Analgesic effect of continuous adductor canal block versus continuous femoral nerve block for knee arthroscopic surgery: a randomized trial

Abstract Background and objectives Anterior cruciate ligament reconstruction (ACLR) is one of the most frequently performed orthopedic procedures. The ability to perform ACLR on an outpatient basis is largely dependent on an effective analgesic regimen. The aim of the study was to compare the analgesic effect between continuous adductor canal block (cACB) and femoral nerve block (cFNB) during arthroscopy guided ACLR. Method In this prospective, randomized, controlled clinical trial, 60 ASA I/II patients for arthroscopic ACLR were recruited. Patients in Group I received cACB and those in Group II cFNB. A bolus dose of 20 cc 0.5% levobupivacaine followed by 0.125% 5 mL.h-1 was started for 24 hours. Rescue analgesia in the form of paracetamol 1 g intravenous (IV) was given. Parameters assessed were time of first rescue analgesia, total analgesic requirement in 24 hours, and painless range of motion of the knee (15 degrees of flexion to further painless flexion). Results The time-to-first postoperative analgesic request (hours) was earlier in Group II (14.40 ± 4.32) than Group I (16.90 ± 3.37) and this difference was statistically significant (p< 0.05). The cumulative 24-h analgesic consumption (paracetamol in g) was 0.70 ± 0.47 in Group I and 1.70 ± 0.65 in Group II (p< 0.001). The painless range of motion (degree) was 55.67 ± 10.40 in Group I and 40.00 ± 11.37 in Group II (p< 0.001). Conclusion The findings of this study suggest that continuous adductor canal block provides superior analgesia in patients undergoing arthroscopic ACLR when compared to continuous femoral nerve block.

Paediatric Mandible Fracture-Various Treatment Modalities – A Report of Case Series

Paediatric mandible fracture is one of the most challenging scenario in maxillofacial trauma to manage. Strategy for management of paediatric mandible fracture must include factors like age, anatomy, stage of dental de-velopment, fracture site and child ability to cooperate with the proposed treatment plan. The main objective be-hind the treatment of these fractures to restore underlying bony architecture to pre-traumatic state as conserva-tively as possible with minimal functional impairment. Therefore, choice of treatment option depends on vari-ous factors. In the present article we have tried to summarise different approaches towards the management of paediatric mandible fracture by presenting different cases of paediatric trauma.

A Comparative Study Of Heart Rate Variability In Middle Aged Obese Male And Non Obese Male

Objectives: Obesity is on the rise in our country once viewed as a sign of prosperity it is a contributing factor to diseases. The purpose of this study is to see whether obesity has an effect on the heart rate of the subject by comparing and possibly contrasting the heart rate variability in obese and non-obese males.Materials and methods: Out of 100 participants, 50 healthy male obese (BMI >25kg/m2) individuals and 50 healthy male non-obese individuals (BMI <25kg/m2) of age group 35yrs-55yrs were taken from the general population. The ECG was recorded and HRV were derived from it. Results were compared by using independent ‘t’ test and Pearson’s correlation test was done for BMI and HRV. P < 0.05 was considered as significant.Results: HRV parameters and heart rate between the two groups LF, HF and HFnu, was found to be significantly reduced and LFnu and LF/HF was found to be significantly higher in obese persons. The correlation of BMI with the parameters such as ratio of LF/HF, normalised units of LF and HF revealed a significantly negative relation with HFnu. A positive relationship was also observed between LFnu and LF/HF ratio. However, it was statistically not significant.Conclusion: The middle aged obese males had reduced parasympathetic activity associated with elevated sympathovagal modulation. This altered balance of the autonomic nervous system increases the risk of cardiovascular disorders.