scholarly journals Caudal tramadol bupivacaine combination for postoperative pain releif in subumbilical paediatric surgery

2014 ◽  
Vol 23 (2) ◽  
pp. 42-46
Author(s):  
Md Shafiqul Islam ◽  
Md Tajul Islam ◽  
Dilip Kumar Bhowmick ◽  
Moinul Hossain ◽  
AKM Akhtaruzzaman ◽  
...  

Background Regional anaesthesia in children provides the advantage of reduced requirements of other anaesthetic agents and of excellent analgesia introduction. Rational use of adjuvant with local anaesthetic in caudal route for prolonged optimal analgesia in paediatric population. Objectives To evaluate the quality and duration of postoperative analgesia in children undergoing subumbilical surgeries with caudally administered mixture of tramadol and bupivacaine. Methods Sixty children of ASA physical status I & II scheduled for elective subumbilical surgery were included in this prospective case-control study. Children were randomly assigned to receive caudal analgesia with plain bupivacaine (Group-I) and a mixture of tramadol-bupivacaine (Group-II) respectively. Blood pressure, heart rate, oxygen saturation and duration of analgesia were recorded postoperatively. Results Study revealed that mean duration of caudal analgesia in Group-I and Group-II were 245.67 ± 6.94 and 612.05 ± 16.49 minutes respectively which was significantly longer (P<0.001) in Group-II. Mean number of postoperative analgesics were 2.97±0.50 and 1.78±0.50 in Group-I and Group-II which was statistically highly significant (P=0.000). Postoperative nausea and vomiting was significantly high in Group-II (P=0.019). Conclusion Combination of tramadol with bupivacaine results in prolonged analgesia when administered in caudal route. In addition, tramadol is more useful in young children considering less respiratory depression than other opioids. DOI: http://dx.doi.org/10.3329/jbsa.v23i2.18172 Journal of BSA, 2009; 23(2): 42-46

2020 ◽  
Vol 27 (1) ◽  
pp. 31-35
Author(s):  
K. Yu. Ukolov ◽  
V. L. Ayzenberg ◽  
M. V. Kapirina ◽  
M. E. Mikitina

Introduction. Spinal anesthesia is widely used in major orthopedic. Primary hip and knee arthroplasty are major surgical procedures associated with significant potential morbidity in elderly patients. This increases requirement to surgical and anesthetic procedures. Some studies provide evidence that levobupivacaine when used as an alternative to bupivacaine in spinal anesthesia is less cardiotoxic and neurotoxic. Aim: To compare the efficacy and safety of these two spinal anaesthetic agents in elderly patients undergoing primary hip or knee replacement. Patients and methods. The study included 90 patients performed arthroplasty with spinal anesthesia. I group patients received spinal anesthesia bupivacaine 0,5%, II group patients received intrathecal levobupicavaine 0.5%. Group I (n=60), 22 (37%) underwent primary hip arthroplasty, and 38 (63%) patients that underwent primary knee arthroplasty with mean age (65,4 + 6,5). Group II (n=30), 18 (60%) patients that underwent primary total hip arthroplasty and 12 (40%) patients that underwent primary knee arthroplasty with mean age (65,5 + 8,1). Anesthesia algorithm did not differ for both groups. Results. Vital parameters and adverse effects in relation to spinal anesthesia were observed. Decrease of heart rate was more significant in group II. Blood pressure parameters were comparable to both groups though, 10% of Group I patients received infusion of norepinephrine for treatment of hypotension. The two groups were comparable with glucose and lactate variations as well as the duration of analgesia and postoperative nausea and vomiting. No postoperative delirium was noted in both groups. Conclusion. Spinal anesthesia with levobupivacaine is more safe for elderly patients undergoing knee and hip arthroplasty.


Author(s):  
Ovais Nazir ◽  
Asif Hussain Bhat ◽  
Hamid Yatoo ◽  
Sanjeevni Gupta ◽  
Rajesh Misra

Background: Laparoscopic tubal ligation have advantages of minimally invasive surgical technique, without risk of major haemorrhage, early postoperative ambulation and alimentation, making it suitable for ambulatory surgery. The choice of aneasthesia for laparoscopic ligation hence should consider the anaesthetic agents with a rapid onset of action and fast recovery time, with minimal problems for intraoperative control of haemodynamic, airway and pain relief as well as take consideration of the safety, quality, efficacy, and utilization of resources available to the given situation.Methods: A total of 100 patients aged from 18 to 45 years who were scheduled to undergo laparoscopic tubal ligation  were divided into Group I-  Ketamine plus pentazocine group (n=50), Group II- Propofol plus fentanyl group (n=50) and studied  for the intraoperative parameters (hemodynamic and respiratory profile), recovery time, postoperative side effects and discharge time.Results: Intraoperatively MAP and HR were consistently higher in group I as compared to group II. Incidence of apnea and need for bag and mask ventilation was significantly more in Group II than in Group I as was the incidence of Bradycardia. Postoperative nausea and vomiting, psychomimetic effects were significantly more in Group I than in Group II. The time to reach modified PADSS ≥9 (discharge time) was significantly longer in group I (140.3±12.82 min than in group II 102.2±9.2 min), P<0.01.Conclusions: Combination of ketamine and pentazocine gives good anaesthetic conditions during procedure with less incidence of airway and haemodynamic complications intraoperatively but more incidence of postoperative side effects like nausea, vomiting, psycomimetic effects, and time to meet discharge criteria, compared to propofol plus fentanyl.


2019 ◽  
pp. 1-6
Author(s):  
Bepasha Naznin ◽  
Md. Ashraful Hoque* ◽  
Daanish Arefin Biswas ◽  
Tamanna Afroz ◽  
Farida Parvin ◽  
...  

Background:Allergic transfusion reactions (ALTR) are very common complication of blood transfusion. Advances in transfusion medicine have significantly decreased the incidence of ALTR; however, ALTR continue to be burdensome for transfusion dependent patients. It increases their existing sufferings. Allergic reaction is more common in platelet concentrate transfusion because stored platelet concentrate supernatants (PCSNs) accumulate striking levels of biological response modifiers (BRMs) during storage. Objective: To determine the risk factors of allergic reactions in platelate concentrate transfusion. Method: It is a case control study enrolled a total of 64 diagnosed case of aplastic anaemia receiving transfusion of platelet concentrate at Department of Transfusion Medicine, BSMMU, Dhaka, from May 2015 to April 2016. Among them 32 case of aplastic anaemia having allergic reaction due to transfusion of platelet concentrate was considered as group I (case) and rest 32 patients not developed allergic transfusion reaction due to transfusion of platelet concentrate was considered as group II (control). Patients age belong to 5 - 50 years and both sex and also patients getting transfusion of plate late concentrate were enrolled in this study. Statistical analysis: Statistical analyses were carried out by using the Statistical Package for Social Sciences version 20.0 for Windows (SPSS Inc., Chicago, Illinois, USA). Chi-Square test, Odds ratio with 95% CI used to analyze the categorical variables, shown with cross tabulation. Student ttest used for continuous variables. Significant value of 'p' was decided to be at a level of 0.05 in two tailed tests. Result: The mean age was found 22.1±11.58 years in group I and 23.5±3.8 years in group II. Twenty four (75.0%) patients were male in group I and 17(53.1%) patients in group II. Almost twenty (62.5%) patients come from urban area in group I and 19(59.4%) in group II. In group I, thirty two (100.0%) patients had urticarialrash, 100.0% had itching, 37.5% had angioedema, 3.1% had cough, 3.1% had chest pain, 3.1% had respiratory distress, 3.1% had fever and 3.1% had vomiting. Almost twenty(62.5%) patients had tachycardia (>100 bpm) in group I and all patients had normal pulse in group II.Thirty two (100.0%) patients had normal blood pressure in both group. In group I, 31(96.9%) patients developed mild allergic reaction, 3.1% moderate allergic reaction. Majority (40.6%) patients belonged to age 16-30 years in present allergic transfusion reaction and 11(34.3%) in absent allergic transfusion reaction. Most (40.6%) of the patients was found blood group B in present allergic transfusion reaction and 11(34.4%) in absent allergic transfusion reaction. Multiple unit of PC transfusion increases 3.69 times risk to develop allergic transfusion reactions with 95% CI 0.99 to 14.44%.Platelet concentrate storage>3daysincreases 5.95timesrisktodevelopallergic transfusionreactionwith95%CI1.75to21.09%. Conclusion: Multiple unit (≥2) transfusion and Platelet concentrate storage >3 days were significantly (p<0.05) associated with allergic transfusion reactions but no significant association was found between allergic transfusion reactions with age and Blood group


2019 ◽  
Vol 15 (4) ◽  
pp. 4-10
Author(s):  
R. N. Akalaev ◽  
V. Kh. Sharipova ◽  
A. A. Stopnitsky ◽  
K. Sh. Khodzhiev

Purpose. To compare the efficacy of metabolic hepatoprotectors at an early stage of acute alcohol poisoning complicated by toxic hepatitis.Material and methods. 80 patients with acute alcohol poisoning complicated by toxic hepatitis who received medical treatment in the toxicology unit of the Republican Research Center of Emergency Medicine during 2015–2017 were examined. The patients were split into 3 groups. At the background of backbone therapy, patients of group I (n=30) received a hepatoprotectors on the basis of inosine, meglumine, methionine, nicotinamide, and succinic acid; patients of group II (n=20) were prescribed to receive drugs based on betaine glucuronate (glucomethamine), diethanol amine (glucodiamine), and nicotinamide ascorbate. Patients of group III (n=30) received the backbone therapy. In all patients, the concentrations of liver enzymes, bilirubin, free ammonia, blood lactate, the condition of vegetative nervous status were analyzed. Psychoastenics was examined using the MMSE score, FAB score and Reitan test.Results. After 48 hours, in group I patients, the concentration of blood lactate became almost normal, in group II patients it decreased to 2.6Ѓ}0.9 mmol/l, and in group III patients it was equal to 2.7Ѓ}0.9 mmol/l. On day 5, in patients of groups I and II the cognitive deficit was almost absent, in patients of group III the MMSE scores were 1.3-fold and 1.4-fold lower than in patients of groups I and II, respectively.Conclusion. The drug used in group I possessed increased antihypoxant properties but smaller hepatoprotective properties than the drug used in group II. When signs of toxic hepatitis are predominant it would be more preferable to use the drug applied in group II and when the signs of tissue hypoxia are predominant the drug applied in group I should be used.


Author(s):  
Basanta Saikia ◽  
Kushal Konwar Sarma ◽  
Kalyan Sarma

Background: The non-availability of the sophisticated anaesthetic machine and the necessary equipment to administer inhalant anaesthetic in the field hospitals make their use practically unfeasible for the field veterinarians. Therefore, the present study was undertaken to evaluate the effect of propofol, ketamine and their combination ‘Ketofol’ as a TIVA on certain haematological, serum biochemical and hormonal profiles in atropine and xylazine premedicated dogs. Methods: The study was conducted in eighteen clinical cases of dogs of either sex. The animals were randomly divided into three groups with six animals in each group. All the three groups were premedicated with Atropine sulphate @ 0.04mg/kg body weight and xylazine HCl @ 0.5mg/kg body weight intramuscularly. In group-I, propofol @ 5mg/kg body weight, in group-II, ketamine @ 5mg/kg body weight and in group-III, ketofol @ 4mg/kg body weight was administered intravenously for induction after 15 minutes of pre-anesthetic administration. Surgical anaesthesia was maintained for 90 minutes in all three groups viz. group-I, group-II and group-III with propofol @ 2.5mg/kg. b.w., ketamine @ 2.5mg/kg b.wt. and ketofol @ 2mg/kg b.wt. respectively by intermittent bolus injection (IBI) technique. Haematological, serum biochemical and hormonal profile were evaluated before administration of the anaesthetic agent (0 minutes) then at 15, 30, 60 and 90 minutes during and after administration of anaesthetic agents. Result: The study revealed that Hb, PCV and TEC were significantly decreased in all the groups at 60 mints and 30 mints respectively. The biochemical evaluation revealed that blood glucose level was significantly increased in all the groups until the end of the experiment. BUN and creatinine value was a significant increase in group-I and group-II than group-III at different time intervals up to the end of the experiment. In all the groups’ alanine aminotransferase (ALT) values significantly increased up to 60th minutes during TIVA whereas AST value was significantly increased in group-II at 30th and 60th minute of the experiment in compare to group-I and group-III. A higher level of cortisol values was recorded in group-I animals for the entire period of observation. There were no changes observed in the case of T3. Transient variables of haemato-biochemical have been reported following propofol, ketamine and their combination (ketofol) as total intravenous anaesthesia (TIVA). Thus, it has been concluded that diligent monitorization and electrolyte support are essential during the period of anaesthesia. 


Author(s):  
Natalia V. Artymuk ◽  
Vitaliy O. Chervov ◽  
Larissa N. Danilova ◽  
Elena G. Polenok ◽  
Olga Zotova

Abstract Objectives The objective of the study was to determine the level of antibodies (AB) of Ig classes A and G to estradiol (E2), progesterone (P) and benzo [a] pyrene (Bp) in patients with endometriosis of various severity and estimate their threshold values as a risk factor for the development of endometriosis. Methods A retrospective case–control study was performed. The study involved 200 women. Group I: women with endometriosis (n=100), Group II: patients with tubal-peritoneal infertility (n=100). All patients underwent immunological studies of blood serum; and the levels of steroid hormones (P, E2), antibodies to them and Bp were determined. A ROC analysis was carried out to identify threshold values of antibodies levels. Results Women with endometriosis were found to have statistically significantly higher levels of antibodies IgA and IgG to E2, P and benzo [a] pyrene compared to women of Group II. The threshold levels of IgA-Bp, IgA-E2 and IgA-P are >5 CU (conventional unit), IgG-Bp, IgG-E2>9 CU and IgG-P>8 CU. The level of IgG-P in patients with severe forms of endometriosis is statistically significantly higher than in minor forms of the disease. In case of severe forms, there is a tendency to increasing other classes of antibodies. Conclusions Patients with endometriosis usually have a higher level of IgA and IgG to Bp, E2, P. Their threshold values, which are risk factors for the development of the disease, are estimated.


JMS SKIMS ◽  
2011 ◽  
Vol 14 (1) ◽  
pp. 11-14
Author(s):  
Abdul Qayoom Lone ◽  
Shruti Sharma ◽  
Mohamad Ommid ◽  
Showkat H Nengroo ◽  
Imtiyaz Naqash

BACKGROUND: Post operative nausea and vomiting (PONV) continue to be frequent occurrences, even when conventional antiemetics are prophylactically used. OBJECTIVE: To compare the efficacy of Granisetron over Droperidol in the prevention of PONV in patients undergoing elective open cholecystectomy under general anesthesia. MATERIAL & METHODS: In this double blind randomized study, 100 adult patients with physical status ASA I and II, (age, 20-60 years), were randomly allocated into two groups, X or Y, to receive either injection Granisetron hydrochloride (3 mg i/v) or Droperidol (2.5 mg i/v), 5 min prior to induction of general anesthesia. The incidence of nausea and vomiting was recorded every six hourly for a period of 24 hour after the surgery. RESULTS: 6 (12%) patients in the granisetron group and 20 (40%) patients in the Droperidol group reported an emetic episode, (p = 0.002); the incidence of PONV in the total 24 hr period after the surgery, 54% in the granisetron group and 76% in Droperidol group (p = 0.022) CONCLUSIONS: It was found that granisetron is superior to Droperidol in the prevention of postoperative nausea and vomiting. JMS 2011;14(1):11-14


2014 ◽  
Vol 24 (1) ◽  
pp. 8-12
Author(s):  
MM Masum-Ul Haque ◽  
Montosh K Mondal ◽  
S Afroz ◽  
SS Akhter ◽  
Abdul Hye ◽  
...  

Background Nausea, retching and vomiting are among the most common postoperative complaints. Premedication with low dose midazolam in addition to ondansetron is more effective in controlling postoperative nausea and vomiting. Objectives This study was designed to observe the effect of low dose midazolam 7.5mg in addition to ondansetron 4mg on postoperative nausea and vomiting in laparoscopic cholecystectomy. Methods 100 patients of ASA grade I and II, age range 30-50 years and weight 50-70 kg were randomly selected by a blind envelop method. They were equally divided into four groups of 25 patients in group each. Group I received vitamin, Group II ondansetron 8mg, Group III ondansetron 8mg and midazolam 7.5mg and Group IV ondansetron 4mg and midazolam 7.5 mg orally one hour before operation. In the recovery room occurrence of nausea and vomiting was assessed for 24 hours. Results The incidence of nausea was in vitamin Group I 64%, in ond8 group II 32%, in ond8+mid7.5 group III 24% and in ond4+mid7.5 group IV 24%. The incidence among the groups was highly significant (p=0.008). The incidence of vomiting was in vitamin Group I 16%, in ond8 group II 16%, in ond8+mid7.5 group III 8% and in ond4+mid7.5 group IV 8%. The difference among the groups were not significant (p=0.808). Conclusion Low dose midazolam 7.5mg in addition to ondansetron 4mg is more effective in controlling postoperative nausea and vomiting in laparoscopic cholecystectomy. DOI: http://dx.doi.org/10.3329/jbsa.v24i1.19793 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(1): 8-12


2011 ◽  
Vol 37 (3) ◽  
pp. 325-334 ◽  
Author(s):  
Ahmed Abd El-Meguid Mostafa Hamdy ◽  
Mohamed Abd El-Moniem Ebrahem

Abstract Individuals bearing the combination of interleukin (IL)-1 allele 2 at IL-1A−889 and IL-1B+3954 are referred to as being genotype positive and are susceptible to increased periodontal tissue destruction. The aim of this study was to assess the possible association of IL-1 allele 2 (IL-1A−889 and IL-B+3954) genotypes with the severity of peri-implantitis progression and the effect of this combination on treatment outcomes. Fifty patients with International Team for Implantology implants were studied; patients ranged in age from 35–55 years, and each patient had 1 implant. According to peri-implant tissue status, patients were divided into 2 groups: group I consisted of 25 patients with peri-implantitis, and group II comprised 25 patients with healthy peri-implant tissue. Clinical parameters were assessed at baseline and after 3 and 6 months. Epithelial cells were collected from the oral mucosa by plastic spatula and were used for IL-1 genotyping by the polymerase chain reaction technique. Group I patients were subjected to a peri-implantitis treatment and maintenance program. In all, 17 patients from group I and 5 patients from group II were genotype positive, with a statistically significant difference noted between the 2 groups. Group I genotype-positive patients presented with higher scores and measurements of clinical parameters with increased suppuration from peri-implant tissues compared with group II; differences were statistically significant (P &lt; .05). In terms of response to treatment, genotype-negative patients demonstrated better response than genotype-positive patients. The combination of IL-1 allele 2 (IL-1A−889 and IL-1B+3954) in patients with inflamed periodontal or peri-implant tissues acts as a risk factor that leads to greater tissue destruction. IL-1 gene polymorphism at IL-1A−889 and IL-1B+3954 may affect outcomes of treatment for peri-implantitis in genotype-positive individuals.


2014 ◽  
Vol 37 (2) ◽  
pp. 141-149 ◽  
Author(s):  
Anubhav Khajuria ◽  
Mujeeb ur Rehman Fazili ◽  
Riaz Ahmad Shah ◽  
Maajid Hassan Bhat ◽  
Firdous Ahmad Khan ◽  
...  

AbstractGoats (n=12) undergoing laparoscopy assisted embryo transfer were randomly allotted to two groups (I and II) and injected lignocaine hydrochloride (4mg/kg) or ropivacaine hydrochloride (1mg/kg) at the lumbosacral epidural space. The animals were held with raised hind quarters for the first three minutes following injection. Immediately after induction of regional anaesthesia, they were restrained in dorsal recumbency in the Trendelenburg position in a cradle. Laparoscopy was performed after creating pneumoperitoneum using filtered room air. The mean (± S.E) induction time in animals of group I was significantly shorter (5.33 ± 0.61 min) than those belonging to group II (12.66 ±1.99 min). Complete analgesia developed throughout the hind quarters and abdomen for 30 min and 60 min in group I and II animal’s respectively. Unlike animals of group I, group II goats continued to show moderate analgesia for 180 minutes. The motor activity returned after a lapse of 130.00 ± 12.64 min and 405.00 ± 46.31 min respectively. Occasional vocalization and struggling was noticed in two goats one from each group irrespective of the surgical manipulations during laparoscopy. The rectal temperature and respiration rates showed only non-significant increase, but the heart rate values were significantly higher (P < 0.5) up to 150 min in animals of both the groups when compared to their baseline values. From this study, it was concluded that both anaesthetic agents produced satisfactory regional anaesthesia in goats undergoing laparoscopy. However, considering the very long delay in regaining the hind limb motor activity, the use of ropivacaine may not be recommended for this purpose. Supplementation of sedative/tranquilizer with lumbosacral epidural anaesthesia needs evaluation.


Sign in / Sign up

Export Citation Format

Share Document