Background:Neuraxial anesthesia greatly expands the anesthesiologist armamentarium, providing alternatives to general anesthesia, especially in the lower abdominal surgeries. Clonidine, an alpha-2 adrenergic agonist, has a variety of actions, including potentiation of effects of local anesthetics. This study was undertaken to assess the degree of sensory and motor block and postoperative analgesia provided by low dose (50 mcg) intrathecal clonidine admixed with bupivacaine.Aims:The aim of this study is to establish efficacy and safety of intrathecal clonidine as adjuvant to bupivacaine.Settings and Design:The type of the study was double-blind randomized trial.Materials and Methods:Hundred patients were randomly allocated in two groups, A and B. Group A received bupivacaine 0.5%, 3 ml with placebo (normal saline 0.33 ml) and Group B, bupivacaine 0.5%, 3 ml with clonidine 50 μg (0.33 ml).Statistical Analysis Used:Statistical Package for Social Sciences version 15.0 statistical analysis software.Results:Mean duration of motor block was significantly higher in Group B (280.80 ± 66.88 min) as compared with Group A (183.60 ± 77.06 min). Significant difference in duration of sensory block was noted between Group B (295.20 ± 81.17 min) and Group A (190.80 ± 86.94 min). Duration of postoperative analgesia was significantly higher in Group B as compared to Group A (551.06 ± 133.64 min and 254.80 ± 84.19 min respectively). Mean visual analog scale scores at different time intervals were significantly lower in the study group (except for 4-h time interval), but the control group had better hemodynamic stability as compared with study group.Conclusion:The findings in this study suggested that use of clonidine 50 μg added to bupivacaine for spinal anesthesia effectively increased the duration of sensory block, duration of motor block, and duration of analgesia.
Context:Anesthesia and analgesia for surgeries to the upper extremity are commonly provided using brachial plexus anesthesia. There are limited or almost no studies comparing the use of ropivacaine with fentanyl to ropivacaine with dexmedetomidine.Aims:To compare the efficacy of fentanyl and dexmedetomidine as adjuvants to ropivacaine for brachial plexus block among patients undergoing upper limb orthopedic surgeries.Settings and Design:This was a prospective, randomized, double-blinded study.Subjects and Methods:The patients were randomly divided into three groups of 35 each using computerized randomization table. Group I patients received 3 mg/kg of 0.75% ropivacaine with 1 μg/kg of fentanyl diluted with normal saline (NS) to make a total volume of 35 ml. Group II patients received 3 mg/kg of 0.75% ropivacaine with 1 μg/kg of dexmedetomidine diluted with NS to make a total volume of 35 ml. Group III patients received 3 mg/kg of 0.75% ropivacaine with NS making a total volume of 35 ml.Statistical Analysis Used:Statistical analysis was performed using Statistical Package for Social Sciences, version 15.0. Analysis of variance followed by independent samples t-test was performed for parametric data, and Kruskal–Wallis test followed by Mann–Whitney U-test was performed for nonparametric data.Results:Mean motor and sensory block onset time was minimum in Group I and maximum in Group III while mean duration of sensory and motor block was maximum in Group I and minimum in Group III. Time taken for first rescue analgesic dose was also maximum in Group I and minimum in Group III.Conclusions:It can be concluded that 3 mg/kg of 0.75% ropivacaine along with 1 μg/kg of fentanyl diluted with NS to make a total volume of 35 ml was the most efficacious regimen for brachial plexus block among patients undergoing upper limb orthopedic surgeries.
Introduction: Midazolam is a water-soluble benzodiazepine which is frequently administered by intravenous and oral routes. Its nasal spray has become recently available. Materials and Methods: In this study, after obtaining clearance from the ethical committe, 66 patients between the age group of 4 and 10 years comparable in demographic variables were randomly allocated into two groups of 33 each. Group “O” received oral midazolam (0.5 mg/kg) 20 min before induction. Group “N” received intranasal midazolam (0.2 mg/kg) 20 min before induction. The heart rate and blood pressure (systolic, diastolic, and mean) and oxygen saturation (SPO 2 ) were recorded. Statistical Analysis Used: The statistical analysis was done using SPSS (Statistical Package for the Social Sciences) version 15.0 software. The values were represented in number (%) and mean±sd. Results: Satisfactory sedation scores were better in nasal spray group than oral group. Satisfactory ease of induction scores, recovery times, and postanesthesia recovery scores were better in the nasal spray group than in the oral group. Conclusion: Nasal midazolam spray is acceptable and is a good alternative to oral midazolam as premedication in the pediatric population.
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