ABSTRACT
Background: Lower limb surgeries are often performed under spinal anesthesia. The conventional anesthetic method for lower limb surgeries is caudal epidural block. The currently available local anesthetic for this purpose is Bupivacaine which has long duration of action of around 6-12 hour. Methods: 60 adult cases ranging in age from 20 to 60 years with ASA Grade I and II requiring elective lower limb surgery under epidural anesthesia were selected for this prospective, randomized, double-blind study. Results: 60 adult cases ranging in age from 20 to 60 years with ASA Grade I and II, requiring elective gynecological surgery under epidural anesthesia were selected for this study. Cases were randomly allocated into two groups containing 20 cases each. Cases in Group B received Bupivacaine 0.25% and those in Group T received Tramadol 100mg. Conclusion: Current study concluded that both intrathecally administered levobupivacaine and racemic bupivacaine are safe and effective local anaesthetics for lower limb surgeries. Overall parameters observed in this study showed no significant difference between the two forms of the same drug. However, intrathecal levobupivacaine produces less toxicity.
ABSTRACT
Background: Brachial plexus piece has reformed the field of regional anaesthesia for upper limb surgeries. Infraclavicular subcoracoid approach gives complete block without significant difficulties. Aim: To compare the additives adenosine and magnesium sulphate with bupivacaine in infraclavicular infusion for upper limb surgeries and postoperative analgesia. Materials & Methods: This Prospective study was done at the Department of Anaesthesiology, Govt. Medical College, Azamgarh. Around 24 patients scheduled for elective unilateral upper limb surgeries involving distal arm/ elbow/ forearm/hand divided into two groups A (n-12) and B (n-12) randomly. Group A - adenosine 6mgs with 28 ml 0.5% bupivacaine bolus followed by infusion of 0.25% bupivacaine 28ml with 6mgs of adenosine (2ml) at a rate of 5ml/hr. Group B - magnesium sulphate 75 mgs (in 2ml) with 28ml of 0.5% bupivacaine bolus followed by infusion of 0.25% bupivacaine 28ml with 75mgs of magnesium sulphate (in 2ml) at a rate of 5ml/hr in USG guided placement of infraclavicular catheter. Results: Our Study revealed that Group A had a faster Onset time of sensory and motor block and faster recovery when compared to group B. Group A needed more rescue analgesia than group B. Conclusion: The addition of magnesium sulphate as an additive to bupivacaine in brachial plexus block may be a better choice when prolonged postoperative analgesia is required.