BACKGROUND Patients sometimes complain of soreness of throat following tracheal extubation. Different analgesic and anaesthetic formulations have been employed to treat and prevent it. We attempted to study the effect of intravenous Paracetamol premedication in preventing it. MATERIALS AND METHODS With permission from Institutional Ethics Committee and written informed consent from patients, this single blind study was conducted on 80 ASA adult subjects of both sexes of ASA Grades I and II who needed general anaesthesia with endotracheal intubation. The patients were randomly divided into two groups of 40 each. Group P patients were given intravenous Paracetamol infusion as premedication while the Group C were studied as the control group. Standard identical anaesthetic techniques were employed for both the groups. Following recovery from anaesthesia, the patients were checked for sore throat and the severity of it at 0,2,6 and 24 hours using verbal rating scale and the data was statistically analysed.
BACKGROUNDAdjuvants/adjuncts are the drugs, which when added to local anaesthetics tend to improve the quality of block and increase duration of analgesia. The purpose of this study was to compare two novel alpha-2 agonist clonidine and dexmedetomidine when added as adjuvant to 0.5% ropivacaine in infraclavicular vertical brachial plexus block in respect to onset, duration of sensory and motor block along with duration of analgesia. MATERIALS AND METHODSA total of 60 patients confirming to inclusion criteria, undergoing elective upper limb surgeries under BPB in VIMSAR, Burla, were enrolled for the study over a period of one year. Sensory block was evaluated by Hollmen scale. Onset time of sensory block, time for complete sensory block and total duration of sensory block were recorded. Motor block was evaluated by using Bromage scale. Onset time of motor block, time for complete motor block and total duration of motor block were recorded. Level of sedation was assessed using the Ramsay sedation score. Postoperatively, sensory block and motor block and postoperative pain (by visual analogue scale) were assessed. RESULTSThe sensory motor block was significantly rapid and the duration of analgesia was significantly prolonged in dexmedetomidine group as compared to clonidine group. CONCLUSIONAddition of 1 μg/kg of dexmedetomidine as adjuvant to 0.5% ropivacaine for infraclavicular vertical brachial plexus block is better as compared to 1 μg/kg of clonidine. KEYWORDSRopivacaine, Dexmedetomidine, Clonidine, Infraclavicular Vertical Brachial Plexus Block. HOW TO CITE THIS ARTICLE: Dalai H, Dash SK, Panda P, et al. Clonidine versus dexmedetomidine as adjuvant to 0.5% ropivacaine in infraclavicular vertical brachial plexus block-A randomised control study. J. Evid. Based Med.
BACKGROUND General anaesthesia is the traditional standard technique for various breast surgery, but Thoracic Epidural Anaesthesia offers advantages like better haemodynamics, early recovery, less postoperative respiratory complications and good analgesia. The objective of this study is to evaluate the effectiveness of Thoracic Epidural Anaesthesia with Dexmedetomidine and Inj. Ropivacaine (0.5%) for breast surgery (MRM) with conventional general anaesthesia. MATERIALS AND METHODS With permission from Institutional Ethics Committee, forty consenting ASA Grades I and II patients posted for MRM were divided into two groups. In Group (TEA) Thoracic Epidural was performed in T4-T8 intervertebral space and 5 cm of epidural catheter was threaded. Inj. Ropivacaine 0.5% with Dexmedetomidine 1 µg/kg was injected into the epidural space in increments via the catheter to achieve the desired height. In Group (GA), patients were managed in conventional way with Glycopyrrolate (0.2 mg), Fentanyl (2 µg/kg) and Midazolam (0.05 mg/kg) for premedication induced with Inj. Propofol (2 mg/kg). Intubation and maintenance of relaxation thereafter was with Vecuronium. Anaesthesia maintained with N20:O2 in 60:40 ratio with Isoflurane 0.4-0.6% in IPPV. Towards the end of surgery, the patients received Ondansetron (4 mg) and Diclofenac (75 mg) infusion and reversed with Neostigmine (0.5 mg/kg) and 20 µg of Glycopyrrolate. Ringer's Lactate was used as maintenance fluid for both the groups. Monitoring of Pulse, NIBP, ECG, SpO2 and Respiration was done throughout surgery in both the groups. RESULTS Adequacy of anaesthesia, surgical condition, bleeding, post-anaesthesia recovery, untoward effects in the perioperative period and overall patient satisfaction were evaluated. CONCLUSION Thoracic epidural with 0.5% Ropivacaine in conjunction with Dexmedetomidine did offer an excellent perioperative outcome without any significant untoward effects.
Cholecystectomy employing combined spinal epidural technique with lignocaine and /or bupivacaine as the local anaesthetic agent has been reported. Here we report a patient with cardiac as well as pulmonary disorders who underwent open cholecystectomy under combined spinal epidural technique with Ropivacaine as sole local anaesthetic agent.
BACKGROUND An ideal induction agent for general anaesthesia should have haemodynamic stability, minimal respiratory side effects and rapid clearance. Sudden hypotension has a deleterious effects on maintaining the circulation to vital organs. Presently, etomidate and propofol are popular rapid acting inducing agents. Hence, this study was conducted to compare the haemodynamic effects of etomidate and propofol. MATERIALS AND METHODS Double-blind randomised study was conducted on sixty patients after informed consent comprising of thirty patients each (Group E for etomidate and group P for propofol). Patients were premedicated with Inj. Glycopyrrolate 0.2 mg IV, Inj. Butorphanol 0.03 mg/kg IV, Inj. Midazolam 0.3 mg/kg IV followed by etomidate 0.3 mg/kg given slowly over 45 seconds in the group E and propofol 2 mg/kg for induction of anaesthesia in the group P. Heart rate and blood pressure were measured before induction and every minute for 3 minute after induction. RESULTS When compared to etomidate group, there was a significant fall in blood pressure in propofol group. There was no significant change in hearts rate in all three groups. CONCLUSION When etomidate is used as an induction agent during general anaesthesia, there is a better haemodynamic stability in comparison to propofol.
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