Intra and postoperative outcome of adding clonidine to bupivacaine in infraorbital nerve block for young children undergoing cleft lip surgery

To evaluate the efficacy of adding clonidine to bupivacaine in bilateral infraorbital nerve block for hemodynamic changes, requirement of opioids, volatile agent, and muscle relaxants intraoperatively and relief of pain postoperatively . Prospective, randomized, double-blind study. Fifty pediatric patients aged less than 24 months undergoing elective cleft lip repair were randomly allocated to two groups of 25 each. After tracheal intubation, group A received bilateral infraorbital nerve block with 1 ml solution of clonidine [1 micro g/kg] and bupivacaine 0.25%, and group B received 1 ml of 0.25% bupivacaine. Hemodynamic parameters, intraoperative requirement of volatile anesthetic agent, muscle relaxant, and analgesic were recorded. Pain was assessed postoperatively using the Face, Legs, Activity, Cry, Consolability scale till the first rescue drug was given. Two sample unpaired t-test and the correlation r test. The duration of analgesia from the time of administration of block in group A was 667.72 +/- 210.74 min compared to 558.48 +/- 150.28 min in group B [P<0.05]. Addition of clonidine as an adjunct to local anesthetic significantly decreased the requirement of other anesthetic drugs and significantly prolonged the duration of postoperative analgesia without any adverse effects

Study of post dural puncture headache with 27g quincke and whitacre needles in obstetrics / non obstetrics patients

The proposed study was carried out in the department of Anaesthesiology, Intensive care and Pain management, Himalayan Institute of Medical Sciences. Swami Rama Nagar, Dehradun. A total of 120 patients of ASA I and II obstetric and non-obstetric undergoing elective/emergency surgery under subarachnoid block were included under the study. To evaluate the frequency of PDPH during spinal anaesthesia using 27 gauge Quincke vs 27G whitacre needle in obstetric/non obstetric patient. In our study patients were in the age group of 15-75 years. Most of the patients in our study belong to ASA Grade I. There was 2%, 1%, 4%and 3%hypotension in-group A, B, C,D respectively. There was 2%, 4% shivering in-group A,C respectively and 1% each in group B,D. In our study failed spinal with 27G Quincke needle was in one case [3.33%] in-group C where successful subarachnoid was performed with a thicken spinal needle 23G Quincke. There was no incidence of PDPH in-group A and D, while 1[2%] patient in-group B and 2[4%] in group C. All the three patients were for lower section caesarean section and were young and had undergone more than one attempt to perform spinal block. The headache severity was from mild to moderate and no epidural blood patch was applied

Comparative evaluation of intravenous propofol, thiopentone sodium and ketamine for short surgical procedures

The increasing popularity of outpatient surgery has prompted the search for new anaesthetic agent that can provide safe and effective anaesthesia with a rapid and smooth recovery We compared three induction agents, namely propofol, thiopentone sodium and ketamine to find the most suitable agent for this purpose. This prospective study was conducted at HIMS, Dehradun on 90 ASA I, II patients of either sex and in age group 16-65 years undergoing minor surgical procedures under general anaesthesia not requiring endotracheal intubation. The patients were randomly allocated into three groups of 30 patients to receive either inj propofol 2-2.5 mg/kg 1V [Group A], inj thiopentone 3-5 mg/kg IV [Group B], or inj ketamine 1-2 mg/kg IV [Group C]. It was noted that the induction time was shortest with Inj thiopentone and recovery was quickest with Propofol. Heart rate, SBP, DBP decreased with injection thiopentone and Propoiil being more in case of injection Propofol in comparison to injection to thiopentone. Inj Ketamine led to increase in all the parameters. Propofol is an ideal choice for short surgical procedures