A B S T R A C TAims: The aim of this study was to evaluate the onset, duration of sensory and motor block, hemodynamic effects (if any), duration and quality of postoperative analgesia, and adverse effects of magnesium or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine in patients with mild preeclampsia undergoing elective caesarean sections. Materials and Methods: A total of 60 women with mild preeclampsia undergoing elective cesarean section were included in a prospective, double-blind, controlled trial. Patients were randomly assigned to receive spinal anesthesia with 2 mL 0.5% hyperbaric bupivacaine with 12.5 µg fentanyl (Group F) or 0.1 mL of 50% magnesium sulfate (50 mg) (Group M) with 0.15 ml preservative free distilled water. Onset, duration and recovery of sensory and motor block, time to maximum sensory block, duration of spinal anesthesia and postoperative analgesia requirements were studied. Statistical comparison was carried out using the Chi-square or Fisher's exact tests and independent Student's t-test where appropriate. Results: The onset of both sensory and motor block was slower in the magnesium group. The duration of spinal anesthesia (246 min ± 11 min vs. 284 min ± 15 min; P < 0.001) and motor block (186.3 ± 12 min vs. 210 ± 10 min; P < 0.001) were significantly longer in the magnesium group. Total analgesic dose requirement was less in Group M. Hemodynamic parameters were comparable in the two groups. Intrathecal magnesium caused minimal side effects. Conclusions: The addition of magnesium sulfate 50 mg to bupivacaine for sub-arachnoid block in patients with mild preeclampsia undergoing elective cesarean section prolongs the duration of analgesia and reduces postoperative analgesic requirements without additional side effects and adverse neonatal outcomes
Objective: To study the prole of hypertensive children admitted in a tertiary care hospital in the age group of 3 to 12 years. Method: It is a Prospective type Study done over 1 year from June 2019 to May 2020 in the Department of Pediatrics, Silchar Medical College and Hospital (SMCH), a tertiary care Hospital in Assam,India. One twenty six children in the age group of 3 to 12 years meeting the inclusion criteria were admitted with hypertension. Results: During the study period a total of 3214 patients were admitted in the Pediatric Department of Silchar Medical College and Hospital. Out of which 126 patients were found to be hypertensive (3.9%). The number of males were 81(65%) and females 45(56%). The most common affected group was school going children age group (6 to 12 years). 37(29.3%) cases presented with hypertensive emergency. 22(17%) cases presented with congestive cardiac failure and 15(11.9%) cases hypertensive encephalopathy. Renal Cause of hypertension was the leading cause of admission and glomerulonephritis was the leading renal cause (80%). The mortality was 4.7% (6 out of 126 patients) and was due to complication of Glomerulonephritis. Conclusion: Hypertension is a common cause of hospitalization in children. Renal or renovascular etiology of hypertension is the most common cause of hypertension.
Objectives: The study was undertaken to observe the effect of intrathecally administered fentanyl with bupivacaine on onset and duration of sensory and motor block, quality of anaesthesia and requirement of analgesia during early postoperative period. Method: In this study 45 women of group 1 received hyperbaric bupivacaine 10 mg and 45 women of group 2 received bupivacaine 10mg with fentanyl 12.5 mg. Onset of sensory and motor block, height of block, sensory regression, requirement of analgesic and any complication were recorded. Result: The onset time for analgesia was significantly shorter in group 2 than in group1 (1.9±0.56 vs 2.46± 0.79). The mean time for sensory regression to L1 is shorter in group1 compared to group 2. The mean time for two segments sensory regression was significantly prolonged in group2 compared to group 1. Time for complete sensory recovery when rescue analgesia was required in postoperative period was significantly prolonged in group 2 compared to group 1 (259.4±35.3 vs 165.0±23.8). There were no significant differences between the two groups with regard to incidence of nausea and vomiting, shivering and pruritus. Conclusion: Addition of fentanyl to hyperbaric bupivacaine augments sensory block without affecting motor block.
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