scholarly journals COMPARISON OF 0.5% ROPIVACAINE ALONE AND IN COMBINATION WITH ADJUVANTS CLONIDINE OR DEXAMETHASONE USED IN BRACHIAL PLEXUS BLOCK THROUGH SUPRACLAVICULAR APPROACH : A RANDOMISED CONTROLLED DOUBLE BLIND CLINICAL STUDY

2020 ◽  
pp. 1-3
Author(s):  
Dinbandhu Prasad ◽  
Avinash Kumar ◽  
Satyeshwar Jha ◽  
Debarshi Jana
Keyword(s):  
Postoperative Analgesia ◽  
Good Choice ◽  
Inclusion Criteria ◽  
Double Blind ◽  
Supraclavicular Approach ◽  
Medical College ◽  
Hemodynamic Variables ◽  
Dexamethasone Group ◽  
Randomised Controlled ◽  
Plexus Block

Background and Aim : Background the present study was planned to evaluate the effect of 0.5% ropivacaine with adjuvants 0.15mg clonidine or 8 mg dexamethasone with consideration to the onset and duration of sensory-motor blockade, hemodynamic variables, postoperative analgesia and adverse effects. Material and Methods The study was conducted in the department of Anaesthesiology, Darbhanga medical college and hospital from April 2018 to December 2019. 105 consenting patients were included scheduled for moderate duration of upper limb surgeries of orthopedics and general surgery. Results : 124 patients were assessed for eligibility. Eleven patients did not give consent for participation and eight was not included due to not meeting inclusion criteria. 105 patients were enrolled and randomized to any of the three groups; 35 each in the intervention and the comparator groups. Finally, 35 patients in placebo and dexamethasone group each and 35 patients in clonidine group were analyzed, the rest being excluded due to failed block. Conclusion : we conclude that dexamethasone as an adjuvant is a good choice to prolong the duration of postoperative analgesia without any serious adverse effect. However, prolonged motor block is a matter of concern and the search for an adjuvant that selectively prolongs analgesia without impairing motor function continues.

Preoperative Ampiroxicam Reduces Postoperative Pain after Hand Surgery

2001 ◽  
Vol 26 (4) ◽  
pp. 377-379 ◽  
Author(s):  
S. SAI ◽  
K. FUJII ◽  
K. HIRANUMA ◽  
T. SATO ◽  
T. NEMOTO
Keyword(s):  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Brachial Plexus Block ◽  
Hand Surgery ◽  
Controlled Study ◽  
Double Blind ◽  
Preoperative Administration ◽  
Randomised Controlled Study ◽  
Randomised Controlled ◽  
Plexus Block

We performed a double blind randomised controlled study to assess whether the preoperative administration of ampiroxicam reduced the level of postoperative pain in 120 patients who underwent surgery to a hand under brachial plexus block. We found that preoperative (pre-emptive) administration of ampiroxicam significantly reduced the postoperative pain levels and the need for postoperative analgesia.

TO STUDY AND COMPARE THE EFFECT OF DEXMEDETOMIDINE AND FENTANY AS AN ADJUVANT TO LEVOBUPIVACAINE IN INTERSCALENE BRACHIAL PLEXUS BLOCK FOR HUMERUS SURGERY: A PROSPECTIVE RANDOMIZED DOUBLE-BLIND CONTROLLED STUDY

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Kushal Jethani ◽  
Khushboo . ◽  
Anjali Bansal
Keyword(s):  
Brachial Plexus ◽  
Postoperative Analgesia ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Controlled Study ◽  
Double Blind ◽  
Interscalene Brachial Plexus Block ◽  
The Mean ◽  
Plexus Block ◽  
Group D

Introduction: Interscalene brachial plexus block provides complete and reliable anaesthesia for surgery of humerus as well as analgesia for postoperative period. Many studies are being done for the search for an adjuvant which when added to a local anaesthetic, prolong the duration of postoperative analgesia. Therefore we compared the effect of fentanyl and dexmedetomidine on postoperative analgesia when added to levobupivacaine for Interscalene brachial plexus block. Material and Methods: In this prospective study, 90 patients were randomly allocated to 3 groups:  Group C (n=30) recieved 30 ml of 0.5% levobupivacaine, Group D (n=30) recieved 30 ml of 0.5% levobupivacaine + dexmedetomidine 1 μg/kg, Group F (n=30) recieved 30 ml of 0.5% levobupivacaine + fentanyl 1 μg/kg. The duration of blockade and analgesia were assessed for all the three groups. Observations: Demographic profile was comparable in all the groups. The onset of sensory and motor block and duration of analgesia and motor block were enhanced in Group D and Group F as compared to Group C. The mean pulse rate and mean arterial pressure were slightly lower in dexmedetomidine group than in other two groups. Results: Compared to the use of levobupivacaine alone for interscalene brachial plexus block, addition of 1 mcg/kg dexmedetomidine or 1 mcg/kg fentanyl to levobupivacaine enhanced the onset of blockade as well as increased the duration of blockade and post-operative analgesia. Also, the blockade characteristics were better improved with addition of dexmedetomidine to levobupivacaine than addition of fentanyl to levobupivacaine without increasing incidence of any unwanted side-effects. Keywords: Interscalene brachial plexus block, Levobupivacaine, Fentanyl, Dexmedetomidine.

scholarly journals Effect of Intravenous Dexamethasone in Combination with Caudal Analgesia on Post Operative Pain Control after Herniotomy in Children

2020 ◽  
Vol 35 (2) ◽  
pp. 145-149
Author(s):  
Md Jahirul Islam ◽  
Ismat Jahan ◽  
Aminul Islam
Keyword(s):  
Adverse Effects ◽  
Postoperative Analgesia ◽  
Control Group ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Pain Scores ◽  
Dexamethasone Group ◽  
Group I ◽  
Caudal Analgesia ◽  
Group Ii

Background: Dexamethasone has a powerful anti-inflammatory action and has demonstrated reduced morbidity after surgery. Objectives: The aim of this study was to examine the effects of a single i.v. dose of dexamethasone in combination with caudalblock on postoperative analgesia in children. Methods: This study was a randomized, double blind clinical trial, in which 77 children of ASA I and II, aged 3-10 years, undergoing elective unilateral herniotomy operation, was allocated in a double blind manner. Control Group I consist of 39 patients and Dexamethasone Group II consists of 38 patients. Group II received i.v. Dexamethasone 0.5 mg/Kg (Maximum 20 mg) and Group I received the same volume of i.v. saline after induction of anaesthesia. After inhalation induction of general anaesthesia, children received either dexamethasone 0.5-1 mg/Kg (maximum 20 mg) (n=39) or the same volume of saline (n=38) i.v. A caudal anaesthetic block was then performed using 1.5 ml/kg of Bupivacaine 0.25% in all patients. After surgery, rescue analgesic consumption, pain scores, and adverse effects were evaluated for 24 h. Results: Significantly, fewer patients in the dexamethasone group required fentanyl for rescue analgesia (7.9% vs38.5%, p<0.05) in the post-anaesthetic care unit or acetaminophen (23.7% vs 64.1%) after discharge compared with the control group. The time to first administration of oral acetaminophen was significantly longer in the dexamethasone group (646 vs 430 min). Postoperative pain scores were lower in the dexamethasone group and the incidence of adverse effects was similar in both groups. Conclusion: Intravenous dexamethasone 0.5-1 mg/Kg in combination with a caudal block augmented the intensity and duration of postoperative analgesia with out adverse effects in children undergoing herniotomy. DS (Child) H J 2019; 35(2) : 145-149

scholarly journals The Effect of Bifidobacterium on Reducing Symptomatic Abdominal Pain in Patients with Irritable Bowel Syndrome: A Systematic Review

2019 ◽  
Vol 12 (3) ◽  
pp. 834-839 ◽  
Author(s):  
Charlotte Pratt ◽  
Matthew D. Campbell
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Fermented Milk ◽  
Controlled Trials ◽  
Inclusion Criteria ◽  
Delivery Method ◽  
Double Blind ◽  
Irritable Bowel ◽  
Dose Response Effect ◽  
Randomised Controlled

AbstractProbiotics, specifically Bifidobacteria, may improve abdominal pain in patients with irritable bowel syndrome (IBS); however, results from randomised controlled trials (RCTs) are conflicting. Here, we systematically reviewed the efficacy of Bifidobacteria on abdominal pain in IBS. We searched MEDLINE, EMBASE and the Cochrane Controlled Trials Register from inception to 20 May 2019, without language or date restrictions. The search strategy comprised of the combination of three concepts: supplementation, abdominal pain, and IBS. Inclusion criteria included double-blind placebo-controlled RCTs featuring Bifidobacteria supplementation in Rome-diagnosed IBS patients. A total of 8 RCTs involving a total of 1045 patients with Rome diagnosed IBS were included. The dose of total Bifidobacteria ranged from 106 to > 1011 cfu (colony-forming unit) and duration of supplementation ranged between 2 and 8 weeks. Bifidobacteria was delivered through either intake of fermented milk products, encapsulation or via a malted milk beverage, with all studies assessing abdominal pain via a visual analogue Likert scale. From the studies included, 50% (n = 4) of studies found a statistically significant improvement in abdominal pain following Bifidobacteria supplementation compared to placebo, 38% (n = 3) of studies found non-significant improvements and 12% (n = 1) showed a statistically significant dose-response effect of improvement. The evidence shows a heterogeneity of effect for Bifidobacteria dependent upon strain, dosage and delivery method. While not all studies demonstrate significant improvements in abdominal pain, none of the selected studies reported an increase in pain or other adverse effects.

COMPARISON OF EFFECT OF 0.25% BUPIVACAINE ALONE AND 0.25% BUPIVACAINE WITH DEXMEDETOMIDINE IN BRACHIAL PLEXUS BLOCK THROUGH SUPRACLAVICULAR APPROACH

2021 ◽  
pp. 77-79
Author(s):  
Palle Krishna Padma Sri ◽  
Niyaz PV ◽  
Madhusudhan Reddy K ◽  
Bonthu Mounica
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Distilled Water ◽  
Double Blind ◽  
Supraclavicular Approach ◽  
Group A ◽  
Group B ◽  
Plexus Block

BACKGROUND AND AIM:Brachial plexus block is a safe, effective, low-cost anesthesia with good postoperative analgesia. Adjuvants to local anesthetics may enhance the quality and duration of analgesia. The aim of the study was to study the efcacy of a combination of 0.25% bupivacaine alone versus 0.25% bupivacaine and dexmedetomidine in brachial plexus block by supraclavicular approach. METHODS: This is a prospective double-blind study conducted on sixty patients of ASA1 and ASA2 posted for upper limb surgeries, randomized in a double-blind fashion into two groups. Group A (N-30) received 34ml of 0.25% bupivacaine with 0.5ml of distilled water and group B (N-30) received 0.5ml dexmedetomidine (50 μg) with 34ml of 0.25% bupivacaine as supraclavicular brachial plexus block with help of a nerve stimulator. Onset and recovery time of sensory and motor block, duration of analgesia, sedation scores, quality of block, and side effects compared in both groups. RESULTS: Baseline characteristics were well matched in both groups. The intraoperative hemodynamic recording was done at 15 min time intervals from the administration of the drugs. There was a reduction in heart rate, systolic blood pressure, and diastolic blood pressure 30 mins onwards in both groups. There was no signicant difference in the onset of sensory and motor blocks. Duration of sensory block was 299.57 ± 35.94 mins in Group A and 782.2 ± 82.76 mins in Group B, duration of motor block was 272.17 ± 37.31 mins versus 755.63 +/- 86.6 mins respectively, total duration of analgesia was 321 ± 35.46 mins versus 815.80 +/- 88.1 mins respectively. Ramsay sedation score was similar at arrival in both groups but in post-op, the score of 3 was noted in 0% (0/ 30) in Gr A and 93.3% (28/ 30) in Gr B . Quality of analgesia was also better in Group B. There were no signicant adverse events noted in both groups. CONCLUSION: This double-blind Randomized Controlled study showing the combination of dexmedetomidine 50 μg with 34ml of 0.25% bupivacaine is better than 0.5ml of distilled water with 34ml of 0.25% bupivacaine in the duration of sensory and motor block, with better sedation and quality of analgesia with the good safety prole in brachial plexus block by supraclavicular approach.

scholarly journals Prevention of Tachycardia with Atenolol Pretreatment for Carotid Endarterectomy under Cervical Plexus Blockade

1992 ◽  
Vol 20 (2) ◽  
pp. 161-164 ◽  
Author(s):  
M. J. Davies ◽  
R. H. Dysart ◽  
B. S. Silbert ◽  
D. A. Scott ◽  
R. J. Cook
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Carotid Endarterectomy ◽  
Controlled Trial ◽  
Cervical Plexus ◽  
Double Blind ◽  
Cervical Plexus Block ◽  
Randomised Controlled ◽  
Plexus Block ◽  
Atenolol Group

A double-blind, randomised, controlled trial of forty patients was carried out to determine if oral atenolol pretreatment would reduce the incidence of tachycardia during carotid endarterectomy performed under cervical plexus block. Twenty patients received a placebo and twenty patients 50 mg of atenolol two hours prior to surgery. The superficial and deep cervical blocks were performed with 1.5% lignocaine containing 1:200,000 adrenaline. The patients were monitored with the V5 lead of the electrocardiogram and intraarterial blood pressure. These measurements were recorded on a correctly calibrated paper recorder. Tachycardia (heart rate > 90 beats per minute for more than three minutes) occurred in thirteen patients in the placebo group and two patients in the atenolol group (P<0.01). There was no difference in the occurrence of bradycardia, hypotension or hypertension between the two groups. It is concluded that atenolol pretreatment is an effective method of reducing the incidence of tachycardia during carotid endarterectomy performed under cervical plexus blockade.

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