Genitofemoral nerve block and intraoperative analgesia in children during inguinal hernia repair

Ilioinguinal and iliohypogastric nerve blocks has been widely used in children undergoing inguinal herniorraphy. This technique may provide insufficient intraoperative analgesia as the inguinal region may receive innervation from genitofemoral nerve. We proposed that the addition of genitofemoral nerve block might improve the quality of analgesia. The objective was to find the efficacy of genitofemoral nerve block in addition to ilioinguinal and iliohypogastric nerve block for better intraoperative pain management in children under going inguinal hernia repair under general anaesthesia. After informed consent, 100 children of 1-10 yrs of age and ASA I or II status undergoing inguinal hernia repair were selected and divided in group I and II of 50 patients each. After induction of general anaesthesia, Group I patients received ilioinguinal and iliohypogastric block using bupivacaine 0.375% at a dose of 0.75 mg/kg, where as patients in group II were given genitofemoral in addition to ilioinguinal and iliohypogastric nerve blocks using bupivacaine 0.375% at a dose of 0.375 mg/kg at each site. Changes in heart rate, systolic, diastolic and mean arterial pressures were recorded before the start of surgery, at skin incision, at sac traction and at the end of surgery as a measure of efficacy of the block. Haemodynamic data was analysed using repeated measures ANOVA. The two groups showed increase in [Heart Rate] but the increase was lesser in group II at sac traction [p<0.05]. In group I all patients had an increase in systolic, diastolic and mean arterial pressure at sac traction while the patients in group II showed no change during the study period [p<0.05]. We conclude that the addition of a genitofemoral nerve block to ilioinguinal and iliohypogastric nerve blocks may contribute to haemodynamic stability during sac traction indicating better pain relief

Saddle block; with pethidine and cinchocaine

Twenty five patients each undergoing perineal operations were given saddle block intradural with Pethidine Hydrochloride 0.5 mg/kg and Cinchocaine 0.5%. The site of injection was given between L3/L4 and L4/L5. The motor blockade caused by Pethidine was adequate and post operative analgesia was much longer than that of Cinchocaine

Laryngeal mask airway insertion with thiopentone, aided with I/V lignocaine or topical lignocaine; a comparative study

Conditions for insertion of Laryngeal Mask Airway in 40 cases were assessed. Each patient received 0.5 mg/kg pethidine intravenous and then 6 mg/kg of thiopentone preceded either by gargles of 4% lignocaine or 0.5 mg/kg I.V. lignocaine 2%. The intravenous lignocaine had better conditions for insertion of L.M.A than topical lignocaine. Dose of intravenous lignocaine was 0.5 mg/kg body weight. The haemodynamic changes, i.e. blood pressure and heart rate did not change significantly after induction

Oral administration of midazolam: a premedicant for pediatric day care anesthesia in Sir Ganga Ram hospital.

24 children aged 5-10 years scheduled for day care anaesthesia were given midazolam 30-60 minutes before surgery. Similar number of children were given placebo and the anxiolytic effect of the drug was noted. It was seen that the recovery time was considerably increased

Failure of diclophenac sodium suppository to augment nalbuphine hydro-chloride post-operative analgesia after day care surgery

To see the efficacy of Diclofenac Sodium Suppository [DSS] in augmenting the effect of nalbuphine hydrochloride for pain. Design: A comparative study of diclofenac sodium suppository and placebo suppository. Setting: Breast clinic of Sir Ganga Ram Hospital Lahore. Subjects: 50 female patients admitted for lump breast surgery. Fifty female patients who were to undergo surgery were given diclofenac sodium suppository or placebo one hour before surgery. There was no difference in the pain score 3 to 6 hours after intramuscular injection of Nalbuphine Hydrochloride in 0.2mg/kg. Failure of diclofenac sodium suppository to augment nalbuphine. P values indicate that patients experiencing pain at various times is not significantly different in the two groups. Conclusion. Uneven absorption of diclofenac sodium suppository or rectum loaded with faeces may produce poor results

Nalbuperine for relief of labour pain in primiparous women

The analgesic efficacy and safety of Butorphanol 2mg [BUT-2] and nalbuphine hydrochloride 15mg [NAL-15] administered intramuscularly were compared in randomized, double blind clinical trail in sixty pregnant women with labour pain. Pain relief was measured by a 4 point verbal rating scale, 10,20,30,45 and 60 minutes after administration of drug. The average total pain relief [TOTPAR] score within first hour was 1.8 with BUT-2 and 1.7 with NAL-15 [P < 0.05]. NAL-15 was associated with higher frequency of adverse events and significantly lower respiratory rate in neonates. The results indicate] that BUT-2 is as effective as NAL-15 but has a superior safety profile

One sitting endodontics by Sargenti method - case reports

Author of this article, Dr. Syed Misdaq Hussain graduated from de-Montmorency College of Dentistry Lahore. He has attended university of California at Los Angeles and New York University before earning his DDS. He was certified as fellow of the American endodintic society for distinguished services in endodontics. Dr. Misdaq Hussain is a member of American dental association as well as American endodontic society