ABSTRACT
Background and Objective: Tonsillectomy in children is the most commonly performed surgery in various otorhinolaryngology departments all over. Acute postoperative pain has adverse effects on the patients' morale as well as on physiological functions of the body. We aimed to compare the analgesic efficacy of diclofenac suppository over acetaminophen suppository for post tonsillectomy pain relief in pediatric age group
Methodology: 60 patients undergoing elective tonsillectomy were randomized into Group [A] [diclofenac group] and Group 'B' [acetaminophen group]. In diclofenac group patients received 2 mg/kg diclofenac, while in acetaminophen group patient received 20 mg/kg per rectum after induction of general anesthesia. Induction of anesthesia was same in both groups. Patients were monitored from 0 min [immediately after extubation, then after 10 min, 20 min and then 1 hourly till patients received rescue analgesic. Heart rate, mean arterial pulse, respiratory rate, pain at rest, pain on mouth opening, pain on swallowing and drowsiness were monitored. Pain was assessed by visual analogue scale [VAS] on a linear scale numbered from 0 to 10
Results: 14 [46.67%] patients needed rescue analgesic at llth hr in Group-A, while 16 [53.33%] patients in Group-B needed it at 8th hr, the difference being statistically significant [P<0.001]. Mean time to rescue analgesia in Group-A was 11.63 hrs and in Group-B was 7.53 hrs, the difference was statistically significant [P<0.001]. Visual analogue score [VAS] between the two groups showed significant increase in mean VAS in Group-B as compared to Group-A which was statistically significant. [P < 0.001]
Conclusion: We conclude that both diclofenac and acetaminophen suppositories were good postoperative analgesics when given by rectal route in pediatric age group undergoing tonsillectomy. Diclofenac sodium suppository provides better analgesia and its duration of action is longer as compared to acetaminophen suppository?
ABSTRACT
Background: Laparoscopic surgery is associated with significant hemodynamic and pathophysiological changes due to creation of pneumoperitoneum. Clonidine is known to inhibit catecholamine and vasopressin release during pneumoperitoneum. This randomized, double-blinded, controlled study was conducted to evaluate the effect of administration of intravenous clonidine for the control of hemodynamic responses during the laparoscopic surgery and also to evaluate requirement of propofol during laparoscopic surgery
Methodology: 60 patients undergoing elective laparoscopic cholecystectomy were randomized into Group-C [clonidine group] and Group-S [saline group]. In clonidine group patients received 3|Ug/kg of clonidine diluted in 10 ml saline over 10 minutes, while in saline group patients received 10 ml saline. Induction of anesthesia was same in both groups. Heart rate, systolic, diastolic blood pressure and mean arterial pressure were measured before premedication, before induction, after intubation, before CO[2] insufflation, after insufflation and then subsequently at 15 min interval till desufflation and after extubation. Propofol requirement was calculated in both groups
Statistical Analysis: Unpaired 'T' test was used to compare both groups. Decision of applying unpaired t-test was based on normality test [Shapiro-Wilk]
Results: Heart rate, systolic, diastolic and mean arterial blood pressures were significantly less in clonidine group as compared to control group. Intraoperatively there was significant heart rate variation in control group 82.93 +/- 6.53/min to 96.13 +/- 6.80/min than in clonidine group 86.30 +/- 9.12/min to 73.13 +/- 8.51/min [P<0.001]. Mean blood pressure varied from 94.51 +/- 4.82 mmHg to 102.18 +/- 5.56 mmHg in control group while in clonidine group it varied from 94.14 +/- 7.82 mmHg to 72.62 +/- 1.87 mmHg. [P<0.001]. Propofol requirement was significantly less in clonidine group
Conclusion: Administration of clonidine attenuates hemodynamic response to pneumoperitoneum and reduces the requirement of propofol
ABSTRACT
Cornelia de Lange syndrome presents with various problems which include anatomical anomalies of face and extremities, cardiopulmonary and endocrine disorders, renal dysfunction, epileptic EEG waves, and mental retardation. Difficult airway and aspiration risk due to gastroesophageal reflux and poor esophageal motility are the main challenges in anesthesia management. The choice of anesthetic procedure must be carefully considered in view of these abnormalities. We report a 14years old male child who was a known case of Cornelia De Lange Syndrome for dental extraction with restorations under general anesthesia. The uneventful course of the anesthesia in the presented case was due to the thorough systemic evaluation and careful anesthetic strategy
ABSTRACT
Background and Objective: Subclavian vein [SV] catheterization via infraclavicular approach is routinely done for multiple uses in operating rooms as well as in intensive care units in selected patients. The aim of this study was to evaluate the influence of shoulder position on central venous catheter [CVC] tip location during infraclavicular subclavian approach
Methodology: A prospective observational study was conducted on 60 patients and included American Society of Anesthesiologist [ASA] physical status 1 and 2 patients in whom CVC was planned. Catheters were introduced either in neutral shoulder position or the shoulder was lowered during venipuncture and guide wire insertion. A post-operative chest X-ray was done to note any complications and catheter tip malposition
Results: Demographic data was comparable between the two groups with respect to age, gender and weight. [P > 0.05]. In one case in Group A and two cases in Group B there was failure to puncture the vein but this was statistically insignificant [P = 0.554]. Failure to thread the guidewire was seen in one case in each group with no statistical significance [P > 0.05] Statistical difference was noted in successful placement of CVC tip between the two shoulder position [P = 0.025]
Conclusion: The neutral shoulder position reduced the incidence of catheter misplacements during infraclavicular approach of right subclavian vein catheterization as compared to lowered shoulder position
ABSTRACT
We report a case of 54 year male, a case of dilated cardiomyopathy with low ejection fraction who underwent Functional Endoscopic Sinus Surgery [FESS] under general anesthesia. Anesthetic management of such patients is always requires the highest level of expertise as they are usually complicated by progressive congestive cardiac failure [CHF]. The uneventful course of the anesthesia in the presented case was related to the thorough systemic evaluation and careful anesthetic strategy