RESUMO
A double blind, prospective, randomized placebo controlled study was carried out to evaluate the antiemetic efficacy of Gabapentin on incidence and severity of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy under general anaesthesia. One hundred patients of ASA grade I & II randomly assigned equally in two groups were given 600mg of gabapentin or matching placebo orally two hours before surgery. A complete response (no nausea and vomiting) was observed in 60% patients in gabapentin group as compared to 38.2% in Placebo group. The difference was statiscally significant (P = 0.028). In addition use of rescue antiemetics was reduced in gabapentin group to 34% (17 patients) compared to placebo group 54% (27 patients) with a statistically significant difference ( P = 0.044). However, there was no difference of severity of PONV amongst two groups; 1st, 2nd, 6th, 12th and 24th. hour of surgery. The study reveals that gabapentin, an anticonvulsant and analgesic may prove to be multimodal when further research is conducted to prove its efficacy as antiemetic.
RESUMO
A study of single space combined spinal epidural (CSE) block was carried out in 30 patients for lower extremity orthopaedic surgery. Hyperbaric bupivacaine (0.5%) was used for subarachanoid block and (0.25%) isobaric bupivacaine was given through epidural catheter for “top-up” doses to facilitate surgery and for postoperative analgesia. Operative conditions were described as excellent in 73.33% patients, good in 23.33% patients and fair 3.33%) patients. Similarly post operative analgesia was excellent in 70%, good in 26.66% and fair in 3.33% cases. Intra operative complications like hypotension < 80mm Hg occurred in 3.33% patients and < 90 mmHg in 10% patients. No post spinal headache or neurological complications were seen. CSE anaesthesia appears to combine the reliability of spinal and the flexibility of epidural block while their drawbacks are minimized.