RESUMEN
Background: Post-operative analgesia has been considered very important for patient in terms of early mobilization and prevention of complications. Opioid analgesics have long been recognized as among the most effective treatments for pain. Opioids like fentanyl and sufentanil have been successfully used for post-operative analgesia by epidural route. Aims & Objective: To evaluate the efficacy of Sufentanil and Fentanyl for post-operative analgesia following thoracic and upper abdominal surgeries through epidural route. Materials and Methods: This was a prospective randomized parallel group study of 60 patients. They were divided into two groups randomly, F and SF. They were given fentanyl and sufentanil by epidural route for post-operative pain relief following upper abdominal and Thoracic surgery. Pain was assessed through Visual analogue scale. Pain Relief assessment, Pulse rate, BP, Respiratory rate, SPO2, Sedation Score and complication if any were assessed after administration of drug at 0,2,5,10,30,60,,120, 240 and 300 minutes. Result obtained were statistically analysed using students unpaired t test after calculating mean and standard deviation. Results: Patients in both group were comparable in terms of demography with male predominance, ASA grade and type of surgery performed. Onset of pain relief was 7.22 ± 1.82 minutes with fentanyl while 3.40±0.90 with sufentanil. Peak analgesic effect was achieved at 20.36 ± 3.44 minutes with fentanyl while it was quicker with sufentanil (9.3±2.4). Duration of analgesia was higher in sufentanil group (254.1 ± 53.80) in comparison to fentanyl (185.2 ± 43.33). Conclusion: Sufentanil via epidural route provides early onset, peak effect and longer duration of effective analgesia in comparison to Fentanyl. Use of either drug via epidural route provide safety and better stabilization as far as the hemodynamic and respiratory parameters were concerned. But, Patients with sufentanil remained sedated for longer duration than fentanyl.
RESUMEN
Background: Endotracheal intubation is of paramount importance in general anaesthesia requires relaxation of laryngeal musculature leading to total inactivity of vocal cords. Suxamethonium chloride, a depolarizing muscle relaxant due to its quick onset of action and excellent intubating conditions has remained a muscle relaxant of choice. Rocuronium was proved to be safe alternative to suxamethonium for endotracheal intubation. Aims & Objective: To find out the utility of Inj. Rocuronium Bromide a non-depolarizing muscle relaxant (NDMR) as an alternative to Suxamethonium chloride, a depolarizing muscle relaxant (DMR) for the purpose of intubation of trachea with emphasis on onset of time for muscle relaxation, duration of action, hemodynamic changes and complications if any. Materials and Methods: This is a randomized clinical study carried out at tertiary care center. 90 patients were randomly divided into three groups. Group S60 (n=30) - Inj. Suxamethonium 1.5 mg/kg IV given I.V, Group R60 (n=30) - Inj. Rocuronium 0.6 mg/kg IV given I.V and Group R90 (n=30) - Inj. Rocuronium 0.6 mg/kg IV given I.V. The intubating conditions were judged clinically at fixed time interval i.e. either at 60 seconds or 90 seconds as per the group of patient, after the injection of study drug with the help of four point scale. The observed results were compiled and analyzed statistically by using chi-square test for qualitative data and students “t” test for quantitative data, the analysing system being that of EPI INFO. Results: The mean age was 29.2 ± 12.60, 28.83 ± 8.50 & 30.1 ± 10.47 years, respectively in S60, R60 and R90 group. Intubating conditions were excellent (score 8-9) in all the 30 patients (100%) in Group S60, in 23 patients (76.66%) of Group R60 and in 28 patients (93.33%) of Group R90. The mean onset time in our study were 46.66±5.46 seconds in Group S60, 76.33 ± 10.33 seconds in Group R60 and 78.33 ± 9.4 in R90. The duration of action in our study was 5.93 ± 1.25 minutes in Group S60 compared to 29.83±5.49minutes in Group R60 and 27.83 ± 3.13 minutes in R90. Conclusion: Rocuronium can serve as a good alternative to Suxamethonium for tracheal intubation in conditions where Suxamethonium is contraindicated or where its use is hazardous.