Online ISSN: 2515-8260

Keywords : post-operative analgesia


EVALUATION OF INTRATHECALDEXMEDETOMIDINE FOR SPINAL ANAESTHESIA FOR PERIANAL AMBULATORY SURGERIES

Dr JaladKapoor, Dr Avdhesh Kumar Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1187-1191

Background:Ambulatory anorectal surgery is an appealing approach for patients and physicians due to its increased efficiency and decreased surgical costs. The present study was conducted to evaluate intrathecaldexmedetomidine as adjuvant for spinal anaesthesia for perianal ambulatory surgeries.
Materials & Methods:50 adult patients presenting for perianal surgeries were divided into 2 groups of 25 each. Group I patients received intrathecal 0.5% hyperbaric bupivacaine 6 mg (1.2 ml) with injection dexmedetomidine 5 μg in 0.5 ml of distilled water and group II received intrathecal 0.5% hyperbaric bupivacaine 6 mg (1.2 ml) with 0.5 ml of distilled water. The parameters such as time to regression of sensory blockade, motor blockade, ambulation, time to void, first administration of analgesic wasassessed.
Results: The mean weight in group I was 64.7 kg and in group II was 63.4 kg, height was 156.8 cm in group I and 157.3 cm in group II, ASA grade I was seen in 15 in group I and 16 in group II and grade II was seen in 10 in group I and 9 in group II.  The difference was non- significant (P>0.05). The mean duration of surgery was 26.5 minutes in group I and 28.2 minutes in group II. The mean duration of sensory block in group I was 430.6 minutes in group I and in group II was 318.6 minutes, duration of motor block was 324.8 minutes in group I and 230.6 minutes in group II and time to ambulation was 314.2minutes in group I and 216.1 minutes in group II. The difference was significant (P< 0.05). Side effects were shivering seen in 1 in group II, bradycardia 1 in group I, hypotension 1 in each group and Nausea/vomiting 1 in group I and 2 in group II. The difference was significant (P< 0.05).
Conclusion: Intrathecaldexmedetomidine provides prolonged post-operative analgesia.

A study on side effects of post-operative analgesia with intravenous paracetamol versus dexmedetomidinein patients undergoing laparoscopic cholecystectomy

Dr. Santosh Kumar, Dr. Deepak Vijaykumar Kadlimatti, Dr. Salim Iqbal M, Dr. Renita Lincia, Dr. Harsoor SS

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1425-1430

Several theories have been proposed, the most consistent being that it acts in a similar fashion to NSAIDs by the inhibition of the cyclo-oxygenase pathways. However, paracetamol lacks both the peripheral anti-inflammatory and anti-platelet response seen with NSAIDs28. More recently, it has been suggested that paracetamol may also be linked with both direct and indirect stimulation of the cannabinoid, nitric oxide synthase, and serotonergic pathways. Patients satisfying the inclusion criteria were selected during the study period from the operation register on a daily basis. After obtaining a written informed consent, sixty patients were recruited for this study. They were allocated into two groups of 30 each. 10 patients in group D and 08 patients in group P complained of nausea, none of the patients in either group had vomiting, bradycardia, and hypotension

Comparison of the analgesic efficacy of ultrasound-guided transversus abdominis plane (tap) block versus local infiltration during laparoscopic surgeries in paediatric patients

Amit Kumar Srivastava, Abhishek Kumar Patel, Sarvjeet Verma, Archana Aggarwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5065-5069

Introduction: Regional anaesthesia has proved to be an essential aspect of modern
paediatric anaesthesia which issues support for the superior and long-lasting analgesia
without the risk of respiratory depression. The transversus abdominis plane (TAP)
block is a type of regional anaesthetic technique which was first elaborated in the
literature as an anatomical landmark technique in the year 2001 by Rafi. Hence this
study is aimed to research whether USG guided TAP block was superior to local
infiltration for intra and postoperative analgesia for paediatric laparoscopic surgeries.
Materials and Methodology: 100 children in the age group of 3–12 years, posted for
elective laparoscopic hernia repair, orchidopexy, appendicectomy or cholecystectomy
were enrolled in the study. All the study participants were basically divided into two
groups like Group – T receiving TAP block and Group – L receiving local infiltration.
Results: The postoperative pain scores were reported to be significantly lower in Group
T at 10 and 30 min, 1 and 2 hours than in Group L as tabulated in table 2. After 2 h, the
pain scores were similar in the two groups. The necessity for rescue analgesia was also
significantly lower in the TAP block group (10/50) when compared with the local
infiltration group (37/50; P < 0.001). The intraoperative heart rates were significantly
lower in TAP block group at port placement, 30 and 60 min compared with the local
infiltration group.
Conclusion: This is to be conclude that TAP block is proven to be superior to local
infiltration for intra and immediate postoperative analgesia in paediatric laparoscopic
surgeries. We recommended the inclusion of TAP block as a routine in the part of
multimodal analgesia for these surgeries in paediatric patients.

Comparative evaluation of tramadol via two different routes for post-operative analgesia after inguinal herniorrhaphy

Dr. Prerna Attal, Dr. Taninder Singh, Dr. Ranika Manhas, Dr. Sunayna Gupta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2294-2300

Aims: To compare the duration of analgesia and side effects of tramadol via two different routes i.e intravenous and rectal administration.
Settings and Design: The study design was Prospective, randomized, single blind and hospital based.
Methods and Material: Sixty adult patients of ASA grade I and II posted for inguinal hernia surgery were randomized to receive either rectal suppository of tramadol 100mg (n=30) Group R or I.V. tramadol 50 mg (n=30) Group I. Pain measurement was performed using visual analogue scale (VAS). Rescue analgesia was given when the VAS was >3 in the postoperative period up to 24 hrs. Side effects like nausea, vomiting, were recorded during the same period.
Statistical analysis used: All data was analysed using the Chi square test and Z-test.
Results: Duration of analgesia was prolonged and requirement of rescue analgesic was less with the suppository group. Nausea and vomiting were also lower with the suppository group.
Conclusions: Rectal suppository of tramadol as well as intravenous tramadol are effective for postoperative analgesia after inguinal herniorraphy, but rectal tramadol is better alternative than I.V. tramadol as it has longer duration of pain relief and lesser incidence of nausea and vomiting.