ABSTRACT
Background: A child awaking without pain is much easier to manage than one who wakes with pain. Regional anesthesia is also useful when general anaesthesia is technically difficult or is associated with an increased morbidity and mortality. Aim: The present study was conducted to identify the efficacy, safety and cardiorespiratory stability under anesthesia in children undergoing various lower abdominal and lower limb surgeries. Materials and methods: The study consisted of sixty patients of either sex, aged 1 to 12 years undergoing lower abdominal and lower limb surgeries under epidural block. Group A patients were premedicated with Inj. Glycopyrrolate I/V 0.1 mg to 0.2 mg, Inj. Ketamine I/V in the dose of 1 mg/kg. Group B patients were premedicated with Inj. Glycopyrrolate I/V 0.1 mg to 0.2 mg and Inj. Diazepam I/V 2.5 mg to 5.0 mg or Inj. Thiopentone sodium I/V 2-3 mg/kg body weight. After per medicating the child was preloded with isolute P/Ringer lactate (5-7 ml/kg body weight) Results: The mean duration of analgesia in group A patients was 151.2±10.84 minutes and in group B it was 149.8±5.74 minutes. There was no significant effect of epidural block on cardiovascular system. In this study none of the cases showed any significant change in respiratory rate and oxygen saturation in both groups. Conclusion: Epidural anesthesia in children is quite safe, economical and effective method for lower abdominal and lower limb surgery. Cardio respiratory Stability is excellent with this technique. Patient wakes pain free after surgery is over child is much easier to manage
ABSTRACT
Background: Preeclampsia is a hypertensive related complication of pregnancy; Parturients with pregnancy induced hypertension may present to the labor and delivery unit with or without a prior diagnosis of preeclampsia and may pose a significant anesthetic challenge. Administration of anesthesia in such cases leads to worse cardiovascular response. Objectives: To determine the efficacy of epidural and spinal anesthesia techniques in preeclamptic parturients. Materials and methods: A total 60 women with severe preeclampsia who required anti-hypertensive therapy and suitable to either spinal or epidural anesthesia were included and were divided in to epidural and spinal groups with equal number of distribution. Results: There were significant differences in SAP at 1 to 15 min (P < 0.0001) and at 16 to 20 min (P < 0.005) and DAP at 1 to 15 min (P < 0.0001) and at 16 to 20 min (P < 0.01) between the 2 groups. There were no significant differences in SAP and DAP at 22 to 30 min between groups. Conclusion: Spinal anesthesia for cesarean delivery in severely preeclamptic patients causes slightly more hypotension than epidural anesthesia during the induction to delivery period. The duration of hypotension, however, was short and there was no difference in neonatal status.