Paravertebral nerve block vs general anaesthesia in cancer breast surgery

The aim of this study to evaluate the effect of thoracic paravertebral nerves block[PVB] as an alternative for general anaesthesia [GA] in cancer breast surgery on haemodynamic, stress responses, pulmonary function tests[PFT] and postoperative pain relief. Fifty patients undergoing for elective simple mastectomy and clearance of axilla allocated for 2 groups. Group 1 [GAG] and group II [PVB]. All patient premedicated by fentanyl 1micro g/kg and 40 micro g midazolam. Group 1 [GAG] received general anaesthesia by propofol 2 mg/kg and 80 mirco g / kg vecuronium and anaesthesia was maintained by gas, oxygen and isoflurane. In PVB group single injection of 0.3 mg/kg bupivacain 0.5% at T4 spine and the patients were sedated by propofol infusion. PVB decreased HR, MABP, blood glucose and plasma cortisol significantly when compared with GAG and significantly improved pulmonary functions tests [FVC and FEVI]. PVB produced significant increase in duration of analgesia and decreased visual analogue scale scores [VAS] when compared with GA. PVB with bupivacain 0.5% at T4 in conjunction with intraoperative sedation was safe and effective for surgical anaesthesia in patient undergoing major breast surgery and attenuated the stress response to surgery and provided complete pain relief postoperative

comparison of clonidine, tramadol and meperidine in post epidural anaesthetic shivering in parturients

This study was performed to compare the antishivering effects and accompanying side effects among clonidine, tramadol and meperidine in parturients. Sixty parturients who shivered during casarean delivery under epidural anaesthesia and requested to one of three groups for IV treatment group C [n=20] received clonidine 3 mirco g/kg Group T [n=20] received tramadol 0.5 mg /kg. and group M [n=20] received meperidine 0.5 mg /kg. the response rate[shivering ceased after treatment was 85%, 90% and 95% for groups C, T and M respectively. The time that elapsed from treatment to the time shivering ceased was 5.2 +/- 2.6 min, 4.1 +/- 1.6 min and 3.8 +/- 3.2 min for groups C, T and M respectively, no significant differences were shown for pruritus, nausea, vomiting or Apgar scores of new borns. We concluded that both tramadol and meperidine show faster response rate in the treatment of post epidural anaesthetic shivering when compared with clonidine