ABSTRACT
Introduction: Depression is a common psychiatric illness inthe elderly. It often co-exists with chronic neuropathic pain inold age group.Case report: We present a case report of an elderly patientwho was successfully treated with subanaesthetic intravenousinfusion for severe depression with suicidal intention andchronic neuropathic pain.Conclusion: Ketamine has been reported to be used indepression with suicidal features as well as refractory pain.Depression is a common psychiatric problem across the agegroups. It occurs due to neurochemical imbalance in the brainnamely dopamine, norepinephrine serotonin.
ABSTRACT
Introduction: Epidural anaesthesia and analgesia hasjustified use in the perioperative care of high-risk surgicalpatients, as they give better analgesia, and also improvedoutcome. Thoracic Epidural analgesia is an excellent methodof postoperative and post injury pain control in proceduresinvolving significant thoracic and abdominal injury weathertraumatically or surgically induced. Though Bupivacaine isconsidered to be the drug of choice, many other agents arebeing used for epidural anesthesia.Material and Methods: This study was carried out on 105ASA grade I and II nulliparous patients, between 20 to 70 yearsof age undergoing laparotomy, voluntary donor nephrectomyand renal surgeries. They were randomly divided in theBuprenorphine, Bupivacaine and Fentanyl Groups. Quality ofanalgesia and post-operative complications were monitored.Results: Analgesic failure was observed in all the threeGroups. But complete pain relief was better in theBuprenorphine Group. Also, complications (hypotension,bradycardia, sedation) were less in the Buprenorphine Groupthan in the Bupivacaine and Fentanyl Groups.Conclusion: Buprenorphine is safer and provides betterquality analgesia than Bupivacaine and Fentanyl.