Background and Aims:Postoperative pain relief following total knee arthroplasty (TKA) is a major concern as it will help to achieve an effective functional outcome. The present study was conducted to compare continuous femoral nerve block (CFNB) and continuous epidural infusion (CEI) techniques using ropivacaine.Material and Methods:Forty patients were randomly allocated into group F and group E to receive 0.2% ropivacaine through femoral catheter or epidural catheter respectively. An infusion was started @6 ml/h post-operatively when VAS was ≥4. The dose was titrated to keep VAS <4 (with minimum rate 2 ml/h and maximum rate 10 ml/h). If VAS ≥4 occurred despite maximum rate of infusion, a rescue analgesic was given. Primary objectives were to compare visual analogue score (VAS), rehabilitation indices, and rescue analgesic requirement. Secondary objectives were to assess patient and surgeon's satisfaction score, motor blockade, and complications if any.Results:The mean VAS score, rehabilitation goals, rescue analgesic requirement, and patient's and surgeon's mean satisfaction scores were comparable in both the groups. Motor blockade was not seen and though the number of side effects were more in group E, they did not achieve statistical or clinical significance.Conclusion:CFNB can be used as an alternative, effective postoperative analgesic technique for TKA.
Study aims to reduce the emergence agitation post operatively and improve the quality of recovery after nasal surgery which in-turn reduce the hospital stay and in-hospital mortality. Settings and Design: Prospective, randomized, double blind study Material and Methods: After institutional review board approval and informed written consent from patients, seventy patients undergoing nasal surgery were selected & randomized into two groups. The dexmedetomidine group (Group D, n=35) received dexmedetomidine infusion @ rate of 0.4 µg/kg/hr from induction of anaesthesia until extubation, while the control group (Group C, n=35) received volumematched normal saline infusion as placebo. Induction of anaesthesia was done using Propofol (2 mg/kg) and fentanyl (1 µg/kg). Maintainance of anaesthesia was done using inhalational sevoflurane & inj.vecuronium. The incidence of agitation, haemodynamic parameters, and recovery characteristics were evaluated during emergence. Patients were assessed for quality of recovery using a 15-item quality-of-recovery questionnaire (QoR-15) 24 hr after surgery. Statistical Analysis: Data were analysed by using unpaired t -test, Chi-square test. Results: The incidence of agitation was lower in group D than group C(22.8% vs 51%). HR and MAP were comparable in group D & group C. Extubation time & grade of cough during emergence were similar between the groups. QoR-15 score was significantly more in group D compare to group C at 24 hour after surgery. Conclusions: Intraoperative infusion of dexmedetomidine decreased incidence of agitation & improved quality of recovery after nasal surgery.
Introduction: Post operative pain relief is desired goal after tonsillectomy, infiltration of local anesthetic with or without adjuvant can reduce post tonsillectomy pain. Objective: To compare the postoperative analgesic efficacy and side-effects of peritonsillar-infiltration of ropivacaine with or without dexmeditomidine. Materials and Methods: Sixty patients aged 4-14 years posted for tonsillectomy under GA were randomly assigned in two groups of 30 each. In group R: Inj. ropivacaine (0.5%) 0.2ml/kg and in group RD: Inj.ropivacaine (0.5%) 0.2 ml/kg + Inj. dexmeditomidine 1mcg/kg were infiltrated in peritonsillar fossa post tonsillectomy. Patient were monitored for post-operative pain using VAS score, CHEOPS score and Wong baker pain rating scale at 30 minute, 1hr, 2hr, 4hr, 10 hr, 16hr and 24hr, pain on deglutination, time to first analgesic requirement, total dose of analgesics requirement in 24 hr postoperatively, amount of bleeding and parent's satisfaction score. Results: VAS score, CHEOPS and Wong baker pain rating scale were comparable in both the groups at 30 min, 1hr, 2hr (P >0.05) but it was significantly low in group RD as compared to group R at 4hr, 10hr, 16hr and 24hr (P<0.05). Time for first analgesia, total analgesic requirement, pain on deglutition were significantly low in group RD compared to group R (P <0.05) and parents satisfaction score was significantly more in group RD.
Conclusion:We concluded, peritonsillar infiltration of ropivacaine with or without dexmeditomidine is effective method for posttonsillectomy pain relief. Addition of dexmeditomidine was found to prolong duration, decrease analgesic requirement and improve parent's satisfaction score.
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