Résumé
Aim: To compare the cacy of paravertebral block with ropivacaine or ropivacaine plus dexmedetomidine for relief of post operative pain in patients undergoing unilateral renal surgeries
Methodology: Sixty adult patients of ASA I and II, undergoing unilateral renal surgery, were included in this prospective, randomized study
After placing the catheter in T12-L1 paravertebral space, block was randomly activated either by 18 ml of ropivacaine 0.25% [Group I] or by 18 ml of ropivacaine 0.25% plus 1microg/kg dexmedetomedine [Group II]. General anaesthesia was instituted in all patients using a standardised technique. After recovery from GA, pain was assessed by VAS
The patients were administered rst top up dose through paravertebral route as soon as VAS score exceeded 3 and time was noted duration of analgesia. Total requirement of ropivacaine in 24 hours was also noted
Result: Mean duration of analgesia was longer in Group II [324.4+/-56.35 min] as compared to Group I [149.2 +/-30.64 min] [p<0.05]. Mean total consumption of ropivacaine was 84+/-14.12 mg in Group II and 120+/-15.26 mg in Group I [p< 0.05]
Conclusion: Addition of dexmedetomidine to local anaesthetic agent ropivacaine signi! cantly prolongs the duration of analgesia in paravertebral blocks
Résumé
Renal cell carcinoma [RCC] constitutes 2-3% of all adult malignancies and often diagnosed incidentally. Classical tried of RCC now rarely seen, it behaves unpredictably and having diverge range of clinical manifestation including paraneoplastic syndromes. Upper gastrointestinal [GI] bleeding due to stomach metastasis of RCC is uncommon and to the best of our knowledge, only few cases are reported in world literature and most of them were diagnosed during follow-up after complete treatment of RCC but in our case, it was the primary manifestation of disease. Our case also demonstrates the importance of imaging in undiagnosed cases of upper GI bleeding