Pain relief in day care arthroscopic knee surgery: a comparison between intra-articular ropivacaine and levobupivacaine: a prospective, doubleblinded, randomized controlled study

Post-operative pain frequently hampers implementation of day care arthroscopic knee surgery in spite of so many analgesic, local anesthetic drugs and routes of administration. The aim of the present study was carried out to compare the efficacy of ropivacaine and levobupivacaine when administered through intra-articular route in controlling pain after day care arthroscopic knee surgery. It was a prospective, double-blinded and randomized controlled study. April 2008-December 2008, 60 patients of both sex, of American Society of Anesthesiologists physical status I and II, undergoing day care arthroscopic knee surgery were randomly assigned into two groups [R, L]. Group R received 10 ml of 0.75% ropivacaine, whereas group L received 10 ml of 0.50% levobupivacaine through intra-articular route at the end of the procedure. Pain assessed using visual analog scale [VAS] and diclofenac sodium given as rescue analgesia when VAS >3. Time of first analgesic request and total rescue analgesic were calculated. Based on comparable demographic profiles; time for the requirement of first post-operative rescue analgesia [242.16 +/- 23.86 vs. 366.62 +/- 24.42] min and total mean rescue analgesic requirement was [104.35 +/- 18.96 vs. 76.82 +/- 14.28] mg in group R and L respectively. Group R had higher mean VAS score throughout the study period. No side effects found among the groups. These two results were clinically and statistically significant [P < 0.05]. Hence, it was evident that intra-articular levobupivacaine give better post-operative pain relief, with an increase in time of first analgesic request and decreased need of total post-operative analgesia compared with ropivacaine

PONV in ambulatory surgery: a comparison between ramosetron and ondansetron: a prospective, double-blinded, and randomized controlled study

Postoperative nausea and vomiting [PONV] frequently hampers implementation of ambulatory surgery in spite of so many antiemetic drugs and regimens. the study was carried out to compare the efficacy of Ramosetron and Ondansetron in preventing PONV after ambulatory surgery. It was a prospective, double blinded, and randomized controlled study. 124 adult patients of either sex, aged 25-55, of ASA physical status I and II, scheduled for day care surgery, were randomly allocated into Group A [[n=62] receiving [IV] Ondansetron [4 mg]] and Group B [[n=62] receiving IV Ramosetron [0.3 mg]] prior to the induction of general anesthesia in a double-blind manner. Episodes of PONV were noted at 0.5, 1, 2, 4 h, 6, 12, and 18 h postoperatively. Statistically significant difference between Groups A and B [P <0.05] was found showing that Ramosetron was superior to Ondansetron as antiemetic both regarding frequency and severity. it was evident that preoperative prophylactic administration of single dose IV Ramosetron [0.3 mg] has better efficacy than single dose IV Ondansetron [4 mg] in reducing the episodes of PONV over 18 h postoperatively in patients undergoing day-care surgery under general anesthesia

Pain relief after arthroscopic knee surgery: a comparison of intra-articular ropivacaine, fentanyl, and dexmedetomidine: a prospective, double-blinded, randomized controlled study

Postoperative pain is very common distressing symptom after any surgical procedure. Different drugs in different routes have been used for controlling post-arthroscopic pain. No one proved to be ideal. We have compared the analgesic effect of ropivacaine, fentanyl, and dexmedetomidine when administered through the intra-articular route in arthroscopic knee surgery. From March 2008 to July 2010, 99 patients undergoing arthroscopic knee surgery were randomly assigned into three groups [A,B,C] in a prospective double-blinded fashion. Group A received 10 ml of 0.75% ropivacaine, where Group B received 50 microg fentanyl, and Group C received 100 microg of dexmedetomidine through the intra-articular route at the end of procedure. Pain assessed using visual analog scale and diclofenac sodium given as rescue analgesia when VAS >4. Time of first analgesia request and total rescue analgesic used in 24 hours were calculated. Demographic profiles are quite comparable among the groups. Time for requirement of first postoperative rescue analgesia in Group A was 380.61 +/- 22.973 min, in Group B was 326.82 +/- 17.131 min and in Group C was 244.09 +/- 20.096 minutes. Total rescue analgesia requirement was less in Group A [1.394 +/- 0.496] compared to Group B [1.758 +/- 0.435] and Group C [2.546 +/- 0.546]. Group A had higher mean VAS score at 6th and 24th postoperative hours. No side effects found among the groups. Therefore, it suggests that intra-articular ropivacaine gives better postoperative pain relief, with increased time of first analgesic request and decreased need of total postoperative analgesia compared to fentanyl and dexmedetomidine.

Changing trend of cervical spine injury deaths: an autopsy based study in eastern India

Cervical spinal injury by virtue of its fatal nature creates psycho-socio-economic impact on our society. Most related studies are clinical; none readily address the changing pattern of death due to cervical spinal injury cases. The autopsy data-based study merits special attention by representing the particular group of the cervical spinal injury cases who due to presence of some direct or indirect factor[s] succumbed to injury; hence identifies those particular risk factors related to death. We therefore tried to have the changing trend of death due to cervical spinal injury cases from a different perspective to identify the changing trend of death due to the cervical spinal cord injury over last the 11 years and to identify the risk factors in the modern era. All the 19742 autopsy reports from the year 2000-2010 in the Department Forensic and State Medicine of a suburban medical college in eastern India were searched for cases of death due to cervical spinal injury. All the available data were taken from the selected 536 cases and they were analyzed in SPSS [version 16.0] for assessing the changing pattern of injury and related factors during this period of time. The significant variables found were increased proportion of deaths aged between 15-30 years [p=0.003], increased number of female victims [p=0.000], increased cases in winter season [p=0.003], increased accidents in earlier hours of the day [p=0.003], increased number of cases admitted before death [p=0.000], increased proportion of injury on Friday and Saturday [p=0.021] There are significant changing trends in death due to cervical spinal injury cases. Until similar data from other sources are available these may be taken as avoidable changing trend factors to avert the risk of death due to cervical spinal injury worldwide