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A comparative study of post-operative analgesia after caesarean section with intrathecal hyperbaric bupivacaine combined with different doses of buprenorphine 鞘内高压布比卡因联合不同剂量丁丙诺啡对剖宫产术后镇痛效果的比较研究
Pub Date : 2021-01-01 DOI: 10.26611/10152012
Veereshkumar Angadi
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.
背景:剖宫产术后疼痛缓解对麻醉师和产科医生都是一个挑战。丁丙诺啡可用于鞘内注射,用于术后镇痛。目的:比较不同剂量(30ug和60ug)丁丙诺啡与高压布比卡因对剖宫产术后疼痛的缓解效果。方法与材料:对60例择期剖宫产术患者进行前瞻性随机对照研究,分为A组(n=30)和B组(n=30),分别接受0.5%布比卡因高压注射2ml +丁丙诺啡注射30ug和0.5%布比卡因高压注射+丁丙诺啡注射60ug。观察以下参数,感觉阻滞的发生和持续时间,术后VAS(视觉模拟评分)疼痛测量,抢救镇痛需求,产妇不良反应。结果:采用未配对t检验和卡方检验进行统计分析。A组镇痛持续时间明显长于b组。A组抢救镇痛需求和VAS均明显低于b组。结论:增加丁丙诺啡鞘内剂量可提高术后镇痛的持续时间和质量。没有严重的副作用。
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引用次数: 0
Comparative assessment of laryngoscopy and intubating conditions using Macintosh Direct Laryngoscope and video laryngoscope at a tertiary level hospital 某三级医院使用Macintosh直接喉镜和视频喉镜进行喉镜检查和插管条件的比较评价
Pub Date : 2021-01-01 DOI: 10.26611/10152034
M. Danish
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引用次数: 0
Comparative study between isobaric levobupivacaine and isobaric chlorprocaine in patients undergoing ambulatory surgeries under spinal anesthesia 等重左布比卡因与等重氯普鲁卡因在脊柱麻醉下门诊手术中的比较研究
Pub Date : 2021-01-01 DOI: 10.26611/10152013
R. Abhishek
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
背景:随着更安全的局麻药的发展和微创手术技术的进步,日托手术的表现越来越普遍。许多不同浓度和物理性质的局麻药物用于脊髓麻醉,以实现早期恢复,动员和最小的不良反应。在本研究中,我们比较了0.5%左布比卡因和1%氯普鲁卡因在脊柱麻醉下进行门诊手术的患者中的疗效。材料与方法:将60例年龄在18 ~ 60岁,身体状态为ASA I-II级,在脊髓麻醉下进行各种选择性门诊手术的患者随机分为两组。A组给予0.5%左布比卡因3ml, B组给予1%氯普鲁卡因4ml。观察起效时间、感觉和运动阻滞持续时间、血流动力学变化及不良反应。结果:B组感觉阻滞和运动阻滞发生时间明显短于a组(p<0.001), B组感觉阻滞和运动阻滞持续时间也明显短于a组(p<0.001)。两组的术中血流动力学参数包括心率、收缩压和舒张压具有可比性。结论:与0.5%左布比卡因相比,鞘内1%等压2-氯普鲁卡因对感觉和运动的阻滞起效和持续时间更短,从而使患者能够早期恢复和活动
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引用次数: 0
Comparative analysis of lignocaine, ropivacaine, and bupivacaine in pain control during extraction of mandibular posterior teeth 利多卡因、罗哌卡因、布比卡因对下颌后牙拔除疼痛控制的比较分析
Pub Date : 2021-01-01 DOI: 10.26611/10152138
Radha Saodekar
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引用次数: 0
A study of intrathecal low dose bupivacaine and fentanyl versus conventional dose of bupivacaine alone for elective caesarean section 择期剖宫产术鞘内低剂量布比卡因联合芬太尼与常规剂量布比卡因的对比研究
Pub Date : 2021-01-01 DOI: 10.26611/10151938
R. M
Background: Spinal anesthesia is the most common method of the regional block in cesarean section, because it is easy to perform, economical produces rapid onset of anesthesia, and good muscle relaxation, and most importantly, it gives immense pleasure to the conscious mother. To improve the quality of subarachnoid block, intrathecal opioids are used as adjuvants to Bupivacaine. Fentanyl has a rapid onset of action as a lipophilic opioid following intrathecal administration. Because of high lipid solubility, it undergoes rapid uptake by the spinal cord, and hence the chances of delayed respiratory depression are less. Methods: We randomly selected 60 patients belonging to the American Society of Anesthesiologists (ASA) class I and II, who are scheduled for elective LSCS. These patients were divided randomly into two groups of 30 each. Group B received 10mg of 0.5% hyperbaric bupivacaine (2ml). Group BF received 7.5mg of 0.5% hyperbaric bupivacaine (1.5ml) with 25mcg of Fentanyl (0.5ml). Lumbar puncture was performed at the level of L3-L4 with 23 Guage Quincke Babcock's needle with the patient in the right lateral position. The sensory block was assessed with the loss of pin prick sensation, and the motor block was set using the Bromage scale technique. We also recorded the hemodynamic parameters like pulse rate, blood pressure, oxygen saturation. Results: No significant statistical difference was found in demographic data between the two groups. Group BF showed early onset of the sensory block with a P value of 0.001. Time taken to attain peak sensory level was early in the BF group with a P value of 0.001. The total duration of sensory block and duration of effective analgesia was longer in the BF group with a P value of 0.001. The onset of motor blockade was early in the bupivacaine only group with a P value of 0.02. Conclusion: The intrathecal fentanyl 25mcg reduces the dose of 7.5 mg of 0.5% hyperbaric Bupivacaine for spinal anesthesia in cesarean section, thus reducing the incidence of side effects associated with it. By its synergistic effect with 0.5% hyperbaric bupivacaine, it provides better excellent sensory blockade and postoperative analgesia, good hemodynamic stability, less incidence of complications like Nausea, vomiting, and shivering without compromising the safety of mother and fetus in comparison to intrathecal 10mg of 0.5% hyperbaric Bupivacaine alone.
背景:脊髓麻醉是剖宫产术中最常用的区域阻滞方法,因为它操作简单,经济,麻醉起效快,肌肉放松好,最重要的是它能给清醒的母亲带来巨大的快感。为了提高蛛网膜下腔阻滞的质量,鞘内使用阿片类药物作为布比卡因的佐剂。芬太尼作为一种亲脂性阿片类药物在鞘内给药后起效迅速。由于高脂溶性,它能被脊髓迅速吸收,因此延迟呼吸抑制的可能性较小。方法:我们随机选择60例属于美国麻醉学会(ASA) I级和II级的患者,他们计划进行选择性LSCS。这些患者被随机分为两组,每组30人。B组给予0.5%高压布比卡因10mg (2ml)。BF组给予0.5%高压布比卡因7.5mg (1.5ml)加芬太尼25mcg (0.5ml)。采用23 Guage Quincke Babcock's针在L3-L4水平行腰椎穿刺,患者取右侧卧位。感觉阻滞以针刺感觉丧失评定,运动阻滞采用Bromage评分法评定。我们还记录了血液动力学参数,比如脉搏率,血压,血氧饱和度。结果:两组患者人口学资料差异无统计学意义。BF组出现感觉阻滞早,P值为0.001。BF组达到感觉峰值所需时间较早,P值为0.001。BF组感觉阻滞总持续时间和有效镇痛持续时间更长,P值为0.001。布比卡因组运动阻滞发生早,P值为0.02。结论:剖宫产术中鞘内芬太尼25mcg可减少7.5 mg 0.5%高压布比卡因腰麻剂量,减少其相关副作用的发生。通过与0.5%高压布比卡因的协同作用,与单独鞘内10mg 0.5%高压布比卡因相比,具有更好的感觉阻滞和术后镇痛效果,血流动力学稳定性好,恶心、呕吐、寒战等并发症发生率低,且不影响母婴安全。
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引用次数: 0
Effect of rectal diclofenac (100mg) for postoperative analgesia in adult perineal surgeries 直肠双氯芬酸(100mg)用于成人会阴手术术后镇痛的效果
Pub Date : 2021-01-01 DOI: 10.26611/10152125
Rajajothi R
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引用次数: 0
Comparative study of epidural ropivacaine with fentanyl versus bupivacaine with fentanyl for labour analgesia 硬膜外罗哌卡因加芬太尼与布比卡因加芬太尼用于分娩镇痛的比较研究
Pub Date : 2021-01-01 DOI: 10.26611/10152116
B. S. Kumar
{"title":"Comparative study of epidural ropivacaine with fentanyl versus bupivacaine with fentanyl for labour analgesia","authors":"B. S. Kumar","doi":"10.26611/10152116","DOIUrl":"https://doi.org/10.26611/10152116","url":null,"abstract":"","PeriodicalId":18595,"journal":{"name":"MedPulse International Journal of Anesthesiology","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79840512","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}
引用次数: 0
Role of pulse plethysmograph in the prediction of hypotension in caesarean section patient under spinal anesthesia 脉搏容积描记仪在预测腰麻剖宫产患者低血压中的作用
Pub Date : 2021-01-01 DOI: 10.26611/10151936
S. Desai
Background: Spinal anesthesia is a commonly employed technique for anesthesia for caesarean section and is associated with hypotension which may cause maternal morbidity. Prediction of hypotension before the procedure can reduce complications. The study aimed to evaluate the role of pulse plethysmograph in the prediction of hypotension in caesarean section patients under spinal anesthesia. Methods: The observational study was conducted on 50 patients who were undergoing emergency or elective caesarean section. Spinal anesthesia was performed by anaesthesiologist using a 25 or 26-gauge spinal needle with bupivacaine at L3-4 interspinous space. Pre and post-anesthesia observations such as the width of pulse plethysmograph, non-invasive blood pressure in another arm, and heart rate were recorded. Paired T-test, Wilcoxon sign rank test, and chi-square test was used to analyse data using R Studio V 1.2.5001 software. Results: Post spinal anesthesia minor fall in systolic blood pressure (SBP) was observed in 11 patients, moderate fall in 21 patients, severe fall in 8 patients and a massive fall in 10 patients. A significant difference was observed between mean pre- and post-spinal anesthesia SBP (P<0.001). Width of pulse plethysmograph (PPG) was maintained in 14 patients whereas, narrowed and significantly narrowed PPGs were observed in 29 and 7 patients, respectively. Significant association was observed between grades of SBP and width of PPG (P<0.05). Receiver operating characteristic curve showed the width of PGG was good for prediction of hypotension in patient (AUC=0.828). Conclusion: Width of PPG can be used to predict SA induced maternal hypotension.
背景:腰麻是剖宫产术中常用的麻醉方法,腰麻伴有低血压,可引起产妇发病。在手术前预测低血压可以减少并发症。本研究旨在评估脉搏容积描记仪在预测脊柱麻醉下剖宫产患者低血压中的作用。方法:对50例急诊或择期剖宫产患者进行观察性研究。脊髓麻醉由麻醉师在L3-4棘间隙使用25或26号脊髓针加布比卡因进行。记录麻醉前和麻醉后的脉搏宽度、另一只手臂的无创血压、心率等观察结果。采用配对t检验、Wilcoxon符号秩检验和卡方检验,采用R Studio V 1.2.5001软件进行数据分析。结果:腰麻后收缩压轻度下降11例,中度下降21例,重度下降8例,大幅下降10例。脊髓麻醉前后平均收缩压差异有统计学意义(P<0.001)。14例患者脉搏体积描记仪(PPG)保持宽度,29例和7例患者PPG变窄和明显变窄。收缩压分级与PPG宽度有显著相关性(P<0.05)。受试者工作特征曲线显示PGG宽度较好预测患者低血压(AUC=0.828)。结论:PPG宽度可用于预测SA诱发的低血压。
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引用次数: 0
Comparison of post-operative analgesic efficacy of rectus sheath catheter versus continuous wound infiltration for laparotomy surgery 剖腹手术中直肌鞘导管与伤口持续浸润术后镇痛效果比较
Pub Date : 2021-01-01 DOI: 10.26611/10151913
S. Abirami, G. Rajashree
Background: The analgesic requirement of patients following laparotomy surgeries could not be met by single method.Pain, if effectively managed in the post operative period will reduce the respiratory complications, decrease the hospital stay and health care cost for the patients. Ultrasound guided rectus sheath catheter allows continuous infiltration of local anaesthetic in the post operative period. Materials and Methods: Randomised controlled trial – 60 patients who underwent Laparotomy surgery were divided into 2 groups. Group A – Bilateral wound catheter was placed subcutaneously at the end of surgery. Group B –Rectus sheath catheter was placed bilaterally under USG guidance. Both patient received bolus of 10ml 0.25% Bupivacaine followed by infusion of 0.25% Bupivacaine at 2ml/hr for 48hrs. The hemodynamic parameters,VAS score, Post operative opioid consumption were recorded for the above mentioned period. Results: The VAS score was significantly low in Group B compared to Group A (2.2, 2.0, 1.67, 1.87, 1.7, 2.17 vs 3.93, 3.86, 3.6,3.97, 4.1, 3.8)(p<0.05) in the observed time intervals. The need for rescue analgesia with opioid was less in Group B (6.7%) compared to patients in Group A (26.7%) (p<0.05). The HR, MAP observed in Group A is increased significantly as compared to Group B at all time intervals (p<0.05). Conclusion: We concluded that USG guided Rectus sheath catheter provides better post operative analgesia in laparotomy surgeries than wound catheter infusion.
背景:剖腹手术后患者的镇痛需求单靠一种方法是无法满足的。如果术后对疼痛进行有效的控制,可以减少呼吸系统并发症的发生,减少患者的住院时间和医疗费用。超声引导下直肌鞘导管可在术后持续浸润局部麻醉。材料与方法:随机对照试验- 60例剖腹手术患者分为两组。A组:手术结束时双侧创面皮下置管。B组在USG引导下双侧放置直肌鞘导管。两例患者均接受0.25%布比卡因10ml的静脉注射,随后以2ml/hr的速度输注0.25%布比卡因,持续48小时。记录上述时间段的血流动力学参数、VAS评分、术后阿片类药物用量。结果:观察时间间隔内,B组VAS评分显著低于A组(2.2、2.0、1.67、1.87、1.7、2.17 vs 3.93、3.86、3.6、3.97、4.1、3.8),差异有统计学意义(p<0.05)。B组患者对阿片类药物的抢救性镇痛需求(6.7%)低于A组(26.7%)(p<0.05)。A组HR、MAP在各时间间隔均较B组显著升高(p<0.05)。结论:USG引导下直肌鞘导管在剖腹手术中的术后镇痛效果优于创面置管。
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引用次数: 0
Euglycemic diabetic ketoacidosis (EDKA)and lactic acidosis following coronary artery bypass graft surgery requiring hemodialysis in a patient on SGLT2 inhibitors[SGLT2i] 服用SGLT2抑制剂的患者冠状动脉搭桥手术后需要血液透析的血糖性糖尿病酮症酸中毒(EDKA)和乳酸酸中毒[SGLT2i]
Pub Date : 2021-01-01 DOI: 10.26611/10152016
Ajeetha P K
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引用次数: 1
期刊
MedPulse International Journal of Anesthesiology
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