Objective: The objective of this analysis was to govern the analgesic effect of tramadol with caudal bupivacaine in children enduring inguinal-scrotal surgery postoperatively. Study design: A Quasi experimental study. Methods: In this comparative and double-blind study, 120 children undergoing inguinal scrotal surgery were involved in the analysis. They were 2-12 years old. The inclusion standards were children from ASA I and II. The two identical groups were formed. After initiation of general anesthesia, group A patients (n = 60) 0.25% bupivacaine 0.75 ml / kg was administered and tramadol 1 mg / kg with 0.25% bupivacaine 0.75 ml / kg were administered in B group (n = 60). Postoperative pain was evaluated with a visual analogue pain score in 6-7 years of age children and with behavioural reflexion in pre-speech children. Using a 4-point sedation scale; Sedation was assessed; heart rate, mean arterial pressure, arterial oxygen saturation and respiration rate. The sedation and pain were documented at consistent duration up to 24 hours after surgery immediately after recovery from anesthesia. If the pain score was higher than 4, paracetamol (20 mg / kg) was administered rectally. Results: Addition of intravenous bupivacaine and tramadol suggestively have longer postoperative analgesia (10.1 ± 2.1 hours) in group B, while the mean duration of analgesia (2.90 ± 0.79 hours) in group A, where bupivacaine alone was, provided. No significant changes were observed in blood pressure, O2 saturation and heart rate between groups. Apart from vomiting and nausea, no side effects like retention of urine, depression and pruritus were observed. Conclusion: In children undergoing inguinal scrotal surgery, caudal bupivacaine and tramadol have more lasting and better postoperative analgesia than bupivacaine alone. Keywords: Postoperative analgesia, tramadol, Caudal and bupivacaine.
The usage of Propofol is the most common method for the sake of insertion of I-Gel. But when propofol is used it may cause serious problems like swelling or inflammation at the injection site, low blood pressure, and apnea. There is a need to find another better method for providing anesthetics during the insertion of I-Gel. Objective: To find out the effects of two anaesthetics propofol and sevoflurane during the insertion of I-Gel. Methods: For the sake of the study a group of 66 patients were selected. All of these patients have to go under some surgeries using commonly available an aesthetics. The patients were divided into two groups 33 patients in each group. One group received Propofol before surgery and the other group receive sevoflurane. Then after the insertion of I –Gel, patients were analyzed in detail for all the changes that took place. Results: After the insertion of I-Gel, all the physical changes of the patients were analyzed in detail. Both of the study groups were given different drugs, but after surgery, no difference was observed between two groups having different an aesthetic. Both of the group have same heart rate, blood pressure and other insertion details except that Sevoflurane need much time to perform it’s an aesthetic function as compared to Propofol. Conclusion: After all these experiments, it is inferred that, when the effects of both drugs were compared, Sevoflurance has stability in the case of hemodynamics, it can replace propofol in a number of procedures due to its stability. Propofol does not have so much hemodynamic stability. But when I-Gel insertion has to be performed, Propofol has a better rate of induction as compared to sevoflurane.
Aim: This study was conducted using the technique of visualization of the recurrent nerves to assess the frequency of recurrent laryngeal nerve injuries in our setting. Methods: A total of 80 patients were selected for this study after a purposive sampling technique. All adult patients, regardless of age and gender, undergoing total thyroidectomy or hemi-thyroidectomy with written informed consent were included in this research. The subjects who had previously undergone thyroid surgery were not encompassed in the study. The thyroid status and preoperative analysis were made biochemically, histo-pathologically and clinically using fine needle aspiration cytology. SPSS version 21.0 was applied for data analysis. Results: The study involved 80 patients, 35 (43.8%) men and 45 (56.2%) women, and the proportion of male to female was 1.4: 2. The mean age was 46.1 years with 8.1 years standard deviation. The indications for thyroid surgery were different: solitary thyroid nodule (31.2%), multinodular goiter (47.5%) and thyroid gland carcinoma (21.3%). Some underwent a total thyroidectomy (52) and others had a hemi-thyroidectomy (28). The total incidence of recurrent laryngeal nerve injuries was unilateral and on right side in 3 cases (3.8%) established by fiber optic laryngoscopy (FOL). In both cases, the palsy was transient, as after six weeks of conservative treatment, these patients achieved full recovery of the paralyzed vocal cords. Conclusions: This analysis demonstrated that surgical exploration of the recurrent laryngeal nerve prevents undesirable nerve injury and thus reduces the frequency of paralysis of vocal cords. Therefore, we recommend routine RLN dissection and identification to minimize its injuries. Keywords: Recurrent laryngeal nerve, Injury, Vocal cords.
Objective: To evaluate the anaesthetic effects, patient satisfaction, and the Oxidative Stress Index between neuroaxial anaesthesia (NA) and general anaesthesia (GA) during gynecologic laparoscopic surgery. Study Design: Prospective randomized study Place and Duration: Lady Reading Hospital Peshawar.1st Jan, 2021 to 30 June, 2021. Methods: The research involved ninety women between the ages of 20 and 55 who were scheduled to undergo diagnostic laparoscopy and hysteroscopy for unexplained infertility and had an ASA I-II physical status.Age, BMI and laparotomy indication were documented after obtaining informed written permission from each patient. Patients were equally divided in two groups group I received neuroaxial anesthesia and group II received general anesthesia. Post-operative outcomes among both groups were compared. SPSS 22.0 was used to analyze complete data. Results:Mean age of the patients in group I was 33.4±11.32 years and had mean BMI 25.4±7.81 kg/m2 while in group II mean age was 30.7±14.63 years with mean BMI 22.8±9.52 kg/m2. In group I 28 (62.2%) cases had ASA class I and in group II 30 (66.7%) cases had ASA class I. Diagnostic laparoscopy was majority in numbers among both groups 29 (64.4%) in group I and 26 (57.8%) in group II. Among both groups paratubal cystectomy was most common symptom found in 6 (13.3%) cases and 7 (15.6%) cases. Mean operative time in neuroaxial group was lower 45.3±6.52 minutes as compared to group II was 54.8±11.42 minutes. Mean time of anesthesia was also lower in group I as compared to group II with p value <0.003. Mean pain score was significantly reduced in group I 3.6±8.61 as compared to group II 6.8±11.92. Heart rate and arterial pressure was lower in group I. Post-operative Oxidative Stress index among patients of group II was higher 1.9±4.45 as compared to group I 0.9±0.42. Conclusion:We concluded in this study that the use of neuroaxial anesthesia undergoing gynecologica laparoscopy was effective and useful as compared to general anesthesia in terms of less pain score and oxidative stress index. Except this frequency of adverse events were also lower in neuroaxial group. Keywords: Laparoscopy, Nueroaxial Anesthesia, General Anesthesia, Complication, Pain score
Objective: To assess the effect of pregabalin in reducing the postoperative requirement of analgesics of patient undergoing knee arthroscopic anterior cruciate ligament repair surgery. Study Design: Prospective randomized control trial. Place and Duration of Study: Department of Anesthesia, Ghurki Trust Teaching Hospital Lahore from 1st June 2021 to 31st December 2021. Methodology: Eighty patients were randomly divided into two groups; group A and group B, each group comprised 40. Group A receive placebo and group B receive pregabalin 150mg once a day for two days after surgery. Pain assessment done with the help of Numeric Rating Scale and rescue analgesia was recorded. Results: The mean age was 31±10.2 years of group A and 33±10.3 year of Group B. There were more males within both groups in comparison to females with a percentage of 77.5% and 85% respectively. The reduction was seen within Group B in comparison of Group A in terms of ASA class, VNRS, and maximum sensory block. Cumulative volume of PCA in ml was also less in group B than group A with a significant difference within 0-6 hours. Conclusions: The use of pregabalin 150mg after surgery for two days significantly reduces the analgesic consumption Keywords: Pregabalin, Postoperative analgesic, Numeric rating scale
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