ABSTRACT
Background: The study was conducted to compare the quality and duration of block by addition of either clonidine or Butorphanol as an adjuvant/additive to epidural bupivacaine in orthopaedic surgical patients. Methods: 75 patients of either sex of ASA status I &II, between 20-60 years of age undergoing orthopaedic surgery were selected for the study. Patients were randomly divided into three groups of 25 each. Group I received 0.5% Bupivacaine (15ml) with 50 μg Clonidine in (1ml), Group II patients, received 0.5%Bupivacaine (15ml) with 1 mg Butorphanol (1ml) and Group III patients received 0.5% Bupivacaine (15ml) with Normal Saline (1ml). The hemodynamic parameters as well as quality of block including onset, completion and regression of motor block were observed. Parametric data were compared using analysis of variance (ANOVA). Inter group comparison was done using unpaired t-test, and chi square test. Results were expressed as mean ± SD and p< 0.05 was considered statistically significant. Result: The demographic profile was comparable among the three groups. Onset of analgesia was significantly early in butorphanol (9.08±2.58 min) group, followed by clonidine (10.6±2.5min) and control group. Duration of analgesia was longest in butorphanol group, followed by clonidine and control group. Height of sensory block achieved was comparable in the three groups (p>.05). Four hour postoperative pain score was significantly lower in butorphanol group as compared to clonidine and control group<0.05.Conclusion: The quality as well as block duration can be enhanced safely by addition of butorphanol as an additive to bupivacaine; butorphanol having an edge over clonidine for the same.
ABSTRACT
We present a case of life threatening laryngospasm following LMA removal in an asymptomatic infant with past history of watery nasal discharge, relieved of his symptoms by nasal drops. Child was operated for hernia under general anaesthesia with spontaneous ventilation on LMA with an uneventful intra-operative course.