Objective:Continuous thoracic epidural analgesia (TEA) is compared with erector spinae plane (ESP) block for the perioperative pain management in patients undergoing cardiac surgery for the quality of analgesia, incentive spirometry, ventilator duration, and intensive care unit (ICU) duration.Methodology:A prospective, randomized comparative clinical study was conducted. A total of 50 patients were enrolled, who were randomized to either Group A: TEA (n = 25) or Group B: ESP block (n = 25). Visual analog scale (VAS) was recorded in both the groups during rest and cough at the various time intervals postextubation. Both the groups were also compared for incentive spirometry, ventilator, and ICU duration. Statistical analysis was performed using the independent Student's t-test. A value of P < 0.05 was considered statistically significant.Results:Comparable VAS scores were revealed at 0 h, 3 h, 6 h, and 12 h (P > 0.05) at rest and during cough in both the groups. Group A had a statistically significant VAS score than Group B (P ≤ 0.05) at 24 h, 36 h, and 48 h but mean VAS in either of the Group was ≤4 both at rest and during cough. Incentive spirometry, ventilator, and ICU duration were comparable between the groups.Conclusion:ESP block is easy to perform and can serve as a promising alternative to TEA in optimal perioperative pain management in cardiac surgery.

Background:Good postoperative analgesia in cardiac surgical patients helps in early recovery and ambulation. An alternative to parenteral, paravertebral, and thoracic epidural analgesia can be pectoralis nerve (Pecs) block, which is novel, less invasive regional analgesic technique.Aims:We hypothesized that Pecs block would provide superior postoperative analgesia for patients undergoing cardiac surgery through midline sternotomy compared to parenteral analgesia.Materials and Methods:Forty adult patients between the age groups of 25 and 65 years undergoing coronary artery bypass grafting or valve surgeries through midline sternotomy under general anesthesia were enrolled in the study. Patients were randomly allocated into two groups with 20 in each group. Group 1 patients did not receive Pecs block, whereas Group 2 patients received bilateral Pecs block postoperatively. Patients were extubated once they fulfilled extubation criteria. Ventilator duration was recorded. Patients were interrogated for pain by visual analog scale (VAS) scoring at rest and cough. Inspiratory flow rate was assessed using incentive spirometry.Results:Pecs group patients required lesser duration of ventilator support (P < 0.0001) in comparison to control group. Pain scores at rest and cough were significantly low in Pecs group at 0, 3, 6, 12, and 18 h from extubation (P < 0.05). At 24 h, VAS scores were comparable between two groups. Peak inspiratory flow rates were higher in Pecs group as compared to control group at 0, 3, 6, 12, 18, and 24 h (P < 0.05). Thirty-four episodes of rescue analgesia were given in control group, whereas in Pecs group, there were only four episodes of rescue analgesia.Conclusion:Pecs block is technically simple and effective technique and can be used as part of multimodal analgesia in postoperative cardiac surgical patients for better patient comfort and outcome.

The present work reports for the first time ultrasound-assisted polymerization of Alizarin Red (AR), Amido Black 10B (AB-10B), and 1,4-benzoquinone (BQ) with o- and p-phenylenediamines. The synthesized polymeric dyes were characterized for their spectral and morphological characteristics. Theoretical calculations were performed via DFT/B3LYP and M06-2X methods with 6-311++G­(d,p) basis set using Gaussian 09 software, and the results were analyzed for the prediction of the optoelectronic properties of the polymers. The theoretically predicted IR and UV spectra determined by DFT/B3LYP and M06-2X methods were found to be in good agreement with the experimental results. Fourier transform infrared (FTIR) and 1H NMR studies confirmed the polymerization of the dyes, while transmission electron microscopy (TEM) and scanning electron microscopy (SEM) studies revealed the formation of well-organized nanostructured morphology. X-ray diffraction (XRD) studies confirmed the formation of semicrystalline polymers. The polymeric dyes exhibited singlet oxygen quantum yields ranging between 20 and 70% and hold immense potential to be used in photodynamic therapy.

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Introduction:Dexmedetomidine is an alpha-2 agonist used for conscious sedation. It has also been shown to have a myocardial protective effect in off-pump coronary artery bypass patients. The aim of the study was to assess the effect of dexmedetomidine for myocardial protection in percutaneous coronary interventional patients.Methodology:A total of 60 patients (group dexmedetomidine, n = 30 and group normal saline, n = 30) were enrolled in the study. Dexmedetomidine infusion (1 mcg/kg) over 15 min was given as a loading dose after coronary angiography in group dexmedetomidine (D) while normal saline was given in the control group (C) and later maintenance infusion was started at 0.5 mcg/kg/h in both the groups. Coronary vessel diameter was noted before (T0) and after (T1) loading dose of dexmedetomidine/saline in each group. Troponin T (Trop T) values were noted at baseline (T0), 6 h (T2), 12 h (T3) and 24 h (T4) after starting the loading dose. Hemodynamic variables (heart rate [HR] and blood pressure) were monitored at T0, T1, and at regular intervals till 2 h postprocedure.Results:Coronary vessel diameter and HR significantly decreased in group D as compared to control group (P < 0.05) whereas the decrease in Trop T at 6 h, 12 h, and 24 h were not statistically significant between the two groups.Conclusion:Dexmedetomidine decreases the coronary vessel diameter, but maintains the myocardial oxygen demand-supply ratio by decreasing the HR. The decrease in Trop T is statistically insignificant at the doses used.

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The synthesis of layered double hydroxide (LDH) was carried out using different ratios of Mg:Al. The intercalation of polypyrrole (Ppy) within interlayer space of LDH was carried out via ultrasonication using different loadings of the conducting polymer. Fourier transform infrared (FTIR) spectra and XRD analysis showed successful intercalation of Ppy in LDH while UV-visible spectra confirmed polaronic state of the conducting polymer within the LDH. Scanning electron microscopy and transmission electron microscopy studies showed successful incorporation of Ppy and loading of the drug was also established. The concentration of Rifampicin, an antituberculosis drug in LDH/Ppy, was confirmed by Langmuir adsorption isotherm. The in vitro release characteristics showed sustained release behaviour at pH 7.4 for a period of 180 hours. The nanocomposites exhibited immense potential for their application as Rifampicin drug carriers.