Sugammadex (ORG 25969) is a unique neuromuscular reversal drug; a novel cyclodextrin, the first in a new class of selective relaxant binding agents, which reverse neuromuscular blockade (NMB) with the aminosteroid non-depolarizing muscle relaxants rocuronium and vecuronium. Sugammadex can reverse moderate or deep NMB. The clinical use of sugammadex promises to eliminate many of the shortcomings in current anesthetic practice with regard to antagonism of rocuronium and other aminosteroid muscle relaxants.
Introduction: Paediatric spinal anaesthesia is often the technique of choice in many short duration surgeries. However, the failure rate is higher with spinal anaesthesia in children than in adults. Aim: To evaluate if a non-touch technique of paediatric spinal anaesthesia can reduce anaesthetic failure. Materials and Methods: A pilot study was done in 10 paediatric patients from January 2018 to July 2018 in Mahatma Gandhi Medical College and Research Institute, Puducherry, India. Ten children posted for infra-umbilical surgeries in the age group of 4-10 years were given a sedative premedication with a combination of Pethidine and Midazolam They were kept in lateral position with the back much inside the edge of the table so that there was a considerable space between the table edge and the baby. Identification of the L3-L4 space was done by touching the patient. The 25-gauge quincke needle was pricked and the hub was held with the hand in the table without touching the patient. Results: The anaesthesia was successful with adequate level in all the patients; T8 in five patients and T10 in the other five patients. There were no significant side effects. Conclusion: From this pilot study on 10 patients, it can be suggested that the novel non-touch Partha’s technique is feasible and more successful with absent failure rate when administering spinal anaesthesia in the paediatric age group.
Objectives: Early awakening and recovery of the cognitive function improves post-operative outcome and early discharge of the patients. Desflurane and Propofol offer rapid emergence from anesthesia. We compared the awakening and recovery of cognitive function between these two agents.
Methods: A total of 50 patients aged 30–60 years belonging to ASA 1 and 2 were studied. In both the groups baseline, Mini Mental State Examination (MMSE) score was recorded and were induced with Target controlled infusion (TCI) of Propofol to achieve plasma site concentration (Cp) of 6 mcg/ml. Group P continued with TCI Propofol Cp 3 mcg ml-1 and in group D, TCI was stopped and started Desflurane 6% end tidal concentration followed by Desflurane 3%. Hemodynamic variables were noted and after stopping the agent, time to eye open, squeeze hands, removal of laryngeal mask airway, state name, and modified Aldrete score were noted. MMSE score was recorded 1, 6, and 24 h postoperatively.
Results: Awakening time was significantly shorter in duration in Desflurane group compared to Propofol. The mean time to eye open in the Propofol group was 10.41±2:31 min and Desflurane group was 06.21±01.42 min (***p=0.000). There was an increase in the mean MMSE score postoperatively at 6 h and 24 h interval when compared to the baseline within the groups. However, there was no difference in recovery of cognitive function between the two groups.
Conclusion: The use of inhalational agent Desflurane provided shorter awakening time than intravenous Propofol in short surgical procedures but the recovery of cognitive function was comparable. There were no significant side effects.
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