Background and Aims:Episure™ AutoDetect™ syringe (EAS), a spring-loaded syringe, is a new loss-of-resistance syringe used to identify epidural space. It has an advantage of subjective and objective confirmation in identifying epidural space over glass syringe (GS) for beginners. We compared the performance of EAS with that of GS for identifying epidural space in lower thoracic epidurals.Methods:A total of 120 American Society of Anesthesiolgists I-II patients aged 18–60 years requiring lower thoracic epidural analgesia for surgery were randomised into Group I (EAS): Epidural identified using EAS and Group II (GS) epidural identified with GS. Patient demographic data, depth to epidural space (cm), number of attempts, time to locate epidural space (s), inadvertent dural puncture and failed epidural analgesia were the parameters noted.Results:There were no differences in patient demographics or depth to the epidural space between the two groups. There were five failed blocks in the GS group and none in the EAS group (P = 0.0287). Similarly, there were five inadvertent dural punctures in the GS group and none in the EAS group (P = 0.0287). When epidural was identified in fewer attempts, the time needed to identify epidural space was quicker with EAS (P = 0.0012).Conclusion:Using EAS allowed reliable and quick identification of the epidural space in lower thoracic epidural technique as compared to use of glass syringe. There was no incidence of inadvertent dural puncture or failed blocks with the EAS.
BACKGROUNDThe epidural technique became popular as it has some specific advantages over spinal anaesthesia. The feasibility of extended duration and differential blockade extended its application into other fields like post-operative analgesia, chronic pain relief and obstetric pain relief. But some inherent negative points of epidural technique like delayed onset and patchy analgesia persist. Various attempts have been made to rectify these negative points. Analgesic effects of magnesium sulphate on peripheral nerves may be due to the antagonism of NMDA receptors, thus preventing central sensitisation from peripheral nociceptive stimulation. Also, magnesium competitively blocks calcium influx into presynaptic endings leading to reduced acetylcholine release. The aim of the study is to add magnesium sulphate as an adjunct to epidural Bupivacaine and evaluate the impact of magnesium sulphate on the quality of the block using the following parameters; Onset of sensory blockade, Motor blockade quality, two segment regression time, Post-operative analgesia and Impact of magnesium sulphate on haemodynamic changes.
BACKGROUNDIntranasal route of drug administration is a practical option as a non-invasive alternative to intravenous route especially for children. We conducted a study to compare the effects of Dexmedetomidine and Midazolam administered as premedication agents through intranasal route. The primary outcome measures were assessing the sedation status upon parental separation and behaviour level during induction. The secondary outcome measures were assessing the acceptance of intravenous cannulation and acceptance of facemask during induction.
BACKGROUNDChildren undergoing Tonsillectomy have significant pain. Various modalities of treatment have been used to treat pain. Our aim is to compare the duration of analgesia and comfort of child with paracetamol administered through intravenous and rectal route.
MATERIALS AND METHODS40 children undergoing tonsillectomy surgeries were randomised into two groups receiving either intravenous paracetamol (Group I) or rectal paracetamol (Group R) as suppositories. After induction and intubation, children were randomised to one of the groups. Haemodynamic parameters were recorded preop; intraop and post-operatively along with assessment of post-operative pain using Wong-Baker face pain scale for period of 10 hours. Kruskal-Wallis chi-square test was used to test the significance of difference between quantitative variables and Yate's chi square test for qualitative variables.
RESULTSThus, duration of analgesia was significantly (p= 0.0029) higher in rectal group than in IV group. Comfort scores were not statistically significant.
CONCLUSIONThe post-operative pain scores were significantly higher in the intravenous group as compared to the rectal group. There was no difference in post-operative comfort.
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