scholarly journals The Effects on Sensorial Block, Motor Block, and Haemodynamics of Levobupivacaine at Different Temperatures Applied in the Subarachnoid Space

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Bahittin Nazli ◽  
Huseyin Oguzalp ◽  
Eyup Horasanli ◽  
Mehmet Gamli ◽  
Beyazit Dikmen ◽  
...  
Keyword(s):  
Side Effects ◽  
Motor Block ◽  
Room Temperature ◽  
Demographic Data ◽  
Sensory Block ◽  
Group I ◽  
Significant Difference ◽  
Different Temperatures ◽  
Group Ii ◽  
Transurethral Prostate Resection

Aim. To evaluate the effects of 0.5% levobupivacaine at 37°C preheated from room temperature, on sensorial block, motor block, and haemodynamics in patients undergoing transurethral prostate resection (TUR-P).Material and Method. The patients were randomly allocated to two groups: Group I patients were injected with 3 mL 0.5% levobupivacaine solution which had been kept at room temperature for at least 24 hours and Group II patients were injected with 3 mL 0.5% levobupivacaine solution which had been kept at 37°C for at least 24 hours. The patients were examined in terms of sensorial block, motor block, haemodynamic profile, and incidence of side effects.Results. No significant difference was found between the groups in terms of demographic data. The time to reachT10sensory block and the time of starting motor block were found to be significantly shorter in Group II . The duration of sensory block overT10andT6, the duration ofL1regression, the duration of the sensory block, and the regression time of the motor blocks from 3 to 2 were found to be longer in Group II.Conclusion. The use of 0.5% levobupivacaine spinal anaesthesia heated to 37°C accelerated the start of sensory and motor block.

scholarly journals A Comparative Evaluation of Dexamethasone and Tramadol as Adjuvant to Levobupivacaine in Supraclavicular Block

2020 ◽  
Vol 5 (1) ◽  
pp. 100-102
Author(s):  
Rangit Priyakar Pandey ◽  
Richa Chandra
Keyword(s):  
Motor Block ◽  
Sensory Block ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
The Difference ◽  
American Society ◽  
Supraclavicular Block ◽  
Plexus Block

Background: The present study was conducted to evaluate and compare dexamethasone and tramadol as adjuvant to levobupivacaine in supraclavicular block. Subjects and Methods: The present study was conducted on 50 patients of American Society of Anesthesiologists (ASA) grade I and II. Patients were divided in to two groups of 25 each. In group I, 30 ml of 0.5% levobupivacaine hydrochloride plus 2 ml tramadol (100 mg) was used. In group II, 30 ml of 0.5% levobupivacaine hydrochloride plus 2 ml dexamethasone (8 mg) was used. Visual Analogue Scale was used. The onset of sensory and motor block was evaluated.Results: The mean onset of sensory block in group I was 5.41 minutes and in group II was 3.86 minutes, motor onset was 9.12 minutes in group I and 7.25 minutes in group II, duration of sensory block in group I was 12.14 hours and in group II was 15.34 hours, duration of motor block in group I was 14.34 hours and I group II was 16.23 hours, duration of analgesia in group I was 16.1 hour and in group II was 18.4 hours. The difference was significant difference (P<0.05). The mean VAS score in group II was better as compared to group I (P <0.05). Conclusion:Authors found that dexamethasone is a better adjuvant than tramadol when added to levobupivacaine in supraclavicular brachial plexus block.

scholarly journals Effect of dexamethasone as an adjuvant with bupivacaine in ultrasound guided single shot supraclavicular brachial plexus block in upper extremity surgeries- a prospective randomized study

2017 ◽  
Vol 5 (5) ◽  
pp. 2139 ◽  
Author(s):  
Shaheena Parveen ◽  
Masrat Jan ◽  
Arshi Taj ◽  
Arif A. Bhat
Keyword(s):  
Side Effects ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Group I ◽  
Supraclavicular Brachial Plexus Block ◽  
Group Ii ◽  
Plexus Block

Background: Supraclavicular brachial plexus block is a good alternative to general anesthesia in surgeries of elbow, forearm, wrist and hand. The aim of this study was to assess the effect of dexamethasone as an adjuvant with bupivacaine in supraclavicular brachial plexus block in upper limb surgeries.Methods: This study was carried out on 60 adult patients of both sexes planned for upper limb surgery during the period from May 2015 to Jan 2016 after approval by the institutional Ethical Committee. Inclusion criteria were American Society of Anesthesiologists physical Status I-II and age between 18 and 50 years. Patients were randomly allocated to two groups of 30 patients each [group I (bupivacaine alone) and group II (bupivacaine + dexamethasone)]. Group I received 30ml of 0.5% bupivacaine with 2ml normal saline while group II received 30ml of 0.5% bupivacaine with 2ml (8mg) dexamethasone for supraclavicular brachial plexus block. Statistical analysis was performed with SPSS for Windows (SPSS Inc., Chicago, IL, USA), version 16.0. For analysis of demographic data and comparison of groups, χ2, unpaired Student's t-test and Mann-Whitney U-test were performed. Power of significance p-value of <0.05 was considered to be statistically significant. We evaluated onset, quality and duration of sensory and motor block along with side effects if any.Results: The mean onset of sensory and motor block in Group I and II was statistically insignificant. The duration of motor and sensory block was significantly prolonged in Group II than in Group I. There were no statistically and clinically significant differences in respiratory and hemodynamic parameters.Conclusions: We conclude that dexamethasone as an adjuvant in supraclavicular brachial plexus block prolongs the duration of motor and sensory block with insignificant side effects.

scholarly journals ADVANTAGES OF INTRATHECAL BUPIVACAINE AND DEXMEDETOMIDINE COMBINATION OVER BUPIVACAINE AND CLONIDINE: A COMPARATIVE ANALYSIS IN GYNAECOLOGICAL INTERVENTIONS

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Aruna Mahanta ◽  
Keshav Saran Agrawal
Keyword(s):  
Regional Anaesthesia ◽  
Motor Block ◽  
Surgical Intervention ◽  
Average Duration ◽  
Sensory Block ◽  
Lower Side ◽  
Regional Analgesia ◽  
Surgical Interventions ◽  
Group I ◽  
Group Ii

Background: most of the gynaecological interventions are generally done under regional anaesthesia. Currently dexmedetomidine came out as a beneficial adjunct for regional analgesia as well as anaesthesia. It is a highly selective α-2 agonist. Aims & objectives: to compare the effects & behavior of dexmedetomidine with clonidine when both are used with bupivacaine for spinal analgesia. Material and Methods: 100 cases of ASA grade 1 & 2 who were undergoing elective gynaecological surgical intervention were studied. They were divided into two groups (50 each). Group I received combination of bupivacaine & clonidine while group II received combination of bupivacaine + dexmedetomidine. Results: Average duration of onset of sensory block was earlier in group II. Arrival of motor block in Group I was slightly on lower side than Group II. Ten cases in Group I and eighteen cases from group II had notable bradycardia and hypotension. Discussion: Our study concludes that dexmedetomidine when used in combination with bupivacaine is very effective in gynaecological surgical interventions that demand longer duration & have comparatively lesser side effects. Keywords: dexmedetomidine, clonidine, Bupivacaine, gynaecological procedures.

scholarly journals A comparative clinical study of intrathecal hyperbaric bupivacaine with and without fentanyl for hysterectomy

2020 ◽  
Vol 11 (2) ◽  
pp. 59-63
Author(s):  
Hari Poudel ◽  
Surinder Nath Bawa ◽  
Surendra Mohan Sharma
Keyword(s):  
Side Effects ◽  
Spinal Anesthesia ◽  
Sensory Block ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Maximum Height ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Group I ◽  
Group Ii

Background: Spinal anaesthesia has been widely used for lower abdominal surgeries like hysterectomy.Hyperbaric bupivacaine is the most extensively used local anesthetic. Addition of fentanyl can allow the reduction in the dose of bupivacaine, increase the height and duration of sensory blockade, and reduces complications of spinal anesthesia. Aims and Objective: The aim of the study was to examine whether adding fentanyl to hyperbaric bupivacaine would increase the height of sensory blockade, accelerate the onset of sensory blockade and increase the duration of the sensory blockade. Material and Methods: This study was done in Manipal Teaching Hospital, Pokhara, Nepal that included hundred patients who underwent total abdominal hysterectomy. The patients were randomly allocated in two groups; Group I: received 0.5% hyperbaric bupivacaine 2.5 ml (12.5 mg) plus normal saline 0.5 ml. Group II: received 0.5% hyperbaric bupivacaine 2.5 ml (12.5 mg) plus 0.5 ml fentanyl (25 μg). Hemodynamic variables, onset of motor and sensory blockade, duration of sensory and motor blockade and any side effects were observed and recorded. Results: The highest and lowest sensory block in Group I was T-7 and T-9 whereas in Group II was T-5 and T-9 respectively. In group I, the mean onset till maximum height of sensory blockade was 7.04 min whereas in group II it was 5.96 min (P<0.00).There was no significant statistical difference in the incidence of side effects in both the groups. Conclusion: Intrathecal fentanyl with hyperbaric bupivacaine for spinal anesthesia significantly accelerated the onset of sensory blockade and increased its maximum height and duration.

scholarly journals Comparison between Clinical Efficacies of Levobupivacaine Plain and Levobupivacaine with Fentanyl for Urological Surgeries under Subarachnoid Block

2017 ◽  
Vol 2 (2) ◽  
pp. 34-39
Author(s):  
Aarti Kulkarni ◽  
Paulomi Dey
Keyword(s):  
Side Effects ◽  
Motor Block ◽  
Randomized Study ◽  
Categorical Variables ◽  
Transurethral Resection Of Prostate ◽  
Sensory Level ◽  
Hemodynamic Parameters ◽  
Subarachnoid Block ◽  
Group I ◽  
Group Ii

ABSTRACT Background and aims Spinal anesthesia for urological operations has been frequently used, because symptoms of overhydration, transurethral resection of prostate (TURP) syndrome, and bladder perforation can be recognized. This prospective randomized study was conducted to compare the clinical efficacies of levobupivacaine with and without fentanyl in subarachnoid block with respect to onset and duration of sensory and motor block and duration of analgesia in urological surgeries. Materials and methods This randomized study was conducted in 100 patients of American Society of Anesthesiologists (ASA) physical status grades I and II, posted for urological surgeries. Patients were randomly allocated to two groups and were given the following drugs intrathecally as per group distribution: Group I: 2.5 mL of 0.5% isobaric levobupivacaine and group II: 2.2 mL of 0.5% isobaric levobupivacaine with 15 μg (0.3 mL) fentanyl citrate. Parameters monitored were onset and duration of sensory and motor block, hemodynamic parameters, postoperative analgesia, and side effects. Data were analyzed using Student's t-test for the continuous variables and chi-square test for categorical variables. Results The onset of sensory level of T10 was earlier in group II (4.74 ± 0.723 minutes) than in group I (5.7 ± 0.953 minutes). Duration of sensory block was longer in group I (292.2 ± 8.154 minutes) than in group II (260 ± 11.066 minutes). Motor block regressed earlier in group II (181.2 ± 7.73 minutes) than in group I. Hemodynamic parameters and side effects were similar in both the groups. Conclusion From our study, we concluded that plain levobupivacaine provided a longer duration of sensory and motor subarachnoid blockade. However, addition of fentanyl as a spinal adjuvant had a dose-sparing effect with earlier onset and early regression of motor block and no hemodynamic alterations. How to cite this article Kulkarni A, Dey P. Comparison between Clinical Efficacies of Levobupivacaine Plain and Levobupivacaine with Fentanyl for Urological Surgeries under Subarachnoid Block. Res Inno in Anesth 2017;2(2):34-39.

Distal Metatarsal Segmental Shortening for the Treatment of Chronic Metatarsophalangeal Dislocation of Lesser Toes

2020 ◽  
pp. 107110072096108
Author(s):  
Tzu-Cheng Yang ◽  
Yun-Hsuan Tzeng ◽  
Chien-Shun Wang ◽  
Ming-Chau Chang ◽  
Chao-Ching Chiang
Keyword(s):  
Demographic Data ◽  
Level Of Evidence ◽  
Radiographic Measurements ◽  
Group I ◽  
Significant Difference ◽  
Scale Scores ◽  
Group Ii ◽  
American Orthopaedic ◽  
Retrospective Comparative Study ◽  
Mtp Joints

Background: This retrospective study aimed to describe the techniques and results of distal metatarsal segmental shortening (DMSS) for the treatment of chronic irreducible metatarsophalangeal (MTP) dislocation of lesser toes. Methods: We retrospectively reviewed patients who underwent DMSS for chronic dislocation of MTP joints of lesser toes between January 2010 and December 2017 with follow-up of at least 24 months. Demographic data, radiographic measurements, functional outcomes, and complications were analyzed. Furthermore, the results of patients with short segment of shortening (group I, <10 mm) were compared to those with long segment of shortening (group II, ≥10 mm). A total of 43 MTP joints of 30 patients with an average age of 70.4 years were included. Results: Union was observed in 42 metatarsals (97.7%). Mean American Orthopaedic Foot & Ankle Society scale scores improved significantly from 42.2 (range, 15-65) preoperatively to 79.1 (range, 52-90) ( P < .001). Mean visual analog scale pain score improved significantly from 5.0 (range, 1-9) preoperatively to 1.8 (range, 0-6) ( P < .001). Complications included 1 nonunion, 1 osteonecrosis, 3 metatarsal angulation, 4 recurrent instability, 4 symptomatic osteoarthritis, 3 transfer metatarsalgia, and 1 floating toe. Group I included 23 MTP joints and group II included 20 MTP joints. There was no significant difference in clinical outcomes and complications between the 2 groups. Conclusion: DMSS was a reliable procedure for the treatment of chronic irreducible dislocated MTP joint of lesser toes. It provided satisfactory surgical outcomes and a low rate of postoperative complications, regardless of length of metatarsal shortening. Level of Evidence: Level III, retrospective comparative study.

Comparative study between paracetamol versus paracetamol and pregabalin combination for postoperative analgesia in hip surgeries

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A R M Hassab ◽  
H M Fawzy ◽  
S M Elfawal ◽  
D M Kamaleldin
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Demographic Data ◽  
Preoperative Assessment ◽  
Multimodal Analgesia ◽  
Blurred Vision ◽  
Arterial Blood ◽  
Group I ◽  
Group Ii

Abstract Introduction Pregabalin has been used for treatment of chronic pain, but recently it has been introduced in treatment of acute postoperative pain. Aim of Study This study is conducted to evaluate the postoperative analgesic effect of paracetamol and pregabalin combination versus paracetamol after hip surgeries. Methods The study was done on 20 randomly chosen patients after approval of the medical ethical committee of Ain Shams University. Patients were divided randomly into two groups, each group consisted of 10 patients.After preoperative assessment and obtaining baseline vital data all patients received spinal anaesthesia. Group I received paracetamol 1gm intravenous immediately postoperatively and every 6 hours for 24 hours. Group II received the same as group I plus two doses of oral pregabalin 300mg in the recovery room and 12 hours later. The two groups were assessed postoperatively and they were compared regarding demographic data, postoperative pain control, sedation, total pethidine consumption, hemodynamics and side effects. Results In pregabalin group (group II), pain scores and total pethidine consumption were significantly lower and sedation scores were higher than group II. Heart rate and arterial blood pressure were lower in group II but without clinical significance. Conclusions This study revealed that combination of paracetamol and pregabalin as multimodal analgesia is better than paracetamol alone in postoperative analgesia, and decreasing use of opioids without significant effect on hemodynamics but with increased incidence of side effects such as somnolence, dizziness and blurred vision.

scholarly journals Efficacy of Intrathecal Neostigmine with Intrathecal Dexmedetomidine in Postoperative Analgesia

2020 ◽  
Vol 5 (2) ◽  
pp. 39-42
Author(s):  
Nischala Reddy G ◽  
Ajay Babu Ramakrishnan ◽  
S. Ankalagowri Sankardevar ◽  
Uthkala B Hegde
Keyword(s):  
Motor Block ◽  
Sensory Block ◽  
Sedation Score ◽  
Age Group ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
The Difference ◽  
Hyperbaric Solution ◽  
Mean Time

Background: The present study was conducted to compare the efficacy of intrathecal neostigmine with intrathecal dexmedetomidine in postop- erative analgesia. Subjects and Methods: The present study was conducted in the department of Anesthesia involving 100 patients belonging to ASA grade I and II, posted for elective Sub umbilical surgeries, under spinal anaesthesia. Group I patients received 3.0ml of hyperbaric solution of 0.5% bupivacaine + 50mcg (0.5ml) of Neostigmine. Group II patients received 3.0ml of hyperbaric solution of 0.5% bupivacaine + 10mcg (0.5ml) of dexmedetomidine. Results: The maximum patients were seen in age group 18-30 years ie 10 in group I and 16 in group II and minimum in 41-50 years ie 6 in group I and 4 in group II. The mean time for onset of sensory block in group I was 1.43 0.53 min and in group II was 2.319   0.44 min. The mean time for onset of peak sensory block in group I was 5.48    0.43 min and Group II was 7.31    0.44 min.  Time for two segment regression was significantly higher in dexmedetomidine group as compared to neostigmine group, the mean time for two segment regression in group I was 124.98 21.48 min and group II was 165.24 14.45 min. The mean time for onset of motor block was 3.079 0.44 min in group I and 4.0454  0.38 min in group II. The mean duration of motor block in group I was 191.58  26.81 min and 324   36.8 min in group II. The difference was significant (P< 0.05). The mean sedation score in group I was 1.03 and in group II was 2.07. The difference was significant (P< 0.05). Conclusion: Authors recommend the use of dexmedetomidine as an adjuvant to bupivacaine in subarachnoid block

scholarly journals COMPARATIVE STUDY OF INTRATHECAL FENTANYL WITH HYPERBARIC BUPIVACAINE TO IMPROVE PERIOPERATIVE ANALGESIA IN PATIENT UNDERGOING ORTHOPEDIC SURGERY

2021 ◽  
pp. 55-58
Author(s):  
Rahul Wagh ◽  
Swapnil Sangale ◽  
Nagesh Jambure
Keyword(s):  
Side Effects ◽  
Lower Limb ◽  
Motor Block ◽  
Control Group ◽  
Study Group ◽  
Hyperbaric Bupivacaine ◽  
Analgesic Requirement ◽  
Sensory Blockade ◽  
Group I ◽  
Group Ii

Background: Various methods exist for treating post-operative pain which includes systemic narcotics, NSAIDS, patient-controlled analgesia, regional anaesthesia techniques, epidural local anaesthetic – narcotic mixtures, cryoanalgesia, transcutaneous electric nerve stimulation, psychological methods. Various opioides intrathecally and epidurally have been tried for post-operative analgesia. These include - morphine, pethidine, pentazocine, methadone, tramadol, Fentanyl, sufentanyl. In present study, we tried to find out analgesic effectiveness of intrathecal Fentanyl for post-operative analgesia, combined with 0.5 % Bupivacaine and side effects if any, in patients undergoing lower limb surgeries. Materials and Methods: After approval from the local ethics committee and with written informed consent from patient, a randomized controlled prospective study is carried out in the medical college and hospital.100 patients belonging to American Society of Anesthesiologists (ASA)classification I &amp; II, aged between 18-60 years, posted for elective lower limb surgeries, were randomly allocated for the study. Group-I: 50 patients received intrathecal 3 ml of 0.5 % hyperbaric Bupivacaine only. Group-II : 50 patients received intrathecal 3 ml of 0.5% hyperbaric Bupivacaine and Fentanyl 25 mcg.The patients studied across the group did not vary much with respect to age,height, weight and sex distribution. Results: The onset of sensory blockade was faster by 1.27 min in Group-BF. The perioperative and postoperative hemodynamic parameters were comparable in both the groups. The sensory analgesia in Group II was significantly prolonged by 159 mins, thus increasing the duration of analgesia. The time of first request of analgesics by the patients in group-II is prolonged compared to group-I thus prolonging the duration of analgesia. Analgesic requirement is also reduced in study group in early post-operative period. The onset of motor block was faster when Fentanyl was added to intrathecal Bupivacaine and it was 1.1 min earlier in study group. The duration of motor block to Bromage III was prolonged by almost 22 min in study group as compare to control group. Visual analogue scores were significantly lower in group-II compared to group-I after two hours of surgery thus reducing the frequency of supplemental postoperative analgesics. Conclusion: With the present study we can summarize that intrathecal Fentanyl potentiates the action of Bupivacaine thereby bringing about better quality and longer duration of analgesia, intense motor block, no hemodynamic disturbance and better postoperative outcome with/ minimum side effects.

scholarly journals Comparison of efficacy between intrathecal nalbuphine and fentanyl as adjuvant to hyperbaric bupivacaine for perianal surgery

2021 ◽  
Vol 53 (1-2) ◽  
pp. 27-30
Author(s):  
Moslema Parvin ◽  
Anjuman Ara ◽  
Kazi Nurjahan ◽  
Lipika Roy ◽  
Lailatunnessa
Keyword(s):  
Side Effects ◽  
Motor Block ◽  
Hyperbaric Bupivacaine ◽  
Duration Of Action ◽  
Female Ratio ◽  
Medical College ◽  
Group I ◽  
Duration Of Surgery ◽  
Group Ii ◽  
American Society

Background: Intrathecal opioids enhance the duration of action of local anasthetic drugs. Both nalpuphine and fentanyl enhance the action of hyperbaric bupivacaine when introduced intrathecally as adjuvant with bupivacaine. Objective: Our study was aimed to compare the clinical efficiency of nalbuphine and fentanyl as adjuvant to hyperbaric bupivacaine for anal and perianal surgery. Methods: In this prospective randomized clinical trial patients were included from January 2007 to June 2008 at Khulna Medical College & some private clinics in Khulna. Patients were ASA (American Society of Anaesthesiology) status I & II of both gender aged 18-70 years and was randomized into two groups. Each group received either nalbuphine, (Group I) or fentanyl (Group-II) with bupivacaine. After intrathecal use every patient was examined for sensory and motor block, drug related side effects like hypotension pruritus, nausea, vomiting respiratory depression for three hours and were recorded. Results: Among two hundred study patients mean age was 49.5 and 5.2 in respective group I & II. Male female ratio was 16:14 in group I, whereas in group II it was 65:35. Mean duration of surgery was 46 and 43 minutes respectively in group I & II. Onset and cephalic extension of block was almost same in both groups. Time to recovery of sensory and motor block were significantly prolonged in Group 1. Duration of analgesia was also extended in group I. No significant drug related side effects were observed in either group. Conclusion: Nalbuphine as adjuvant to bupivacaine was clinically more efficient than fentanyl for post--operative analgesia and duration of sensory and motor block in SAB (Sub Aracnoid Block) for anal and perianal surgery. Bang Med J Khulna 2020: 53 : 27-30

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