Anesthesia, essays and researches
-
Hyperbaric bupivacaine along with either fentanyl or sufentanil as additive, has been widely used in spinal anesthesia. In the present study, we compared the analgesic effects of intrathecal fentanyl versus sufentanil combined with bupivacaine for surgical procedures over the abdomen and lower limbs. ⋯ Fentanyl with bupivacaine produced prolonged analgesia and delayed two-segment regression and demonstrated reduced incidence of complications as compared with intrathecal sufentanil. As the quality of analgesia was complete and comparable, fentanyl emerges as a better option for analgesia and it is much economical too when compared to sufentanil.
-
Monitored anesthesia care (MAC) combines intravenous sedation along with local anesthetic infiltration or nerve block. Several drugs have been used for MAC, but all are associated with complications. Dexmedetomidine is a selective α2-adrenoceptor agonist with both sedative and analgesic properties and is devoid of respiratory depressant effects. Its short elimination half-life makes it an attractive agent for sedation during MAC. ⋯ During MAC dexmedetomidine provides better sedation and analgesia than midazolam.
-
Anesthetic agents should be chosen not only on the basis of safety-efficacy profile, but also on the economic aspect. Propofol and sevoflurane are commonly utilized anesthetic agent for general anesthesia. ⋯ We conclude that sevoflurane appears to be better anesthetic agents in terms of cost-effectiveness and recovery profile.
-
Infraclavicular brachial block with coracoids approach has gained popularity because of consistent bony landmarks and less chances of vascular puncture and pneumothorax. ⋯ Addition of clonidine to bupivacaine lead to early onset and prolonged duration of sensory and motor block with prolonged analgesia as compared to the addition of clonidine to ropivacaine.
-
The sparing of ulnar nerve often leads to the failure of the upper limb blockade. It has been claimed that local anesthetic injection at the site of stimulator evoked finger flexion response is associated with highest success rate of a successful block. The lower trunk stimulation of plexus should yield similar results as this trunk contributes significantly for median and ulnar nerves of hand and forearm. ⋯ We conclude other than finger flexion, the wrist flexion the forearm twitches, pronation and wrist adduction may be used for lower trunk blockade and thus for higher accuracy.