Online ISSN: 2515-8260

Keywords : anesthesia


A comparative study of local anaesthetics ropivacaine and bupivacaine for caudal epidural anaesthesia in children undergoing lower abdominal surgery

Dr. Marie Ninu, Dr. Jagadish Basumatary, Dr. Ashim Saikia, Dr. Sangeeta Deka

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1863-1871

Background: Caudal blocks have been shown to reliably block dermatomes below the level of the umbilicus (T10–S5) in children <20 kg (∼6 yr of age).  Caudal epidural anaesthesia involves accessing the epidural space through the sacrococcygeal ligament via the sacral hiatus at the base of the sacrum. The aim of this study was to compare the effects of ropivacaine and bupivacaine for caudal anaesthesia in children undergoing lower abdominal surgery.
Methods: After the hospital ethics committee approval, 60 (ASA I–II) children scheduled for lower abdominal surgery were included in this study. The group A (n=30) patients received ropivacaine 0.25% and group B (n = 30) patients received bupivacaine 0.25% via the caudal route. In this study we assessed demographic and clinical characteristics, AIIMS pain score at 1, 2, 4, 8, 12, 16 and 24 hours after operation and level of residual motor block (Modified Bromage Scale) immediately after surgery and at 1, 2 and 3 hours post operatively.
Results: There were no statistically significant differences in AIIMS pain scores between groups A and B at all postoperative time points – 1hr, 2hr, 4hr, 8hr, 12hr, 16hr and 24hr (P < 0.00001). The quality and duration of analgesia were comparable in both the groups. However, degree of motor block was significantly less in the ropivacaine group. After 3 hours there was no significant difference in the level of residual motor block.
Conclusion: The single shot caudal epidural block with 1ml/kg ropivacaine 0.25% is a safe and effective, long lasting dose for postoperative analgesia in paediatric lower abdominal surgery, producing less duration of motor block than bupivacaine 0.25%.

Rutkow–Robbins versus Gilbert Double Layer Graft Methods of hernia repair

Dr Devender Grover, Dr Irum Jawaid

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 393-397

Background:Inguinal hernias are common, and although the results of surgical repair
are often satisfactory, postoperative recovery may be slow, and the hernia may recur.
The present study compared Rutkow–Robbins and Gilbert Double Layer Graft
Methods of hernia repair.
Materials & Methods: 60 patients of inguinal hernia of both genders were divided into 2
groups of 30 each. Group I were treated with Rutkow–Robbins method and group II
with Gilbert double layer graft methods. Parameters such as VAS and complications
were compared
Results: There were 18 males and 12 females in group I and 11 males and19 females in
group II. Anesthesia used was local in 16 in group I and 10 in group II, general 6 in both
groups and spinal 8 in group I and 14 in group II. The mean hospitalization (days) was
2.24 in group I and 2.31 in group II and operation time (mins) was 26.2 in group I and
24.6 minutes in group II. The mean VAS was 1.91 and 2.14 at day 1, 0.84 and 1.21 at
day 7 and 0.09 and 0.27 at day 30 in group I and II respectively.
Conclusion: Both methods of inguinal hernia repair was comparable

A comparative study of ropivacaine and bupivacaine for caudal epidural anaesthesia in children undergoing lower abdominal surgery

Dr. Marie Ninu, Dr. Jagadish Basumatary, Dr. Sangeeta Deka .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5330-5339

Background: Caudal epidural anaesthesia blocks dermatomes below the level of the umbilicus  in children.
Objectives:This study intends to compareropivacaine and bupivacaine for caudal anaesthesia in children undergoing lower abdominal surgery.
Materials and methods: After the hospital ethics committee approval, 60 (ASA I–II) children scheduled for lower abdominal surgery were included in this study. Group A (n=30) patients received ropivacaine 0.25% and group B (n = 30) patients received bupivacaine 0.25% via the caudal route. We assessed the demographic and clinical characteristics, AIIMS pain score at 1, 2, 4, 8, 12, 16 and 24 hours after operation and level of residual motor block (Bromage Scale)immediately after surgery and at 1, 2 and 3 hours post operatively.Data analysis was performed using one way ANOVA test.P value less than 0.05 was considered significant.
Results and conclusion: There were no statistically significant differences in AIIMS pain scores between groups A and B at all postoperative time points –1hr, 2hr, 4hr, 8hr, 12hr, 16hr and 24hr(P < 0.00001). The quality and duration of analgesia were comparable in both the groups. However, degree of motor block was significantly less in the ropivacaine group. After 3 hours there was no significant difference in the level of residual motor block.
The single shot caudal epidural block with 1ml/kg ropivacaine 0.25% is a safe and effective, long lasting dose for postoperative analgesia in paediatric lower abdominal surgery, producing less duration of motor block than bupivacaine 0.25%.

Anaesthetic management of adrenal tumours presenting with combination of rare syndromes during a pandemic: experience from a tertiary cancer care centre in Northeast India

Dr.Sonai Datta Kakati, Dr. Biplob Borthakur, Dr.Barnali Kakati, Dr. Marie Ninu, Dr. Dokne Chintey .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10682-10692

Background and Aims: Perioperative management of functional adrenal tumours is resource intensive. Due to the covid 19 pandemic, there has been sizeable delay in preparing and conducting these time sensitive surgeries.Quality of care andresource utilisation may worsen. This retrospective review was aimed at finding if care quality deteriorated due to covid 19 related restrictions, from anaesthetic perspective.
Methods:Three cases of hormone-secreting adrenal tumours operated during a two year period in a tertiary cancer centre in India were retrospectively reviewed.Summary of the demographic profile, tumour characteristics, and the perioperative care were described using tables and analysed in the discussion.
Results: Out of the three cases operated for adrenal gland tumour, pheochromocytoma tumour type with distant metastasis had prolonged hospital stay. One patient developed covid 19 infection in hospital. Cases were adequately managed during the perioperative period and the covid 19 related constraints didn’t affect the quality of care.
Conclusion:As in any other major surgery, adhering to a unique checklist, multidisciplinary approach, clear communication, knowledge sharing and establishing a care pathway helps to maintainquality care in high risk cases and at times of crisis.
 

Comparative study to evaluate the Desflurane Versus Sevoflurane in outpatientanesthesia

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1585-1595

Introduction: Currently, new volatile anaesthetics such as sevoflurane and desflurane are in widespread clinical use for maintenance of general anesthesia. The advantage of these anaesthetics is their low blood solubility, which accounts for its extremely rapid onset of action and recovery from general anesthesia. Since 2001, several randomized controlled trials (RCT) have been carried out to assess the efficiency and safety of desflurane and sevoflurane anesthesia in patients. As each type of anesthesia has some advantages and/or disadvantages, and the conclusions have not been completely consistent.
AIM: Aim of present study is comparison of maintenance and emergence characteristics after

Evaluation of general anesthesia and sedation during dental treatment in emotionally immature children: A Randomized Clinical Trial

Dr. Arunkumar Sajjanar; Dr. Nilesh Rojekar; Dr. Pankaj Chavan; Dr. Milind Wasnik; Dr. Niharika Gahlod; Dr. Harshita Shukla

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 7645-7651

Background
Emotionally immature children are more likely to develop health problems, including dental
problems. Dental treatments require a good level of communication with the patient.
Therefore, in these patients, sedation and general anesthesia are an extremely humanistic
approach for comfortable and successful treatment. In such children, there is no standard
anesthetic approach due to varying clinical conditions. The aim of this study was to compare
general anesthesia and sedation during dental treatment of such children.
Methods
25 children with greater than 16 score on Rutters Child Behaviour Scale were treated under
general anesthesia or sedation. Demographic data, the American Society of Anesthesiologists
classification, Mallampati score, anesthesia duration, anesthesia type, anesthetic and
analgesic agents used, dental treatment performed, secondary diseases, and complications in
the perioperative period were recorded.

Improving the epidemiology, epizootology, and prevention of echinococcosis in Uzbekistan

Sh.M. Rasulov; G.S. Matnazarova; A. Mirtazayev; N.T. Xamzayeva

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 3029-3052

Echinococcus (Echinococcus granulosus) is a parasitic disease
that occurs in some mammals and humans, is transmitted orally, infects human
parenchymal organs (liver, lungs, spleen, and various other organs), and is
chronic, causing echinococcal vomiting. The Republic of Uzbekistan is an
endemic area for echinococcosis. According to official data, the damage rate is
6-9 people per 100,000 population. The number of surgeries performed
annually due to echinococcosis ranges from 1,000 to 1,500. The article
provides an analysis of the prevalence of echinococcosis among humans and
animals, the long-term (1994-2019) dynamics of echinococcosis among the
population of the Republic of Uzbekistan, routes of transmission, infectious
factors, epidemiological and epizootiological features.

Ease of Intubation While Using Macintosh and (Mccoy’s Type) Laryngoscope Blade Undergoing with Anaesthesiology

N.V. Kanase; Saudamini Gandhi; Saurabh R Todi

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 70-73

Various anesthesia devices have been designed to overcome the difficult airway scenario in anesthesia practice. The ease of intubation, timing, and hemodynamic variability between the two groups during intubation are considered as primary results compare. The study was conducted in two groups, each group set aside of 65 patients, named Group A and Group B with normal physical status I-II to endothelial intubation. Determined to perform surgery under anesthesia by consent. This includes simple rigid laryngoscopes for complex fiber-optic incubating devices; However, there is weak evidence to support the superiority of one device over another. McCoy’s blade shows overall minimal haemodynamic response and provides better glottic view and ease of intubation as compared to Macintosh blade.

Anaesthesia for the elderly patients and Techniques: preoperative assessmentand evaluation, Peri and Postoperative care of the elderlypatients’painmanagement

Arunachala D Edukondalu,Yamuna Devi .V.R ,E.Prabhakar Reddy

European Journal of Molecular & Clinical Medicine, 2019, Volume 6, Issue 1, Pages 103-113

Elderly person of 80 years of age and older presents a specific challenge to anesthetists,
who needs toacquire and maintain skill and expertise in the management of such patients.
Departments should havea lead clinician with an interest in the care of the elderly.
Development in anesthesia and operative techniques hasconsiderably reduced morbidity
and mortality in the elderly patients.Several anesthetic techniques have been used for
elderly patientsincluding general anesthesia, regional anesthesia, intravenoussedation and
monitored anesthesia care. However, anesthesiarelatedmortality in these patients is still
high. All elderly patientsundergoing surgical procedures require a preprocedural
evaluationto assess the risks of anesthesia and procedure and to manageproblems related
to the preexisting medical conditions, monitoringpatients during intraprocedural and
postprocedural periods aswell as postprocedural management. This article considers
theage-related physiological changes, preprocedure assessmentand preparation, anesthetic
techniques, intraoperative care andpostoperative care. Age does not obtund the perception
of pain. Acute and chronic pain management teams should be available totreat the elderly.
Prophylaxis for Thrombo embolic disease should initiated to prevent further complications.