Background: Pain is the most common complain causing distress to the patients in immediate postoperative period. Various studies have shown that transverse abdominal plane (TAP) 13 block is effective modality for postoperative pain relief using ropivacaine or bupivacaine. But duration of these blocks with local anesthetics only is limited to few hours. The present study was conducted with the aim to compare the postoperative analgesia amongst subjects receiving ropivacaine and clonidine versus ropivacaine alone. Subjects and Methods: The present prospective and double blinded study involving 70 patients was performed for a period of 2 years at the Department of Anesthesiology. Monitors were attached and baseline (preoperative) heart rate by ECG, systolic and diastolic blood pressure was measured by noninvasive blood pressure monitoring. The duration of postoperative analgesia and complications like nausea, vomiting or any other were noted during the procedure. Student t test was used for statistical analysis and probability value of less than 0.05 was considered as significant. Results: Abdominal Hysterectomy was performed in 4 patients in Group c and 6 patients in Group R. Hernioplasty was performed in 5 patients in Group c and 7 patients in Group R. The mean time for first dose in Group c was 646.83 mins and in group R was 393.43 mins. The mean time for second dose in Group c was 1284.89 mins and in group R was 393.43 mins. Conclusion: TAP block under USG guidance should be used to provide better analgesia in postoperative Period. Adjuvants like clonidine should be used along with local anesthetics for prolongation of analgesic effect of TAP block in post-operative period.
Introduction: Empyema thoracis is an uncommon complication of childhood pneumonias but a common problem faced by a thoracic surgeon. Its management is still controversial, with a range of treatment options available and evolving gradually towards adoption of video-assisted thoracoscopic surgery (VATS) as the most commonly practiced one.
Aim: The aim of this study was to review our experience in pediatric empyema thoracis.
Methods: It was a retrospective review of the prospectively recorded data, spanning a period of 18 months in the Department of Cardio-Thoracic and Vascular Surgery in Manmohan Cardio-Thoracic Vascular and Transplant Center.
Results: A total of 40 consecutive patients, 29 males and 11 females, aged 15 years or less were operated upon for a diagnosis of empyema thoracis made based on clinical, radiological and laboratory evidence. All of them were referred patients, mostly from pediatricians. VATS was undertaken in 36 of them, the remaining four treated by open approach. Deloculation sufficed in majority (26/40; 65%) of the patients which mostly (23/26; 90%) had either acute or subacute presentation. Decortication was required in 35% (14/40) of the patients. However, all of the patients but one had a successful outcome in terms of lung expansion, sterilization of the pleural cavity and absence of recurrence. There was no operative mortality.
Conclusion: Surgical management of pediatric thoracic empyema is feasible and safe with favorable outcome. VATS is gradually becoming the more favored modality of operative management.
Most pathology of the thymus gland warrant its surgical removal; and this requires significant expertise and adequate medical set-up. This study aimed to audit the results of thymectomies performed in a specialised tertiary level centre in a resource-poor country. The outcomes of open and minimally invasive video-assisted thoracoscopic surgery (VATS) thymectomies were also compared. Out of 58 patients operated at
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