Search

Introduction: Spinal anaesthesia is known as a safe and effective way to give anaesthesia during infraumbilical and lower limb surgeries. Intrathecal clonidine is a safe non opioid adjuvant used with local anaesthetics to prolong sensory and motor block, promotes sedation and analgesia. Aim: To compare the effects of bupivacaine with two different doses of clonidine under spinal anaesthesia in infraumbilical surgeries. Materials and Methods: This randomised double-blinded study was conducted in the Department of Anaesthesiology at Hind Institute Of Medical Science, Sitapur, Uttar Pradesh, India. The duration of the study was 19 months, from January 2021 to August 2022. A total of 60 patients (36 males and 24 females) were enrolled in the study and were randomly assigned to one of two groups (group A and group B) of 30 patients each. Group A bupivacaine heavy 12.5 mg with 15 mcg of clonidine, total volume 3 mL and group B bupivacaine heavy 12.5 mg with 30 mcg of clonidine, total volume 3 mL. The study parameters were: onset of sensory and motor block, duration of postoperative analgesia and any side effects (hypotension, bradycardia, sedation or any other). The statistical analysis was done using Statistical Package for Social Sciences (SPSS) Version 21.0. Results: The mean age of the study participants group A (44.51±12.84) years and group B (42.28±13.12) years. The demographical data showed comparable findings. The mean of onset of sensory (160.37±33.64) seconds and motor block (197.2±12.36) seconds in group B was statistically lower than group A. The mean duration of analgesia in group A (302.58±18.62) minutes was lower than group B (318.73±29.46) minutes. The mean Visual Analogue Scale (VAS) score was higher at every follow-up in group A as compared to in group B. The mean Ramsay sedation score was significantly higher in Group B at every follow-up than in group A. Conclusion: Spinal anaesthesia performed with 0.5% bupivacaine heavy with 30 mcg clonidine was proven to be a more effective adjuvant in providing early onset of the sensory and motor blockade intraoperatively and prolongation of the duration of effective postoperative analgesia when compare to 15 mcg clonidine. [ABSTRACT FROM AUTHOR]

Introduction: Ropivacaine is a well-accepted local anaesthetic drug used in spinal and peripheral nerve blocks. It provides a better central nervous system and cardiovascular stability in comparison to bupivacaine. Adjuvants are also added with these drugs as they provide haemodynamic stability, increase efficacy, and decrease the dose requirement of the local anaesthetic drugs. Aim: To determine the efficacy of isobaric 0.75% ropivacaine in combination with normal saline, fentanyl, and neostigmine in Elderly Patients Undergoing Transurethral Resection of Prostate Under Spinal Anaesthesia. Materials and Methods: This double-blinded randomised clinical study conducted in the Department of Anaesthesiology and Critical Care, Institute of Medical Sciences-Banaras Hindu University, Varanasi, Uttar Pradesh, India, from July 2018 to June 2019. The study included 90 patients who were divided into three groups of 30 subjects each. Ropivacaine combined with normal saline in group RNS, ropivacaine combined with fentanyl in group RFE and ropivacaine combined with neostigmine in group RNE, was administered intrathecally. Heart rate, respiratory rate, blood pressure, onset and duration of sensory and motor block, along with the duration of analgesia, were recorded at different time points. The Analysis Of Variance (ANOVA) was used to compare the variables among the three study groups, and Student-Newman-Keuls was used to compare the data between the groups. Results: Patients in group RNE showed a significant fall in heart rate in comparison to groups RNS and RFE at all the time points. Respiratory rate followed a similar pattern in group RNE (p-value <0.001), except at 5 min and 90 min. Mean systolic blood pressure showed a significant rise in group RNE compared to the other two groups, while diastolic blood pressure followed a similar trend at 10, 20, 30, and 60 min. The SpO2 (%) was comparable among groups. The onset of sensory loss was significantly earlier in group RNE (239.6±28.8 sec) than in groups RNS (298.1±27.8 sec), and RFE (261.9±32.2 sec). The duration of the sensory block was significantly longer in group RFE (227.8±30.5 min). The mean time to the onset of motor block (480.7±30.2 sec) and analgesia (582.33±30.2 min) was longer in group RNE than in other groups. Conclusion: The addition of neostigmine to ropivacaine intrathecally is a reliable method to prolong spinal anaesthesia but close monitoring of vitals is desirable. [ABSTRACT FROM AUTHOR]

Aims: To compare sensory, motor effects and haemodynamic stability of 2ml intrathecal isobaric ropivacaine (0.75%) with 3ml hyperbaric bupivacaine (0.75%) in patients undergoing endoscopic urological surgery. Study Design: Randomized controlled trial involving 142 patients undergoing transurethral resection of prostate (TURP) and URS (urethroscopy) in a tertiary care hospital, India. Methods and materials: Patients were randomly allocated to, Group 1 (3ml of 0.5% (15mg) hyperbaric bupivacaine) and Group 2 (2ml of 0.75% isobaric ropivacaine(15mg)). Onset and highest level of sensory block, onset and duration of motor block, quality of anaesthesia and muscle relaxation, haemodynamic parameters and adverse effects if any were studied. Statistical analysis used: Unpaired t-test was used to test continuous variables and chi square test/Fisher's exact test for categorical variables. Results: The mean of highest sensory block, 2 segment regression of sensory block and time for sensory level to regress below T10 was significantly more in group 1 compared to group 2 (P<0.05). There was a significant delay of mean time to onset of motor block to Bromage score 1 in group 2(P<0.001). The mean duration of complete motor blockade was significantly more in group 1 (P value <0.001). Hypotension was most commonly seen in group 1. Conclusion: Ropivacaine provides comparable quality of sensory block but has slower onset and significantly shorter duration of motor block compared to hyperbaric bupivacaine. [ABSTRACT FROM AUTHOR]