ABSTRACT
The purposes of this study were to evaluate the onset, quality and duration of sensory and motor blockade between hyperbaric bupivacaine and clonidine combination with bupivacaine alone when administered intrathecally for unilateral spinal anesthesia in below-knee orthopedic surgery, efficacy of clonidine for post-operative analgesia and side-effects of clonidine, if any. Sixty ASA I and ASA II patients scheduled for elective surgery with time duration up to 90 min were studied. Patients were randomised in two equal groups by the lottery method. Group A [control group] was given Inj. bupivacaine [hyperbaric] 0.5% - 12.5 mg [2.5 ml] 0.5 ml of normal saline intrathecally. Group B [clonidine group] was given Inj. bupivacaine [hyperbaric] 0.5% - 12.5 mg [2.5 ml] 50 mcg clonidine in 0.5 ml volume intrathecally. The mean peak sensory block was earlier in Group B [4.7 +/- 1.23 min] as compared with Group A [6.27 +/- 1.51 min]. The mean peak motor block was earlier in Group B [6.17 +/- 1.20 min] as compared with Group A [8.63 +/- 1.71 min]. The two-segment regression of sensory block was longer in Group B [106.23 +/- 9.17 min] as compared with Group A [104.43 +/- 17.75 min], which is clinically significant. Requirement of rescue analgesia was considerably prolonged in Group B [450.33 +/- 95.10 min] as compared with Group A [220 +/- 36.36 min], which was also clinically highly significant. Intrathecal clonidine potentiates bupivacaine induced spinal sensory block and, motor block and reduces the analgesic requirement in the early post-operative period in unilateral spinal anesthesia for lower limb below knee surgery
ABSTRACT
The purpose of this study was to evaluate the onset, quality and duration of sensory and motor blockade achieved with hyperbaric bupivacaine and nalbuphine combination when administered intrathecally for spinal anesthesia in lower abdominal surgery as well as efficacy of nalbuphine for postoperative analgesia and its side effects if any. 40 ASA I and II patients of age group 50-70 years, scheduled for below umbilicus surgeries were chosen for this study. Patients were randomised in two equal groups of 20 each by lottery method. Group I [Study Group] received 3 ml of hyperbaric bupivacaine 0.5% + 0.5 ml inj. nalbuphine [0.5 mg] intrathecally. Group II [Control Group] received 3 ml of hyperbaric bupivacaine 0.5% + 0.5 ml of inj. normal saline intrathecally. Assessment of motor and sensory blockade was done by Bromage scale and pin prick method. Pulse rate, BP, respiratory rate and SpO[2] were monitored. There is no significant difference between 2 groups for onset of motor and sensory blockade but mean time of postoperative analgesia in Study Group was highly significant than Control Group. No patient in our study developed any side effects. Nalbuphine provides better quality of block as compared to bupivacaine alone. It also prolongs postoperative analgesia when used as adjuvant to spinal bupivacaine in elderly patients
ABSTRACT
Some of the main objectives of anesthesia plan for tracheoesophageal fistula [TEF] repair are to provide good analgesia and smooth post-operative recovery. The anesthetic considerations in neonatal surgical emergencies are based on the physiological immaturity of various body systems, poor tolerance to the anesthetic drugs associated with congenital heart disease and preterm baby. The use of regional anesthesia has shown to be safe and effective. TEF repair of 1 day old baby which was successfully managed by caudal epidural analgesia along with GA is reported in this article. So management of every TEF case with caudal block shows excellent hemodynamic stability, postop pain relief for successful recovery and increased survival of the baby
ABSTRACT
Pheochromocytomas are highly vascular and catecholamine producing tumours derived from sympathetic or parasympathetic nervous system, and are estimated to occur in 2-8 out of 1 million population per year; about 0.1% of all hypertensives harbour a pheochromocytoma. Patients usually present with signs and symptoms of sympathetic stimulation, e.g. tachycardia and hypertension etc. We present a rare presentation of pheochromocytoma; a patient with undiagnosed abdominal mass posted for exploratory laparotomy diagnosed to be pheochromocytoma only by histopathology postoperatively. This patient developed intraoperative hypertensive crisis and pulmonary oedema but was managed successfully with proper treatment