Comparison of the effects of propofol versus sevoflurane on the systemic inflammatory response to surgery

The present study was constructed to compare between the effects of Sevoflurane and Propofol on the inflammatory response to major and minor surgeries by measuring the levels of interleukine-6, interleukine-10 and cortisol pre-operatively, 4 hours and 24 hours post-operative. The study was performed on 40 patients, aged 20-40 years, ASA physical status I, II and were randomly allocated into 4 groups; 10 patients each: Group I Sevoflurane group undergoing major abdominal surgery. Group II: Propofol group undergoing major abdominal surgery. Group III Sevoflurane group undergoing minor abdominal surgery. Group IV: Propofol group undergoing minor abdominal surgery. Statistical analysis was done and we found that interleukin-6 [pro-inflammatory cytokine] levels increased postoperatively in all groups but with higher levels in Sevoflurane groups more than Propofol groups, and in major groups than the minor groups. Interleukin-10 [anti-inflammatory cytokine] increased slightly in propofol groups more in major group and was higher in Sevoflurane groups especially after 24 hours post-operatively, more in major group. Also noticed a correlation between cortisol levels with interleukin-6 levels, this means increase more in major surgery than minor surgery groups and with higher levels in Sevoflurane groups than Propofol groups which showed slight increase in cortisol levels. It was obvious in this study that the Propofol had the least effect on inflammatory response to surgical operations than the Sevoflurane whether on major or minor surgical operations

comparison of equipotent low concentrations of epidural bupivacaine or ropivacaine with sufentanil for labor analgesia

In a double-blind study, we compared the effects of epidural bupivacaine 0.06% and ropivacaine 0.1% with sufentanil for analgesia during labor. One hundred parturients were randomly assigned to receive epidural analgesia using intermittent bolus doses of 10 ml of either 0.06% bupivacaine with 10 micro g sufentanil [n = 50] or 0.1% ropivacaine with 10 micro g sufentanil [n = 50]. Pain score, modified Bromage score for motor block, onset, duration and quality of analgesia, total analgesic doses, duration of first and second stages of labor, mode of delivery, umbilical cord pH, Apgar scores of the newborn were recorded. Also, oxygen saturation, blood pressure, heart rate and any side effects were recorded. Pain relief started after 10 min, and continued for approximately 100 min in both groups. The percentage of women who had adequate analgesia during first and second stages of labor were 98, 92% in bupivacaine group and 94, 88% in ropivacaine group, respectively [p > 0.05]. Full range of motion was present in 86% of women in bupivacaine group and 90% in ropivacaine group [p > 0.05]. The incidence of instrumental deliveries was only 20% in bupivacaine group and 16% in ropivacaine group [p> 0.05]. Side effects were not troublesome and there was no detrimental effect on the mothers or their babies. Epidural administration of equipotent concentrations of bupivacaine 0.06% or ropivacaine 0.1% combined with 10 micro g sufentanil produces an adequate analgesia for labor without jeopardizing the safety of the mothers or the r babies. Analgesia produced by this mixtures, is associated with minimal motor blockade, normal duration of labor, low incidence of instrumental deliveries and minor side effects

Comparative study between epidural clonidine and neostigmine in extended post - operative analgnsia

This study was carried out to compare the postoperative analgesic effects of the addition of both of epidural clonidine and neostigmine to bupivacaine. Sixty parturients [20 in each group] with ASA I and II physical status were studied. All patients were scheduled for classical vaginal repair under epidural bupivacaine anesthesia. The subjects were divided into three groups: Group I [control group] was given bupivacaine 0.5% in a dose of 1-1.5 ml/segment to be blocked, group II received bupivacaine in the same volume and concentration [2 mug/kg of neostigmine was added] and group III received bupivacaine in the same volume and concentration [75 mug clonidine was added]. The results showed a faster onset of analgesia in group III and the duration was longer in group II than the control group. However, women in neostigmine group [group II] had a higher incidence of nausea and vomiting and they required more frequent anti-emetic medication

Two doses of midazolam and standard bupivacaine for the assessment of post-operative analgesic effect of intrathecal midazolam

Postoperative pain relief is a concern to an anaesthesiologest and intrathecal block is one of the effective means providing that especially in caesarean section. This study was performed to evaluate the postoperative analgesic effects of intrathecal midazolam with bupivacaine and was carried out on 60 women with ASA I or II physical status, and undergoing elective caesarean section. they were randomly allocated into three groups [20 in each]: the control group [group I] received 2m1 of 0.5% hyperbaric bupivacaine in 2m1 saline, and group [II] received 2m1 of 0.5% hyperbaric bupivacaine plus 1mg midazolam, and group [III] received 2ml of 0.5% hyperbaric bupivacaine plus 2mg midazolam. Respiratory rate and hemodynamic changes [Heart rate and blood pressure] were stabe in all groups. The duration of postoperative analgesia and the time of the first analgesic requirement were proportional to the dose of midazolam reaching up 15 hours in some patients in group III. Apgar score at 1 and 5 minutes was reported for all babies after delivery. We concluded that intrathecal midazolame, bupivacaine induced significant prolonged postoperative analgesia than bupivacaine alone with better outcome for both mother and baby, and no adverse hemodynamic or respiratory effects