BACKGROUNDCombined Spinal Epidural Anaesthesia (CSEA) is frequently used for its rapid onset of analgesia and good patient satisfaction. In this group, various types of intrathecal intervention are possible.The aim of the present study has been designed to evaluate the quality of analgesia when intrathecal fentanyl 25 mcg was given along with epidural 0.0625% bupivacaine 10 cc with fentanyl 2 mcg/mL in one group in companion with another group who has been given intrathecal fentanyl 25 mcg given long with epidural 10 cc bupivacaine 0.1% with fentanyl 2 mcg/mL.
BACKGROUND Dexmedetomidine is a centrally acting selective α2A agonist is used as an adjuvant to anaesthesia, because it produces analgesia with little respiratory depression and amnesia, sympathetic response to stress is also blunted. Present study is conducted with an aim to compare the efficacy of dexmedetomidine as an adjuvant to local anaesthetic agent in comparison with fentanyl. MATERIALS AND METHODS Patients were randomised and separated into group D and group F. Group D is dexmedetomidine 1 mg/kg with 0.75% ropivacaine 15 mL. Group F is fentanyl 1 mg/kg with 0.75% ropivacaine 15 mL. RESULTS Time required to reach T10 level was 2.33 mins. in group D and 4.28 mins. in group F. Peak sensory level reach in group D was T5, and in group F, it was T4. Time to reach peak sensory level was 9.86 mins. in group D and 11.40 mins. in group F. Time for regress to L5 was 412.6 mins. in group D and 360.40 mins. in group F. Onset of motor block in group D was 4.65 mins. and group F was 6.68 mins. Duration of block was 358 mins. in group D and 286 mins. in group F. Time required for first dose of required oranges was 8 hrs. in group D and 5 hours in group F. Similarly, 26 patients in group D required analgesics that are 48 in group F. CONCLUSION We conclude that dexmedetomidine is a better adjuvant than fentanyl along with ropivacaine. It produces early sensory and motor block and duration of block is also prolonged. It is a better analgesic, than fentanyl in postoperative period.
BACKGROUND Emergence delirium is also called emergence agitation which occurs more frequently in children in the immediate post-operative period. It is assumed that lack of adequate pain control before emergence may be the cause of this. But other studies it found that even if pain is managed proper with nerve block there was episodes of ED. Rapid emergence from anaesthesia also may be the cause of ED. Several drugs have been used as adjuvants to Sevoflurane to decrease the incidence of ED. Present study is aimed to evaluate the efficacy to two α2-receptor agonist on emergence delirium with Sevoflurane anaesthesia in paediatric day care surgery. MATERIALS AND METHODS After taking permission from institutional ethics committee and written informed consent from parent this study was started. This study was conducted in the department of anaesthesia, Andhra medical collage Visakhapatnam from November 2015 to August 2017. During this period sixty patients were included in this study based on inclusion and exclusion criteria. Patient selected in this study were randomized and divided into two groups. Group D is dexmedetomidine group and Group C is clonidine group. RESULTS We have found that emergence agitation with time was less in group D than group C. At T0 min it was 8 in group D in comparison to 12 in group C, at T15 min it was nil in group D and 4 in group C.PAED score was high in group C than group D in first-20 min. At T0 it was 7.20 in group D and 10.46 in group C. CONCLUSION Both the drugs are agonist on α2a receptor, but affinity of dexmedetomidine is higher and it has both sedative analgesics, amnestic and sympatholytic effect. Both used to decrease severity and incidence of ED but dexmedetomidine is more effective. Dexmedetomidine also used to decrease duration of stay in PACU.
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