ABSTRACT
Study DesignThis was a prospective, randomized, and double-blind study.PurposeThoraco-lumbar spine surgery is associated with severe postoperative pain and can cause chronic pain. We aimed to compare the impact of epidural ropivacaine with and without dexmedetomidine on postoperative analgesia after thoracolumbar spine instrumentation wherein an epidural catheter was placed by the surgeon intraoperatively.Overview of LiteratureVery few studies have reported the use of epidural dexmedetomidine in spine surgeries. When used via the epidural route, dexmedetomidine is safe and efficacious and is associated with reduced rescue analgesia consumption, increased duration of analgesia, reduced pain scores, but not with major hemodynamic adverse effects.MethodsTotal 60 American Society of Anesthesiologists I–III adult patients aged 18–65 years who were scheduled to undergo thoraco-lumbar spine instrumentation were randomly allocated into group RD (epidural ropivacaine+dexmedetomidine) or group R (epidural ropivacaine plus saline). We aimed to compare the total rescue analgesic consumption on postoperative day 0, 1, and 2. Moreover, we studied the time to first rescue analgesia with visual analogue scale score ResultsThere was no difference between the demographic characteristics of the two groups. The mean value of total rescue analgesia consumption was 162.5±68.4 mg in the RD group and 247.5±48.8 mg in the R group. The mean time to first rescue analgesia was 594.6±83.0 minutes in the RD group and 103.6±53.2 minutes in the R group. The mean patient satisfaction score was 4.2±0.7 in the RD group and 3.2±0.6 in the R group. No patient had any respiratory depression or prolonged motor blockade during the postoperative period.ConclusionsThis study demonstrated the superior efficacy, in terms of postoperative analgesia and patient satisfaction scores, of epidural ropivacaine plus dexmedetomidine over that of ropivacaine alone in patients undergoing surgery for thoraco-lumbar spine.
ABSTRACT
Study DesignThis was a prospective, randomized, and double-blind study.PurposeThoraco-lumbar spine surgery is associated with severe postoperative pain and can cause chronic pain. We aimed to compare the impact of epidural ropivacaine with and without dexmedetomidine on postoperative analgesia after thoracolumbar spine instrumentation wherein an epidural catheter was placed by the surgeon intraoperatively.Overview of LiteratureVery few studies have reported the use of epidural dexmedetomidine in spine surgeries. When used via the epidural route, dexmedetomidine is safe and efficacious and is associated with reduced rescue analgesia consumption, increased duration of analgesia, reduced pain scores, but not with major hemodynamic adverse effects.MethodsTotal 60 American Society of Anesthesiologists I–III adult patients aged 18–65 years who were scheduled to undergo thoraco-lumbar spine instrumentation were randomly allocated into group RD (epidural ropivacaine+dexmedetomidine) or group R (epidural ropivacaine plus saline). We aimed to compare the total rescue analgesic consumption on postoperative day 0, 1, and 2. Moreover, we studied the time to first rescue analgesia with visual analogue scale score ResultsThere was no difference between the demographic characteristics of the two groups. The mean value of total rescue analgesia consumption was 162.5±68.4 mg in the RD group and 247.5±48.8 mg in the R group. The mean time to first rescue analgesia was 594.6±83.0 minutes in the RD group and 103.6±53.2 minutes in the R group. The mean patient satisfaction score was 4.2±0.7 in the RD group and 3.2±0.6 in the R group. No patient had any respiratory depression or prolonged motor blockade during the postoperative period.ConclusionsThis study demonstrated the superior efficacy, in terms of postoperative analgesia and patient satisfaction scores, of epidural ropivacaine plus dexmedetomidine over that of ropivacaine alone in patients undergoing surgery for thoraco-lumbar spine.
ABSTRACT
The aesthetic restoration of anterior teeth has been revolutionized by the introduction of porcelain laminate veneers. Laminate veneers are now used as conservative aesthetic alternative to full coverage restorations in some cases. This case report highlights management of spaced anterior teeth and localized discolorations with porcelain laminate veneers
Subject(s)
Humans , Male , Dental Porcelain , Esthetics, Dental , Diastema , Incisor , Tooth DiscolorationABSTRACT
OBJECTIVE: To report the causes and pattern of endodontic retreatment in a private dental practice. DESIGN: This was a retrospective descriptive study. PLACE AND DURATION OF STUDY: Rahman and Rahman Dental Surgeons, Karachi, Pakistan over the period of four years. MATERIALS AND METHODS: The study included sixty-two patients with eighty-nine failed endodontically treated teeth. The data for reasons of endodontic retreatment was collected on a proforma and analyzed. Radiographic evaluation revealed periapical radiolucency in majority [51.7%] of the cases. 64% were related to poor obturation while 34% reported untreated rood canal spaces. The reasons for endodontic retreatment highlighted by the study were pain, periapical radiolucency and inadequate filling of the canal space. Generally, retreatment is considered a better option as compared to endodontic surgery
Subject(s)
Humans , Male , Female , Tooth, Nonvital , Retreatment , Private Practice , Retrospective Studies , PainABSTRACT
The goal of the orthodontic treatment is to create the balanced profile based on the norms that produce a pleasing face. There are numbers of soft tissues cephalometric aesthetics measurements that can be used. This study was conducted upon 100 aesthetically pleasing persons, who did not have apparent malocclusion the data included the photographs of 5 x 7 size of each. We took the frontal and lateral view of the face. Cephalometric analysis was performed on the photographs of the subjects. We concluded that significant similarity was seen in the results of analysis performed and certain criteria were found necessary to claim a beautiful face