Introduction: Preoperative anxiety may cause hemodynamic problems in the intraoperative period, increased analgesic need, and lower postoperative satisfaction of the patients. Melatonin has anxiolytic, sedative and potential analgesic effects when used as premedication before surgery. After institutional ethical committee clearance and patient Materials and methods: s informed written consent, 100 ASA 1 and 2 patients aged between 18 to 65 years posted for laparoscopic surgeries under GA were randomized into M and P groups with 50 in each. All patients received either 6mg oral melatonin dissolved in 3ml distilled water in melatonin group or 3ml distilled water in placebo group one hour before surgery. APAIS anxiety scale was measured before and one hour after premedication. Post operatively RSS scale for sedation and NRS scale for pain were measured at 30 min, 60 min, 90min, 120min in post anaesthetic care unit. The time of rst rescue analgesia was noted. APAIS anxiety Results: scores determined prior to administration of medications showed non-signicant differences between the groups (11.9 SD 1.3 in melatonin group, 11.8 SD 1.6 in placebo/control group). APAIS anxiety scores determined at one hour after receiving the study medication were decreased more signicantly in melatonin group than in control group with p value of 0.0005 (3.5 SD 1.1 in melatonin group, 7.5 SD 1.2 in placebo/control group). Postoperatively RSS scores showed better sedation in Melatonin group than in Placebo group. Pain scores were less in melatonin group than in placebo group. The time for rst request of rescue analgesia was delayed in melatonin group than in placebo. Preoperative oral Conclusion: melatonin 6mg reduces preoperative anxiety, postoperative pain and analgesia requirement.
Abdominal surgeries done under general anaesthesia is associated with severe pain in the post-operative period. There are many drugs that can be administered to alleviate post-operative pain. Opioids are an essential to the mitigation of visceral pain associated with abdominal surgeries. Apart from needles and epidural catheters which are invasive, transdermal drug delivery systems are novel, non-invasive, and is associated with increased patient comfort. Among drugs that can be delivered by transdermal route fentanyl is an effective opioid analgesic that has a high potency and high lipid solubility making it suitable for transdermal delivery1. This study attempts at the evaluation of the analgesic efcacy of fentanyl patch applied pre-operatively in alleviation of post-operative pain in patients undergoing abdominal surgeries under general anaesthesia
In any patient, the skin to subarachnoid space depth varies significantly at completely different levels of the spinal cord and it additionally varies from patient to patient at the same vertebral level as per patient characteristics like age, sex and body mass index. An estimate of the skin to subarachnoid space depth has been shown to minimize the number of unsuccessful tries, consecutive attempts, traumatic or blood-filled lumbar punctures, typically acting as a depth guide for correct spinal needle placement. In this study we estimated the subarachnoid space depth using ultrasound, stocker’s formula and craig’s formula to determine which provided better correlation to the actual subarachnoid space depth. This study is a Prospective observational study done in the Department of Anaesthesiology, Saveetha Medical College and Hospital, Chennai from August 2020 to February 2021.This study concluded that Ultrasound guided measurement of subarachnoid space depth provided better correlation with actual subarachnoid space depth compared to stocker’s and craig’s.
Robotic assisted laparoscopic surgeries are a recent advancement in minimal access surgeries that
guarantee faster recovery and minimal life altering choices to the patients. However, the advent of robotic
laparoscopic surgeries has placed and increasing amount of responsibility on the anaesthesiologist to maintain intra-operative
stability as robotic procedures have a unique set of general consideration and their own plethora of physiological changes in the
patient. This case repost describes the anaesthetic management of a 57-year-old Female patient who underwent Robotic
assisted laparoscopic nephrectomy of a non-functioning left kidney
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