Background: Ultrasound guided abdominal nerve blocks are increasingly being used for anaesthesia and analgesia for surgeries like appendectomy, hernia repair in our centre. The aim of the study was to compare abdominal nerve blocks and subarachnoid block for appendectomy.Method: Retrospective data of patients that underwent appendectomy either under subarachnoid block (Group-S) or abdominal nerve blocks (Group-A) for three months were collected from hospital records. The groups were compared for conversion to general anaesthesia as a primary end point of study and also for the time taken for the procedure, the first requirement of opioids, total opioid consumption and length of hospital stay.Result: Out of 116 patients studied, 75 surgeries were performed under subarachnoid block and 41 under abdominal plane blocks. Two patients in Group-S and 1 patient in Group-A were converted to general anaesthesia due to inadequate blockade. The time taken to perform the block was around four minutes in Group-S and 12 minutes in Group-A. The mean pethidine consumption in 24 hours was 62.33+16.63 mg and 23.17+15.19 mg in Group-S and Group-A respectively. The time to the first dose of pethidine in Group-S groups was 224.66+43.56 minutes and 813.17+361.80 minutes in Group-A. The mean duration of hospital stay in Group-S was 5.14+0.72 days and Group-A was 2.24+0.58 days.Conclusion: Appendectomy can be safely performed under subarachnoid block as well as the abdominal nerve blocks. The abdominal nerve block technique is found to be advantageous in terms of better postoperative analgesia, less opioid consumption and early hospital discharge.
Background: Cooled Radiofrequency ablation is a newer technique for management of chronic knee pain in osteoarthritis. The aim of the study is to evaluate the clinical outcomes in patients with chronic osteoarthritis in terms of pain scores for first six months of cooled radiofrequency ablation using ultrasound guidance. Methods: A cross-sectional study with retrospective review of database was evaluated to analyze the change in the Numerical Rating Scale from baseline scores at 1 day, 1 month and 6 months after the Cooled Radiofrequency ablation of genicular nerves around knee in patients with chronic knee osteoarthritis. Results: Median age was 71 years [ 61-73 years (IQR: 25-75)] with more female preponderance. Numerical Rating Scale (Mean ± S.D.) was significantly less at 1 day (1.87 ± 1.22), 1 month (3.03 ± 0.99) and 6 months (3.37 ± 1.098) from baseline values (6.77 ± 1.00). No soreness and numbness were noted.Conclusions: Cooled Radiofrequency using Ultrasound guidance for management of knee pain in chronic osteoarthritis is promising and reduces Numerical Rating Score significantly from baseline at 1 month and 6 months respectively.Keywords: Cooled radiofrequency ablation; genicular nerve; numeric rating scale
Diagnosis and surgery pertaining cancer are increasing day by day in the developing world. Delay in diagnosis, poor socioeconomic status, and poor medical facilities are the challenge in treating these patients. Decreasing or preventing postoperative morbidity is of paramount importance in these cases. Ultrasound guided abdominal plane blocks like transversus abdominis plane block, rectus sheath block and coeliac plexus in combination with ketofol and/or dexmedetomidine sedation may be the alternative to general anaesthesia with an endotracheal tube or neuraxial block. These techniques, successfully used in our patients undergoing cancer surgeries, have a potential to decrease intensive care length of stay, decrease requirement of mechanical ventilation, early ambulation, and discharge.
Background: Ultrasound guided peripheral nerve blocks have become increasingly popular in the lower limb orthopaedic and gaining more acceptances in total hip replacement surgeries too. The main objective of this study was to compare peripheral nerve block and spinal anesthesia for total hip replacement surgeries.
Methods: In this retrospective study, total patients that underwent total hip replacement in our institution during specific time period were included for the study. They were divided into spinal and peripheral nerve block groups, and data were collected for the analysis. USG guided lumbar plexus, sacral plexus, superior gluteal nerve block was done and conventional landmark technique was done for spinal group. Mean arterial blood pressure, total fluid consumption, total fentanyl consumption, pain scores and incidence of nausea was compared.
Results: We included 43 patients for the study in which 23 patients were included in nerve block group, and 20 patients in the spinal group. In compared to spinal group, nerve block group had more stable mean arterial blood pressure (P <0.05), less total fluid consumption (P=.000), lower pain scores and fentanyl consumption (P <0.05), and less incidence of nausea (4% to 20%).
Conclusions: Peripheral nerve block can be good alternative to spinal anesthesia for total hip replacement surgeries, with more hemodynamic stability and better pain management along with less opioid and fluid consumption.
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