Background: Use of thoracic epidurals for intra‑ and post‑operative analgesia for open abdominal surgeries has exponentially increased over the last decade. Spinal anaesthesia is used a landmark – guided midline approach, in these absent, indistinct or distorted in the presence of obesity, previous spinal surgeries, deformities, or degenerative changes associated with ageing. In the present study evaluates the efficacy of real‑time ultrasound (RUS)‑guided paramedian approach, and pre‑procedure ultrasound (PUS) landmark‑guided paramedian approach in obese persons. Methods: This is a Prospective Randomized Double-Blind Study conducted in Akash Institute of Medical Sciences and Research centre. Total 50 subjects (Group A – 25, Group A – 25). All the subjects included after informed consent, Along with Chest X- ray and ECG-for patients over 40 years of age. The primary end point was to attain a successful lumbar puncture. Variables like the number of attempts, the number of passes, the time taken for identifying landmark(s), and time for a successful lumbar puncture(s) were secondary end points and were recorded in both the groups. Results: This study was evaluated In real‑time ultrasound (RUS)‑guided paramedian approach, and pre‑procedure ultrasound (PUS) landmark‑guided paramedian approach in obese patients. There is a statistically high significant difference in PUS group than RUS Group. A P value < 0.002 is the statistically in between 2 groups. Conclusion: the space identification and number of attempts, passes and time consuming in pre procedure ultrasound when compared to real time ultrasound. This study suggest real time ultrasound is good for identification of space.
{"title":"A study of comparison between pre procedural ultrasound and real time ultrasound for spinal spaces","authors":"C RaghuK","doi":"10.26611/10151921","DOIUrl":"https://doi.org/10.26611/10151921","url":null,"abstract":"Background: Use of thoracic epidurals for intra‑ and post‑operative analgesia for open abdominal surgeries has exponentially increased over the last decade. Spinal anaesthesia is used a landmark – guided midline approach, in these absent, indistinct or distorted in the presence of obesity, previous spinal surgeries, deformities, or degenerative changes associated with ageing. In the present study evaluates the efficacy of real‑time ultrasound (RUS)‑guided paramedian approach, and pre‑procedure ultrasound (PUS) landmark‑guided paramedian approach in obese persons. Methods: This is a Prospective Randomized Double-Blind Study conducted in Akash Institute of Medical Sciences and Research centre. Total 50 subjects (Group A – 25, Group A – 25). All the subjects included after informed consent, Along with Chest X- ray and ECG-for patients over 40 years of age. The primary end point was to attain a successful lumbar puncture. Variables like the number of attempts, the number of passes, the time taken for identifying landmark(s), and time for a successful lumbar puncture(s) were secondary end points and were recorded in both the groups. Results: This study was evaluated In real‑time ultrasound (RUS)‑guided paramedian approach, and pre‑procedure ultrasound (PUS) landmark‑guided paramedian approach in obese patients. There is a statistically high significant difference in PUS group than RUS Group. A P value < 0.002 is the statistically in between 2 groups. Conclusion: the space identification and number of attempts, passes and time consuming in pre procedure ultrasound when compared to real time ultrasound. This study suggest real time ultrasound is good for identification of space.","PeriodicalId":18595,"journal":{"name":"MedPulse International Journal of Anesthesiology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90442640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Pre emptive analgesia is multimodal approach where drug is used before surgery and has potential to be more effective than a similar analgesic treatment initiated after surgery. Pregabaline and Gabapentin are GABA analogue used is used as pre-emptive analgesic. Its analgesic action is mediated through α2δ subunit of voltage gated calcium channels on dorsal horn neurons. Material and Method:96 patients satisfying selection criteria were enrolled for this study and divided in to three groups Group P, Group G and Group C each having 32 patients. All patients were explained about visual analogue score. Result: There is significant difference between three groups regarding time of first rescue analgesia and tramadol consumption. The mean time for rescue analgesia was longer in pregabaline group then gabapentin group (482.7±113.5 min vs 343.35±70.74 min). The mean amount of dose of tramadol requirement was also less in pregabaline and gabapentin group (164.32±39.41 vs178.32±48.21 vs 272.82±83.01) in comparison control. Conclusion: The VAS score was significantly higher in control then pregabaline and gabapentin group. Both pregabaline (group P) and gabapentin (group G) are comparable to each other regarding VAS score at different time interval in post operative period. Ramsay sedation score was significantly higher in pregabaline and gabapentin group up 4 hour post operatively but after that there was no significant difference between two groups. Both pregabaline (group P) and gabapentin (group G) are comparable to each other regarding Ramsay sedation score at different time interval in post operative period.
背景:先发制人的镇痛是一种多模式的方法，在手术前使用药物，可能比手术后开始的类似镇痛治疗更有效。普瑞巴林和加巴喷丁是GABA类似物，被用作先发制人的镇痛药。其镇痛作用是通过背角神经元电压门控钙通道α2δ亚基介导的。材料与方法:入选96例符合入选标准的患者，分为P组、G组和C组，每组32例。对所有患者进行视觉模拟评分。结果:三组患者首次抢救镇痛时间及曲马多用量差异有统计学意义。普瑞巴林组抢救镇痛的平均时间较加巴喷丁组长(482.7±113.5 min vs 343.35±70.74 min)。普瑞巴林加巴喷丁组曲马多的平均需药量(164.32±39.41 vs178.32±48.21 vs 272.82±83.01)也低于对照组。结论:对照组VAS评分明显高于普瑞巴林加巴喷丁组。普瑞巴林(P组)和加巴喷丁(G组)术后不同时间间隔的VAS评分具有可比性。普瑞巴林组和加巴喷丁组术后4 h Ramsay镇静评分显著高于对照组，术后无显著差异。P组普瑞巴林与G组加巴喷丁在术后不同时间间隔的Ramsay镇静评分具有可比性。
{"title":"A prospective comparative evaluation of gabapentin vs pregabaline for the acute post-operative pain management in lower limb surgeries under spinal anaesthesia","authors":"S. Ramakrishna, C. Agarwal","doi":"10.26611/10151911","DOIUrl":"https://doi.org/10.26611/10151911","url":null,"abstract":"Background: Pre emptive analgesia is multimodal approach where drug is used before surgery and has potential to be more effective than a similar analgesic treatment initiated after surgery. Pregabaline and Gabapentin are GABA analogue used is used as pre-emptive analgesic. Its analgesic action is mediated through α2δ subunit of voltage gated calcium channels on dorsal horn neurons. Material and Method:96 patients satisfying selection criteria were enrolled for this study and divided in to three groups Group P, Group G and Group C each having 32 patients. All patients were explained about visual analogue score. Result: There is significant difference between three groups regarding time of first rescue analgesia and tramadol consumption. The mean time for rescue analgesia was longer in pregabaline group then gabapentin group (482.7±113.5 min vs 343.35±70.74 min). The mean amount of dose of tramadol requirement was also less in pregabaline and gabapentin group (164.32±39.41 vs178.32±48.21 vs 272.82±83.01) in comparison control. Conclusion: The VAS score was significantly higher in control then pregabaline and gabapentin group. Both pregabaline (group P) and gabapentin (group G) are comparable to each other regarding VAS score at different time interval in post operative period. Ramsay sedation score was significantly higher in pregabaline and gabapentin group up 4 hour post operatively but after that there was no significant difference between two groups. Both pregabaline (group P) and gabapentin (group G) are comparable to each other regarding Ramsay sedation score at different time interval in post operative period.","PeriodicalId":18595,"journal":{"name":"MedPulse International Journal of Anesthesiology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87829550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Ankylosing spondylytes is a chronic inflammatory disorder characterized by inflammation in spines and spinal arthritis with a complex polygenic aetiology. The disease is more common in young males and risk factors include both genetic and environmental. Anesthesia management for ankylosing spondylitis is a challenge due to management of difficult airway, respiratory and cardiovascular complications, as well as the medications for disease and pain control. Both airway management and neuraxial access may prove to be difficult. Awake fibreoptic intubation is the safest option (²) in these patients with a potentially difficult airway as it allows continuous neurological monitoring while achieving a difficult airway. Methods: This is a Prospective Randomized Double-Blind Study conducted in Sri Sathya Sai Institute of Higher Medical Sciences; Total 70 Patients (Group A – 35, Group A – 35). All the subjects included after informed consent, blood samples and urine samples are collected from the all the subjects. Hb, RBCs, WBCs and Platelets was measured by laboratory standard methods. Along with Chest X- ray and ECG-for patients over 40 years of age. Results: This study was evaluated that in ankylosing spondylitis cases most of the physicians prefer to give general anaesthesia because to prevent trauma to the spinal cord but in these cases spine and surrounding tissues also it will involve at that time for maintain airway to the patient is challenge to the physicians by using fibreoptic intubation is good way to approach and maintain airway to the ankylosing patients. Conclusion: In this study suggest that in ankylosing spondylitis patients during surgery in place of tracheal intubation fibreoptic intubation is the best way to maintain airway to the patients and also we can prevent spinal cord damage.
{"title":"Fibreoptic intubation in ankylosing spondylitis patients","authors":"C RaghuK, R. Nagesh, K ViswashG","doi":"10.26611/10151914","DOIUrl":"https://doi.org/10.26611/10151914","url":null,"abstract":"Background: Ankylosing spondylytes is a chronic inflammatory disorder characterized by inflammation in spines and spinal arthritis with a complex polygenic aetiology. The disease is more common in young males and risk factors include both genetic and environmental. Anesthesia management for ankylosing spondylitis is a challenge due to management of difficult airway, respiratory and cardiovascular complications, as well as the medications for disease and pain control. Both airway management and neuraxial access may prove to be difficult. Awake fibreoptic intubation is the safest option (²) in these patients with a potentially difficult airway as it allows continuous neurological monitoring while achieving a difficult airway. Methods: This is a Prospective Randomized Double-Blind Study conducted in Sri Sathya Sai Institute of Higher Medical Sciences; Total 70 Patients (Group A – 35, Group A – 35). All the subjects included after informed consent, blood samples and urine samples are collected from the all the subjects. Hb, RBCs, WBCs and Platelets was measured by laboratory standard methods. Along with Chest X- ray and ECG-for patients over 40 years of age. Results: This study was evaluated that in ankylosing spondylitis cases most of the physicians prefer to give general anaesthesia because to prevent trauma to the spinal cord but in these cases spine and surrounding tissues also it will involve at that time for maintain airway to the patient is challenge to the physicians by using fibreoptic intubation is good way to approach and maintain airway to the ankylosing patients. Conclusion: In this study suggest that in ankylosing spondylitis patients during surgery in place of tracheal intubation fibreoptic intubation is the best way to maintain airway to the patients and also we can prevent spinal cord damage.","PeriodicalId":18595,"journal":{"name":"MedPulse International Journal of Anesthesiology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76026498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparative study of onset and duration of sensory block with magnesium sulphate and bupivacaine versus bupivacaine only in axillary brachial plexus block under ultrasound guidance","authors":"P. Sharma","doi":"10.26611/101520314","DOIUrl":"https://doi.org/10.26611/101520314","url":null,"abstract":"","PeriodicalId":18595,"journal":{"name":"MedPulse International Journal of Anesthesiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81239829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparative study between intravenous clonidine versus intravenous dexmedetomidine for attenuation of pressor response during endotracheal intubation","authors":"Rajashree Bhagwan Rawate","doi":"10.26611/10152027","DOIUrl":"https://doi.org/10.26611/10152027","url":null,"abstract":"","PeriodicalId":18595,"journal":{"name":"MedPulse International Journal of Anesthesiology","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91410552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Post-operative pain relief after caeserean section is challenging to both anesthetista and obstetricians. Injection buprenorphine can be used intrathecally for post operative analgesia. Aim: the aim of the study was to compare the efficacy of two different doses(30ug and 60ug) of buprenorphine intrathecally with hyperbaric bupivacaine for post operative pain relief in caserean section. Methods and Materials: A prospective randomised controlled study was done on 60 subjects undergoing elective casarean section where in two groups were made, Group A (n=30) and Group B (n=30) who received inj bupivacaine 0.5% hyperbaric 2ml plus inj buprenorphine 30ug and inj bupivacaine 0.5% hyperbric plus inj buprinorphine 60ug intrathecally respectively. Following parameters were observed, onset and duration of sensory block, postopertive pain measured on VAS(visual analogue scale),rescue analgesia requirement, maternal side effects. Results: Unpaired t test and Chi square test were used for statistical analysis. Duration of analgesia was longer significantly in group A compared to group B. rescue analgesia requirement and VAS were significantly lower in group A as compared to group B.No major side effects were seen. Conclusion: Increasing the dosage of buprenorphine intrathecally increased the duration and quality of post operative analgesia. with no major adverse effects.
{"title":"A comparative study of post-operative analgesia after caesarean section with intrathecal hyperbaric bupivacaine combined with different doses of buprenorphine","authors":"Veereshkumar Angadi","doi":"10.26611/10152012","DOIUrl":"https://doi.org/10.26611/10152012","url":null,"abstract":"Background: Post-operative pain relief after caeserean section is challenging to both anesthetista and obstetricians. Injection buprenorphine can be used intrathecally for post operative analgesia. Aim: the aim of the study was to compare the efficacy of two different doses(30ug and 60ug) of buprenorphine intrathecally with hyperbaric bupivacaine for post operative pain relief in caserean section. Methods and Materials: A prospective randomised controlled study was done on 60 subjects undergoing elective casarean section where in two groups were made, Group A (n=30) and Group B (n=30) who received inj bupivacaine 0.5% hyperbaric 2ml plus inj buprenorphine 30ug and inj bupivacaine 0.5% hyperbric plus inj buprinorphine 60ug intrathecally respectively. Following parameters were observed, onset and duration of sensory block, postopertive pain measured on VAS(visual analogue scale),rescue analgesia requirement, maternal side effects. Results: Unpaired t test and Chi square test were used for statistical analysis. Duration of analgesia was longer significantly in group A compared to group B. rescue analgesia requirement and VAS were significantly lower in group A as compared to group B.No major side effects were seen. Conclusion: Increasing the dosage of buprenorphine intrathecally increased the duration and quality of post operative analgesia. with no major adverse effects.","PeriodicalId":18595,"journal":{"name":"MedPulse International Journal of Anesthesiology","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86782527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparative study of ketamine, clonidine and tramadol for control of shivering under neuroaxial anaesthesia","authors":"M. Murthy","doi":"10.26611/10152039","DOIUrl":"https://doi.org/10.26611/10152039","url":null,"abstract":"","PeriodicalId":18595,"journal":{"name":"MedPulse International Journal of Anesthesiology","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81284590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparative evaluation of intubating dose of atracurium with Cisatracurium for abdominal surgeries","authors":"Tanuja Chambyal","doi":"10.26611/10152124","DOIUrl":"https://doi.org/10.26611/10152124","url":null,"abstract":"","PeriodicalId":18595,"journal":{"name":"MedPulse International Journal of Anesthesiology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82927206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Attenuation of haemodynamic responses to endotracheal extubation-diltiazem versus lidocaine","authors":"Shibu Sreedhar","doi":"10.26611/10152122","DOIUrl":"https://doi.org/10.26611/10152122","url":null,"abstract":"","PeriodicalId":18595,"journal":{"name":"MedPulse International Journal of Anesthesiology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76438242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: With development of safer local anesthetic agents and advances in minimally invasive surgical techniques, the performance of day care surgeries are increasing in prevalence. Many local anesthetic drugs with varying concentrations and physical properties are used in spinal anesthesia to achieve early recovery, mobilization with minimal adverse effects. In the present study we are comparing the efficacy of Isobaric 0.5% Levobupivacaine with isobaric 1% 2-chlorprocaine in patients undergoing ambulatory surgeries under spinal anesthesia. Material and Methods: Sixty patients aged 18 to 60 years belonging to ASA physical status I-II, scheduled for various elective ambulatory surgeries under spinal anesthesia were randomized into two groups. Group A patients received 3ml of 0.5% Levobupivacaine and Group B received 4ml of 1% chlorprocaine. The time of onset, duration of sensory and motor block, hemodynamic changes and adverse effects were studied. Results: The time of onset of sensory block and motor block was significantly shorter (p<0.001) in Group B compared to Group A. Similarly, the duration of sensory and motor block in Group B was shorter (p<0.001). Intraoperative hemodynamic parameters including heart rate, systolic blood pressure and diastolic blood pressure were comparable in both groups. Conclusion: Intrathecal isobaric 1% 2- chloroprocaine has a shorter onset and duration of both Sensory and motor blockade compared to Isobaric 0.5% Levobupivacaine thereby, enabling early recovery and ambulation
{"title":"Comparative study between isobaric levobupivacaine and isobaric chlorprocaine in patients undergoing ambulatory surgeries under spinal anesthesia","authors":"R. Abhishek","doi":"10.26611/10152013","DOIUrl":"https://doi.org/10.26611/10152013","url":null,"abstract":"Background: With development of safer local anesthetic agents and advances in minimally invasive surgical techniques, the performance of day care surgeries are increasing in prevalence. Many local anesthetic drugs with varying concentrations and physical properties are used in spinal anesthesia to achieve early recovery, mobilization with minimal adverse effects. In the present study we are comparing the efficacy of Isobaric 0.5% Levobupivacaine with isobaric 1% 2-chlorprocaine in patients undergoing ambulatory surgeries under spinal anesthesia. Material and Methods: Sixty patients aged 18 to 60 years belonging to ASA physical status I-II, scheduled for various elective ambulatory surgeries under spinal anesthesia were randomized into two groups. Group A patients received 3ml of 0.5% Levobupivacaine and Group B received 4ml of 1% chlorprocaine. The time of onset, duration of sensory and motor block, hemodynamic changes and adverse effects were studied. Results: The time of onset of sensory block and motor block was significantly shorter (p<0.001) in Group B compared to Group A. Similarly, the duration of sensory and motor block in Group B was shorter (p<0.001). Intraoperative hemodynamic parameters including heart rate, systolic blood pressure and diastolic blood pressure were comparable in both groups. Conclusion: Intrathecal isobaric 1% 2- chloroprocaine has a shorter onset and duration of both Sensory and motor blockade compared to Isobaric 0.5% Levobupivacaine thereby, enabling early recovery and ambulation","PeriodicalId":18595,"journal":{"name":"MedPulse International Journal of Anesthesiology","volume":"155 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77992503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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