ABSTRACT
Caudal block is most popular regional anesthetic technique used in children. It provides excellent analgesia duringsurgery as well as in postoperative period in subumblical surgeries. In this study, we compared the analgesic efficacyand safety of caudal dexmedetomidine added to caudal ropivacaine for postoperative analgesia in children. 60patients aged 1 to 8 years scheduled for subumblical surgeries were randomly allocated into two groups of 30 patientseach. Group RD received 1ml/kg of 0.2% ropivacaine with dexmedetomidine 2ìg/Kg in normal saline 1 ml. Group Rreceived 1ml/kg of 0.2% ropivacaine with normal saline 1ml.Hemodynamic parameters, duration of analgesia, painscores using observational pain scoring (OPS), requirement of rescue analgesia, and various complications wererecorded.The duration of analgesia in group R was 8.4± 1.4 hours while in group RD the duration was 10.4 ± 2 hours.Maximum OPS scores were lower in group RD compared to group R.It was concluded that caudal dexmedetomidinewhen added to ropivacaine as an adjuvant increases the efficacy and duration of analgesia, reducing the need of postoperative rescue analgesia with no additional side effects.
ABSTRACT
Carcinoma of the colon and rectum is a relatively uncommon malignancy in Kashmir (north India) when compared with the western world. Colorectal cancer is generally a disease affecting individuals 55 years of age and older and is much less common in persons under 35 years of age. Methods: One hundred and fifty six colonoscopies were performed by a single gastroenterologist in GMC Srinagar. We find the anatomical distribution and age at diagnosis of colorectal cancer patients diagnosed by colonoscopy for evaluation of their symptoms in a teaching hospital in Kashmir India, Records of patients who had complete colonoscopic examination till the cecum, presence of tumor in the colon or rectum, and biopsy showing adenocarcinoma, were scrutinized. Results: Age-stratified incidence of CRC showed that majority of the cases were in the age group 55–65 years (30.76%), followed by 45-55 years (20.5%). There were 19 (12.2%) cases of CRC below the age of 35 years. Conclusion: Colorectal cancer (CRC) in Kashmiri (Indian) occurs at a younger age and is often distal to the splenic flexure.