Medpulse International Journal of Anesthesiology

Medpulse International Journal of Anesthesiology

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  • Publisher: MedPulse Publishing Corporation
  • Country of publisher: india
  • Date added to EuroPub: 2019/Nov/09

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  • Language of fulltext: english
  • Time from submission to publication: weeks

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  • Year open access content began: 2017
  • Does the author retain unrestricted copyright? False
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This journal has '286' articles

Study of comparative evaluation of bupivacaine and bupivacaine with dexmedetomidine in subarachnoid block for below umbilical surgeries

Study of comparative evaluation of bupivacaine and bupivacaine with dexmedetomidine in subarachnoid block for below umbilical surgeries

Authors: Nitinkumar Ingle, Pradnya Hingole, Deepak kokane, Satish G Deshpande
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Abstract

Background: Spinal anaesthesia is the most preferred regional anaesthesia technique as it is easy to perform, economical and produces rapid onset of anaesthesia and complete muscle relaxation. Dexmedetomidine, an α2 agonist drug providing stable hemodynamic conditions, good quality of intraoperative and prolonged postoperative analgesia with minimal side effects. Aim and Objective: To compare and evaluate bupivacaine and bupivacaine with dexmedetomidine in subarachnoid block for below umbilical surgeries. Material and Methods: It was prospective, randomized, double blind study conducted at tertiary care centre over a period extending from January 2014 to October 2015. The study included a total of 100 patients divided into two groups (each of 50 patients) i.e. control and study groups depending upon drugs administered. Results: The onset of sensory block as well as time for attaining maximum sensory level was significantly faster (p < 0.05) in study group as compared to control group. Also, regression of sensory block was slower and onset of motor block is quicker in patients those who received intrathecal dexmedetomidine. There was a significant prolonged duration of sensory analgesia among study group. Summary and Conclusions: Use of0.5% hyperbaric Bupivacaine (15mg) with dexmedetomidine (5mcg) in subarachnoid block Leads to significantly quicker onset of Motor and Sensory block also a minimal intraoperative and postoperative complication as compared to 0.5% hyperbaric Bupivacaine

Keywords: bupivacaine, dexmedetomidine.
Comparison of intracuff air, lignocaine, lignocaine with sodium bicarbonate and ketamine for attenuating post operative sore throat

Comparison of intracuff air, lignocaine, lignocaine with sodium bicarbonate and ketamine for attenuating post operative sore throat

Authors: Rashmi N R, Shashidhar G S, Balabhaskar S, Kiranchand N
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Abstract

Background and Aims: Tracheal intubation is a foremost cause of trauma to the airway mucosa, resulting in postoperative sore throat (POST) with reported incidence of 21 – 65%.Various pharmacological methods have been used for attenuating POST like topical lignocaine, inflation of endotracheal tube (ETT) cuff with lignocaine, lignocaine with sodium bicarbonate and preoperative ketamine gargle etc. We conducted a study to compare the incidence and severity of POST when intracuff ketamine is used and compared with intracuff air, lignocaine and lignocaine with sodium bicarbonate. Materials and Methods: A randomised study with 100 patients divided into 4 groups of 25 each was done. After intubation, the endotracheal tube cuff was inflated with either air (Group A), 2% lignocaine with normal saline (Group L), 2% lignocaine with 7.5% sodium bicarbonate (Group B) or ketamine with normal saline (Group K) and study parameters like Sore throat with incidence/severity (Mild, Moderate, Severe) and hemodynamics at extubation, TUBE tolerance, hoarseness, dysphagia, postoperative nausea vomiting and cough were observed. The results were tabulated and compared statistically. Results: The incidence and severity of POST was reduced in all groups compared to group A. Tube tolerance was better in Group K, but with slight increase in arterial blood pressure at extubation. Inflation of endotracheal tube cuff with lignocaine, lignocaine with sodium bicarbonate and ketamine can reduce the incidence and severity of POST. The best results are seen with lignocaine with sodium bicarbonate and ketamine, with minimal side effects. Conclusion: Intracuff Ketamine could be a better alternative to gargle in reducing POST and needs further trial

Keywords: post operative sore throat, ketamine gargle, intracuff ketamine, intracuff lignocaine, sodium bicarbonate.
Comparison of effects of hyperbaric bupivacaine with or without dexmedetomidine use in subarachnoid block

Comparison of effects of hyperbaric bupivacaine with or without dexmedetomidine use in subarachnoid block

Authors: Nitinkumar Ingle, Vaibhav Mahankale, Deepak Kokane, Satish G Deshpande
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Abstract

Background: The primary aim of intrathecal local anaesthetic is to provide adequate sensory and motor block necessary for all below umbilical surgeries. A number of adjuvants, such as clonidine, midazolam and others have been studied to prolong the effect of spinal anaesthesia. Dexmedetomidine, a substance that has been used for sedation and analgesia in veterinary medicine for many years is under evaluation as a neuraxial adjuvant. Aim and Objectives: To study Effects of use of hyperbaric Bupivacaine with or without Dexmedetomidine for subarachnoid block in relation to various anaesthetic parameters Material and Methods: It was prospective, randomized, double blind study conducted at tertiary care centre over a period extending from January 2014 to October 2015. The study included a total of 100 patients divided into two groups (each of 50 patients) i.e. control and study groups depending upon drugs administered. Results: The regression of sensory block was slower and onset of motor block is quicker in patients those who received intrathecaldexmedetomidine. There was a significantly prolonged duration of sensory analgesia also, the onset as well as time for attaining maximum sensory level was significantly faster in study group. Summary and Conclusions: Subarachnoid block using 0.5% hyperbaric Bupivacaine (15mg) with dexmedetomidine (5mcg) leads to significantly quicker onset and prolonged duration of action of Motor and Sensory block also a minimal intraoperative and postoperative complication as compared to 0.5% hyperbaric bupivacaine.

Keywords: analgesia, Spinal anesthesia.
Comparative study of dexmedetomidine and clonidine along with ropivacaine in epidural anaesthesia for vaginal hysterectomy

Comparative study of dexmedetomidine and clonidine along with ropivacaine in epidural anaesthesia for vaginal hysterectomy

Authors: Jadhav Shashikant Abhimanyu, Kore Rahul Dharma
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Abstract

Background: The present randomized double blind prospective study was carried out for Comparison of Dexmedetomidine and Clonidine along with Ropivacaine in epidural anaesthesia for vaginal hysterectomy. Methods: 60 female patients of ASA grade I and II, between the age group of 45 - 60 years were randomly assigned to 2 groups. Group RD: received 17 ml of 0.75% Ropivacaine Hcl and 1µg/kg of Dexmedetomidine Hcl, Group RC: received 17 ml of 0.75% Ropivacaine Hcl and 2µg/kg of Clonidine Hcl in supine position via epidural catheter. Onset, quality, duration of sensory and motor block and hemodynamic parameters evaluated. Results: Patients from Group RD have fast sensory block onset (i.e. 9.96±0.61min), prolonged two seg. regression time (138.93±4.48) and prolonged Analgesia time ((i.e 353.9±4.03min) as compared to Group RC i.e. (12.4±0.77), (128.8±3.46),(308.06±5.47) respectively. The duration of motor blockade was prolonged in patients of group RD (242.23±5.72min) as compared to the patients in group RC (230.66±5.20min). Patients in group RD were more sedated as compared to the patients in group RC. Initial fall in heart rate was more in patients of RD group as compared to the patients of group RC but later on both the groups showed stable heart rate. Fall in systolic, diastolic and mean arterial blood pressure was more in patients of RD group (during 5 to 50- 55 min of epidural injection) as compared to the patients of group RC. Later on both the groups showed stable systolic blood pressure. Conclusion: Dexmedetomidine is better adjuvant as compared to Clonidine for providing early onset and prolonged intraoperative as well as postoperative analgesia, better sedative property Both the drugs showed bradycardia and hypotension which was clinically insignificant.

Keywords: Dexmedetomidine, Ropivacaine.
Evaluation of efficacy of intravenous magnesium sulphate in general anaesthesia cases for post operative analgesia

Evaluation of efficacy of intravenous magnesium sulphate in general anaesthesia cases for post operative analgesia

Authors: Sudeep Sudeep, N Gopal Reddy
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Abstract

Background: Surgical procedures are associated with tissue injury and postoperative pain after surgical interventions. Aim: To evaluate the efficacy of intravenous magnesium sulphate on post operative analgesia following surgeries done under general anaesthesia. Objectives: 1. To evaluate post operative pain at different intervals following the use of preoperative and intraoperative intravenous magnesium sulphate 2. To assess the level of sedation in the immediate post operative period. 3. To monitor hemodynamic parameters perioperatively. Material and Methods: This study was done on 60 patients posted for surgery under general anaesthesia, after fulfilling required formalities. 30 mins before induction of anaesthesia, in Group 1, MgSO4 infusion was administered at the rate of 40mg/kg in 100 ml NS IV over 15 mins and same volume of normal saline was administered in group 2. Results: The mean VAS score postoperatively in magnesium group are at 0,1,2,3,4,8,16,24 hours was 1.96±0.66, 1.46±0.50, 1.20±0.48, 1.33±0.47, 1.43±0.62, 3.00±0.45, 1.70±0.53, 0.86±0.34 respectively. The mean VAS score postoperatively in control group at 0,1,2,3,4,8,16,24 hours 2.56±0.56, 1.96±0.41, 1.76±0.56, 1.96±0.41, 2.30±0.53, 4.16±0.69, 2.36±0.61, 2.00±0.26 respectively. The decrease in pain scores in magnesium group was statistically significant (p<0.05). The mean number of rescue analgesics required postoperatively is lesser in magnesium group compared to that in control group. Conclusion: From the present study it is concluded that IV administration of MgSO4. useful as adjuvant preemptive analgesic, significantly reduces postoperative pain and analgesics requirement..

Keywords: General anaesthesia, Magnesium sulphate, Post –op Analgesia, sedation score, VAS scores
Comparison of levobupivacaine and clonidine with plain levobupivacaine in spinal anaesthesia in lower limb surgeries

Comparison of levobupivacaine and clonidine with plain levobupivacaine in spinal anaesthesia in lower limb surgeries

Authors: Sudeep 1, N Gopal Reddy
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Abstract

Background: Intrathecal Levobupivacaine is having similar clinical profile with less cardio-toxicity than Bupivacaine is used commonly in lower limb surgeries. Clonidine as an additive to LA provides effective prolongation and dose dependent analgesia. Aim: To compare effect of intrathecal 0.5% Levobupivacaine heavy 10 mg with Clonidine 30 µg with 0.5% levobupivacaine 10mg for lower limb surgeries. Material and Method: In this study we compared onset, degree, maximum sensory level achieved, time required to achieve the maximum level of sensory blockade, duration of effective sensory blockade and onset and degree of effective motor blockade and post-operative analgesia. Results: The onset of Analgesia and motor block started at 2.25±0.19 and 8.51± 0.18 minutes in group I and slightly delayed 2.48±0.18 and 9.33±0.14 minutes in control group mean duration of two segment regression in clonidine group was 210.51±6.99 minutes and in control group was 124.83±5.098 minutes, duration of motor blockade in clonidine group is 220.17±9.68 minutes and in control group is 155.34±6.262 minutes. The mean duration of analgesia in clonidine group is 650.17±9.26 minutes and in control group is 230.86±26.22 minute. The prolongation in duration of analgesia in clonidine group was statistically more significant (p<0.05). Conclusion: We observed that that isobaric Levobupivacaine with Clonidine has got comparable pharmacokinetic in onset of sensory and motor block, good intraoperative and postoperative prolonged analgesia.

Keywords: Levobupivacaine, Clonidine, Lower-limb surgeries
A study of the efficacy of paravertebral block in the patients of breast surgeries at tertiary health care centre

A study of the efficacy of paravertebral block in the patients of breast surgeries at tertiary health care centre

Authors: Pravin C Jadhav, Vaishnavi V Kulkarni, Pushpa I Agrawal, Surekha Shinde
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Abstract

Background: Breast cancer is perhaps the most common cancer in women that requires frequent surgical intervention. Until recently breast surgeries were typically performed under general anaesthesia by intravenous and inhalational anesthetic agents. Although G.A. provides desired state of unconsciousness, it does not eliminate the surgical stress response during intubation. It may cause postoperative nausea, vomiting and pain so prolongs recovery time. Using thoracic paravertebral block has emerged as a suitable alternative to GA, as it offers good surgical anaesthesia along with prolonged post-operative analgesia. Aim and objective: To assess the efficacy of paravertebral block in the patients of breast surgeries. Material and Methods: Study of thoracic paravertebral block (TPVB) in 40 patients of benign or malignant breast diseases. The PVB was given according to guidelines describe by Eason and Wyatt (1979). Efficacy of analgesia was assessed as Onset of analgesia. Result: Mean time for onset of analgesia was 8.325±130 min. In present study block was excellent in 28 patients out of 40. Intraoperatively there were no significant (P>0.05) changes in pulse rate, SABP, DABP and SPO2 at various periods. Mean duration of postoperative analgesia was 7.025±1.187 hour. Conclusion: Paravertebral block for breast surgery is very safe and effective technique with good postoperative analgesia

Keywords: paravertebral block, Breast Surgery
A comparative study of dexmedetomidine and nalbuphine as an adjuvant to bupivacaine in lower limb surgeries done under epidural anaesthesia

A comparative study of dexmedetomidine and nalbuphine as an adjuvant to bupivacaine in lower limb surgeries done under epidural anaesthesia

Authors: Sonali M Khobragade, Jagdish Kalbhor, Ruchi Saran, Sandhya Manjrekar, Soma Cham
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Abstract

Aims and Objectives: To compare the clinical profile of Nalbuphine and Dexmedetomidine as an adjuvant to Bupivacaine when administered epidurally with respect to sensory and motor blockade, level of sedation and duration of analgesia. Material and Methods: A study was carried out in the Department of Anaesthesiology of Indira Gandhi Government Medical College and Hospital, Nagpur from Nov 2014 to October 2016. The study included 70 adult patients undergoing infraumbilical and lower limb surgeries in epidural anaesthesia. Assessment of motor blockade was done with Modified Bromage Scale. Degree of pain was evaluated by Visual Analogue Scale. Level of Sedation was assessed by Five Point Scale. Result: There was statistically significant difference between the groups for onset of sensory block, duration of analgesia and reversal of motor blockade. The onset of motor blockade, time to achieve maximum sensory and motor blockade, sedation score, Visual analogue scale score were comparable between the groups. Conclusion: Dexmedetomidine is a better adjuvant to Bupivacaine for epidural anaesthesia when compared to Nalbuphine as it provides earlier onset of sensory blockade, prolonged duration of sensory block and postoperative analgesia with stable vitals and minimal side effects.

Keywords: Dexmedetomidine, Nalbuphine, Bupivacaine, Epidural anaesthesia, Infraumbilical surgeries
Comparing effect of Phenylephrine and ephedrine in patients undergoing lower segment caesarean section under spinal anaesthesia

Comparing effect of Phenylephrine and ephedrine in patients undergoing lower segment caesarean section under spinal anaesthesia

Authors: P Savanth Kumar, G S Nikilesh Kumar
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Abstract

Background: Spinal anesthesia, a frequently used technique for caesarean delivery may be associated with maternal hypotension in as many 85% of patients. Various vasopressor have been studied for the treatment. Aim: The study was undertaken to compare the effect of phenylephrine and ephedrine in prophylactic intravenous infusion given to prevent and control intraoperative hypotension in patients undergoing lower segment caesarean section under spinal anaesthesia for ASA –PS 2014 I and II. Materials and Methods: Fifty patients were taken for this present study and distributed randomly to two groups with consent. Group A included 25 patients who were administered inj. Phenylephrine 100ugm/min infusion soon after giving spinal anaesthesia. In group B 25 patients were administered inj. Ephedrine 1mg/min as an infusion after giving spinal anaesthesia. Parameters observed were maternal heart rate, blood pressure, O2 saturation, level of block. Results: Maximum cases were in the age group of 21-25years, 56% in group A and 52% in group B belong to this age group. Maximum cases were in between the 51-55kgs group 40% in group A and 48% in group B. Spinal anaesthesia with 2ml (10mg) of 0.5% of inj. Bupivacaine was given and the level of block checked at 2 min and 5 mins. The level of anaesthesia achieved was T4 in group A (44%) and group B (56%). Inj. Phenylephrine 100ugm/min infusion was found to be superior in preventing and controlling the hypotension, as 96% of cases the fall of blood pressure was prevented and it was brought back to normal preoperative levels within 2-4minutes after giving spinal anaesthesia. In group B with inj.ephedrine 1mg/min it took a 8-10minutes for the control of blood pressure. Bradycardia was not a significant finding in ephedrine group. Conclusions: Titrated prophylactic phenylephrine infusion is preferred over ephedrine group in controlling fall of blood pressure with careful monitoring of pulse rate

Keywords: Hypotension, Bradycardia, Phenylephrine, Ephedrine.
Safety and efficacy of supraglottic airway device proseal in mechanically ventilated patients

Safety and efficacy of supraglottic airway device proseal in mechanically ventilated patients

Authors: Kalyani Venkatrao Malshetwar, Sachin R Totawar
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Abstract

Background: The Proseal Laryngeal Mask Airway (PLMA) is a new innovation of classic LMA. The PLMA has been reported to be an effective rescue airway for failed tracheal intubation. The present study was undertaken to evaluate safety and efficacy of supraglottic airway device proseal in mechanically ventilated patients. Material and Methods: This prospective study involved a total of 40 patients where Proseal for airway management was used for surgery under general anaesthesia and controlled ventilation. The insertion time of the devices, difficulty during insertion, difficulty during gastric tube insertion, coverage of airway pressure, and complications were recorded. Results: Vital parameters remained stable throughout surgeries. 100% success rate of insertion of nasogastric tube was found. Nasogastric tube was passed in 1st attempt. Postoperative complications like sore throat was found in 4 cases, whereas cough occurred in one patient. Discussion: PLMA is efficient with regards to the ease of insertion as evidenced by similar number of attempts required and the manoeuvers required. The time taken for insertion was also considerably less. The nasogastric channel provided a conduit to gastric chamber with similar success rates. The PLMA can be used safely and effectively for airway maintenance during general anaesthesia under mechanical ventilation.

Keywords: Proseal LMA, mechanical ventilation, attempts, ease of insertion, complications.
Comparison of intrathecal dexmedetomidine - 0.5% heavy bupivacaine combination with intrathecal 0.5% heavy bupivacaine alone for lower limb and lower abdominal surgeries

Comparison of intrathecal dexmedetomidine - 0.5% heavy bupivacaine combination with intrathecal 0.5% heavy bupivacaine alone for lower limb and lower abdominal surgeries

Authors: Deoshri Bal Ramteke, Surekha Shinde
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Abstract

Aims: To assess the effects of intrathecal dexmedetomidine on the onset and duration of action of sensory and motor block, haemodynamic alteration, associated complications, level of sedation and intraoperative analgesia. Methods: The study consists of 100 patients scheduled for lower abdominal and lower limb surgeries. Patients were randomly allocated in 2 groups. Group -1 received 0.5% Hyperbaric bupivacaine 3cc (15 mg) and Group-2: received 0.5% hyperbaric bupivacaine (15mg) + 5ug Dexmedetomidine. Time of onset of sensory blockade, maximum level of sensory blockade, time to achieve maximum level of sensory blockade, and maximum level of motor blockade, duration of maximum motor blockade, time for segment regression of Sensory blockade, total duration of analgesia and sedation, and incidence of side effects were recorded. Result: Mean duration of onset of sensory blockade to level T10 with Group 1 was 9.70±1.23minute while it was 6.84±0.93 minutes with Group 2. Mean duration of onset of maximum sensory blockade to level T6 in Group was 18.86 ± 1.77 minute while it was 17.30 ± 1.88 minute with Group 2. Mean duration of onset of maximum motor blockade to bromage 3 with Group 1 was 21.86 ± 1.68 minute while it was 13.12 ± 1.00 minute with Group 2. Mean duration of segment regression of sensory blockade to level S1 segment prolonged in Group 2. (Group 1-170.24 ± 10.53 minute while it was 296.90 ± 22.24minute with Group 2) (p-value<0.001). Mean duration of regression of motor blockade to bromage 0 with group 1 was 147.02 ± 9.58minute while it was 254.60 ± 13.99 minute with group 2. Duration of analgesia was measured as time interval between intrathecal injection to patients 1st request of analgesic. It was prolonged in group 2. (Group 1 -184.52 ± 13.83 minute, Group 2 -344.60 ± 31.51minute). There is no significant difference between mean heart rate and MAP in group 1 and group 2. Sedation was assessed by Ramsays sedation score graded from 1 to 6 depending upon whether patient is awake or in deep sleep. Sedition in patients in whom dexmedetomidine was used was comparatively more than with bupivacaine alone. There no significant difference of side effects in group 1 and group 2. Conclusion: Addition of dexmedetomidine to intrathecal bupivacaine produced significantly fast onset of sensory and motor block as well as significantly longer duration of sensory and motor block than bupivacaine alone without serious side effects

Keywords: Dexmeditomidine, bupivacaine.
Comparative study of supraglottic airway device proseal versus I-gel in mechanically ventilated patients

Comparative study of supraglottic airway device proseal versus I-gel in mechanically ventilated patients

Authors: Kalyani Venkatrao Malshetwar, Sachin R Totawar
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Abstract

Background: Laryngeal mask airways (LMA) represent a good alternative to endotracheal intubation in suitable cases. I-gel is more frequently used in patients under general anesthesia and receiving positive pressure ventilation. Another supraglottic airway device that enables gastric aspiration is the LMA ProSeal. In this study, we compared supraglottic airway device proseal versus I-gel with respect to ease of insertion, duration, number of attempts required and complications in surgeries under general anaesthesia and controlled ventilation. Material and Methods: A total of 80 patients were randomly assigned in two groups: Group I (n- 40) in which I-gel was used and
in Group P (n- 40) Proseal was used for airway management. In both groups, the insertion time of the devices, difficulty during insertion, difficulty during gastric tube insertion, coverage of airway pressure, and complications were recorded. Results: In 85% (34/40) patients I gel was inserted in first attempt, whereas in 80% (32/40) patients Proseal was inserted in first attempt. I gel required lesser time (10.78±2.10 seconds) for insertion compared to the PLMA (12.30 ± 2.54 seconds). Placement of nasogastric tube was 100% successful in both the groups. Hemodynamic response for insertion between two groups did not show any statistically significant differences. The incidence of post-operative complaints of cough and sore throat were similar in both the groups. It was minimal with both groups.

Keywords: Proseal LMA, I-gel, ventilation, insertion, attempts, complications
Comparative study of 0.5% lignocaine with dexmedetomidine and 0.5% lignocaine in intravenous regional anesthesia

Comparative study of 0.5% lignocaine with dexmedetomidine and 0.5% lignocaine in intravenous regional anesthesia

Authors: Suhas Jewlikar, Ashwini Suryawanshi
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Abstract

Background: Intravenous regional anaesthesia (IVRA) is a simple and reliable technique, with success rates between 94% to 98%. The local anaesthetic most often used is lignocaine. dexmedetomidine, a potent α-2 adrenoceptor agonist is approximately 8 times more selective than clonidine4. Administration of dexmedetomidine as an adjuvant to local anaesthetic has many advantages. In this study we compared lignocaine with lignocaine and dexmedetomidine in IVRA for elective hand and forearm surgeries. Aims and Objectives: To compare onset, quality and duration of sensory and motor block, tourniquet pain, postoperative analgesia, complications and hemodynamic stability after using Dexmedetomidine as an adjuvant. Materials and Methods: 60 Patients undergoing elective hand and forearm surgeries were randomly assigned to Group L (0.5% Lignocaine 200 mg) and Group LD (0.5% Lignocaine 200 mg and 0.5 ug/kg of Dexmedetomidine). Results: Demographic data were comparable. Conclusion: Addition of Dexmedetomidine to lignocaine provides IVRA with quicker onset of sensory and motor block, better quality of anaesthesia, prolonged duration of sensory, motor blockade and postoperative analgesia, delays the onset and severity of tourniquet pain, better hemodynamic stability without any adverse effects.

Keywords: IVRA, Dexmedetomidine, lignocaine. Hand and forearm Surgeries
A double blind, randomized, controlled trial to study the effect of dexmedetomidine on hemodynamic and recovery responses during tracheal extubation

A double blind, randomized, controlled trial to study the effect of dexmedetomidine on hemodynamic and recovery responses during tracheal extubation

Authors: Chintala Kishan, Gopal Reddy Narra
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Abstract

Background: Extubation is known to produce significant hemodynamic disturbances. Literature claims that dexmedetomidine, provides excellent cardiovascular stability, no respiratory depression and may be a useful adjunct to facilitate smooth tracheal extubation. Aim: To study the effect of Dexmedetomidine on haemodynamics and recovery response during tracheal extubation. Materials and Methods: sixty persons of American Society of Anesthesiologists grade I II, aged 20 45 years, scheduled for elective general surgery and Obstetrics and Gynecology were studied after randomization into two groups. Group D and C received an intravenous infusion of dexmedetomidine 0.5 µg/kg or placebo respectively, over 10 minutes before anticipated time of end of surgery, in a double blind manner. Anesthesia techniques were standardized. Vitals were recorded while starting of the injection, before extubation and at 3 and 10 minutes after extubation. Quality of extubation was evaluated on a 5 point scale and postoperative sedation on a 6 point scale. Adverse events were recorded. Results: Heart rate, systolic, diastolic, mean arterial pressures were significantly higher in group C (P <0.05). Extubation quality score of majority of patients was 2 in group D and 3 in group C. Sedation score of most patients was 3 in group D and 2 in group C. Bradycardia and hypotension incidences were higher in group D. Hypertension, tachycardia and agitations were more in control group. One patient in group D, two patients in group C had vomiting. Complications were also more in control group. Conclusion: Dexmedetomidine 0.5 µg/kg administered 10 minutes before extubation, stabilizes hemodynamics and facilitates smooth extubation

Keywords: General anaesthesia, α2 adrenoreceptor agonist, dexmedetomidine, extubation quality, hemodynamic responses.
Prevalence of acute neuropathic pain after cancer surgery: A prospective study

Prevalence of acute neuropathic pain after cancer surgery: A prospective study

Authors: Surya N, Vamshi Kiran, Murari 3
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Abstract

Aim: The aim of this study was to evaluate the prevalence of neuropathic pain after cancer surgery on the 1st, 2nd and 5th day using visual and verbal analogue scales. Materials and Methods: This study was conducted on all patients were treated for pain. All the patients were given paracetamol round the clock. This is a prospective study which included patients who had major cancer surgery during the defined period. The patients who had a neuropathic pain history before the operation and patients who refused to undergo the survey were excluded from the study. The pain score was calculated using visual and verbal analogue scale (VAS) after 1st, 2nd and 5th day after surgery. Results: This study had 200 patients out of which males were 70 (35%) were males and 130 (65%) were females. Neuropathic pain prevails before surgery and is dependent on gender and anxiety. Before surgery, females tend to have more neuropathic pain as they have more anxiety compared to males. On the first day, Females: Males ratio and anxiety was 10/4, On the second day, it was 10/6 and on the 5th day, it was 10/5. Conclusion: Neuropathic pain is common after any surgery including cancer surgery. This study focuses on the relationship between post operative pain with the occurrence of ANP to assessment of neuropathic pain and that it doesn’t lead to persistent neuropathic pain. Neuropathic pain depends on gender and anxiety before surgery.

Keywords: acute neuropathic pain.

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