ABSTRACT
This is a prospective, randomized, double blind study to evaluate the postoperative analgesia following supraclavicular brachial plexus block with Tramadol or Dexamethasone as an admixture to bupivacaine in upper extremity surgery. Total 60 patients of ASA I and II undergoing upper extremity surgery under brachial plexus block with Bupivacaine were randomly divided in to two groups; one group received Tramadol (2 mg/kg) and the other group received Dexamethasone (8 mg) as an admixture to Bupivacaine. The duration of postoperative analgesia was recorded in both groups using pain VAS score which was determined by maximum VAS score of 8-10 and when patient demands for additional analgesics. The mean duration of postoperative analgesia in the Dexamethasone group was 1028.00 minutes while in the tramadol group it was 453.17 minutes We concluded that Dexamethasone with local anaesthetic prolongs postoperative analgesia significantly than Tramadol (P<0.05) when used as admixture to local anaesthetic in brachial plexus block in upper extremity surgery.
Subject(s)
Adolescent , Adult , Aged , Analgesia/methods , Analgesics, Opioid/administration & dosage , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Dexamethasone/administration & dosage , Double-Blind Method , Drug Therapy, Combination , Female , Follow-Up Studies , Glucocorticoids/administration & dosage , Humans , Injections , Male , Middle Aged , Nerve Block/methods , Pain Measurement , Pain, Postoperative/drug therapy , Postoperative Care/methods , Prospective Studies , Shoulder Pain/diagnosis , Tramadol/administration & dosage , Treatment OutcomeABSTRACT
Management of intractable ascites has always been a challenge. Peritoneovenous shunt (PVS) plays a major role in the surgery of intractable ascites in patients with liver cirrhosis. Positive pressure gradient between the ascitic fluid and venous pressure leading to one-way drainage of ascitic fluid into venous circulation is the mainstay. Over decades, various modifications of shunting technique have been done. Here we report our experience with this procedure which is safe, easy and effective. Here the long saphenous vein is used as a drainage system. One-way ascites flow is ensured by a natural valve in the saphenous orifice.
Subject(s)
Ascites/surgery , Humans , Liver Diseases, Alcoholic/surgery , Male , Middle Aged , Peritoneovenous Shunt/instrumentation , Recurrence , Saphenous VeinABSTRACT
A 22 years male admitted with severe pancreatitis with central venous catheter implanted for central venous pressure monitoring and for providing total parental nutrition developed catheter fragment embolus due to accidental fracture of the same while manipulating it. Non surgical retrieval of the same was done by radiological intervention without any complication.
Subject(s)
Adult , Blood Pressure Determination , Catheterization, Central Venous/instrumentation , Catheters, Indwelling/adverse effects , Central Venous Pressure , Device Removal/methods , Embolism/etiology , Equipment Failure , Fluoroscopy/methods , Foreign-Body Migration/etiology , Heart Atria , Cardiac Catheterization/methods , Humans , Male , Monitoring, Physiologic/instrumentation , Pancreatitis/diagnosis , Parenteral Nutrition, Total/instrumentation , Radiology, Interventional/methods , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: To measure the lipid peroxidation and endogenous antioxidant enzyme status in oral carcinoma and the protective role of exogenous antioxidants. MATERIAL AND METHODS: 20 new cases of histologically proven oral squamous cell carcinoma, 20 of leukoplakia and 20 age and sex matched healthy conrols were included. Intra oral pH of patients and controlled were measured by quantitative litmus paper test and serum was analysed for malonialdehyde (MDA), super oxide bismutase (SOD), catalase and glutathione peroxidase (GP). Patients with leukoplakia were treated with exogenous antioxidants for 3 months and the same were reassessed. RESULTS: Oral pH of oral cancer patients was neutral (PH-7) but that of leukoplakia and controls were mildly acidic (6.64 and 6.58 respectively). Serum malonialdehyde levels were highest in oral cancer group. With antioxidant enzymes super oxide bismutase, catalase and glutathione peroxidase different pattern was noticed. Antioxidant enzymes remained almost the same (P > 0.005 each) in patients with leukoplakia after 3 months of vitamin A,C and E. but there was marginal increase in catalase level (P<0.05). CONCLUSION: This study shows the positive benefit of vitamin (A,C,E) and nutrition supplementation on the antioxidant enzyme defense system hence prevention of oral carcinogenesis in patients with leukoplakia.