Evaluation OfAnalgesic Effect of Femoral Nerve Block for Positioning Of Patient For Subarachnoid Block In Patients With Fracture Femur: A Randomized, Double Blind, Parallel Group, Comparative Study Between Ropivacaine And Bupivacaine.

Background: Ropivacaine is recently introduced in Indian market, need to evaluate further for its clinical profile. We evaluated the analgesic effect of Ropivacaine in comparision with Bupivacaine in femoral nerve block (FNB) for positioning of patient for subarachnoid block in patients with fracture femur. Method: Hundred patients of either sex, aged 18-80 years, American Society of Anaesthesiologist physical status I–III having femur fracture scheduled for surgery under subarachnoid block. The patients were randomly allocated into two groups of 50 patients each. Group R received Ropivacaine and Group B received Bupivacaine (20 ml, 0.5 %) in FNB guided by peripheral nerve locator. Patients were observed for onset and peak effect of sensory and analgesia, hemodynamic profile and complications if any. Results: The mean time for onset of sensory block and analgesia were comparable in both the groups (p>0.05). The peak of sensory block and subjective analgesia achieved earlier in group R (p<0.001), but objective analgesia score was comparable in both the groups (p > 0.05). Haemodynamics remain stable and no complications were noted except vascular puncture. Conclusion: We conclude that FNB provides effective analgesia in patients with fracture femur for positioning of patient before subarachnoid block. We recommend the use of Ropivacaine as safer alternative to Bupivacaine in femoral nerve block, especially in compromised cardiovascular patients.

Oily fraction of Semecarpus anacardium Linn nuts involves protein kinase C activation for its pro-inflammatory response.

The oily fraction (non polar fraction-NPF) of S. anacardium (SA) significantly increased the expression of protein kinase C-δ (PKC-δ) in macrophages in concentration dependent manner, which was similar to phorbol myristate acetate (PMA) response. Further, H-7 (1-(5-isoquinolinesulphonyl)-2-methylpiperazine), an inhibitor of PKC significantly inhibited this NPF mediated response in a concentration dependent manner. In the post treatment kinetics, H-7 showed this inhibition only up to 6 min post NPF/PMA addition, but in similar condition, quercetin, a flavone with reported antioxidant property, showed this inhibition only up to 2 min. The results clearly suggest that oily fraction of SA nuts enhances the expression of PKC protein, which may be responsible for its reported pro-inflammatory property.