Objective: To compare the frequency of opioid requirement, after intravenous lignocaine infusion and ketorolac tromethamine in the upper limb surgeries. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Lahore Pakistan, from Oct 2017 to Apr 2018. Methodology: ASA I/II patients of either gender undergoing upper limb surgery were included. Patients were randomly divided into two equal groups, “L” (Lignocaine) and “K” (Ketorolac). In L-group, patients were given intravenous 1.5 mg/kg lignocaine bolus, followed by 2.0 mg/kg/hr infusion during entire procedure; while in K-group, patients were given intravenous 0.5 mg/kg (maximum 30 mg) ketorolac, at induction. The patients were monitored for 12 hours postoperatively and in case of severe postoperative pain (Visual Analogue Scale score >5), rescue analgesia (intravenous Nalbuphine 0.1 mg/kg) was provided. Results: Total eighty patients were included in the study. There was no statistical difference between the two groups with age (p-value 0.823), gender (p-value 0.808) and ASA status (p-value 0.184). There was statistically significant difference between the two groups in terms of opioid requirement at 1-hour (p-value 0.035), 6-hours (p-value 0.032) and 12-hours (p-value 0.035), with K-group showing more requirement as compared to the L-group. Conclusion: Intraoperative administration of intravenous lignocaine infusion is superior to ketorolac in effective postoperative pain management in patients undergoing upper limb surgeries.
Objective: To determine the peri-operative analgesic efficacy and quality of block by adding Dexmedetomidine as an adjuvant to Bupivacaine for spinal anaesthesia in patients undergoing abdominal hysterectomy. Study Design: Comparative cross-sectional Study. Place and Duration of Study: Anesthesia Department, Nishtar Hospital, Multan Pakistan, Jan to Jun 2019.Methodology: A total of 100 women aged 30-65 years, who were planned for abdominal hysterectomy due to benign causes, and having ASA) status I-II were included. The patients were divided into two equal groups. In Group-B, 12.5mg of 0.5% hyperbaric diluted in 3ml normal saline was administered for induction of spinal anaesthesia. In contrast, in Group-B+D, 10µg Dexmedetomidine and 12.5mg 0.5% hyperbaric Bupivacaine diluted in 3ml normal saline were given. Time of sensory and motor block onset, total duration of the block, and analgesia were noted. Results: The mean time of sensory and motor onset was significantly lower in the Group-B+D. The total duration of sensory block was 181.6±31.6 minutes in Group-B versus 345.2±23.5 minutes in Group-B+D (p-value <0.001). The total duration of the motor block was 142.9±8.6mins in Group-B versus 314.2±8.9mins in Group-B+D (p-value <0.001). Total analgesia duration was 129.4±8.3mins in Group- B versus 263.8±13.7mins in Group-B+D (p-value <0.001). A total of 2.54±0.35mg of rescue analgesia were required in Group- B versus 1.42±0.51mg in Group-B+D (p-value <0.001). Conclusion: The use of Dexmedetomidine as an adjuvant to Bupivacaine for spinal anaesthesia shortens the onset and prolongs the duration of sensory and motor block and the total duration of analgesia.
Objective: To define the rate of raised serum uric acid in patients with Stroke.Study Design: Cross-sectional study.Place and Duration of study: The study was carried out in the Department of Medicine, Military Hospital, Rawalpindi, Pakistan, from 13th July 2017 to 12th January 2018.Materials and Methods: A total of 96 cases of ischemic Stroke aged 26-74 years were selected. Cases with hemorrhagic Stroke who were consuming anti-hyperuricemia medications, diuretics, and Gout were excluded. Patients who fulfilled the clinical or radiological diagnostic criteria of Stroke underwent laboratory tests which included serum uric acid levels, fasting lipid profile, 24hrs urine for creatinine clearance and proteinuria, blood sugar levels, and renal profile.Results: Among 96 patients from 26 to 74 years of age, with a mean of 54.01 ± 12.42 years. Fifty six cases (58.33%) were from 51 to 74 years of age, 48 (50.0%) were male, and 48 (50.0%) were females. Hyperuricemia was found in 55 (57.29%) patients, whereas there was no Hyperuricemia in 41 (42.71%) patients. Conclusion: The rate of raised serum uric acid is high in patients with Stroke.
Objective: To compare the efficacy lignocaine alone with lignocaine plus ketorolac in intravenous regionalanesthesia technique in terms of mean pain and time for analgesia.Study Design: Randomized controlled trial.Place and Duration of Study: The study was carried out at Department of Anesthesia, KRL Hospital, Islamabadfrom April 2017 to October 2017.Materials and Methods: Sixty consecutive patients undergoing ambulatory hand/forearm surgery, whofulfilled inclusion criteria. They were divided into two equal groups of 30 patients in each. In “Group A”Lignocaine only and in “Group B” Lignocaine plus ketorolac was used for intravenous regional anesthesia(IVRA).Results: Pain relief was better in Group B as shown by comparison of pain in Group A at 10, 20, 30, 40 and 60minutes was as 0.13+0.35 v/s 0.27+0.52, p value was 0.24, 0.23+0.43 v/s 1.60+0.50, p value was 0.000,1.27+0.45 v/s 1.53+0.51, p value was 0.03, 1.23+0.43 v/s 2.67+0.48, p value was 0.0001 and 1.27+0.45 v/s3.53+0.68, p value was 0.0001 respectively.Conclusion: Lignocaine plus ketorolac in intravenous regional anesthesia technique was significantly betterwhen compared with lignocaine alone in terms of mean pain and time for analgesia.How to cite this: Ghori K, Ahmad MS, Sufyan A, Maka TA. Lignocaine Alone Vs Lignocaine plus Ketorolac in Reducing Perioperative Pain in Intravenous Regional Anesthesia. Life and Science. 2022; 3(3): 105-109. doi: http://doi.org/10.37185/LnS.1.1.204
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