Background and aim: This study aimed to compare the efficacy of combined suprascapular nerve block (SSNB) and axillary nerve block (ANB) with SSNB alone for analgesia after shoulder arthroscopy in terms of level of pain scores, total analgesic consumption and patient satisfaction in 24 hours. Methods: Forty one patients posted for shoulder arthroscopy were randomly allocated into two groups, group S (n=20), receiving SSNB and group C (n=21) receiving combined SSNB and ANB. Visual analogue scale (VAS) both at rest and during movement at 1, 3, 6, 12, 24 hours and at the time of first demand, total consumption of analgesics in 24 hours and patient satisfaction score at 12 and 24 hours were noted. Results: The VAS scores both at rest and during movement were significantly less in group C at 1, 6, 12 hours and at the time of first demand of analgesic (p < 0.05). Compared to group S, group C had a longer pain free duration (154.3 ± 11.41 min vs 36.60 ± 6.553 min; p < 0.001) and lesser cumulative consumption of pethidine (300.0 ± 8.894 mg vs 336.8 ± 13.27 mg; p = 0.0256). The satisfaction level was better in group C at 12 hours (p = 0.002) but comparable to the group S at 24 hours (p= 0.0673). Conclusion: Combined SSNB and ANB provided better pain relief in first 12 hours, better patient satisfaction in the first 12 hours and decreased overall consumption of analgesics in the first 24 hours compared to SSNB alone.
Pain sensation from venepuncture not only affects the patient physically and psychologically but also hinders the functioning of the health care provider. Lignocaine has been tested for its use in order to decrease intensity of pain during intravenous cannulation for long time. A newer drug tetracine with less systemic adverse effects has been tried recently. The analgesic efficacy of the eutectic mixture of lignocaine and prilocaine has been compared with mixture of Lignocaine and tetracaine when applied during venepuncture in adult patients under similar condition, as there is dearth of study with tetracaine. 90 patients randomly allocated in two groups and finally 80 patients analysed, after dropout each group having 40 patients. Group P- Topical application of Lignocaine & Prilocaine cream before venepuncture (n=40).Group T - Topical applicaton of Lignocaine & Tetracaine cream before venepuncture (n=40).The effectiveness of analgesia was determined by documenting the 10 point Visual Analogue Scale (VAS). Hemodynamic parameters were noted as secondary outcome. Demographic profile were comparable, mean pain score (VAS) of the patients of Group-P was significantly higher than that of the patients of Group-T (t=3.74; p<0.001). Hemodynamic parameters were normal.Finding of the study corroborate that Lignocaine 7% & Tetracaine 7% cream (group T) offers better analgesia than Lignocaine 2.5% & Prilocaine 2.5% cream (group P) when applied under similar conditions 60 minutes before venepuncture in adult patients.
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