BACKGROUND In children Sevoflurane is associated with delirium upon recovery from anaesthesia, cause is not clear. It is called emergence delirium or emergence agitation. This is usually seen in first thirty minutes and it is described as a disturbance in children awareness and attention to environment with disorientation and perceptual alterations including hypersensitivity to stimuli and hyperactive motor behaviour in the immediate post anaesthesia period. Propofol is effective in preventing emergence agitation (E.A). Dexmedetomidine is reported to reduce the frequently of EA. So we have conducted a study to evaluate, the efficacy of propofol in comparison with dexmedetomidine, to reduce the Emergence agitation with Sevoflurane anaesthesia in paediatric patients. MATERIALS AND METHODS Patient selected for this study were randomly divided in to two groups, group A, is a propofol group, group B is dexmedetomidine group. The severity of EA was evaluated by using paediatric anaesthesia emergence delirium scale (PAED) devised by Sikich and lerma. Incidence of emergence agitation and PAED score were noted every 5 min up to first 30 min. RESULTS Regarding Incidence of emergence agitation and PAED score, we have found that number of patient with emergence agitation was more in propofol group than dexmedetomidine group at T0, T5 ,T10, T15 and T20 but not at T30. Accordingly the PAED score was high in group A that is propofol group then group B at T0 ,T5 ,T10 and T15 but at T20 and T30 it was same in both the group. CONCLUSION We have found in our study that dexmedetomidine is more effective than propofol in reducing the severity and incidence of emergence agitation. There is no significant difference in the duration of stay in patient in PACU but time of emergence was also delayed in dexmedetomidine Group.
BACKGROUND Spinal anaesthesia for surgical procedure was started in late nineteenth century and so the post dural puncture headache. In those days incidence use to be very high but with the fine gauge needle and better technique the incidence has largely reduced. But it is still an important cause of headache in post-operative period and depends upon not only the size type of needle but also various other factor like experience of person performing, age, sex and technique used. MATERIALS AND METHODS Present study has been conducted in the department of anaesthesia Konaseema institute of medical science. It is a prospective randomized observational study conducted during May 2015 to June 2017. The study is approved by institutional ethical committee. Patient selected for this study were divided into two groups. First group belongs to spinal flexion group (Gs) having 30 patients and second group having HIP flexion group (GH) having 30 patients. Various date like Age, body weight, BMI, type of surgery, duration of surgery, number of skin puncture, number of needle passage., experience of anaesthesiologist (years), Duration of anaesthesia, Episodes of PDPH were noted. RESULTS Out of 60 patients enrolled under study group 10 developed PDPH. Four patients were in spine flexion group and 6 were in hip flexion group. In spine flexion group 1 st day one patient developed PDPH, on 2 nd day two patients developed PDPH and one patient on third day. In hip flexion group one on first day, four on second day and one on third day but both are not statistically significant. CONCLUSION We have found that incidence of PDPH was more in hip flexion than in spinal flexion but it was not statistically significant. We have found that the PDPH was more in younger age group than older people, but not significant statistically. In our study we have found that lower BMI is associated with higher PDPH which is not statistically significant.
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