effect of dopamine pre-treatment on intubating conditions and haemodynamics during rapid tracheal intubation using propofol and rocuronium

To assess intubating conditions and haemodynamic changes in patients pre-treated with dopamine during rapid tracheal intubation using rocuronium and propofol. Forty adult patients of ASA I and II, aged 20-60 years, scheduled for elective as well as emergency surgery, were included in this prospective randomized open label group double blind study. In Group A patients injection dopamine infusion 3 micro g/Kg/min and in Group B patients an equal volume of normal saline was infused over 15 minutes before administering general anesthesia using propofol 2 mg/Kg and rocuronium 0.6 mg/Kg. Laryngoscopy and tracheal intubation was attempted at 60 seconds, whereby anaesthesiologist assessed the intubating conditions. Duration of laryngoscopy, Train of four ratio [TOF ratio] at 60 sec after rocuronium administration, time from disappearance of all four twitches on TOF count, intubation score at 60 seconds were recorded. Mean arterial pressure, pulse rate and oxygen saturation were recorded at different time points. Intubating conditions at 60 seconds were significantly better in Group A than in Group B patients. Haemodynamic parameters were not significantly altered in Group A. Time taken for intubation was significantly lower in Group A than in Group B. Dopamine pretreatment improves intubating conditions after rocuronium injection without significantly altering haemodynamic parameters

Comparative study of analgesic efficacy of ropivacaine with ropivacaine plus dexmedetomidine for paravertebral block in unilateral renal surgery

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