Effect of Gelfoam Soaked Epidural Dexmedetomidine or Bupivacaine for Postoperative Analgesia in Lumbar Laminectomy: A Prospective Randomized Clinical Study.

BACKGROUND AND AIMS: Postoperative pain is spine surgery can last for an average of two to three days. Epidural catheter management are difficult in spine surgery for postoperative pain. Still, there have been not much studies on epidural administered gelfoam soaked dexmedetomidine or bupivacaine, to enhance postoperative analgesia. METHODS: Ninety six adult patients were randomized into three groups. Gelfoam soaked in 0.1 mg dexmedetomidine (0.02 mg. mL-1) in group D, 0.25% isobaric bupivacaine (5 mL) in group B and gelfoam soaked in 0.9% normal saline (5 mL) in group C. The Primary outcome was to compare the total amount of rescue analgesic consumption till 48 hours. The Secondary outcome was to compare time to first dose of rescue analgesia (duration of analgesia), the visual analogue scale and side effects up to 48 hours. Chi-square test, independent t test and analysis of variance test were used, and P < 0.05 was considered significant. RESULTS: Ninety patients completed the study. Total dose of rescue analgesic consumed in 48 hours was significantly higher in control group (paracetamol 4.17 ± 0.75 gm with tramadol 205 ± 37.94 mg). Bupivacaine soaked gelfoam group (paracetamol 3.04±0.71 gm with tramadol 151.85 ± 35.31 mg) had more rescue analgesic consumption than dexmedetomidine soaked gelfoam group (paracetamol 1.72 ± 0.57 gm with tramadol 86.11 ± 28.73 mg). Time for first rescue analgesic requirement with dexmedetomidine soaked gelfoam group was significantly longer (14.67 ± 7.76 hours) than in bupivacaine soaked gelfoam group (11.33 ± 6.08 hours) and control group (6.40 ± 2.77 hours). Postoperative mean VAS scores were lower in group D and group B compared with group C along with no significant adverse effects. CONCLUSION: Patients undergoing lumbar laminectomy with gelfoam soaked epidural dexmedetomidine or bupivacaine decreases rescue analgesic consumption, prolongs the duration of analgesia and decreases mean VAS score postoperatively.

Fluorescence Spectral Properties of Methyl Orange in Homogeneous Media.

The methyl orange [C14H14N3SO3Na], an azo dye exhibited strong emission and large Stokes shift in various solvents, and the largest shift (Δλ = 125.51nm or Δν = 9297cm-1) was obtained in the water. The UV-visible spectra of the dye showed the absorption in the range (33,333 - 20,000) cm-1. We found that solvent effects on the absorption wavelength are consistent. The bathochromic shift in water and the hypsochromic shift in methanol observed in the absorption (43 nm) as well as in the fluorescence (42 nm) spectra predict the strong solute-solvent interaction. The fluorescence quantum yield (ɸf) was decreased from 24% in DMSO to 5% in water. The fluorescent properties of this dye are strongly solvent dependent, the wavelength of minimum fluorescence emission (λem = 435.51nm) shifts to the red. The maximum and minimum calculated oscillator strength is 32% with (Ɛmax = 29011 M-1cm-1) and 11% (Ɛmax = 6682 M-1cm-1) in methanol and DMSO, respectively. Protonated solvents without exception give a shorter lifetime and lower quantum yield. The average excited-state lifetime of the dye was found maximum (τav = 5.36 ns) in DMSO. Also, fluorescence lifetime was combined to deduce the radiative and non-radiative decay rate.

Effect of Minimally Invasive Pain Intervention in Frozen Shoulder Patients: A Cross-Sectional Study.

BACKGROUND: Adhesive capsulitis or frozen shoulder (FS) is the second most common disorder accounts for 15%-30% shoulder pain and functional disability. Suprascapular nerve (SSN) interventions with corticosteroid alone have shown limited duration efficacy, adding pulsed radiofrequency (PRF) provides long-term relief. AIMS AND OBJECTIVE: We aimed to analyze the efficacy of SSN intervention on pain relief and range of mobility in patients with FS. SETTINGS AND DESIGN: This is a cross-sectional study of 37 patients of FS who underwent SSN interventions in a dedicated pain medicine unit of the department of anesthesiology. MATERIALS AND METHODS: Thirty-seven patients, who underwent SSN interventions for FS and followed for 6 months, were included in this study. Pain (Visual Analog Scale [VAS]), range of motion (ROM) (17), and Oxford 12 point Shoulder Score (OSS) for functional outcomes were recorded. In the final analysis, two subsets of patients who underwent SSN steroid injection or SSN PRF plus steroid were found and compared using Student's t-test paired and independent with P < 0.05 considered significant at 95% confidence interval. RESULTS: The patient population was demographically comparable. Mean VAS score and ROM improved at 1, 3, and 6 months to statistically significant. On comparing the subgroups, the VAS score and OSS in both the SI and PRF groups were significantly improved, but the PRF group showed highly significant improvement, showing better and sustained improvement in the PRF group. CONCLUSION: PRF with steroid injection of the SSN provides better and long-lasting relief from pain and improved mobility in FS patients in comparison to steroid alone.