BACKGROUNDMany drugs have been used as adjuvants to local anaesthetics to prolong the duration of analgesia after a peripheral nerve block. In this study, we evaluate the effects of adding MgSO4 to local anaesthetics in supraclavicular block to prolong the duration of analgesia.
Background: More than 40% of general anaesthetics are managed with supraglottic airway devices. First generation SADs act as airway conduits whereas second generation devices have safety designs like integrated bite block, gastric drainage channel and act as airway conduit for endotracheal intubation. Supraglottic airway devices are getting accepted by many anaesthetists during laparascopic surgeries.Methods: Authors did a study, comparing the functional analysis of I- gel with Baska mask during laparascopic surgeries with controlled ventilation. The study was conducted on sixty patients of either sex scheduled for short duration laparascopic surgeries (<2 hs). The study conducted on ASA I and II patients with a BMI of <30kg/m2. Patients with restricted mouth opening(<2.5cm), difficult airway, known GERD patients, obese patients (>30kg/m2), and ASA physical status III and IV patients were excluded from the study. patients were induced with fentanyl 2µg/ kg, propofol 2-2.5mg/kg and neuromuscular paralysis facilitated with atracurium 0.5mg/kg. Anaesthesia was maintained with oxygen, air (fio2 40%) with isoflurane1.5-2%. Ease of insertion was evaluated using 4-points scale. Score 1 means easy insertion to score 4 denotes impossible to insert. Oropharyngeal seal pressure was measured after five minutes of placement. FGF 5L/min was used after closing the APL valve at 70cm h2o, recording the pressure at which pressue is plateaued. Presence of sore throat, dysphagia and dysphonia were examined 2hrs and 24hrs post operatively.Results: The insertion time was shorter for I-gel (12.3±3.8secs) than Baska mask (20.1±8.1secs). Oropharyngeal leak pressure was significantly higher for Baska mask (24-32cmh20). Oropharyngeal airway morbidity was not significantly different between two groups. So, it has been decided that both airways are suitable for laparascopic surgeries, but I-gel was quicker to insert, but Baska mask gave good airway seal.Conclusions: In this study, authors have noticed that Baska mask will give good airway seal when compared with I-gel. But I-gel was quicker to insert than Baskamask. The main problem of the study was that it was not blinded.
Background: Gynaecological surgeries are performed by abdominal incision is common and post-operative pain and discomfort is always anticipated. TAP block is a regional anaesthetic technique which blocks the abdominal neural afferents by administrating local anaesthetic drugs into the neuro-fascial plane. The other method for postoperative analgesia is surgical wound infiltration with local anaesthetic drugs. The aim of this study was to evaluate the post-operative analgesic efficacy of TAP block versus wound infiltration in gynaecological surgeries.Methods: The study was a prospective randomized study conducted on patients undergoing open gynaecological surgeries, conducted at the Government medical college and ESI hospital, Coimbatore. The study was initiated after obtaining an ethical clearance from the institution. Group A: patients who underwent bilateral TAP block with 0.3 ml/kg 0.25% Bupivacaine on each side. Group B: patients who received wound infiltration of 0.25% Bupivacaine 0.6ml/kg.Results: TAP block provided superior analgesic effect than the surgical site infiltration group, without significant changes in the hemodynamic parameters. The duration of analgesia was longer and the need of Tramadol in the postoperative period was found to be lesser in the TAP block group as compared to wound infiltration group.Conclusions: The TAP block is an effective and safe technique for postoperative analgesia for gynaecological surgeries than compared to the surgical wound infiltration. The requirement of Tramadol as a postoperative analgesia was less with TAP block compared to surgical wound infiltration.
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