Pub Date : 2022-07-01DOI: 10.4103/TheIAForum.TheIAForum_49_22
S. Sinha, SA Kshama, L. Shenoy
Aims and Objectives: The purpose of this study was the comparison of hemodynamic variables such as heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure during the extubation period following administration of two doses of intravenous (IV) esmolol. Materials and Methods: This prospective double-blind randomized controlled trial was conducted on patients (American Society of Anesthesiologists Physical Status), aged between 18 and 65 years, scheduled for elective laparoscopic procedure done under general anesthesia with endotracheal intubation. Sixty participants were randomized into three groups of 20 each, the first two groups received IV esmolol injection of 0.5 mg/kg and 1 mg/kg doses, respectively, and the third group received placebo injection of 10 ml of saline intravenously after the completion of surgery before extubation. Statistical Analysis: Statistical analysis of data was done using SPSS 20 software. Repeated measures analysis of variance (ANOVA) test was used for the analysis of trends of different parameters within the group. For comparison between the groups and to find if any significant difference exists, one-way ANOVA was used. Post hoc Tukey's test was used to find where the difference originated from, once significant difference was found. Results: Demographic data were statistically similar between groups. IV administration of esmolol at both 0.5 mg/kg and 1 mg/kg is effective in attenuating heart rate response but IV esmolol bolus of 1 mg/kg is more effective than bolus of 0.5 mg/kg in attenuating blood pressure response to extubation as it provided a more consistent hemodynamic control during the extubation as well as in the postextubation period. Conclusion: Extubation and emergence from general anesthesia cause significant increases in heart rate and blood pressure and emphasis must be given on attenuation of this sympathetic response, especially in vulnerable patients. IV administration of esmolol is effective in attenuation of heart rate response and blood pressure response with consistently good hemodynamic control during extubation postoperatively.
{"title":"Comparison of two doses of intravenous esmolol in attenuation of hemodynamic response to extubation in laparoscopic surgeries","authors":"S. Sinha, SA Kshama, L. Shenoy","doi":"10.4103/TheIAForum.TheIAForum_49_22","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_49_22","url":null,"abstract":"Aims and Objectives: The purpose of this study was the comparison of hemodynamic variables such as heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure during the extubation period following administration of two doses of intravenous (IV) esmolol. Materials and Methods: This prospective double-blind randomized controlled trial was conducted on patients (American Society of Anesthesiologists Physical Status), aged between 18 and 65 years, scheduled for elective laparoscopic procedure done under general anesthesia with endotracheal intubation. Sixty participants were randomized into three groups of 20 each, the first two groups received IV esmolol injection of 0.5 mg/kg and 1 mg/kg doses, respectively, and the third group received placebo injection of 10 ml of saline intravenously after the completion of surgery before extubation. Statistical Analysis: Statistical analysis of data was done using SPSS 20 software. Repeated measures analysis of variance (ANOVA) test was used for the analysis of trends of different parameters within the group. For comparison between the groups and to find if any significant difference exists, one-way ANOVA was used. Post hoc Tukey's test was used to find where the difference originated from, once significant difference was found. Results: Demographic data were statistically similar between groups. IV administration of esmolol at both 0.5 mg/kg and 1 mg/kg is effective in attenuating heart rate response but IV esmolol bolus of 1 mg/kg is more effective than bolus of 0.5 mg/kg in attenuating blood pressure response to extubation as it provided a more consistent hemodynamic control during the extubation as well as in the postextubation period. Conclusion: Extubation and emergence from general anesthesia cause significant increases in heart rate and blood pressure and emphasis must be given on attenuation of this sympathetic response, especially in vulnerable patients. IV administration of esmolol is effective in attenuation of heart rate response and blood pressure response with consistently good hemodynamic control during extubation postoperatively.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"23 1","pages":"125 - 130"},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41561405","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}
Pub Date : 2022-07-01DOI: 10.4103/theiaforum.theiaforum_11_22
S. Chowdhury, A. Malviya, Anju Gupta
{"title":"Trivia of an unnoticed miscreant at the glottis resulting in an unanticipated difficult airway","authors":"S. Chowdhury, A. Malviya, Anju Gupta","doi":"10.4103/theiaforum.theiaforum_11_22","DOIUrl":"https://doi.org/10.4103/theiaforum.theiaforum_11_22","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"23 1","pages":"149 - 150"},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43089255","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}
Pub Date : 2022-07-01DOI: 10.4103/TheIAForum.TheIAForum_66_22
Ruchi Ohri, S. Noufiya
{"title":"An unusual appearance of capnograph - dilemma for an anesthesiologist!","authors":"Ruchi Ohri, S. Noufiya","doi":"10.4103/TheIAForum.TheIAForum_66_22","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_66_22","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"23 1","pages":"150 - 152"},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46103371","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}
Pub Date : 2022-07-01DOI: 10.4103/TheIAForum.TheIAForum_95_22
G. Biyani, Rajasekhar Metta
{"title":"Sensory blocks for knee surgery: The dawn of a new era","authors":"G. Biyani, Rajasekhar Metta","doi":"10.4103/TheIAForum.TheIAForum_95_22","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_95_22","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"23 1","pages":"81 - 82"},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47568462","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}
Pub Date : 2022-07-01DOI: 10.4103/theiaforum.theiaforum_7_22
V. Ravindran, S. Rajan, Susmitha Mammen, L. Kumar
{"title":"A case of positional alopecia following prolonged surgery","authors":"V. Ravindran, S. Rajan, Susmitha Mammen, L. Kumar","doi":"10.4103/theiaforum.theiaforum_7_22","DOIUrl":"https://doi.org/10.4103/theiaforum.theiaforum_7_22","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"23 1","pages":"145 - 147"},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48294082","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}
Pub Date : 2022-07-01DOI: 10.4103/TheIAForum.TheIAForum_37_22
Neelakshi Koul, V. Dhir, N. Choudhary, J. Singh, Deepak Nohwar, Mohandeep Kaur
Background: Management of difficult airway remains a cornerstone of anesthesiology requiring constant probe into newer devices challenging set gold standards. Hence, we compared the effectiveness of intubating laryngeal mask airway (ILMA) with flexible fiberoptic bronchoscope (FOB) in anticipated difficult airway. Aims: The aim of this study was to compare and evaluate ILMA and FOB for tracheal intubation in patients with anticipated difficult airway. Settings and Design: The study design involves comparative randomized study. Materials and Methods: Fifty patients undergoing elective surgery under general anesthesia with anticipated difficult airway (Modified Mallampati Class III/Wilson's Score 6-7) were divided into Group I (ILMA) and Group F (FOB). Primary outcomes, i.e., ease of intubation (number and duration of attempts) and success rate; and secondary outcomes, i.e., hemodynamic parameters and adverse events were noted. Results: Both the groups were comparable in age, gender distribution, body mass index, and type of surgery. The number of attempts required and hemodynamics changes were similar in both groups. ILMA required lesser time, i.e., 59.76 s versus FOB, i.e., 109.88 s in the first attempt (DA1) and 62.67 s for Group I versus 120.86 s for Group F in the second attempt (DA2), being statistically significant. ILMA showed higher adverse event rate versus FOB; however, the difference was statistically insignificant. Conclusions: ILMA is an effective alternative to FOB in patients with anticipated difficult airway with respect to ease of intubation, with similar hemodynamic stability, success rate, and adverse events. Anticipated difficult airway, fiberoptic bronchoscope, intubating laryngeal mask airway
{"title":"Comparative evaluation of intubating laryngeal mask airway with fiberoptic bronchoscopic intubation in anticipated difficult airway: A randomized controlled study","authors":"Neelakshi Koul, V. Dhir, N. Choudhary, J. Singh, Deepak Nohwar, Mohandeep Kaur","doi":"10.4103/TheIAForum.TheIAForum_37_22","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_37_22","url":null,"abstract":"Background: Management of difficult airway remains a cornerstone of anesthesiology requiring constant probe into newer devices challenging set gold standards. Hence, we compared the effectiveness of intubating laryngeal mask airway (ILMA) with flexible fiberoptic bronchoscope (FOB) in anticipated difficult airway. Aims: The aim of this study was to compare and evaluate ILMA and FOB for tracheal intubation in patients with anticipated difficult airway. Settings and Design: The study design involves comparative randomized study. Materials and Methods: Fifty patients undergoing elective surgery under general anesthesia with anticipated difficult airway (Modified Mallampati Class III/Wilson's Score 6-7) were divided into Group I (ILMA) and Group F (FOB). Primary outcomes, i.e., ease of intubation (number and duration of attempts) and success rate; and secondary outcomes, i.e., hemodynamic parameters and adverse events were noted. Results: Both the groups were comparable in age, gender distribution, body mass index, and type of surgery. The number of attempts required and hemodynamics changes were similar in both groups. ILMA required lesser time, i.e., 59.76 s versus FOB, i.e., 109.88 s in the first attempt (DA1) and 62.67 s for Group I versus 120.86 s for Group F in the second attempt (DA2), being statistically significant. ILMA showed higher adverse event rate versus FOB; however, the difference was statistically insignificant. Conclusions: ILMA is an effective alternative to FOB in patients with anticipated difficult airway with respect to ease of intubation, with similar hemodynamic stability, success rate, and adverse events. Anticipated difficult airway, fiberoptic bronchoscope, intubating laryngeal mask airway","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"23 1","pages":"118 - 124"},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49093881","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}
Pub Date : 2022-07-01DOI: 10.4103/TheIAForum.TheIAForum_42_22
Mehul V. Makwana, Bhumika Pathak, Niral Panchal, M. Chaudhari, A. Phatak
Background and Aims: Analgosedation before and during regional anesthesia provides analgesia, anxiolysis, and amnesia. This study has been conducted to compare ketamine-dexmedetomidine (KD) versus ketamine-propofol (KP) for sedation, pain on needle prick while giving block, hemodynamics, and their side effects under supraclavicular brachial plexus block. Materials and Methods: After obtaining ethics committee approval, CTRI registration and patient consent, 75 patients were recruited who satisfy inclusion and exclusion criteria. Patients were divided into two groups. Group KP received a loading dose of ketamine 0.5 mg/kg, propofol 1 mg/kg over 10 min, followed by a maintenance dose of ketamine 0.3 mg/kg/h and propofol 10 μg/kg/min. Group KD received loading dose of ketamine 0.5 mg/kg, dexmedetomidine 0.5 μg/kg over 10 min, followed by maintenance dose of ketamine 0.3 mg/kg/h and dexmedetomidine 0.3 μg/kg/h. Patients were monitored for sedation, pain on needle prick while performing block, side effects of study drugs, hemodynamic and respiratory parameters. An independent sample t-test was used to compare continuous outcomes, descriptive statistics were used to depict the baseline profile of the study participants, Chi-square test was used to compare the categorical outcomes. A value of P < 0.05 was considered statistically significant. Results: Pain on needle prick was experienced in 5.7% and 42.9% in Group KD and Group KP, respectively. In Group KD, 28.6% and Group KP 5.7% of patients experienced nausea. Conclusion: In this study, group KD has adequate sedation as compared to group KP with less pain on needle prick while performing supraclavicular block. Group KD has higher incidence of nausea than gruop KP.
{"title":"Preemptive analgosedation with ketamine-dexmedetomidine versus ketamine-propofol in upper limb surgeries under supraclavicular brachial plexus block: A randomized controlled trial","authors":"Mehul V. Makwana, Bhumika Pathak, Niral Panchal, M. Chaudhari, A. Phatak","doi":"10.4103/TheIAForum.TheIAForum_42_22","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_42_22","url":null,"abstract":"Background and Aims: Analgosedation before and during regional anesthesia provides analgesia, anxiolysis, and amnesia. This study has been conducted to compare ketamine-dexmedetomidine (KD) versus ketamine-propofol (KP) for sedation, pain on needle prick while giving block, hemodynamics, and their side effects under supraclavicular brachial plexus block. Materials and Methods: After obtaining ethics committee approval, CTRI registration and patient consent, 75 patients were recruited who satisfy inclusion and exclusion criteria. Patients were divided into two groups. Group KP received a loading dose of ketamine 0.5 mg/kg, propofol 1 mg/kg over 10 min, followed by a maintenance dose of ketamine 0.3 mg/kg/h and propofol 10 μg/kg/min. Group KD received loading dose of ketamine 0.5 mg/kg, dexmedetomidine 0.5 μg/kg over 10 min, followed by maintenance dose of ketamine 0.3 mg/kg/h and dexmedetomidine 0.3 μg/kg/h. Patients were monitored for sedation, pain on needle prick while performing block, side effects of study drugs, hemodynamic and respiratory parameters. An independent sample t-test was used to compare continuous outcomes, descriptive statistics were used to depict the baseline profile of the study participants, Chi-square test was used to compare the categorical outcomes. A value of P < 0.05 was considered statistically significant. Results: Pain on needle prick was experienced in 5.7% and 42.9% in Group KD and Group KP, respectively. In Group KD, 28.6% and Group KP 5.7% of patients experienced nausea. Conclusion: In this study, group KD has adequate sedation as compared to group KP with less pain on needle prick while performing supraclavicular block. Group KD has higher incidence of nausea than gruop KP.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"23 1","pages":"138 - 143"},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45364998","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}
Pub Date : 2022-07-01DOI: 10.4103/TheIAForum.TheIAForum_84_22
Vinod Krishnagopal, R. Murugan, AShanmuga Priya, S. Divyashree
{"title":"A rare case of unintentional cannulation of superficial radial artery mistaken for the cephalic vein – An ultrasound evaluation","authors":"Vinod Krishnagopal, R. Murugan, AShanmuga Priya, S. Divyashree","doi":"10.4103/TheIAForum.TheIAForum_84_22","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_84_22","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"23 1","pages":"144 - 145"},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46368674","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}
Pub Date : 2022-07-01DOI: 10.4103/TheIAForum.TheIAForum_170_21
KCharishma Begum, K. Gnanadurai, Chandrappa Sreekanth, D. Pushpa Latha
Background: Various anesthetic drugs are used for procedures conducted outside the operation theater. Very few studies are done in the emergency department to compare the combination of ketamine and propofol (ketofol) versus midazolam–fentanyl for procedural sedation and analgesia, thus we conducted this study to compare these drug combinations in terms of analgesic and sedation efficacy in the emergency department. Materials and Methods: A prospective, open-label, randomized, comparative study was conducted on 60 patients, who were randomly assigned to the ketofol and midazolam–fentanyl groups (30 each) to compare these drugs in terms of sedation efficacy using modified Ramsay sedation score, pain scores using Visual Analog Scale, and alteration of hemodynamic, adverse effects such as respiratory distress and nausea. The mean pain score before and after the study was compared using paired t-test, and the difference between the two groups was assessed using Student's t-test. Chi-square test and Fisher's exact test were employed to compare the distribution of qualitative data. Results: Our study showed that ketofol provides better analgesia as compared to the midazolam–fentanyl group because reduction in Visual Analog Scale scores was 1.27 ± 1.52 (mean ± standard deviation [SD]) in the ketofol group as compared to 3.07 ± 1.25 (mean ± SD) in the midazolam–fentanyl group. Ketofol 4.47±0.73 (mean ± SD) had a better modified Ramsay sedation score when compared to midazolam–fentanyl 3.47±0.90 (mean ± SD). There was reduction in systolic (from 119 ± 18.4 to 113.3 ± 18.81 mmHg) and diastolic blood pressure (from 72 ± 9.61 to 69.67 ± 10.33 mmHg) in the midazolam–fentanyl group during and after the procedure in comparison to the ketofol group where none had hypotension. Conclusion: Results concluded that ketamine–propofol (ketofol) combination is safe and better in providing adequate analgesia and sedation than midazolam and fentanyl combination in the emergency room.
{"title":"Comparison of ketamine–propofol (ketofol) versus midazolam–fentanyl for procedural sedation and analgesia in emergency care department: An open-label randomized controlled study","authors":"KCharishma Begum, K. Gnanadurai, Chandrappa Sreekanth, D. Pushpa Latha","doi":"10.4103/TheIAForum.TheIAForum_170_21","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_170_21","url":null,"abstract":"Background: Various anesthetic drugs are used for procedures conducted outside the operation theater. Very few studies are done in the emergency department to compare the combination of ketamine and propofol (ketofol) versus midazolam–fentanyl for procedural sedation and analgesia, thus we conducted this study to compare these drug combinations in terms of analgesic and sedation efficacy in the emergency department. Materials and Methods: A prospective, open-label, randomized, comparative study was conducted on 60 patients, who were randomly assigned to the ketofol and midazolam–fentanyl groups (30 each) to compare these drugs in terms of sedation efficacy using modified Ramsay sedation score, pain scores using Visual Analog Scale, and alteration of hemodynamic, adverse effects such as respiratory distress and nausea. The mean pain score before and after the study was compared using paired t-test, and the difference between the two groups was assessed using Student's t-test. Chi-square test and Fisher's exact test were employed to compare the distribution of qualitative data. Results: Our study showed that ketofol provides better analgesia as compared to the midazolam–fentanyl group because reduction in Visual Analog Scale scores was 1.27 ± 1.52 (mean ± standard deviation [SD]) in the ketofol group as compared to 3.07 ± 1.25 (mean ± SD) in the midazolam–fentanyl group. Ketofol 4.47±0.73 (mean ± SD) had a better modified Ramsay sedation score when compared to midazolam–fentanyl 3.47±0.90 (mean ± SD). There was reduction in systolic (from 119 ± 18.4 to 113.3 ± 18.81 mmHg) and diastolic blood pressure (from 72 ± 9.61 to 69.67 ± 10.33 mmHg) in the midazolam–fentanyl group during and after the procedure in comparison to the ketofol group where none had hypotension. Conclusion: Results concluded that ketamine–propofol (ketofol) combination is safe and better in providing adequate analgesia and sedation than midazolam and fentanyl combination in the emergency room.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"23 1","pages":"131 - 137"},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43266482","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}
Pub Date : 2022-07-01DOI: 10.4103/TheIAForum.TheIAForum_2_22
Veena Mathur, A. Verma, A. Khare, D. Garg, Beena Thada, Maina Singh
Background and Aims: Subarachnoid block is the most preferred anesthetic technique for infraumbilical surgeries as it provides better postoperative analgesia, effective muscle relaxation, and cost-effectiveness. Levobupivacaine is preferable over bupivacaine due to its lower cardiotoxicity, prolonged sensory block, and shorter duration of motor block. Opioids as an adjuvant to intrathecal local anesthetics enhance the quality of both analgesia and anesthesia during intraoperative as well as postoperative period. The present study aimed to compare levobupivacaine with and without fentanyl in spinal anesthesia. Methods: In this prospective, randomized, double-blinded study, a total of 80 patients belonging to the American Society of Anesthesiologists Physical Status I and II were enrolled for infraumbilical surgeries. Patients were randomly allocated into two groups. Group Levobupivacaine (L) (n = 40) received isobaric levobupivacaine 0.5% 2.5 ml with 0.5 ml normal saline and Group Levobupivacaine + fentanyl (LF) (n = 40) received isobaric levobupivacaine 0.5% 2.5 ml with fentanyl 25 μg (0.5 ml). Time of onset and duration of both sensory and motor block, Visual Analog Scale score, duration of analgesia, hemodynamic changes, and any adverse events were noted in both the groups. Results: The onset of both sensory and motor block was significantly faster in Group LF (P < 0.05). The duration of sensory block was significantly longer in Group LF (P < 0.05). The duration of motor block was found to be comparable between two groups with stable hemodynamics and no perioperative sedation (P > 0.05). The duration of analgesia was significantly longer in Group LF (336.5 ± 31.3 min) compared to Group L (223.65 ± 32.17 min) P < 0.001. Conclusion: Intrathecal fentanyl (25 μg) can be effectively used as an adjuvant to isobaric 0.5% levobupivacaine as it provides better block characteristics with minimal adverse effects in patients undergoing infraumbilical surgeries.
{"title":"A prospective randomized study to compare intrathecal isobaric levobupivacaine with or without fentanyl in various infraumbilical surgeries","authors":"Veena Mathur, A. Verma, A. Khare, D. Garg, Beena Thada, Maina Singh","doi":"10.4103/TheIAForum.TheIAForum_2_22","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_2_22","url":null,"abstract":"Background and Aims: Subarachnoid block is the most preferred anesthetic technique for infraumbilical surgeries as it provides better postoperative analgesia, effective muscle relaxation, and cost-effectiveness. Levobupivacaine is preferable over bupivacaine due to its lower cardiotoxicity, prolonged sensory block, and shorter duration of motor block. Opioids as an adjuvant to intrathecal local anesthetics enhance the quality of both analgesia and anesthesia during intraoperative as well as postoperative period. The present study aimed to compare levobupivacaine with and without fentanyl in spinal anesthesia. Methods: In this prospective, randomized, double-blinded study, a total of 80 patients belonging to the American Society of Anesthesiologists Physical Status I and II were enrolled for infraumbilical surgeries. Patients were randomly allocated into two groups. Group Levobupivacaine (L) (n = 40) received isobaric levobupivacaine 0.5% 2.5 ml with 0.5 ml normal saline and Group Levobupivacaine + fentanyl (LF) (n = 40) received isobaric levobupivacaine 0.5% 2.5 ml with fentanyl 25 μg (0.5 ml). Time of onset and duration of both sensory and motor block, Visual Analog Scale score, duration of analgesia, hemodynamic changes, and any adverse events were noted in both the groups. Results: The onset of both sensory and motor block was significantly faster in Group LF (P < 0.05). The duration of sensory block was significantly longer in Group LF (P < 0.05). The duration of motor block was found to be comparable between two groups with stable hemodynamics and no perioperative sedation (P > 0.05). The duration of analgesia was significantly longer in Group LF (336.5 ± 31.3 min) compared to Group L (223.65 ± 32.17 min) P < 0.001. Conclusion: Intrathecal fentanyl (25 μg) can be effectively used as an adjuvant to isobaric 0.5% levobupivacaine as it provides better block characteristics with minimal adverse effects in patients undergoing infraumbilical surgeries.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"23 1","pages":"98 - 104"},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44139666","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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