ABSTRACT
Introduction: TIVA has many advantages over inhalational anaesthesia such as minimal cardiac depression, decreased oxygen consumption, avoids postoperative diffusion hypoxemia, decreases the incidence of postoperative nausea and vomiting etc. This study was conducted to evaluate and compare two TIVA drug combinations using propofol- ketamine and propofol-fentanyl, and to examine the characteristics of induction of anaesthesia, maintenance, and recovery. Method: 34 patients of ASA grading 1,2 and 3 aged between 20 to 65 years of either sex undergoing short surgical procedures were included in the study. According to Comparison of systolic blood pressure of both the groups at intubation time of anaesthesia in group I and group II. Patients in group I received propofol and ketamine intravenously (IV) to induce anaesthesia. For group II, fentanyl and propofol were administered as IV bolus doses. All the results were tabulated and analyzed statistically. Result: Propofol-fentanyl combination produced a significantly greater fall in pulse rate and in both systolic and diastolic blood pressures as compared to propofol-ketamine during induction of anaesthesia. Propofol-ketamine combination produced stable hemodynamic during maintenance phase while on the other hand propofol-fentanyl was associated with a slight increase in both PR and BP. During recovery, ventilation score was better in group I while movement and wakefulness score was better in group II. Conclusions: Both propofol-ketamine and propofol-fentanyl combinations produce rapid, pleasant and safe anaesthesia with only a few untoward side effects and only minor hemodynamic effects.
ABSTRACT
Background: Caudal anaesthesia is a useful adjunct to general anaesthesia for lower abdominal surgery in children as it provides intraoperative analgesia, smooth recovery period and good post-operative pain control which reduces Perioperative narcotic requirements. Aims & Objective: This Study was designed to evaluate duration of analgesia of Ropivacaine and Ropivacaine with Tramadol administered caudally for postoperative pain relief in children. Materials and Methods: Study was conducted in 60 paediatric patients of either sex belonging to ASA grade I or II in the age group 1 to 6 years scheduled for elective lower abdominal and lower limb surgery. Patients were randomly selected by sealed envelope method and divided into two groups of thirty patients each. Group RS received 0.2% Ropivacaine, 1 ml/kg with saline 0.04 ml/kg and Group RT received 0.2% Ropivacaine, 1 ml/kg with Tramadol 2 mg/kg by caudal route immediately after induction of general anaesthesia. Vitals and oxygen level was monitored. The analgesic effect of the caudal block was evaluated by using the observational Pain discomfort Scale and Four Point Sedation Score was used for assessment of sedation after extubation at 30 minutes and at 1, 2, 4, 6, 12 and 24 hrs. The time for the first analgesic requirement and side effects in 24 hours period were recorded. Results: Duration of analgesia was longer in Group RT [19.21 ± 2.25 hours] as compared to Group RS [6.38 ± 0.897 hours] (p<0.01). There were no significant changes in heart rate, blood pressure and oxygen saturation between two groups. Conclusion: Caudal Tramadol 2 mg/kg, combined with 0.2% Ropivacaine, 1ml/kg, provides longer duration of postoperative analgesia as compared to 0.2% Ropivacaine alone in children undergoing lower abdominal and lower limb surgery.