To find the ideal drug combinations which can be used during day care surgeries and procedures. AIMS: This study was conducted. To evaluate and compare the efficacy, and haemodynamic stability of ketamine and fentanyl combination with propofol. To compare the incidence of side effects. To compare the time of awakening and recovery time. To compare the discharge criteria in both groups. METHODS: The study was conducted in 50 patients of age group 18-50 years of either gender belonging to ASA grade I and II, were divided into two groups of 25 each. They underwent elective surgery of approximately 1 hour duration. Group I received Propofolketamine while group II received Propofol-fentanyl for induction and maintenance of anaesthesia. Postoperatively, time for awakening, recovery time '(by modified Aldrete scoring system) and discharge status (by modified post anaesthetic discharge scoring system) were recorded and compared in two groups. RESULTS: Profol-fentanyl combination produced a significantly greater fall in pulse rate and in both systolic and diastolic blood pressure as compared to Propofol-ketamine during induction and maintenance of anaesthesia. Fall in respiratory rate was greater in Propofolfentanyl group as compared to Propofol-ketamine group. The recovery time in group I was longer than group II. Discharge criteria is significantly earlier in group II. CONCLUSION: Both Profolketamine and Propofol-fentanyl combination reduce rapid, pleasant and safe anesthesia with only a few untoward side effects and propofol-ketamine produces better haemodynamic statistic, during anaesthesia.
BACKGROUND: Addition of lipophilic opioids like Fentanyl and Sufentanil to local anaesthetic for spinal anaesthesia has shown to prolong the duration of analgesia. This study was carried out to study (a) Comparison of effect of Fentanyl and Sufentanil added to Bupivacaine on onset and duration of anaesthesia in Cesarean Section. (b) To compare the quality and duration of analgesia between the two opioids and (c) To compare the effect on neonatal outcome. METHODS: 50 parturients of ASA grade 1 and 2 undergoing Cesarean Section were randomized into two groups of 25 each. Group F received 2.5 ml 0.5% Bupivacaine heavy + inj. Fentanyl 0.25 ml (12.5 mcg) and Group S received 2.5 ml 0.5% Bupivacaine heavy + inj. Sufentanil 0.1 ml (5 mcg) intrathecally. Onset of sensory and motor blockade was noted in all the patients. Haemodynamic parameters were recorded every 5 minutes for first 30 minutes and then every 15 minutes till the completion of surgery. Duration of sensory and motor sensory blockade was observed post operatively. RESULT: Both the groups were stable haemodynamically. Both the groups were comparable regarding the duration of sensory and motor block, but the total duration of effective analgesia was significantly longer in Sufentanil group. Pruritus was significant side effect in Sufentanil group. Neither the mother nor the neonate had respiratory depression. CONCLUSION: Addition of Sufentanyl to intrathecal bupivacaine provides longer duration of analgesia as compared to intrathecal fentanyl-bupivacaine. However, the incidence of pruritus was greater in Sufentanyl group.
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