scholarly journals Combination of Dexmedetomidine and Bupivacaine for Caudal Anesthesia In Children

2021 ◽  
Vol 15 (7) ◽  
pp. 1999-2000
Author(s):  
Nasibova E.M. ◽  
Poluxovr. SH
Keyword(s):  
Pain Relief ◽  
Caudal Block ◽  
Caudal Anesthesia ◽  
Caudal Analgesia ◽  
Provide Pain Relief ◽  
Group A ◽  
American Society ◽  
The Moment ◽  
Group B ◽  
American Society Of Anesthesiologists

Background: Caudal anesthesia is one of the most popular, reliable and safe methods of pain relief in children and can provide pain relief for various surgical procedures below the navel. Aim: To evaluate the efficacy and safety of the caudal use of dexmedetomidine in caudal anesthesia in children. Methods: The subject of the study was 46 children with physical status I and II class of the American Society of Anesthesiologists (ASA), aged 0 to 12 years, who underwent elective surgeries below the navel, such as hernia repair, orchiopexy, hypospadias repair, epispadias, etc. Results: The duration of caudal analgesia was determined from the moment the anesthetic was injected until the moment the child first complained of pain or the time when the first postoperative analgesia was required. The average duration of postoperative caudal analgesia in patients of group A was 4.21 ± 0.88, while in patients of group B this duration was 10.18 ± 0.85 hours. Conclusions. Our results show that the addition of dexmedetomidine to the local anesthetic for caudal block significantly increases the duration of analgesia and reduces the need for analgesics. More data is also needed on the neurological safety of dexmedetomidine. Key words: dexmedetomidine,caudal block, bupivacaine.

scholarly journals Management of Pain During Propofol Injection Using Intravenous Nitroglycerine

KYAMC Journal ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 202-205
Author(s):  
Muhammad Sazzad Hossain ◽  
Mohammad Mamunur Rashid ◽  
Md Anisur Rahman Babu ◽  
Afsana Sultana ◽  
Md Sirajul Islam Mahfuz ◽  
...  
Keyword(s):  
Placebo Group ◽  
Venous Occlusion ◽  
Saline Group ◽  
Injection Pain ◽  
Group A ◽  
American Society ◽  
Group B ◽  
Double Blinded ◽  
American Society Of Anesthesiologists ◽  
To Receive

Background: Propofol is an intravenous (IV) anesthetic agent, can irritate the skin, mucous membrane and venous intima. The main drawback is the pain at injection site following its intravenous injection. Objectives: This study was performed to evaluate the effect of intravenous nitroglycerine on pain in patients following propofol injection. Materials and Methods: Eighty adult patients of both sexes, aged 20-50 years, according to American Society of Anesthesiologists (ASA) physical status were divided into two equal groups (n=40) to receive 200 mcg intravenous nitroglycerine diluted in 10 ml saline (group A) and 10 ml normal saline as placebo (group B) at an ambient operating room temperature in a randomized and double blinded fashion to compare the pain-relieving effects of the drugs during propofol injection before the patients lost consciousness. The pain on propofol injection was assessed according to the Mc Crirrick and Hunter scale. Results: The overall incidence and severity of pain were significantly less in Groups A (nitroglycerine group) than group B (placebo group) (p< 0.05). The incidence of mild and moderate pain in Group A versus group B was 25% vs 45% and 15% vs 30% respectively (p<0.05). The incidence of score '0' (no pain) was higher in Group A (60%) than Group B (25%) (p<0.05). Conclusion: Pretreatment with 200 mcg nitroglycerine with venous occlusion for one minute is effective pretreatment in alleviating propofol injection pain when compared to placebo. KYAMC Journal Vol. 10, No.-4, January 2020, Page 202-205

scholarly journals EFFICACY OF ATRACURIUM VERSUS CISATRACURIUM IN PATIENTS UNDERGOING RETROGRADE CHOLANGIOPANCREATOGRAPHY PROCEDURE UNDER GENERAL ANAESTHESIA – A COMPARATIVE STUDY

2020 ◽  
pp. 197-201
Author(s):  
ALISHA SAHU ◽  
SAMBEET SWAIN ◽  
SOUMYA SAMAL ◽  
SIBANARAYAN MOHANTY
Keyword(s):  
Adverse Effects ◽  
Rapid Onset ◽  
Hemodynamic Parameters ◽  
Onset Of Action ◽  
Duration Of Action ◽  
Group A ◽  
American Society ◽  
Group B ◽  
Time Required ◽  
American Society Of Anesthesiologists

Objectives: The objectives of the study were to compare the efficacy of injection atracurium 0.5 mg/kg intravenous (IV) versus injection cisatracurium 0.2 mg/kg IV for intubation in patients undergoing endoscopic retrograde cholangiopancreatography procedure (ERCP). Methods: Hundred adult patients of both sexes in the age group of 18–60 years belonging to the American Society of Anesthesiologists I/II category posted for ERCP procedures under general anesthesia were randomly allocated into two groups of 50 each. Group A received injection atracurium besylate 0.5 mg/kg intravenously and Group B received injection cisatracurium besylate 0.2 mg/kg intravenously. Parameters observed were time to the maximum blockade, intubating condition, time required for intubation, duration of action, hemodynamic parameters during intubation, and after 1, 2, 3, 5, and 15 min and any adverse effects. Results: Demographic profile was comparable between the groups. Intubating condition as per Cooper et al. score was excellent in 36 patients in cisatracurium group as compared to 19 patients in atracurium group. The overall intubating condition was found to be better in Group B (p=0.00001). Time to the maximum blockade was significantly high with atracurium as compared to cisatracurium. The mean of intubation time was less with cisatracurium (135±11.1) than that of atracurium (144±9.48) in seconds, which was statistically significant. Duration of neuromuscular blockade was found to be prolonged in Group B as compared to Group A (p=0.000). Hemodynamic parameters during intubation and after 1, 2, 3, 5, and 15 min were comparable between the groups. No adverse effect was seen in both groups. Conclusion: Cisatracurium 0.2 mg/kg provides excellent intubating conditions with rapid onset of action, longer duration of action, and no significant hemodynamic changes as compared with atracurium 0.5 mg/kg for ERCP procedures without any adverse effects.

scholarly journals Comparison of oxycodone hydrochloride and sufentanil used in painless fiberbronchoscopy

2018 ◽  
Vol 16 ◽  
pp. 205873921877420
Author(s):  
Ke Zhang ◽  
Tianke Xiao ◽  
Zuqi Chen ◽  
Shuguang Xiong ◽  
Xiaohong Wang
Keyword(s):  
Heart Rate ◽  
Recovery Time ◽  
Adverse Reactions ◽  
Vital Signs ◽  
Fiberoptic Bronchoscopy ◽  
Group A ◽  
Oxycodone Hydrochloride ◽  
American Society ◽  
Group B ◽  
American Society Of Anesthesiologists

The study was designed to understand the effects of oxycodone hydrochloride and sufentanil used in painless fiberoptic bronchoscopy. A total of 90 patients aged 3–84 years undergoing painless fiberoptic bronchoscopy were selected, American Society of Anesthesiologists (ASA): I–III criteria—the equal number of subjects were randomly divided into sufentanil group (group A) and oxycodone hydrochloride group (group B). The vital signs, surgical examination and anesthesia, the effect of anesthesia, and adverse reactions were compared between the two groups during the operation. The change of heart rate and changes of hemodynamics in group B were found to be lower than in group A. The number of breaths was significantly lower than group B. The decrease of SpO2 in group A was higher than in group B. Cases of SpO2 <90% was higher in group A than in group B. The dosage of propofol and the recovery time in group A was significantly higher than in group B. The incidence of nausea and vomiting in group A was higher than in group B. Oxycodone hydrochloride combined with propofol used in painless fiberoptic bronchoscopy could improve the safety and efficiency of analgesia compared to sufentanil combined with propofol. The effect was found to have stable hemodynamics and fewer adverse reactions.

scholarly journals PERBANDINGAN PEMBERIAN LIDOKAIN 2% INTRAVENA DENGAN FENTANIL INTRAVENA SETELAH ANESTESI UMUM DIHENTIKAN TERHADAP KEJADIAN BATUK SAAT EKSTUBASI SADAR

2020 ◽  
Vol 8 (2) ◽  
pp. 256
Author(s):  
Dedy Hendra Gunawan
Keyword(s):  
General Anesthesia ◽  
Abdominal Pressure ◽  
Physical Status ◽  
Oral Intubation ◽  
Patient Discomfort ◽  
Group A ◽  
Coronary Ischemia ◽  
American Society ◽  
Group B ◽  
American Society Of Anesthesiologists

Cough after extubation not only causes patient discomfort, but can also cause hypertension, tachycardia, increased intracranial, intraocular, and intra-abdominal pressure, which can cause coronary ischemia, arrhythmia, or surgical difficulties. Cough after extubation can be prevented with several drugs. The purpose of this study is to compare the effects of lidocaine 2% 1.5 mg / kg intravenously compared to fentanyl 1 mcg / kg intravenously in reducing the incidence of cough during conscious extubation. Research conducted on 36 patients aged 18-65 years with the physical status of the American Society of Anesthesiologists (ASA) I and II who performed operations with general anesthesia using oral intubation in a position during supine surgery and correctly extubated. Patients were divided into 2 groups: group A received fentanyl 1 mcg / kg and group B received lidocaine 2% 1.5 mg / kg. The results of the study concluded that 2% lidocaine at a dose of 1.5 mg / kg better in coughing and rejected haemodynamics compared to fentanyl at a dose of 1 mcg / kg at the time of extubation was understood to be moderate.

scholarly journals Study of Dexmedetomidine in Caudal Block for Children Undergoing Inguino-scrotal Surgery

2020 ◽  
Vol 18 (1) ◽  
pp. 68-73
Author(s):  
B. Gautam ◽  
B. Piya ◽  
D. Karki
Keyword(s):  
Adverse Events ◽  
Local Anaesthetics ◽  
P Value ◽  
Healthy Children ◽  
Caudal Block ◽  
Chi Square ◽  
Hemodynamic Variables ◽  
Caudal Analgesia ◽  
Group A ◽  
Group B

Background Caudal block is the most common anaesthetic technique employed in children for managing perioperative pain of inguino-scrotal surgery. However, despite using long-acting local anaesthetics, caudal analgesia lasts relatively shorter. Dexmedetomidine, an alpha-2 agonist, augments local anaesthetic action. Objective To assess the analgesic effect of caudal Dexmedetomidine. Method This is a randomized, double-blinded study conducted on otherwise healthy children (one to five years) undergoing elective inguino-scrotal surgery. General anaesthesia was administered and a laryngeal mask airway was inserted for assisting ventilation. The caudal block was applied using 0.8 milliliters/kilogram drug volume comprising either two milligrams/kilogram Bupivacaine in group A (n=42) or two milligrams/ kilogram Bupivacaine mixed with 0.75 micrograms/kilogram Dexmedetomidine in group B (n=42). Intraoperatively, inhaled Halothane, intravenous Fentanyl, fluids, and ventilation were titrated to maintain monitored hemodynamic variables within 15% from baseline values. The primary endpoint comprised the duration of analgesia, defined by a time when postoperative pain score (face, legs, activity, cry, consolability; FLACC scale) reached four out of ten. Perioperative events were studied for 24 hours. Student’s t-test and Chi-square test were used for analysis, with p-value less than 0.05 considered as significant. Result Demographic, surgical, and anaesthetic characteristics were similar between the groups. Duration of analgesia was significantly prolonged in group B (group B, 413±101 minutes; group A, 204±40 minutes). The intraoperative requirement for supplement Fentanyl was significantly reduced in group B. Adverse events were comparable between the groups. Conclusion Dexmedetomidine prolongs the duration of analgesia when mixed with caudal Bupivacaine, without increasing adverse events.

EFFICACY OF INTRAVENOUS LIGNOCAINE VERSUS TOPICAL LIGNOCAINE IN ATTENUATION OF HAEMODYNAMIC SURGE DURING LARYNGOSCOPY AND INTUBATION IN PATIENTS UNDERGOING SURGERY UNDER GENERALANAESTHESIA - A SINGLE BLIND RANDOMIZED CONTROL STUDY

2021 ◽  
pp. 59-61
Author(s):  
Gautam Piplai ◽  
Amrita Roy ◽  
Dipanjan Dutta ◽  
Sayantan Mukhopadhyay
Keyword(s):  
Elective Surgery ◽  
Haemodynamic Response ◽  
Randomized Control Study ◽  
Group A ◽  
Randomized Control ◽  
American Society ◽  
Group B ◽  
American Society Of Anesthesiologists ◽  
Single Blind ◽  
Control Study

The present study was undertaken to evaluate the efcacy of intravenous lignocaine versus topical lignocaine for attenuating haemodynamic response during laryngoscopy and intubation in patients undergoing surgery under general anaesthesia. This single blind randomized control study was done on sixty patients of either sex aged between 18 to 55 years, of American Society of Anesthesiologists (ASA) status class I undergoing elective surgery under general anesthesia with endotracheal intubation. Patients were randomly allocated into two groups (group A and group B). Group A and Group B received intravenous preservative free lignocaine hydrochloride 2% 2 mg/kg and topical (nebulized) lignocaine hydrochloride 4% at 2mg/kg. Heart rate, systolic, diastolic and mean blood pressure was documented before administering premedication (T0), at time of intubation (TI) and 1 min (T-1), 2 min (T-2) & 5 min (T- 5) after intubation. Attenuation in the HR , SBP, DBP, MBPwere found statistically signicant (P<0.05) in group B in comparison to the group A. So, to conclude, topical lignocaine 4% blunts haemodynamic response to laryngoscopy and intubation better than intravenous lignocaine 2% when other confounding factors are eliminated.

A comparative study between Levobupivacaine alone and in combination with Dexmedetomidine in caudal analgesia of hernia repair in pediatrics

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed K Kamar ◽  
Hala G Awad ◽  
Hanan Mahmoud F Awad ◽  
Mohammed M Maarouf
Keyword(s):  
Hernia Repair ◽  
Pediatric Population ◽  
P Value ◽  
General Anesthesia Group ◽  
Caudal Anesthesia ◽  
Analgesic Regimen ◽  
Caudal Analgesia ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background Inguinal hernia repair is one of the most frequently performed surgical procedures in the pediatric population. Using optimal analgesic regimen provides safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery. Aim of the Work to examine the effect of Dexmedetomidine as an adjuvant to Levobupivacaine in caudal anesthesia, mainly its effect in enhancing and prolonging post-operative analgesia. Patients and Methods The study was conducted on 50 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. Patients were divided randomly into two groups, each group consisted of 25 patients. After preoperative assessment and obtaining baseline vital data, all patients received general anesthesia. Group A: Patients in this group received caudal anesthesia with Levobupivacaine 0.25% at a dose of 2 mg·kg−1 (0.8 ml·kg−1) before the beginning of the procedure. Group B: Patients in this group received Levobupivacaine 0.25% at a dose of 2 mg·kg−1 (0.8 ml·kg−1) in addition to Dexmedetomidine 1 μg·kg−1 in 1 ml normal saline before the beginning of the procedure. Results The results of the study revealed that there was significant reduction in FLACC score in group B at 4, 8, and 12 hours postoperatively compared to group A, at the twenty-fourth hour there was no significant difference. Regarding the duration of analgesia postoperatively we found statistically significant increase in group B compared to that in group A (p-value &lt;0.001). Regarding the number of doses of analgesia required post operatively (Paracetamol 15ml/kg/dose) there was a statistically significant decrease in patients requirement in group B compared to that in group A (p-value &lt;0.001). Conclusion Dexmedetomidine as adjuvant to Levobupivacaine provided significantly prolonged postoperative analgesia, reduced the postoperative analgesic requirements and better parents’ satisfaction as compared with caudal analgesia using Levobupivacaine alone in children undergoing hernia repair.

scholarly journals Comparison of Caudal Block vs. Penile Block in Terms of Surgical Incision Response for Circumcision and Postoperative Analgesia Requirements

2019 ◽  
pp. 1-5
Author(s):  
Mohammad Asim Bajwa ◽  
Aziz-Ur- Rahman ◽  
Amir Majeed ◽  
Muhammad Imran Azeem
Keyword(s):  
Heart Rate ◽  
Pain Relief ◽  
Recovery Period ◽  
Caudal Block ◽  
Nerve Blocks ◽  
Surgical Incision ◽  
Group A ◽  
Group B ◽  
Penile Block ◽  
Better Than

Circumcision is a frequently performed surgery in children worldwide. For circumcision, penile and caudal epidural blocks are commonly used. Nerve blocks not only decrease the systemic analgesia requirements intra-operatively but also increase the length of pain relief postoperatively. The aim of the present study was to compare the surgical incision response in circumcision, in children with a caudal block and penile block. We also compared the systemic analgesic requirements postoperatively in both groups. Materials and Methods: The study was conducted in pediatric patients. Total of 30 samples (n = 30) was taken and divided into two groups of 15 each. The group A received caudal block and group B received penile block. The blocks were performed after general anesthesia. We tried our best to eliminate all the factors which can lead to tachycardia (such as hypoxia, light plane of anesthesia, hyperthermia and hypothermia, hypercarbia, hypovolemia etc). The patients were keenly observed for change in heart rate on incision, the heart rates were recorded before and at incision (surgical incision response) in both groups. The postoperative consumption of the pain killers were also noted in both the groups. Results: We observed that the patients in group A with caudal block did not show any significant surgical response, whereas in group B patients with penile block showed increased heart rate at the incision. There was no complain of pain in group A in the recovery period. Whereas complains of pain were recorded in most of the children in group B, hence pain killers were given to the patients in this group. Conclusion: Our data proved that the caudal block was better than the penile block in terms of pain relief.

scholarly journals Pain management and bupivacaine

2021 ◽  
Vol 10 (9) ◽  
pp. 1083
Author(s):  
Anupam Nath Gupta ◽  
Paras Nath
Keyword(s):  
Tissue Injury ◽  
Control Group ◽  
Intraoperative Care ◽  
Background Pain ◽  
Analgesia Requirement ◽  
Group A ◽  
American Society ◽  
Group B ◽  
American Society Of Anesthesiologists

Background: Pain is an unpleasant experience associated with tissue damage. Peripheral tissue injury results in functional disturbances in the nervous system. Modern anaesthesiologists are not only concerned about preoperative and intraoperative care of the patient but also with postoperative welfare of the patient.Methods: In present study we have compared the efficacy of injection bupivacaine 0.25% infiltration preoperatively versus postoperatively on duration of postoperative analgesia, VAS (visual analogue scale) at the onset of pain, total analgesia requirement in 24 hours. 150 patients belonging to ASA (American society of anesthesiologists) class I and II between the age of 15 and 75 who underwent lower abdominal surgeries belonging to either sex were included in the study. The patients were randomly allocated to three groups. Control group (C) received 20 ml normal saline, preoperative group (A) received 0.25% bupivacaine before incision, postoperative group (B) received 0.25% bupivacaine before closure.Results: Duration of analgesia, VAS score at the time of first request of analgesia and total doses of analgesia over 24 hours were recorded. The total analgesia requirement was reduced over 24 hours in the group B in which the infiltration was done postoperatively.Conclusions: The postoperative infiltration with 0.25% bupivacaine produces longer duration and better quality of analgesia as compared to preoperative infiltration.

scholarly journals Patient-Controlled Epidural Levobupivacaine with or without Fentanyl for Post-Cesarean Section Pain Relief

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Shin-Yan Chen ◽  
Feng-Lin Liu ◽  
Yih-Giun Cherng ◽  
Shou-Zen Fan ◽  
Barbara L. Leighton ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Epidural Analgesia ◽  
University Hospital ◽  
Control Regimen ◽  
Background Infusion ◽  
Continuous Background ◽  
American Society ◽  
Group B ◽  
Double Blinded ◽  
American Society Of Anesthesiologists

Purpose.The purpose of this study was to compare the analgesic properties of levobupivacaine with or without fentanyl for patient-controlled epidural analgesia after Cesarean section in a randomized, double-blinded study.Methods.We enrolled American Society of Anesthesiologists class I/II, full-term pregnant women at National Taiwan University Hospital who received patient-controlled epidural analgesia after Cesarean section between 2009 and 2010. Eighty women were randomly assigned into two groups. In group A, the 40 subjects received drug solutions made of 0.6 mg/ml levobupivacaine plus 2 mcg/ml fentanyl, and in group B the 40 subjects received 1 mg/ml levobupivacaine. Maintenance was self-administered boluses and a continuous background infusion.Results.There were no significant differences in the resting and dynamic pain scales and total volume of drug used between the two groups. Patient satisfaction was good in both groups.Conclusion.Our study showed that pure epidural levobupivacaine can provide comparative analgesic properties to the levobupivacaine-fentanyl combination after Cesarean section. Pure levobupivacaine may serve as an alternative pain control regimen to avoid opioid-related adverse events in parturients.

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