Background
Laparoscopic cholecystectomy has changed the surgical management of cholelithiasis and has become the mainstay of the management of uncomplicated gallstone disease. Adequate postoperative pain relief leading to early ambulation is imperative for patient satisfaction and early discharge of the patient. The use of ultrasound in anesthetic practice has ushered in a new era of ultrasound-guided blocks for postoperative analgesia, replacing the conventional methods. This study compares two modalities of postoperative pain relief, namely the oblique subcostal transversus abdominis plane block and the newer erector spinae plane block for patients undergoing laparoscopic cholecystectomy.
Results
Sixty patients between the age group 18 to 75 of ASA grades I, II, and III were enrolled in the study. The erector spinae plane block group showed lower numerical rating scores up to 12 h, a longer time period for the requirement of first rescue analgesic, and lower total analgesic consumption postoperatively compared to the oblique subcostal transversus abdominis plane block group. Both blocks were found to have minimal side effects.
Conclusions
The erector spinae plane block is superior to the oblique subcostal transversus abdominis plane block in that it affords lower pain scores and a longer duration of analgesia and reduces the total analgesic consumption after laparoscopic cholecystectomy.
Trial registration
Clinical Trials Registry of India/CTRI/2020/10/028603/ registered on 23 October 2020
http://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=47807&EncHid=18303.55562&modid=1&compid=19
Background: Hypertension is an extremely common comorbid condition in DM, affecting 20-60% patients with DM. As the common denominator of hypertensive diabetic target organ-disease is the vascular tree, the co-existence of hypertension and DM is devastating to cardiovascular and renal system. Lipids stand one of the major contributing factor in cardiovascular morbidity amongst these patients. Many drugs are available in the market to control this, we have studied the efficacy of Telmisartan and Ramipril in improving the lipid profile of these patients. Observation and Results: Group A received Telmisartan while Group B received Ramipril. The baseline lab values of both the groups showed no any statistical difference showing the homogeneity of the groups. Similarly there was no any significant difference between the baseline Lipid profile values of TC, LDL, TG & HDL (All P > 0.05). The reduction in mean SBP & DBP was statistically significant over 12 weeks of therapy in both the groups. But there was no statistical difference inter group wise. It was observed that there was statistically significant difference in mean TC levels, mean LDL levels, when two groups are compared after 12 weeks of therapy. (P value < 0.05). While no significant difference was observed in the values of TG & HDL (P value > 0.05). Conclusion: Our study concludes that there is significant correlation between the use of Telmisartan and Ramipril in lowering the lipids in the patients of Diabetes with Hypertension. Lowering the lipids is very important to prevent any cardiovascular complications, which are one of the major contributing factors to the morbidity and mortality amongst these patients.
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