Background: Pregabalin provides good postoperative analgesia in nociceptive stimuli. Various studies show that preemptive oral pregabalin reduces acute postoperative pain. We conducted a study to evaluate the efficacy of two different doses of pregabalin and its effect on onset and duration of spinal anesthesia and postoperative pain.
Methods: In prospective, double-blind and randomized study, 60 patients posted for vaginal hysterectomy under spinal anesthesia were randomly allocated to two groups recieving cap. Pregabalin 75 mg (group 1) and cap pregabalin 150 mg (group 2) orally, 90 min prior to surgery. Onset and duration of motor and sensory blockade were observed. Postoperative pain was assessed by VAS for 24 hrs. Injection paracetamol 1 gm. was given intravenously as rescue analgesic. Time of first rescue analgesic and total dose of rescue analgesics was noted.
Results: Group 2 patients had better postoperative analgesia in terms of prolonged sensory and motor blockade which correlated well with the time of first request for rescue analgesia (504±123.2 min) as compared to group 1 patients (304.9±37.6 min). Also the total dose of rescue analgesic (paracetamol) was significantly less with 150mg pregabalin (p = 0.0001).
Conclusion: Pregabalin 150 mg prolongs the duration of spinal anesthesia and has better analgesic profile without significant side effects. Thus we conclude that 150 mg pregabalin given preemptively optimizes spinal anesthesia well in patients for vaginal hysterectomy.
Introduction: Ondansetron is widely used perioperative antiemetic. In this study, we have assessed the anti-emetic efficacy of orally disintegrating film (ODF) in middle ear surgeries, associated with higher incidence of PONV. Materials and Methods: We studied two doses of ODF (4 and 8 mg) and compared it with IV ondansetron and placebo. All 120 cases were done under general anesthesia with standard anesthesia technique. Results: Oral intake was significantly delayed in placebo group. (p= 0.001) During first 6hrs, the PONV score was significantly low (p<0.001) in ODF4 and ODF8 group as compared to placebo group, however there was no difference in the intravenous group. In 6-24hr interval, all the groups were comparable. Also, there were no side effects in any patient in any group which required treatment.
Conclusion:We conclude that all patients undergoing surgeries of middle ear should receive prophylactic antiemetic. Ondansetron in the form of orally disintegrating film is an effective as well as safe choice for PONV prevention in middle ear surgery with 8 mg to be the desired dose as compared to placebo and IV ondansetron.
Maintenance of patent airway is essential for adequate oxygenation and ventilation. Failure, even for a short period can be life-threatening. So expertise in airway management is essential in every medical speciality. Management of the airway has come a long way since the endotracheal intubation done by Macewan (1880) to present day use of modern and sophisticated devices. The wide variety of airway armamentarium is available today. Since, time available to secure airway is short one has to be optimally prepared with proper selection of equipment, technique and participation of personnel experienced in doing it. This is a brief review of evolution of airway devices.
Obstetric emergencies have always put the anaesthetist on nerves. More so in this era of novel coronavirus pandemic managing obstertric cases in emergency has been a diverse challenge. COVID 19 parturients presenting in emergencies have prompted us to redesign the strategies regarding their management.
Here we report a series of three obstetric cases presenting as emergency and emphasize on anaesthesia concerns in these COVID-19 positive parturients.
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