Background: The aim was to compare the efficacy of addition of clonidine to hyperbaric bupivacaine and to compare it with plain hyperbaric bupivacaine for caudal analgesia in children aged 3 months to 3 years in term of analgesic duration, hemodynamic change and degree of sedation.Methods: Sixty ASA I and II children undergoing lower abdominal surgeries were divided into two groups of 30 each, plain hyperbaric bupivacaine group (Group B) and hyperbaric bupivacaine with clonidine group (Group C). Group B received only bupivacaine and Group C received bupivacaine with clonidine in caudal block.Results: Hemodynamic and demographic profiles were comparable between both the groups. Addition of clonidine significantly prolonged duration of caudal analgesia and significantly reduce the FLACC scores in group C as compared to group B. Mean sedation score immediately after postoperative period was higher in group C but after 4 hours of awakening, there was gradual fall in mean sedation score in both groups.Conclusions: Addition of clonidine to bupivacaine in caudal analgesia significantly increases the duration of post-operative analgesia.
Background: Brachial plexus block via interscalene approach is an excellent option for upper limb surgeries, but due to sparing of ulnar nerve (lower trunk, C8-T1) and its’ complications, it is not so popular. To overcome this problem, interscalene block via lower approach has been tried which has more advantage in view of ulnar nerve blockage and also less complications. In addition, ultrasound provides reliability, ease, rapidity and also patient comfort during block procedure. This prospective study was performed to evaluate the anaesthetic effect of lower approach interscalene block with the help of ultrasound and peripheral nerve stimulator.Methods: Ultrasound guided interscalene brachial plexus block via lower approach was given in randomly selected 30 patients, undergoing upper limb orthopaedic surgeries. After localisation of brachial plexus with ultrasound, the nerve roots were confirmed with the help of peripheral nerve stimulator, before injecting drug. At 5 and 15 min after block, all patients were assessed for the effect. Postoperatively they were assessed for any complication and also for their satisfaction level by Likert’s scale.Results: In territories of ulnar, radial and musculocutaneous nerve there was 100% effect while in median nerve territory 92.8% motor block was there. There was no need of analgesics during intra operative period in any patient and there were no major complications with this approach.Conclusions: Ultrasound guided interscalene block via lower approach is an excellent alternative for upper limb surgeries over classical approach in view of ulnar nerve blockage without any major complication.
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