Indian journal of anaesthesia
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Spinal anaesthesia is used for many years for surgeries below the level of umbilicus. It has certain disadvantages such as limited duration of blockade and post-operative analgesia. This study was undertaken to evaluate the effects of additives fentanyl and magnesium sulphate along with bupivacaine during spinal anaesthesia for prolongation of analgesia and motor blockade. ⋯ Addition of magnesium sulphate at 100 mg dose or fentanyl 25 μg as adjuvants to intrathecal bupivacaine significantly prolongs the duration of analgesia, though in the given doses, magnesium provides better haemodynamic stability than fentanyl, with fewer side effects.
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The use of propofol as the most common induction agent and the high prevalence of propofol injection pain (PIP) highlight the significance of finding the ideal combination of drug, dosage and mode of administration of premedicants to alleviate PIP. A number of bolus drugs with variable efficacy have been studied to reduce PIP. The aim of our study was to assess the efficacy of single dose intravenous (IV) infusion of dexmedetomidine 0.5 μg/kg compared with ketamine 0.5 mg/kg to alleviate PIP. ⋯ There was no difference in elimination of the arm withdrawal response and in incidence of moderate to severe PIP between the groups.
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Application of tourniquet during orthopaedic procedures causes pain and increase in blood pressure despite adequate anaesthesia and analgesia. In this study, we compared ketorolac with ketamine in patients undergoing elective lower limb surgery with tourniquet in order to discover if ketorolac was equally effective or better than ketamine in preventing tourniquet-induced hypertension. ⋯ We conclude that ketamine is superior to ketorolac in preventing tourniquet-induced increases in blood pressure.
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Episure™ AutoDetect™ syringe (EAS), a spring-loaded syringe, is a new loss-of-resistance syringe used to identify epidural space. It has an advantage of subjective and objective confirmation in identifying epidural space over glass syringe (GS) for beginners. We compared the performance of EAS with that of GS for identifying epidural space in lower thoracic epidurals. ⋯ Using EAS allowed reliable and quick identification of the epidural space in lower thoracic epidural technique as compared to use of glass syringe. There was no incidence of inadvertent dural puncture or failed blocks with the EAS.