The Effect of Intrathecal Tramadol and Clonidine on Saddle Block with Heavy Bupivacaine / 대한마취과학회지

BACKGROUND: The saddle block with heavy bupivacaine is confinal to the lower lumbar and sacral dermatomes. We reduced the infusion dose of bupivacaine to confine the blocked area to the perineum, and evaluated intrathecal bupivacaine with intrathecal bupivacaine and tramadol or clonidine for their anesthetic and analgesic effect in patients undergoing hemorrhoidectomy. METHODS: Sixty patients (ASA I - II, aged 20 to 55) scheduled for hemorrhoidectomy were divided into three groups. We gave a 0.2 ml placebo (0.9% normal saline) in the control group (n = 20), 0.2 ml tramadol (10 mg) in the tramadol group, and 0.2 ml clonidine (50 microgram) in the clonidine group (n = 20) intrathecally 1 minute after saddle block with 0.5% heavy bupivacaine 2 mg. We compared the effects of the sensory and motor blocks by using the analgesic time and the degree of anal relaxation and the side effects. RESULTS: The analgesic time was greater in the tramadol group than is the control group (P < 0.05), and in the clonidine group if was group then in the tramadol group (P < 0.05) and the control group (P< 0.01). Anal relaxation for hemorrhoidectomy in the tramadol group and the clonidine group was better than that of the control group. The incidence of paresthesia of the foot in the clonidine group (n = 16) was higher than in tramadol group (n = 3) and the control group (n = 1) (P < 0.01). The incidence of patients with urinary retention was significantly lower in the control group than in the tramadol group (n = 3) and the clonidine group (n = 4). CONCLUSIONS: Both bupivacaine 2 mg with tramadol and clonidine were efficient in hemorhoidectomy provided good conditions for hemorhoidectomy.

The Effect of Intrathecal Tramadol and Clonidine on Saddle Block with Heavy Bupivacaine / 대한마취과학회지

BACKGROUND: The saddle block with heavy bupivacaine is confinal to the lower lumbar and sacral dermatomes. We reduced the infusion dose of bupivacaine to confine the blocked area to the perineum, and evaluated intrathecal bupivacaine with intrathecal bupivacaine and tramadol or clonidine for their anesthetic and analgesic effect in patients undergoing hemorrhoidectomy. METHODS: Sixty patients (ASA I - II, aged 20 to 55) scheduled for hemorrhoidectomy were divided into three groups. We gave a 0.2 ml placebo (0.9% normal saline) in the control group (n = 20), 0.2 ml tramadol (10 mg) in the tramadol group, and 0.2 ml clonidine (50 microgram) in the clonidine group (n = 20) intrathecally 1 minute after saddle block with 0.5% heavy bupivacaine 2 mg. We compared the effects of the sensory and motor blocks by using the analgesic time and the degree of anal relaxation and the side effects. RESULTS: The analgesic time was greater in the tramadol group than is the control group (P < 0.05), and in the clonidine group if was group then in the tramadol group (P < 0.05) and the control group (P< 0.01). Anal relaxation for hemorrhoidectomy in the tramadol group and the clonidine group was better than that of the control group. The incidence of paresthesia of the foot in the clonidine group (n = 16) was higher than in tramadol group (n = 3) and the control group (n = 1) (P < 0.01). The incidence of patients with urinary retention was significantly lower in the control group than in the tramadol group (n = 3) and the clonidine group (n = 4). CONCLUSIONS: Both bupivacaine 2 mg with tramadol and clonidine were efficient in hemorhoidectomy provided good conditions for hemorhoidectomy.

Effect of Water Ingestion before Elective Surgery on Gastric Volume and pH in Adults / 대한마취과학회지

BACKGROUND: To decrease the risk of pulmonary aspiration of gastric contents, patients are routinely asked not to eat or drink anything for at least 6 to 8 hours before surgery. We studied to evaluate whether the volume and pH of gastric fluid immediately after induction of anesthesia is correlated with water ingestion. METHODS: Fifty patients, scheduled for elective surgery, were randomly divided into two groups. Control group(n=25) were fasted overnight and received no water. Experimental group(n=25) were fasted overnight and received 150 ml water approximately 2 hours before the induction of anesthesia. Gastric fluid was obtained via multiorifice gastric tube with the patient in three different positions. The volume of gastric fluid was recorded and its pH was measured. RESULTS: The gastric volumes were no differences between the two groups. The gastric pH values were significant differences. The incidence of patients with the high risk factors of gastric volume greater than 25 ml and pH less than 2.5 was decreased in experimental group. CONCLUSIONS: We concluded that surgical patients could be permitted to ingest 150 ml water approximately 2 hours before the induction of anesthesia.