Introduction: Dexmedetomiodine is a selective α2 agonist drug. This study aimed to assess the onset and duration of sensory and motor block and postoperative analgesia in the first 12 hours after surgery after adding Dexmedetomidine with 0.375% Levobupivacaine for brachial plexus block. Material and Method: 100 patients aged 18-60 years of ASA Grade I & II posted for upper limb surgeries under supraclavicular brachial plexus block were randomly allocated into two groups with 50 patients in each. Group L and L+D received 35cc of 0.375% injection Levobupivacaine and 35cc of 0.375% Levobupivacaine with 1 µg/kg of injection Dexmedetomidine respectively through nerve stimulator guided supraclavicular block. Onset and duration of sensory and motor block, time to first and total analgesic need were noted postoperatively for 12 hours. Results: Sensory and motor block onset time was significantly lower in the Group L+D than Group L (p=0.001). Duration of sensory and motor block was significantly longer in the Group L+D than Group L (p=0.001). The time to the first analgesic requirement was longer in Group L+D than Group L (p=0.001). The total analgesic requirement was significantly lower in Group L+D than Group L (p=0.001).Heart rate and systolic and diastolic blood pressure was significantly lower after drug administration in group L+D than group L. Conclusion: Dexmedetomidine added to Levobupivacaine causes early onset and increased duration of sensory and motor block and prolonged period of postoperative analgesia in supraclavicular brachial plexus block. Therefore, Dexmedetomidine seems to be a good alternate adjuvant.
Introduction – Total knee arthroplasty is considered as one of the most painful procedures in field of orthopedic surgery. In this study we intended to evaluate the analgesic efficacy of Local Infiltration Analgesia (LIA) with post-surgical single shot of adductor canal block in terms of good post-operative analgesia and early post- operative mobilization thus allowing faster rehabilitation and recovery and thereby improving the final outcome of TKA in long term. Material and method- A total of 60 patients were enrolled, 30 in each group. Group A received Standard General anesthesia & postoperative analgesia with a single shot of adductor canal block with 20cc of 0.25% ropivacaine along with intraoperative local infiltration analgesia. Group B also received Standard General anesthesia & postoperative analgesia with a single shot of adductor canal block with 20cc of 0.25% ropivacaine but intraoperative local infiltration analgesia was not administered in group B. Result- Group B patients required a greater number of rescue analgesic doses in comparison to Group A patients. The majority of the patients in Group A had early postoperative mobilization in comparison to Group B (p=0.003). Mean preoperative and 6-week postoperative WOMAC scores showed that difference was statistically significant (p=0.034), showing a significantly lower 6-week postoperative WOMAC score in Group A in comparison to Group B. Conclusion – Our study gives us a conclusion that intraoperative Local Infiltration Analgesia along with single shot of adductor canal block provides better post-operative pain relief & allows early mobilization of the patient thus enhancing the rehabilitation thereby improving the final outcome of the Total Knee Arthroplasty.
Introduction – Total knee arthroplasty is one of the most painful procedures. In this study we intended to compare two analgesic modalities i.e. single shot of Adductor canal block & Continuous epidural analgesia in terms of good post-operative analgesia, minimal motor involvement, good post-operative muscle strength thus allowing faster rehabilitation and recovery thereby improving the final outcome of TKR in long term. Material and method- A total of 60 patients were enrolled, 30 in each group. Group A received Standard General anesthesia & postoperative analgesia with a single shot of adductor canal block with 20cc of 0.25% ropivacaine. Group B received Combined spinal-epidural block & postoperative analgesia was maintained on continuous epidural infusion in the form of a mixture of 0.125% ropivacaine & fentanyl(2microgram/cc) at the rate of 6ml/hour. Result- Group B patients required a greater number of rescue analgesic doses in comparison to Group A patients. The majority of the patients in Group A had early postoperative mobilization in comparison to Group B (p=0.003). Mean preoperative and 6-week postoperative WOMAC scores showed that difference was statistically significant (p=0.034), showing a significantly lower 6-week postoperative WOMAC score in Group A in comparison to Group B. Conclusion – Our study gives us a conclusion that the post-surgical Single Shot of the adductor canal block is a better post-operative analgesic modality when compared with continuous epidural analgesia post-surgically in terms of better pain relief, good post-operative muscle strength, early mobilization of the patient, higher patient acceptability.
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