RESUMEN
Background: Pain pathway has profound implications for management of acute pain and provoked interest in the use of pre-emptive analgesia and new methods of postoperative pain management with new agents like opioid and non-opioid drugs either independently or in combination. The objective of the study was to study efficacy of Ketamine Hcl and Tramadol Hcl (preservative free) by epidural route for lower abdominal surgeries.Methods: This study has been conducted on hundred patients in the age group of 20 to 50 years. These patients have undergone various lower abdominal surgeries, gynecological and surgical procedures. Failed epidurals, catheter kinking, catheter migration and dural puncture cases are excluded from the study. The patients were divided into two groups namely Group-A and Group-B, with 50 patients in each group.Results: Both groups were similar in terms of age, sex and weight. In Group-A patients who received 30 mg of Ketamine, the mean time of onset of analgesia being 17.01+2.65 minutes compared to 12.18+2.28 minutes in Group -B patients who received 100 mg of tramadol, In Group-A the mean time of duration of analgesia is 6.75+0.46 hours compared to 9.36+0.84 hours in Group-B. Nausea and vomiting (24% vs. 2%), urinary retention (4% vs. 2%) was more in group B compared to group A patients. Backache was equal in both the group patients (6% vs. 6%). Pain on injection more in group A patients i.e. 8% compared to only 2% in patients who belonged to group B.Conclusions: Epidural tramadol is superior to epidural ketamine for postoperative pain relief.
RESUMEN
Background: Dexmedetomidine is considered as safe adjuvant as it does not cause depression of the respiratory system. Whether it can be used in the dose of 5 mcg or 10 mcg needs evaluation. Objective of the study was to compare two doses of dexmedetomidine on hemodynamic parameters of patients undergoing spinal anesthesia.Methods: Present study was hospital based follow up study. 80 patients were studied who were of age 18-60 years. These patients were operated using spinal anesthesia. History in detail was taken. They were examined thoroughly and investigated. Informed written consent is taken. Two groups were made. One group with 30 patients received dexmedetomidine 5 mcg. Second group with 50 patients received 10 mcg dexmedetomidine.Results: All baseline parameters were similar in two group patients. Heart rate at various intervals was also similar in two groups patients. Systolic blood pressure at various intervals was also similar in two groups patients. Diastolic blood pressure at various intervals was also similar in two groups patients. Highest level of sensory block was also similar in two groups patients. Patients in 5 mcg group had both the sensory and motor block more compared to patients in 10 mcg group. All other parameters were similar in two group of patients.Conclusions: Dexmedetomidine in doses of 5 mcg and 10 mcg has been found to have similar effect on hemodynamic parameters of the patients. So, it can be used in any of these two doses without affecting the hemodynamic parameters.