Background: Supraglottic airway devices (SAD) are becoming increasingly popular for use in patients undergoing laparoscopic surgeries. In this prospective randomised study, we compared three supraglottic airway devices namely, I-gel, Supreme LMA and Ambu Auragain. Aims and Objectives: The study was undertaken to compare three supraglottic airway devices I-gel, Supreme LMA and Ambu Auragain in laparoscopic surgeries under general anaesthesia with controlled ventilation. Materials and Methods: This was a randomized comparative study in which 90 patients undergoing laparoscopic surgeries under general anesthesia were included. In group A Ambu AuraGain was used whereas in group I and Group S I-gel and Supreme LMA was used respectively. Primary outcome measures which were compared amongst the studied groups included time taken for insertion, ease of insertion, attempts required for insertion, ease of insertion of Ryles tube, fiberoptic bronchoscopic grading and Oropharyngeal leak pressure. Results: There was highly significant difference in the time taken for insertion of SAD in Group-A when compared to Group- I (p<0.0001) and Group-S (p<0.0001). Group-A had significantly increased grades of ease of insertion of SAD when compared to Group-I (p=0.04) and Group-S (p=0.004). 16.66% of patients in Group-A required 3 attempts for successful insertion of the SAD, while no patients in Group- I or Group A required more than two attempts for insertion(p<0.05). Conclusion: Ambu AuraGain provides better oropharyngeal seal and has higher leak pressures as compared to I-gel and Supreme LMA with similar hemodynamic stability and post-operative outcome makingit a preferable SAD over I-gel and Supreme LMA.
Background: Tonsillectomy is one of the most common surgical procedures in population and post tonsillectomy pain affects analgesic consumption, hospital stay, oral intake and return to regular activity. Aims and Objectives: The purpose of the study was to compare peritonsillar infiltration and intravenous administration of dexmedetomidine for perioperative analgesia in tonsillectomy. Materials and Methods: This was a placebo-controlled study to compare peritonsillar infiltration and intravenous administration of dexmedetomidine in patients undergoing tonsillectomy. Ninety patients were included in this study on the basis of a predefined inclusion and exclusion criteria. These patients were divided in 3 groups on the basis of whether they received Peritonsillar dexmedetomidine, intravenous dexmedetomidine or intravenous normal saline. The groups were compared for post-operative pain, time to first request of rescue analgesia (duration of analgesia), post-operative sedation, analgesic requirement during first 24 hours and side effects. SSPS 21.0 was used for statistical analysis and p value less than 0.05 was taken as statistically significant. Results: Out of total 90 patients included in this study there was a female preponderance with a M: F ratio of 1:1.5. The mean age and ASA grades and mean duration of surgery of patients in all 3 groups were found to be comparable with no statistically significant difference in any of the groups (P>0.05). Preoperative mean systolic and diastolic blood pressures as well as mean arterial pressure and SPO2 was found to be comparable in all 3 groups. However intraoperative blood pressures (systolic, diastolic as well as mean arterial pressures) and SPO2 showed significant difference amongst the groups (P<0.05). Time to first request of rescue analgesia was found to be more in group - Dpt than group – Div and group – Pb which was highly statistically significant (p <0.0001).There was statistical significant difference in number of diclofenac injections consumed during first 24 hours between group – Dpt & group – Div and highly significant difference between group – Dpt & group – Pb, group – Div & group – Pb. Conclusion: Peritonsillar infiltration of dexmedetomidine is better alternative to intravenous dexmedetomidine in tonsillar surgeries.
Background: Spinal anesthesia is a reliable and safe technique for infraumbilical surgeries. Nevertheless, some of its characteristics may limit its use for day care surgery. Use of long-acting anesthetic drugs like bupivacaine in spinal anesthesia may lead to side effects such as delayed ambulation and risk of urinary retention. Chloroprocaine is an amino-ester local anesthetic with a very short half-life now being extensively evaluated in volunteer studies and clinical practice with a favorable safety profile and efficacy, suggesting that it may be a suitable alternative to long-acting local anesthetics like bupivacaine in day care surgeries. Aims and Objective: This study aims at evaluating the duration and efficacy of chloroprocaine in spinal anesthesia for infraumbilical surgeries. The primary outcome of the study was to evaluate the duration and efficacy of chloroprocaine 1% in spinal anesthesia for infraumbilical surgeries and the secondary outcome was to find out the incidence of adverse effects if any. Materials and Methods: In this randomized single-blinded clinical evaluation, after institutional ethical committee approval, 30 adult patients (18–70 years, ASA physical Status I-III, BMI < 36 kg/m2) scheduled for infraumbilical surgeries received chloroprocaine 40 mg intrathecally. Patients were evaluated for onset and regression of sensory and motor blockade, peak level of sensory blockade, and time of ambulation postoperatively. Results: The average duration of the surgeries was 46.87±15.24 min. Anesthesia was sufficient for the planned surgery. Only three patients required sedation intraoperatively. The median peak sensory block height was T8. The mean time for peak height sensory block was 6.6±1.673 min and complete motor block was 2±1.05 min. Mean time for complete sensory block regression was 95.37±20.79 min and complete motor block regression was 81.43±20.33 min. Four patients required inj. atropine following bradycardia and three patients required vasopressors following hypotension. Conclusion: Spinal anesthesia with chloroprocaine provides reliable sensory and motor block for short duration infraumbilical surgeries with fewer intraoperative and post-operative complications.
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