in Group A was 81.23±4.87 minutes and Group B was 109.83±2.61 minutes (p<0.0001). Time to rescue analgesic was 289.27±7.37 minutes in Group A and 378.41±10.25 minutes in Group B (p<0.0001). HR, SBP and DBP were comparable among the groups. Conclusion: Intrathecal bupivacaine-butorphanol mixture was clinically better as it provided longer duration of analgesia with lesser incidences of pruritus and nausea/vomiting compared to intrathecal fentanyl-bupivacaine mixture.

scholarly journals Effects of Intrathecal Dexmedetomidine as an Adjuvant to Hyperbaric Bupivacaine for Spinal Anaesthesia in Adults Undergoing Elective Infra-umbilical Surgery

2017 ◽  
Vol 56 (208) ◽  
pp. 379-87 ◽  
Author(s):  
Binod Gautam ◽  
Sujata Niroula ◽  
Mona Sharma ◽  
Sushila Moktan Lama
Keyword(s):  
Spinal Anaesthesia ◽  
Local Anaesthetic ◽  
Visceral Pain ◽  
Sensory Block ◽  
P Value ◽  
Double Blind Study ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Group A ◽  
Group B

Introduction: Various adjuvants to local anaesthetic are used to improve quality and duration of spinal anaesthesia. Dexmedetomidine, a novel alpha-2 adrenergic agonist, has been proposed to augment local anaesthetic effects. This study aims to investigate effects of intrathecal Dexmedetomidine on duration of analgesia and duration of sensory block during spinal anaesthesia. Methods: In this randomized double-blind study 38 patients were allocated into each of two groups. Otherwise healthy patients (18 to 75 years) scheduled for inguinal hernia repair or vaginal hysterectomy were included. For spinal anaesthesia, Group A received 2.5 ml hyperbaric Bupivacaine 0.5%, whereas Group B received five micrograms intrathecal Dexmedetomidine in addition. Characteristics of sensory and motor blocks, duration of analgesia, analgesic requirements, and side effects were studied for 24 hours. Student’s t-test for quantitative variables and Chi- squared test for qualitative variables were used for statistical analysis. Results: Duration of analgesia was prolonged in Group B (326 min ±91) as compared to 217 min ±98 in Group A (P value <0.05). Sensory and motor block durations were significantly prolonged in Group B. Time taken to reach significant peak sensory block level was earlier in Group B. Significant reductions in incidence of visceral pain, shivering and analgesic requirements were observed in Dexmedetomidine group, without increased need of medications for altered hemodynamic parameters. Conclusions: Dexmedetomidineas an intrathecal adjuvant to hyperbaric Bupivacaine in spinal anaesthesia prolongs duration of analgesia and sensory block with minimal adverse effects. Keywords: Bupivacaine; Dexmedetomidine; intrathecal adjuvant; spinal anaesthesia.

scholarly journals COMPARISON OF INTRATHECAL DEXMEDETOMIDINE AND MAGNESIUM SULPHATE AS AN ADJUVANT TO 0.5% HYPERBARIC BUPIVACAINE IN LOWER LIMB SURGERY

2021 ◽  
pp. 1-3
Author(s):  
Shaheer Ahmed Siddiqui ◽  
Kapil Rastogi ◽  
Aamir Laique Khan
Keyword(s):  
Magnesium Sulfate ◽  
Postoperative Analgesia ◽  
Lower Limb ◽  
Motor Block ◽  
Onset Time ◽  
Sensory Block ◽  
Hyperbaric Bupivacaine ◽  
Block Level ◽  
Lower Limb Surgery ◽  
Group B

Background: Epidural anesthesia is commonly used for perioperative as well as postoperative analgesia in lower limb surgeries. Adjuvant in spinal anesthesia prolongs the duration of anesthesia as well as postoperative analgesia. In this study we evaluate the effects of intrathecal dexmedetomidine and magnesium sulfate as an adjuvant to 0.5% hyperbaric bupivacaine in lower limb surgeries. Methods: Total 60 patients belonging to ASA I or II aged 24 to 57 years of either sex were included in this study and randomly distributed into two groups. Group (B+M) received intrathecal 100mg magnesium sulfate and Group (B+D) received intrathecal 5.0 mcg dexmedetomidine with hyperbaric bupivacaine 15mg (3ml of 0.5%). Onset and duration of sensory and motor block, duration of analgesia, hemodynamic changes and complications were recorded. Results: The mean Onset time of sensory block at T10 (min.), Time to maximum sensory block level (min.), Time in minutes for complete motor block (min.), Time for Motor Emergence from Bromage 3 (min.), Time for Sensory Emergence and Time for first analgesia (min) were significantly different between groups. Conclusion: The dexmedetomidine as an adjuvant with hyperbaric bupivacaine leads to earlier onset and prolonged duration of both sensory and motor block as compared to magnesium sulfate.

scholarly journals 050419-OA- Spinal-Beena

2019 ◽  
pp. 162-167
Author(s):  
Tariq H Khan
Keyword(s):  
Spinal Anaesthesia ◽  
Motor Block ◽  
Sensory Block ◽  
Primary Objective ◽  
Spinal Block ◽  
Hemodynamic Parameters ◽  
Hyperbaric Bupivacaine ◽  
Voiding Function ◽  
Group A ◽  
Group B

Background: Spinal anaesthesia is a reliable and safe technique for infra-umbilical surgeries. Preservative-free 2-chloroprocaine has re-emerged for use in spinal anaesthesia. We compared onset and duration of sensory block with intrathecal use of 1% 2-Chloroprocaine (30 mg) or 0.5% Hyperbaric Bupivacaine (15 mg) as primary objective. Secondary objectives being onset and duration of motor block, duration of analgesia, time to return of voiding function, hemodynamic parameters and side effects. Materials and Methods: 90 patients of age group 18-60 years, either sex, belonging to ASA physical status I/II undergoing infra-umbilical surgeries were randomly divided into two groups, 1% 2-chloroprocaine Group A (n=45) and 0.5% hyperbaric bupivacaine Group B (n=45). Each group received intrathecally either 30 mg of 2-Chloroprocaine or 15 mg of hyperbaric bupivacaine 15 mg. For statistical analysis unpaired-t-test and chi-square test were used.  Results: Earlier onset and shorter duration of sensory block were observed in Group A as compared to Group B respectively (p < 0.001). Similarly, onset was earlier and duration of motor block, duration of analgesia and time to return of voiding function were shorter in Group A as compared to Group B respectively (p < 0.001). Hemodynamic parameters (HR, MAP) were comparable in both groups. Conclusion: Intrathecal 1% 2-Chloroprocaine 30 mg provides spinal anaesthesia of adequate duration for infra-umbilical surgeries with the advantage of earlier onset and faster regression of spinal block resulting in earlier voiding with stable hemodynamics as compared to 0.5% hyperbaric bupivacaine 15 mg. Keywords: Infra-umbilical surgeries, 2- chloroprocaine, Bupivacaine, Spinal Anaesthesia, Sensory Block, Motor Block.

scholarly journals Comparison of Three Different Doses of Nalbuphine as Adjuvant to Intrathecal Hyperbaric Bupivacaine in Knee Joint Surgeries

2021 ◽  
Vol 8 (15) ◽  
pp. 950-955
Author(s):  
Amit Pradhan ◽  
Ranjitha Kusumanchi ◽  
Pulak Priyadarshi Padhi ◽  
Saswati Das
Keyword(s):  
Postoperative Pain ◽  
Adverse Effects ◽  
Knee Joint ◽  
Spinal Anaesthesia ◽  
Motor Block ◽  
Onset Time ◽  
Sensory Block ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Different Doses

BACKGROUND Postoperative pain is the most challenging task in patients undergoing knee joint surgeries under spinal anaesthesia. Spinal anaesthesia with bupivacaine provides adequate intraoperative conditions but falls short in providing prolonged postoperative pain relief. Intrathecal opioids are synergistic with local anaesthetics and intensify the sensory block without affecting the sympathetic block. This study intends to compare three different doses of intrathecal nalbuphine as an adjuvant to 0.5 % hyperbaric bupivacaine and determine the optimal dose in knee joint surgeries. METHODS A double-blind comparative study was conducted in one hundred and twenty American Society of Anaesthesiologists (ASA) I and II patients undergoing knee joint surgeries in a randomised prospective way. The patients were randomly allocated to A, B, and C groups who received 0.4, 0.8 and 1.2 mg nalbuphine respectively added to 12.5 mg of 0.5 % hyperbaric bupivacaine. The onset, duration of block, duration of effective analgesia, Visual Analogue Scale (VAS) score, and the incidence of adverse effects were studied and compared between the groups. RESULTS The mean onset time of sensory and motor block of group B and C was significantly faster as compared to the onset in group A. The duration of sensory, motor blockade and duration of analgesia were highest with 1.2 mg of nalbuphine followed by 0.8 and 0.4 mg (P < 0.05). VAS readings were comparable in all the groups. Hemodynamic variability among the three groups was comparable. Incidence of adverse effects was highest in group C when compared with others, although it was statistically insignificant (P > 0.05). CONCLUSIONS Nalbuphine in a dose of 0.8 mg when added to 0.5 % hyperbaric bupivacaine for subarachnoid block in patients undergoing knee joint surgeries provides excellent analgesia, prolonged duration of sensory block and motor block, with minimal adverse effects. KEYWORDS Local Anaesthesia, Opioid, Postoperative Pain, Orthopaedic Surgeries

scholarly journals A comparative study of intrathecal bupivacaine and levobupivacaine for patients undergoing caesarean section

2019 ◽  
Vol 6 (6) ◽  
pp. 1792
Author(s):  
Kiranpreet Kaur ◽  
Sanjay Johar ◽  
Anil Kumar ◽  
Mamta Jain ◽  
Prashant Kumar ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Onset Time ◽  
Sensory Block ◽  
P Value ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Pregnant Females ◽  
Haemodynamic Stability ◽  
Group B

Background: The present study was conducted to compare the effects of 0.5% isobaric levobupivacaine and 0.5% hyperbaric bupivacaine in pregnant females undergoing caesarean section.Methods: Study was conducted on 100 pregnant females undergoing caesarean section. They were randomly divided into two groups B and L receiving 2 ml of 0.5% hyperbaric bupivacaine and 0.5% levobupivacaine respectively. Two groups were compared with regard to sensory block, motor block, haemodynamic stability and complications if any.Results: Time to achieve sensory blockade till T6 dermatome was prolonged in group B (162.52±80.55 sec) as compared to group L (139.40±49.79 seconds) (p value= 0.087). Prolonged duration of motor blockade was observed in group B (160.76±6.56 minutes) as compared to group L (131.48±14.42 minutes) (p<0.001). Less haemodynamic stability was seen in patients of group B with more incidence of hypotension and bradycardia.as compared to group L.Conclusions: Levobupivacaine is nearly equally effective to bupivacaine to produce sensory and motor blockade with comparable onset time and better haemodynamic stability with lesser side effects.

scholarly journals A COMPARATIVE STUDY OF CLONIDINE VERSUS NALBUPHINE AS INTRATHECAL ADJUVANTS TO 0.5% HYPERBARIC BUPIVACAINE DURING LOWER ABDOMINAL SURGERIES – A RANDOMIZED DOUBLE BLIND INTERVENTIONAL STUDY.

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Trishala Jain ◽  
Jaipal .
Keyword(s):  
Motor Block ◽  
Sensory Block ◽  
Double Blind Study ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Institutional Ethics ◽  
Group A ◽  
Group B ◽  
Intrathecal Clonidine

Background: Regional anesthesia techniques for gynecological procedures are on increasing trends due to their advantage of postoperative analgesia owing to intrathecal adjuvants. The present study was aimed to comparatively evaluate the clinical efficacy of clonidine with nalbuphine when co-administered intrathecally with 0.5% hyperbaric bupivacaine for Lower abdominal surgeries in Gynecology. Methods: With institutional ethics committee clearance No. 193MC/EC/2018, randomized, double blind study was conducted. After obtaining informed written consent total of 84 patients scheduled for lower abdominal surgeries were randomly allocated into two groups: Group A (n=42) - Inj.  3.5 ml Bupivacaine 0.5% + 0.2 ml Clonidine(30µg) intrathecally.  Group B (n=42) - Inj.3.5 ml Bupivacaine 0.5%+0.2 ml Nalbuphine(2mg) intrathecally. The characteristics of sensory and motor block, hemodynamic data, side effects were recorded. Results: The onset of sensory block was earlier in Group B than Group A (3.08±0.52 min vs 4.00±0.54 min, p<0.001 ). The onset of motor block was also earlier in Group B than Group A (7.78±0.80 min vs 8.80±0.95min, p<0.001). The time to first rescue analgesia in patients receiving intrathecal clonidine was significantly delayed than patients receiving intrathecal nalbuphine (284.95 ± 12.93 min vs 211.52 ± 15.92 min, p<0.001). Introperative hemodynamic changes were comparable and none of the patient suffered from respiratory depression except very little cases of shivering which are not significant. Conclusions: Intrathecal clonidine as adjuvant to bupivacaine provided was clinically more effective than nalbuphine for prolonging the duration of analgesia for gynecological procedures. Keywords: Bupivacaine, Clonidine, Lower abdominal surgeries in gynecology, Nalbuphine, Subarachnoid block.

scholarly journals A randomised prospective comparative study of evaluation of dexmedetomidine an adjuvant to ropivacaine for ultrasound guided supraclavicular block

2018 ◽  
Vol 5 (3) ◽  
pp. 127
Author(s):  
V. S. S. N. Murthy ◽  
N. Hari Kiran Verma ◽  
Anand Acharya
Keyword(s):  
Motor Block ◽  
Sensory Block ◽  
Study Patient ◽  
P Value ◽  
Ultrasound Guided ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Supraclavicular Block ◽  
Other Regarding

<p class="abstract"><strong>Background:</strong> There are clinical evidences for efficacy of dexmedetomidine as an adjuvant to local anaesthetic for peripheral nerve block, but very few published study are available on continuation of dexmedetomidine, with ropivacaine for ultrasound guided supraclavicular block. The present study has been designed to elucidate the effect of dexmedetomidine, in combination ropivacaine on various parameters.</p><p class="abstract"><strong>Methods:</strong> During period of 2 year and 3 months 84 patients were enrolled for this study. Patient in Group A were received 15 ml of 0.5% ropivacaine with 100 microgram one ml dexmedetomidine and Group B were received 15ml of 0.5% of ropivacaine with 1 ml of normal saline. Drug solution was prepared by same individual and was not part of study.</p><p class="abstract"><strong>Results:</strong> Both the group were comparable to each other regarding demography profile. The duration of sensory block 644.96±72.4 min in group A and the duration of sensory block in Group B was 731.53±131.54 min with p value 0.00354. The duration of motor block was 661.5±29.25 in group A and 559.77±29.25 in Group B with P value 0.0001. Duration of analgesia in Group A was 457.06±34.47 min and it was 345.70±38.032 min in Group B. The supplementation of intravenous opioid was required in 3 patients in Group A and 10 patients in group B with P value 0.037.</p><p class="abstract"><strong>Conclusions: </strong>When 100 microgram of dexmedetomidine was added as an adjuvant to ropivacaine is associated with early onset of sensory and motor block, prolongation of sensory and motor block and duration of analgesia in comparison with ropivacaine alone.</p>

scholarly journals Comparison between isobaric levobupivacaine 0.5% and hyperbaric bupivacaine 0.5% in spinal anesthesia in lower limb surgeries and lower abdominal surgeries in adult patients

2021 ◽  
Vol 9 (2) ◽  
pp. 418
Author(s):  
Preeti Parashar ◽  
Anisha Singh ◽  
Manoj Kumar Sharma ◽  
Dipak L. Raval
Keyword(s):  
Blood Pressure ◽  
Lower Limb ◽  
Motor Block ◽  
Total Duration ◽  
Sensory Block ◽  
Hyperbaric Bupivacaine ◽  
Significant Difference ◽  
The Mean ◽  
Group B ◽  
Mean Time

 Background: The aim of our study was to compare sensory and motor block characteristics and hemodynamic changes following intrathecal hyperbaric bupivacaine (0.5%) and isobaric levobupivacaine (0.5%) in elective lower limb and lower abdominal surgeries.Methods: 60 patients of either sex, aged 18-60 years, ASA grade I or II scheduled for elective lower abdominal and lower limb surgeries were randomized into two groups, group B (n=30) and group L (n=30) and received either 3 ml of intrathecal hyperbaric bupivacaine or isobaric levobupivacaine intrathecally.Results: The mean time of onset of sensory block at shin of tibia in both the groups was comparable i.e. levobupivacaine (1.19±0.2 minutes) and bupivacaine (1.1+0.2 minutes). The mean time for total duration of sensory block was 211.1±8.2 minutes in group L, while 193.13±13.7 minutes in group B. Time for total duration of motor block in group L was 198.76±8.428 minutes and in group B was 182.6±13.989 minutes. Statistically significant difference was observed in total duration of sensory and motor block in both levobupivaciane and bupivacaine group (p<0.0001). Patients in group L were hemodynamically more stable with significantly less decrease in pulse rate, systolic blood pressure and diastolic blood pressure as compared to group B.Conclusions: We observed that 0.5% isobaric levobupivacaine provided better hemodynamic stability, longer duration of sensory and motor block as compared to bupivacaine. 

scholarly journals Comparison of effects of Bupivacaine and Ropivacaine in patients undergoing elective Caesarean section

2020 ◽  
Vol 4 (3) ◽  
pp. 859-863
Author(s):  
Sangeeta Subba ◽  
Arjun Arjun Chhetri ◽  
Rupak Bhattarai
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Motor Block ◽  
Elective Caesarean Section ◽  
Sensory Block ◽  
Elective Cesarean Section ◽  
Hyperbaric Bupivacaine ◽  
Safe Alternative ◽  
Elective Cesarean ◽  
Group B

Introduction: Spinal anesthesia is considered a reasonable choice for cesarean section. Bupivacaine and ropivacaine have been used as intrathecal drugs alone or in combination with various opioids. Ropivacaine is considered a valid and safe alternative to bupivacaine for spinal anesthesia. Objectives: To compare the efficacy and safety of hyperbaric ropivacaine with hyperbaric bupivacaine in spinal anesthesia for elective cesarean section. Methodology: Sixty pregnant women undergoing elective cesarean section were allocated into two groups. Group R received 3 ml of 0.5% hyperbaric ropivacaine (2 ml 0.75% plain ropivacaine mixed with 1 ml of 25 %dextrose) and Group B received 2.5 ml of 0.5% hyperbaric bupivacaine. Both the groups were compared in terms of onset of sensory and motor block, regression of sensory and motor block, duration of analgesia and side effects. Results: The onset of sensory block was comparable in both groups but was statistically insignificant. The onset of motor block in Bupivacaine(7.53 ± 1.72) min was faster when compared to Ropivacaine group(14.33 ± 6.19) min. Regression of sensory and motor block both were faster in Ropivacaine group. Duration of analgesia was longer in Bupivacaine group(131.17 ± 32.95)min than Ropivacaine group(125.33 ± 30.54)min. Conclusion: Ropivacaine can be used as an alternative to Bupivacaine for spinal anesthesia in cesarean section but has a shorter duration of sensory and motor block.

Sign in / Sign up

Export Citation Format

Share Document