scholarly journals Comparison of efficacy between intrathecal nalbuphine and fentanyl as adjuvant to hyperbaric bupivacaine for perianal surgery

2021 ◽  
Vol 53 (1-2) ◽  
pp. 27-30
Author(s):  
Moslema Parvin ◽  
Anjuman Ara ◽  
Kazi Nurjahan ◽  
Lipika Roy ◽  
Lailatunnessa
Keyword(s):  
Side Effects ◽  
Motor Block ◽  
Hyperbaric Bupivacaine ◽  
Duration Of Action ◽  
Female Ratio ◽  
Medical College ◽  
Group I ◽  
Duration Of Surgery ◽  
Group Ii ◽  
American Society

Background: Intrathecal opioids enhance the duration of action of local anasthetic drugs. Both nalpuphine and fentanyl enhance the action of hyperbaric bupivacaine when introduced intrathecally as adjuvant with bupivacaine. Objective: Our study was aimed to compare the clinical efficiency of nalbuphine and fentanyl as adjuvant to hyperbaric bupivacaine for anal and perianal surgery. Methods: In this prospective randomized clinical trial patients were included from January 2007 to June 2008 at Khulna Medical College & some private clinics in Khulna. Patients were ASA (American Society of Anaesthesiology) status I & II of both gender aged 18-70 years and was randomized into two groups. Each group received either nalbuphine, (Group I) or fentanyl (Group-II) with bupivacaine. After intrathecal use every patient was examined for sensory and motor block, drug related side effects like hypotension pruritus, nausea, vomiting respiratory depression for three hours and were recorded. Results: Among two hundred study patients mean age was 49.5 and 5.2 in respective group I & II. Male female ratio was 16:14 in group I, whereas in group II it was 65:35. Mean duration of surgery was 46 and 43 minutes respectively in group I & II. Onset and cephalic extension of block was almost same in both groups. Time to recovery of sensory and motor block were significantly prolonged in Group 1. Duration of analgesia was also extended in group I. No significant drug related side effects were observed in either group. Conclusion: Nalbuphine as adjuvant to bupivacaine was clinically more efficient than fentanyl for post--operative analgesia and duration of sensory and motor block in SAB (Sub Aracnoid Block) for anal and perianal surgery. Bang Med J Khulna 2020: 53 : 27-30

scholarly journals COMPARATIVE STUDY OF INTRATHECAL FENTANYL WITH HYPERBARIC BUPIVACAINE TO IMPROVE PERIOPERATIVE ANALGESIA IN PATIENT UNDERGOING ORTHOPEDIC SURGERY

2021 ◽  
pp. 55-58
Author(s):  
Rahul Wagh ◽  
Swapnil Sangale ◽  
Nagesh Jambure
Keyword(s):  
Side Effects ◽  
Lower Limb ◽  
Motor Block ◽  
Control Group ◽  
Study Group ◽  
Hyperbaric Bupivacaine ◽  
Analgesic Requirement ◽  
Sensory Blockade ◽  
Group I ◽  
Group Ii

Background: Various methods exist for treating post-operative pain which includes systemic narcotics, NSAIDS, patient-controlled analgesia, regional anaesthesia techniques, epidural local anaesthetic – narcotic mixtures, cryoanalgesia, transcutaneous electric nerve stimulation, psychological methods. Various opioides intrathecally and epidurally have been tried for post-operative analgesia. These include - morphine, pethidine, pentazocine, methadone, tramadol, Fentanyl, sufentanyl. In present study, we tried to find out analgesic effectiveness of intrathecal Fentanyl for post-operative analgesia, combined with 0.5 % Bupivacaine and side effects if any, in patients undergoing lower limb surgeries. Materials and Methods: After approval from the local ethics committee and with written informed consent from patient, a randomized controlled prospective study is carried out in the medical college and hospital.100 patients belonging to American Society of Anesthesiologists (ASA)classification I & II, aged between 18-60 years, posted for elective lower limb surgeries, were randomly allocated for the study. Group-I: 50 patients received intrathecal 3 ml of 0.5 % hyperbaric Bupivacaine only. Group-II : 50 patients received intrathecal 3 ml of 0.5% hyperbaric Bupivacaine and Fentanyl 25 mcg.The patients studied across the group did not vary much with respect to age,height, weight and sex distribution. Results: The onset of sensory blockade was faster by 1.27 min in Group-BF. The perioperative and postoperative hemodynamic parameters were comparable in both the groups. The sensory analgesia in Group II was significantly prolonged by 159 mins, thus increasing the duration of analgesia. The time of first request of analgesics by the patients in group-II is prolonged compared to group-I thus prolonging the duration of analgesia. Analgesic requirement is also reduced in study group in early post-operative period. The onset of motor block was faster when Fentanyl was added to intrathecal Bupivacaine and it was 1.1 min earlier in study group. The duration of motor block to Bromage III was prolonged by almost 22 min in study group as compare to control group. Visual analogue scores were significantly lower in group-II compared to group-I after two hours of surgery thus reducing the frequency of supplemental postoperative analgesics. Conclusion: With the present study we can summarize that intrathecal Fentanyl potentiates the action of Bupivacaine thereby bringing about better quality and longer duration of analgesia, intense motor block, no hemodynamic disturbance and better postoperative outcome with/ minimum side effects.

scholarly journals Comparison of Intrathecal Dexmedetomidine and Fentanyl as Adjuvants to Hyperbaric Bupivacaine: A Randomised Controlled Trial

2021 ◽  
Author(s):  
Anuradha Deotale ◽  
Sandeep S Kadam
Keyword(s):  
Motor Block ◽  
Controlled Trial ◽  
Sensory Block ◽  
Rank Test ◽  
Hyperbaric Bupivacaine ◽  
Duration Of Action ◽  
Randomised Study ◽  
Group I ◽  
Block Time ◽  
Group Ii

Introduction: Subarachnoid block using bupivacaine along with fentanyl is routinely used in regional anaesthesia technique in lower limb and lower abdominal surgeries. However, fentanyl is often associated with various side effects. The use of dexmedetomidine as an alternative to fentanyl in regional blocks is emerging due to minimal adverse effects and prolonged duration of action. Aim: To compare intrathecal dexmedetomidine and fentanyl as adjuvants to hyperbaric bupivacaine. Materials and Methods: The prospective, randomised study was performed on 100 patients, divided into two groups. Group I patients were administered with bupivacaine 12.5 mg (2.5 mL)+ fentanyl 25 μg (0.5 mL) whereas group II patients received bupivacaine 12.5 mg (2.5 mL) + dexmedetomidine 5 μg (0.5 mL). Post anaesthesia Heart Rate (HR) and Blood Pressure (BP) were recorded. The onset of sensory and motor block, level of sensory block, time for two segment regression, motor and sensor recovery, duration, quality of analgesia and Visual Analog Scale (VAS) score were recorded. Data were analysed using R Studio V 1.2.5001 software. Wilcoxon signed rank test and independent sample t-test were used to find the difference between mean. The p<0.05 was considered statistically significant. Results: Time for onset of sensory block (p=0.0027), motor block (p<0.001) and peak sensory block (p<0.001) was significantly high in group I patients. Most of the patients of group I had a T8 level of sensory block (38%) while in group II around 36% of patients had T6 level of sensory block. Time for full motor recovery (p=0.0015) and sensor recovery (p<0.001) was high in group II patients. Conclusion: Dexmedetomidine is associated with long term motor and sensory block, excellent analgesia and there was less demand for rescue analgesics as compared to fentanyl.

Comparison of the effectiveness of antibacterial therapy regimens in the treatment of asymptomatic bacteriuria during pregnancy

2018 ◽  
pp. 57-60
Author(s):  
T.G. Romanenko ◽  
◽  
O.M. Sulimenko ◽  
Keyword(s):  
Urinary Tract ◽  
Side Effects ◽  
Bacterial Infection ◽  
Asymptomatic Bacteriuria ◽  
Urine Specimen ◽  
Cultural Research ◽  
Group I ◽  
Group Ii ◽  
American Society ◽  
Practical Recommendations

The objective: to evaluate the effectiveness of the proposed therapy in pregnant women with asymptomatic bacteriuria. Materials and methods. All patients were divided into two groups. І group – 38 patients received the course of amoxicillin with clavulanic acid 625 mg per os twice a day for 7 days, group II – 33 patients received D-mannose (1.2 g), powder of 5.8 g in a sachet 2 times a day for 7 days. Diagnostic criteria for asymptomatic bacteriuria were based on practical recommendations of the American Society of Infectious Diseases. Results. In the first cultural research of the urine specimen (immediately after the end of the course of therapy), the percentage of microorganism’s persistence in the urinary tract of a woman was determined, in case of its detection, an additional course of treatment was prescribed. In the second and subsequent control urine samples, the percentage of relapsing bacteriuria was determined. Percentage of the persistence of the pathogen in the urinary tract among the treated women with bacteriuria remained rather low – 10.5% (4 patients) in group I, but higher than in group II 3.1% (1 patient). The percentage of sterile first urine sample was high and probably did not differ between groups – 31 (81.6%) and 32 (96.9%) women respectively in I and II groups. In the first group, the percentage of relapses during gestation after the diagnosed and treated bacteriuria remained rather high and amounted to 23.7% (9 patients), and in the second group, the relapse was not recorded. Conclusions. The 7-day course of therapy with the D-mannose drug is associated with fewer cases of persistent pathogenic pathogens in urine, no recurrence of bacterial infection, and no side effects. Key words: asymptomatic bacteriuria, D-mannose, urinary tract, pregnancy.

scholarly journals A comparative clinical study of intrathecal hyperbaric bupivacaine with and without fentanyl for hysterectomy

2020 ◽  
Vol 11 (2) ◽  
pp. 59-63
Author(s):  
Hari Poudel ◽  
Surinder Nath Bawa ◽  
Surendra Mohan Sharma
Keyword(s):  
Side Effects ◽  
Spinal Anesthesia ◽  
Sensory Block ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Maximum Height ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Group I ◽  
Group Ii

Background: Spinal anaesthesia has been widely used for lower abdominal surgeries like hysterectomy.Hyperbaric bupivacaine is the most extensively used local anesthetic. Addition of fentanyl can allow the reduction in the dose of bupivacaine, increase the height and duration of sensory blockade, and reduces complications of spinal anesthesia. Aims and Objective: The aim of the study was to examine whether adding fentanyl to hyperbaric bupivacaine would increase the height of sensory blockade, accelerate the onset of sensory blockade and increase the duration of the sensory blockade. Material and Methods: This study was done in Manipal Teaching Hospital, Pokhara, Nepal that included hundred patients who underwent total abdominal hysterectomy. The patients were randomly allocated in two groups; Group I: received 0.5% hyperbaric bupivacaine 2.5 ml (12.5 mg) plus normal saline 0.5 ml. Group II: received 0.5% hyperbaric bupivacaine 2.5 ml (12.5 mg) plus 0.5 ml fentanyl (25 μg). Hemodynamic variables, onset of motor and sensory blockade, duration of sensory and motor blockade and any side effects were observed and recorded. Results: The highest and lowest sensory block in Group I was T-7 and T-9 whereas in Group II was T-5 and T-9 respectively. In group I, the mean onset till maximum height of sensory blockade was 7.04 min whereas in group II it was 5.96 min (P<0.00).There was no significant statistical difference in the incidence of side effects in both the groups. Conclusion: Intrathecal fentanyl with hyperbaric bupivacaine for spinal anesthesia significantly accelerated the onset of sensory blockade and increased its maximum height and duration.

scholarly journals Comparison between Clinical Efficacies of Levobupivacaine Plain and Levobupivacaine with Fentanyl for Urological Surgeries under Subarachnoid Block

2017 ◽  
Vol 2 (2) ◽  
pp. 34-39
Author(s):  
Aarti Kulkarni ◽  
Paulomi Dey
Keyword(s):  
Side Effects ◽  
Motor Block ◽  
Randomized Study ◽  
Categorical Variables ◽  
Transurethral Resection Of Prostate ◽  
Sensory Level ◽  
Hemodynamic Parameters ◽  
Subarachnoid Block ◽  
Group I ◽  
Group Ii

ABSTRACT Background and aims Spinal anesthesia for urological operations has been frequently used, because symptoms of overhydration, transurethral resection of prostate (TURP) syndrome, and bladder perforation can be recognized. This prospective randomized study was conducted to compare the clinical efficacies of levobupivacaine with and without fentanyl in subarachnoid block with respect to onset and duration of sensory and motor block and duration of analgesia in urological surgeries. Materials and methods This randomized study was conducted in 100 patients of American Society of Anesthesiologists (ASA) physical status grades I and II, posted for urological surgeries. Patients were randomly allocated to two groups and were given the following drugs intrathecally as per group distribution: Group I: 2.5 mL of 0.5% isobaric levobupivacaine and group II: 2.2 mL of 0.5% isobaric levobupivacaine with 15 μg (0.3 mL) fentanyl citrate. Parameters monitored were onset and duration of sensory and motor block, hemodynamic parameters, postoperative analgesia, and side effects. Data were analyzed using Student's t-test for the continuous variables and chi-square test for categorical variables. Results The onset of sensory level of T10 was earlier in group II (4.74 ± 0.723 minutes) than in group I (5.7 ± 0.953 minutes). Duration of sensory block was longer in group I (292.2 ± 8.154 minutes) than in group II (260 ± 11.066 minutes). Motor block regressed earlier in group II (181.2 ± 7.73 minutes) than in group I. Hemodynamic parameters and side effects were similar in both the groups. Conclusion From our study, we concluded that plain levobupivacaine provided a longer duration of sensory and motor subarachnoid blockade. However, addition of fentanyl as a spinal adjuvant had a dose-sparing effect with earlier onset and early regression of motor block and no hemodynamic alterations. How to cite this article Kulkarni A, Dey P. Comparison between Clinical Efficacies of Levobupivacaine Plain and Levobupivacaine with Fentanyl for Urological Surgeries under Subarachnoid Block. Res Inno in Anesth 2017;2(2):34-39.

scholarly journals Comparison of 0.5% Levobupivacaine Versus 0.5% Isobaric Levobupivacaine with 3mcg Dexmedetomidine in Spinal Anaesthesia- A Comparative Study

2020 ◽  
Vol 5 (1) ◽  
pp. 146-148
Author(s):  
Rajeev Tiwari ◽  
Saurabh Misra ◽  
Shivendu Shekhar Ojha
Keyword(s):  
Motor Block ◽  
Surgical Patient ◽  
Motor Blockade ◽  
Sensory Blockade ◽  
Group I ◽  
Duration Of Surgery ◽  
The Mean ◽  
Group Ii ◽  
Time Required ◽  
Mean Time

Background: Effective postoperative pain control is an essential component of the care of the surgical patient. The present study was conducted to compare levobupivacaine 0.5% versus isobaric levobupivacaine 0.5% with 3mcg dexmedetomidine in spinal anaesthesia.Subjects and Methods:The present study was conducted on 80 patients of ASA Grade-I and Grade-II of both genders. They were divided into 2 groups of 40 each. Group I were those who received 3 ml of 0.5% isobaric levobupivacaine with 0.3 ml of normal saline and group II patients received 3 ml of 0.5% isobaric levobupivacaine with  3µg of dexmedetomidine. Parameters such as onset of sensory blockade at T10 dermatome and onset of motor blockade motor blockade, maximum level of sensory and motor blockade attained and the time taken for the same, total duration of sensory blockade and motor blockade were recorded.Results:Group I, ASA grade I was seen in 25 and II in 15, in group II, ASA grade I was seen in 22 and II in 18 patients. Group I comprised of 18 males and 22 females, group II had 20 males and 20 females. Mean duration of surgery in group I was 58.2 minutes in group I and 56.4 minutes in group II. Mean heart rate was 82.3 per minute in group I and 81.6 per minute in group II. The mean time required to obtained sensory block in group I was 10.4 minutes and in group II was 7.4 minutes. The mean time for motor block in group I was 8.2 minutes and in group II was 5.4 minutes. The mean time required to obtain motor block in group I was 16.5 minutes and in group II was 16.1 minutes.Conclusion:Authors found that addition of intrathecal dexmedetomidine to 0.5% isobaric levobupivacaine shortens sensory and motor block onset time and prolongs block duration.

scholarly journals A Comparative Evaluation of Dexamethasone and Tramadol as Adjuvant to Levobupivacaine in Supraclavicular Block

2020 ◽  
Vol 5 (1) ◽  
pp. 100-102
Author(s):  
Rangit Priyakar Pandey ◽  
Richa Chandra
Keyword(s):  
Motor Block ◽  
Sensory Block ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
The Difference ◽  
American Society ◽  
Supraclavicular Block ◽  
Plexus Block

Background: The present study was conducted to evaluate and compare dexamethasone and tramadol as adjuvant to levobupivacaine in supraclavicular block. Subjects and Methods: The present study was conducted on 50 patients of American Society of Anesthesiologists (ASA) grade I and II. Patients were divided in to two groups of 25 each. In group I, 30 ml of 0.5% levobupivacaine hydrochloride plus 2 ml tramadol (100 mg) was used. In group II, 30 ml of 0.5% levobupivacaine hydrochloride plus 2 ml dexamethasone (8 mg) was used. Visual Analogue Scale was used. The onset of sensory and motor block was evaluated.Results: The mean onset of sensory block in group I was 5.41 minutes and in group II was 3.86 minutes, motor onset was 9.12 minutes in group I and 7.25 minutes in group II, duration of sensory block in group I was 12.14 hours and in group II was 15.34 hours, duration of motor block in group I was 14.34 hours and I group II was 16.23 hours, duration of analgesia in group I was 16.1 hour and in group II was 18.4 hours. The difference was significant difference (P<0.05). The mean VAS score in group II was better as compared to group I (P <0.05). Conclusion:Authors found that dexamethasone is a better adjuvant than tramadol when added to levobupivacaine in supraclavicular brachial plexus block.

scholarly journals The Effects on Sensorial Block, Motor Block, and Haemodynamics of Levobupivacaine at Different Temperatures Applied in the Subarachnoid Space

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Bahittin Nazli ◽  
Huseyin Oguzalp ◽  
Eyup Horasanli ◽  
Mehmet Gamli ◽  
Beyazit Dikmen ◽  
...  
Keyword(s):  
Side Effects ◽  
Motor Block ◽  
Room Temperature ◽  
Demographic Data ◽  
Sensory Block ◽  
Group I ◽  
Significant Difference ◽  
Different Temperatures ◽  
Group Ii ◽  
Transurethral Prostate Resection

Aim. To evaluate the effects of 0.5% levobupivacaine at 37°C preheated from room temperature, on sensorial block, motor block, and haemodynamics in patients undergoing transurethral prostate resection (TUR-P).Material and Method. The patients were randomly allocated to two groups: Group I patients were injected with 3 mL 0.5% levobupivacaine solution which had been kept at room temperature for at least 24 hours and Group II patients were injected with 3 mL 0.5% levobupivacaine solution which had been kept at 37°C for at least 24 hours. The patients were examined in terms of sensorial block, motor block, haemodynamic profile, and incidence of side effects.Results. No significant difference was found between the groups in terms of demographic data. The time to reachT10sensory block and the time of starting motor block were found to be significantly shorter in Group II . The duration of sensory block overT10andT6, the duration ofL1regression, the duration of the sensory block, and the regression time of the motor blocks from 3 to 2 were found to be longer in Group II.Conclusion. The use of 0.5% levobupivacaine spinal anaesthesia heated to 37°C accelerated the start of sensory and motor block.

scholarly journals EFFICACY OF CRYSTALLOIDS AND COLLOIDS AS PRELOADING FLUIDS TO PREVENT HYPOTENSION IN SPINAL ANESTHESIA IN ELECTIVE C-SECTIONS

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Dr. Seema Yadav ◽  
Dr. Rajendra Verma
Keyword(s):  
Spinal Anesthesia ◽  
P Value ◽  
Eligibility Criteria ◽  
Medical College ◽  
Group I ◽  
Significant Difference ◽  
Keywords Anesthesia ◽  
Group Ii ◽  
The Difference ◽  
American Society

Background: Different crystalloids commonly used in preloading are Ringer lactate, normal saline and colloids that are used in preloading are gelatin, dextran, hetastarch, pentastarch, tetrastarch. This study was aimed to compare the efficacy of both as preloading infusion to prevent hypotension, requirement of vasopressors and requirement of total fluid given during surgery to maintain stable hemodynamics Methods: This randomized control trials was conducted in the Department of Anaesthesia , R.V.R.S. Medical College, Bhilwara.  60 patients between 18- 40 years of age, belonging to American society of anaesthesia grade I or II going for elective caesarian section under spinal anesthesia were screened for the study eligibility criteria Results: In group (I), in 20 females, efficacy was achieved while in 10 females efficacy could not be achieved because of drop in BP. In group (II), in 22 females, efficacy was achieved while in 8 females, efficacy could not be achieved. The difference between both groups was statistically insignificant but there were more females in group II in which efficacy was achieved. (p-value=>0.05) Conclusion: According to this randomized trial we did not find any significant difference between both groups for prevention of hypotension. Keywords: Anesthesia, coload, hypotension, preload, spinal

scholarly journals A comparison of HDL-c, VLDL-c among diabetics with and without dyslipidemia and healthy controls.

2020 ◽  
Vol 27 (11) ◽  
pp. 2427-2432
Author(s):  
Hajira Siddique ◽  
Sarah Sadiq ◽  
Asifa Majeed
Keyword(s):  
Mean Value ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Female Ratio ◽  
Mean Values ◽  
Group Iii ◽  
Medical College ◽  
Group I ◽  
Group Ii ◽  
Disease Study

Objectives: To determine and compare the levels of HDL-c and VLDL-c between Diabetic with/without dyslipidemia with normal healthy controls and risk of Cardiovascular disease. Study Design: Cross Sectional Comparative study. Setting: Multidisciplinary Lab I, Department of Biochemistry and Molecular Biology Army Medical College, Rawalpindi. Period: 2 years January 2016 to January 2019. Material & Methods: Total 90 subjects were enrolled in three groups i.e., group I comprised of 30 patients of Diabetic dyslipidemia, group II consisted of 30 patients of Diabetes without dyslipidemia and group III consisted of 30 healthy normal controls. Demographic and clinical data were collected. Data collected was analyzed by SPSS version 22. Results: Male to female ratio included in group I was 1:1.73 and in group II and III was 1:1.5 each. Mean value of the HDL-c among group I was significantly lower as compared to controls. Mean values of the triglycerides (TG) among group I and group II were significantly elevated as compared to the controls. Most of the subjects of group III were doing exercise as part of everyday routine. Conclusion: The HDL-c and TG (VLDL-c) levels are perturbed significantly among Diabetic dyslipidemic patients as compared to Diabetic non-dyslipidemic patients and normal healthy controls. Exercise is an important factor missed by patients to manage their disease.

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