Background: Clonidine has been used as an adjuvant in Brachial plexus block (BPB) to enhance its quality and duration. However, whether, clonidine in BPB acts perineurally or via systemic absorption is not entirely clear. Methods: Ninety-three patients of either sex, ASA I and II, aged 18-70 years, undergoing lower end humerus fracture fixation were included in the study. Patients were randomized into 3 groups. All the patients received brachial plexus block using nerve stimulator with 28 ml 0.5% Bupivacaine and 2 ml of NS/NS with clonidine. In the first group (Bc) 2 mcg/kg of clonidine was added to the anaesthesia solution and 10 ml of NS was injected intravenously; second group (Bivc) received clonidine 2 mcg/kg diluted up to 10 ml by intravenous route with 28 ml of 0.5% Bupivacaine and 2 ml of NS in the block; third group (B) received 28 ml of 0.5% Bupivacaine with 2 ml of NS in the block and 10 ml of NS intravenously, as placebo. Onset and duration of sensorimotor block, hemodynamic variables, duration of analgesia, level of sedation and adverse effects were noted. Results: Onset of sensory blockade was faster in group Bc (7 ± 0.720 min) compared to group B (11.46 ± 1.138 min) and Bivc (11.46 ± 1.170 min) (p < 0.001). Onset of motor block was faster in group Bc (16.43 ± 1.136 min) compared to group B (22.75 ± 1.456 min) and Bivc (22.25 ± 1.295 min) (p < 0.001). The mean durations of analgesia were recorded as 1160.71 ± 53.259 min in group Bc, 454.64 ± 14.07 min in Group Bivc and 442.50 ± 18.634 min in group B. Conclusion: Addition of clonidine 2mcg/kg to 28 ml of 0.5% bupivacaine in brachial plexus blocks results in a faster onset, increased duration of block and longer postoperative pain relief when compared to bupivacaine alone. These advantages are not observed when the same dose of clonidine is injected intravenously.
Introduction: Laryngoscopy and tracheal intubation is integral part of general anaesthesia but is frequently associated with haemodynamic disturbances. Propofol, ketamine and etomidate have their own limitations when they used alone for induction. Thus, this study was designed to compare haemodynamic changes during induction and intubation with propofol, etomidate and ketofol. Materials And Methods: After taking Clinical Trial Registry of India (CTRI/2018/04/013409) registration, this prospective, randomized, comparative, double blind Study was conducted on 120 patients aged 18-60 yrs, ASA grade I or II, posted for elective surgery under general anaesthesia. The patients were randomly allocated into three groups. Group P- Inj Propofol (2.0 mg/kg), Group E -Inj Etomidate (0.3 mg/kg) and Group KP- Inj Propofol (1.5 mg/kg) plus Inj ketamine (0.5mg/kg) intravenously. Heart rate, systolic blood pressure , diastolic blood pressure and mean arterial blood pressure were recorded before induction, immediately after induction, 0,1,3,5 and 10 min after intubation. Results: The data related analysed using Student t test, Pearson Chi-square test and ANOVA wherever applicable, P<0.05 was considered statistically signicant. A statistically signicant difference was noted between the groups regarding vital parameters at different time interval [p<0.05]. Conclusion: The combination of ketamine plus propofol has better haemodynamic stability without side effects than etomidate and propofol alone as an induction agent. Hence, combination (ketofol) may be better choice than either propofol or etomidate alone as induction agent with stable haemodynamics.
Background And Aims: Hypotension is commonly associated side effect with Subarachnoid block (SAB) and it is widely used technique for parturients undergoing lower segment caesarean section (LSCS). Hypotension is detrimental to both mother and baby so prophylactic measures are essential to prevent it. So this study was conducted to use perfusion index as a predictive non-invasive measure of hypotension in parturients posted for LSCS under SAB. Materials And Methods: After obtaining written and informed consent, this prospective, double blind, observational study was carried out in 100 term pregnant females aged 20-40 years and were devided in two groups (50 in each) based on baseline PI, PI values ≤3.5 were in Group I and PI values >3.5 in Group II. All parturients were given inj. bupivacaine 0.5% Heavy 2 ml (10 mg) in SAB. Incidence of hypotension and other parameters, requirement of rescue drug and uids were recorded. Results: In Group I (PI≤3.5) incidence of hypotension (8 vs 40, P=0.00), requirement of rescue drug (mephentermine) per parturient (1.92±4.92 vs 8.4±5.6, P=0.00) and Fluid requirement (ml) per parturient (1243.20±115.24 vs 1381.60±110.79, P=0.00) were signicantly less as compared to Group II (PI>3.5). (p<0.05) Conclusion: Parturients with PI>3.5 are at higher risk of developing hypotension after subarachnoid block and requirement of vasopressors and uid is more as compared to those parturients with PI≤3.5.
Acute hypocalcaemia is a medical emergency that can have catastrophic implications like tetany, seizures, cardiac arrythmias or laryngospasm if left untreated. We are presenting a case of a 30-year-old female patient undergoing total abdominal hysterectomy with bilateral salpingoopherectomy under spinal anaesthesia. She developed unexpected bilateral carpal spasm intraoperatively which was promptly diagnosed and successfully managed with intravenous calcium administration. We conclude that the anaesthetist should be aware of the clinical presentation of acute hypocalcaemia, its causes and emergency management in the perioperative period to prevent any adverse outcomes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.