Aim & Objectives:The aim of the present study is to compare the recovery pattern after total intravenous anaesthesia using thiopentone sodium, ketamine hydrochloride and propofol for short surgical cases. Methodology: The randomized controlled trial was a comparison between three groups of adult patients each receiving thiopentone sodium, ketamine hydrochloride or propofol as the anaesthetic agent. Analysis of variance (ANNOVA) was applied to all the variables. Barring four parameters the tests of homogeneity were round to be significantly different for the three drugs respectively. Hence it was decided to go for non-parametric tests. Results: In the present study, recovery of consciousness, cognitive and fine motor functions with thiopentone sodium was slower than with propofol but earlier than with ketamine hydrochloride. Recovery of cognitive and motor functions was slowest with ketamine hydrochloride. Recovery of gross motor activities like sitting, standing and walking was earliest with propofol and equivocal between thiopentone sodium and ketamine hydrochloride. Conclusion: Thus, propofol has the best recovery profile when compared with thiopentone sodium and ketamine hydrochloride for short surgical cases.
Background & Objectives: Caudal epidural analgesia is one of the most commonly performed regional blocks in pediatric anaesthesia for intra and post-operative analgesia. However, the mean duration of analgesia provided by local and aesthetics alone is limited. Caudal opioids is associated with side effects like respiratory depression, urinary retention, pruritis, vomiting etc. Tramadol, an opioid agonist, is known for its analgesic effects with lesser side effects. Hence, this study was conducted to know the efficacy and safety of addition of tramadol to bupivacaine in a single shot caudal block in children. Methods: This study was conducted among 50 children in the age group of 1 -13 years coming for various infraumbilical surgical procedures. They were divided into two groups of 30 each. Group B received caudal 0.25% bupivacaine (1ml/kg) and group BT received caudal 0.25% bupivacaine (1ml/kg) with tramadol (1mg/kg). The various parameters studied were hemodynamic changes, duration of analgesia and incidence of side effects. Pain assessment was done at the 1 st , 2 nd , 3 rd , 4 th , 8 th , 12 th and 24 th hour after the surgery. Results: The groups were similar in age, sex and weight. The hemodynamic parameters like heart rate, blood pressure, respiratory rate were also similar between the two groups after administering caudal block. The mean duration of analgesia in group BT (425.3±33.4 min) was significantly longer (p< 0.05) than group B (219.3±19.1 min).The pain score in the two groups were similar up to 2 hours after surgery but was higher in group B at the end of 3 rd and 4 th hour compared with group BT. Sedation score was similar in both the groups. Incidence of vomiting was comparable in both the groups while there were no incidence of bradycardia, hypotension or respiratory depression in both the groups. Conclusion: This study showed that the addition of tramadol in the dose of 1mg/kg to 0.25% bupivacaine (1ml/kg) improved the analgesic duration and efficacy after a single shot caudal block with minimal side effects in children.
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