The objective of this study is to compare clonidine and dexmedetomidine as an adjuvant to levobupivacaine in supraclavicular brachial plexus block with respect to onset, duration of sensory and motor block and duration of analgesia. MATERIALS AND METHODS A total of 90 ASA grade I and II patients of either sex, aged 18-60 yrs. scheduled for elective upper limb surgeries under supraclavicular brachial plexus block were divided into 3 equal groups in a randomized fashion. Group L (n=30) received 1 mL NS, group LC (=30) received 1 mL (150 g) clonidine and group LD (n=30) received 1 mL (100 g) dexmedetomidine added to 30 mL of 0.5% levobupivacaine. Onset and recovery time of sensory and motor block, duration of analgesia and quality of block were studied in all three groups. RESULTS Onset time of sensory and motor blockade was 12.43±2.56 min and 17.96±3.05 min respectively in group L, 9.03±1.60 min and 15.00±2.40 min respectively in group LC and 8.13±2.51 min and 12.13±2.89 min respectively in group LD. Duration of sensory and motor blockade was 660.16±44.28 min and 535.33±50.66 min respectively in group L, 880.16±55.48 min and 771.83±54.19 min respectively in group LC and 930.66±48.02 min and 811.83±52.08 min respectively in group LD. Time of rescue analgesia was 728.86±45.12 min in group L, 1013.5±59.01 min in group LC and 1159.8±56.8 min in group LD (p<0.05). CONCLUSION Dexmedetomidine when added to LA in supraclavicular brachial plexus block prolongs the duration of sensory and motor blockade and also the time for rescue analgesia as compared to clonidine. Dexmedetomidine also enhances quality of block (LD>LC>C).
Spot urinary ACR values are higher in asymptomatic women in early pregnancy, who developed pre-eclampsia later on. When measured early in the second trimester, an ACR ≥ 35.5 mg/mmol predicted pre-eclampsia well before the onset of clinical manifestations with high sensitivity and specificity. It can be used as a good screening tool for predicting pre-eclampsia in early pregnancy.
OBJECTIVETo evaluate the comparative pre-emptive effects of gabapentin and pregabalin on postoperative pain in patients scheduled for surgery under general anaesthesia.
MATERIAL AND METHODS90 patients of ASA grade I and II posted for elective surgeries under general anaesthesia were randomised into 3 groups (Group G, P and C of 30 patients each). One and a half hour before surgery, the drug selected for the study was given blindly with a sip of water. Group G -Received 600 mg Gabapentin capsule; Group P -Received 300 mg of pregabalin capsule; Group C -Received identical placebo capsule. Pain (Visual analogue score) and side effects assessments were performed immediately and then at 15 mins., 30 mins., 45 mins., 60 mins., 90 mins., 120 mins. and at 180 mins. postoperatively.
RESULTSThe mean (±SD) of VAS score was 5.86±0.34 in group C, 5.10±0.84 in group G and 4.96±1.03 in group P. VAS score were significantly lower in both groups G and P as compared to group C. Time for analgesic requirement is more with oral pregabalin than gabapentin and control group. The mean (±SD) TRA-I was 38.40±24.61 in group C, 44.03±8.94 in group G and 58.69±25.21 in group P. Pregabalin causes more sedation than gabapentin. No significant difference was observed among the three groups regarding side effects during the study period.
CONCLUSIONOur study demonstrated that pre-emptive oral pregabalin 300 mg and oral gabapentin 600 mg significantly decreases the severity of pain postoperatively in patients posted for surgery under general anaesthesia. Oral pregabalin produces higher degree of sedation as compared to oral gabapentin.
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