BACKGROUND Various adjuvants have been added to bupivacaine to shorten the onset of block and prolong the duration of block. Present study was undertaken to compare the efficacy of intrathecal fentanyl or buprenorphine with bupivacaine for all infraumbilical surgeries. MATERIALS AND METHODS 100 ASA I and II patients of both sexes posted for various infraumbilical surgeries were chosen for the study and the patients were divided into two groups of 50 each. Group F received 3mL of 0.5% bupivacaine heavy with 0.5mcg/kg of fentanyl and groupB received 3mL of 0.5% bupivacaine heavy with 2mcg/kg of buprenorphine. The time of onset of sensory block was tested with pinprick method and motor block was assessed by onset of Bromage scale 3 and it was found that the onset of sensory block with buprenorphine was earlier compared to fentanyl. RESULTS Bradycardia observed in Group B in 7 patients (14%), which was successfully treated with vagolytic agents. In Group B, it was observed that there was hypotension in 14 patients (28%), and in Group F, 7 patients developed hypotension, which was successfully treated with vasopressors. Also, few patients developed pruritus, nausea and vomiting, which were negligible. Intraoperatively, sedation score was assessed using modified Ramsay. Sedation scale and there was higher incidence of sedation with buprenorphine group. Regression of motor block to Bromage0 was observed and the time to regression was significantly prolonged to 205±37.71 in the buprenorphine group, while it was 152.90±8.31 in the fentanyl group. Postoperatively, VAS scores were significantly low for the buprenorphine group when compared with fentanyl. CONCLUSION To summarise, buprenorphine has higher efficacy with intrathecal bupivacaine with prolonged duration of sensory and motor blockade with decreased incidence of side effects, better haemodynamic stability and intraoperative sedation and also analgesic sparing effect in the postoperative period when compared to fentanyl.
Background: Myopia is a major cause of visual impairment in both the developed and the developing world. Its prevalence ranges between 83% to 97% and the prevalence of high myopia ranges between 7% and 22%. Individuals with high myopia have increased risk of retinal complications which can be potentially sight threatening. Aims And Objectives: To determine the prevalence and types of retinal changes in patients with myopia and the relationship of the retinal changes with the severity of myopia. Materials And Methods: Patients attending the outpatient department having myopia and age more than 8 years were selected for the study. They underwent dilated fundoscopy (direct and indirect ophthalmoscopy) to record the various retinal changes. Results: Tessellated fundus (58.5%) and peripapillary atrophy (40.5%) were the most common ndings. Temporal crescent (21.5%), lattice degeneration (16.5%), white with or without pressure (11%), retinal tears (4%) and retinal detachment (2%) were also seen. No changes were observed in 22% of the eyes. Conclusion: Myopic individuals should be educated on the symptoms of various complications and seek care immediately if symptoms arise
Background: Extraintestinal manifestations (EIM) are often observed in patients with Inammatory bowel disease (IBD). Approximately 10%–13% of IBD patients present with ocular manifestations which can be potentially sight threatening. They occur more frequently in patients with Crohn's disease (CD) than Ulcerative Colitis (UC). They can occasionally manifest before the usual intestinal manifestations. It is important to understand the clinical presentation of possible ocular manifestations in order to initiate appropriate treatment and to help prevent signicant visual morbidity. Aim of this study is to determine theAims and objectives: prevalence and types of ocular manifestations in IBD. Patients attending the Gastroenterology outpatient department atMaterials and methods: R. G. Kar Medical college, Kolkata having diagnosed with IBD were selected for the study. They underwent complete ophthalmological examination. This study is a prospective observational study. Total of 160 patients were examined and ndings noted. The prevalence ofResults: ocular manifestations in our study was found to be 13.75%. The mean age was 32.5 years (23-63 years). There were 52 females (32.5%) and 108 males (67.5%). The mean duration of IBD was 5.4 years. Various ocular manifestations found in our study were 12 episcleritis (7.5%), 8 anterior uveitis (5%) and 2 scleritis (1.25%). Patients with IBD can have sight threatening ocular complications. They should be educatedConclusion: about the symptoms of ocular complications and advised to seek ophthalmic care promptly.
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