Comparative efficacy and safety of p6 acupressure versus ondansetron in preventing nausea and vomitingafter laparoscopic cholecystectomy

We have evaluted the antiemetic effect of P6 acupressure compared with standard doses of commonly used prophylactic antiemetic [ondasetron 4mg i.v.] in the prevention of nausea and vomiting after laparoscopic cholecystectomy. We studied Sixty patients requireing general anaethesia for laparoscopic cholecystectomy in a randomized, placebo-controlled study. The anaesthetic technique and postoperative analgesia were standardized. Failure of treatment was defined as the occurrence of nausea and /or vomiting within the first 24h after anaesthesia. Data analysis showed that both P[6]acupressure and ondansetron [4mg i.v.] significantly reduced the incidence of nausea and vomiting from 48% to 16% and 19% respectively compared to placebo. Other variables were similar between groups. We conclude that P[6]acupressure is effective, safe procedure and considerably economic in preventing nausea and vomiting after laparoscopic cholecystectomy

Comparison between Clonidine, and Ketamine With ropivacainfor caudal anaesthesia inpediatric patients

Application of regional anaesthetic techniques to infants and children dates back to the early days of regional anaesthesia in adult patients.The most common regional anaesthetic technique used in pediatric patients is the caudal block and it successfully followed the other regional techniques [e.g] infiltration of local anaesthetics for abdominal operations in critically ill inants and children in [1920] , lumber epidural block in [1936] and brachial plexuses block in[1950], and then caudal epidural block in [1993]. In recent years there has been an increased interest in regional anaesthetic techniques in children, although general anaesthesia continued to be used for most pediatric patients, and this was due to considerable increase in clinical experience in regional techniques in adults and applications of this experience in the pediatric patients. Also these regional techniques give excellent postoperative analgesia in children [13].As a single caudal injection of ropivacaine gives analgesia for [3-5]hours and the patient requires further analgesia during the postoperative period, methods of prolongation of the duration of caudal analgesia would clearly e useful. Addition of adrenaline was the most common methodto be used, and also opioids were used with the risk of respiratory depression. Also addition of ketamine or Clonidine were found to increase the duration of analgesia more with less side effects.[13]

Aim of the work: Recentlytheimprovementofpharmacology and medicine allowed new-drugs to be used caudlly for anaesthesia and postoperative analgesia [6]. In this study we willcompare the effectsof addition of ketamine and clonidine with ropivacaine on the duration of action of caudal anaesthesia in children