Context:Spinal block is the first choice for lower abdominal surgeries. Bupivacaine is the most common local anesthetic used but has a shorter duration of action. Many adjuvants have been used to improve the quality of analgesia till postoperative period. In this study, we used α2-agonists.Aims:The aim of this study is to compare the effects of intrathecal dexmedetomidine and clonidine as adjuvants to hyperbaric bupivacaine with respect to onset and duration of sensory and motor blockade duration of analgesia and incidence of side effects.Settings and Design:This was a prospective randomized double-blind study.Subjects and Methods:One hundred and fifty patients of physical status American Society of Anesthesiologists Classes I and II were randomly divided into Groups B, C, and D each administered with bupivacaine with normal saline, clonidine, and dexmedetomidine, respectively.Statistical Analysis Used:Data were entered into Microsoft excel data sheet. Analysis software used in this study was SPSS 22 version IBM. Categorical data were represented in the form of frequencies and proportions. Chi-square test was the test of significance. Continuous data were represented as mean and standard deviation. Independent t-test was used for mean difference between two groups. P < 0.05 was statistically significant.Results:Mean sensory onset in Group B was 2.8 ± 0.7 min, in Group C was 1.4 ± 0.5 min, and in Group D was 1.2 ± 0.4 min. Mean sensory regression by two segments in Group B was 78.5 ± 9.9 min, in Group C was 136.7 ± 10.7 min, and in Group D was 136.4 ± 11.7 min.Conclusions:α2-agonists with hyperbaric bupivacaine intrathecally have a faster onset of both motor and sensory block. It also prolongs the duration of analgesia.
Ebstein’s anomaly is a rare congenital heart defect comprising less than 1% of patients with congen-ital heart disease. Among the congenital heart lesions, Ebstein’s anomaly is one of the most diverse in presentation, severity and management. It involves the septal cusp of the tricuspid valve wherein, due to anomalous attachment of the leaflets of the valve the cusp is elongated causing downward displacement of the valve into right ventricle. This results in tricuspid regurgitation. The abnormally situated valve produces atrialization of the right ventricle. It may be associated with atrial septal defect and supraventricular ar-rhythmias. Here, we report a case of second gravida patient with Ebstein’s anomaly. She was diagnosed with it a year back and was not on any treatment. Her echocardiogram showed grossly dilated right atrium grade III tricuspid regurgitation with mild pulmonary artery hypertension. Patient was taken up for elective cae-sarean section under spinal anaesthesia. Key-words: caesarean section, spinal anaesthesia, bupivacaine
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.