Background: Different additives have been used to prolong brachial plexus block. We performed a prospective, randomized single-blind study to compare Bupivacaine alone and Bupivacaine along with Buprenorphine for onset, quality, and duration of block as well as post-operative analgesia and any complication in axillary brachial- plexus block. Methods: Randomized controlled study was carried out among 60 patients of either sex, aged 20-60 years. ASA grade I or II undergoing elective hand, forearm, elbow surgery under axillary brachial plexus block. Patients were randomly divided into two groups. Group-l received 30 ml of 0.35% Bupivacaine alone in axillary block. Group-II received 30 ml of 0.35% Bupivacaine with 3µg/kg Buprenorphine in axillary block. Time taken for onset and completion of motor and sensory block as well as complete duration of block were noted in both groups. Any complication during procedure, during surgery as well as post-operatively were noted and treated. Results: Addition of Buprenorphine (3µg/kg) to Bupivacaine mixture in peripheral nerve block did not affected the onset time for motor as well as sensory block. Mean duration of motor block was 284.33±78.94 mins. in group I and in group II 307.33±60.26 mins. Mean duration of sensory block 305.066±83.64 mins. in group I while 580.166±111.45 mins. in group II. It suggests duration of sensory block was prolonged in group II then group I. Conclusions: Addition of Buprenorphine to local anesthetic drug provides good post-operative analgesia. Buprenorphine significantly prolongs sensory block and lengthens duration of analgesia without prolonging duration of motor block. [Int J Basic Clin Pharmacol 2013; 2(5.000): 640-644
Clonidine activates the α2-adrenergic receptors in the brain and spinal cord to decrease sympathetic outfl ow, causing sedation, analgesia, hypotension, and bradycardia without signifi cant respiratory depression. It is well-absorbed after ABSTRACT Background: Airway instrumentation of direct laryngoscopy and tracheal intubation are noxious stimuli that should be attenuated by appropriate premedication, smooth induction, and rapid intubation. The present study evaluated the clinical effi cacy of oral premedication with pregabalin or clonidine for attenuation of hemodynamic pressure response of airway instrumentation. The objective was to fi nd out the effi cacy of pregabalin and clonidine as an oral premedication and to observe hemodynamic stability during laryngoscopy. Methods: A total of 100 healthy patients aged 30-70 years with American Society of Anesthesiology Physical Status I and II of both gender, who met the inclusion criteria of general anesthesia, were randomly received pregabalin (150 mg) Group I or clonidine (100 μg) Group II, 60-70 mins before surgery as an oral premedication. Both groups were compared to pre-operative sedation, anxiety, heart rate (HR), and mean arterial pressure (MAP) at baseline, after premedication, induction, laryngoscopy, and extubation. Intraoperative analgesic drug requirement and any post-operative complication were recorded. Results: Incidence of hypotension and bradycardia were observed in 4% case in the clonidine group. Pre-operative sedation level was higher in the pregabalin group as compared to clonidine group. p>0.05 which shows there is no difference in both the drugs in terms of control of HR and MAP perioperatively. Both drugs are equally good to maintain hemodynamic stability during laryngoscopy. None of the patients has suffered from any post-operative side effects. Conclusion: Hemodynamic pressure response of airway instrumentation was attenuated with pregabalin and clonidine oral premedication without prolongation of recovery time and side effects.
The objective of this prospective multicenter study was to determine whether cisapride is associated with increased risk of malformations, spontaneous abortions, or decreased birthweight when used during pregnancy. Cases were paired for age, smoking, and alcohol consumption with controls exposed to nonteratogens, as well as with disease-paired controls. One hundred and twenty-nine pregnant women were exposed to cisapride during pregnancy, including 88 during the period of fetal organogenesis. There were no differences in maternal history, birthweight, gestational age at delivery, and rates of livebirths, spontaneous or therapeutic abortions, fetal distress, and major or minor malformations among groups. It is concluded that exposure to cisapride during pregnancy is not associated with a major increased risk of malformations or spontaneous abortions or with decreased birthweight.
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