Indian journal of anaesthesia
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Sevoflurane, a popular inhalational anaesthetic for children, has been associated with significant emergence agitation in the recovery phase. This study was intended to compare two doses of caudal clonidine added to ropivacaine 0.2% in order to decide on the optimal dose for prevention of sevoflurane induced emergence agitation (EA) and to get a meaningful prolongation of postoperative analgesia with minimal side effects. ⋯ Caudal clonidine 2 μg/kg added to 0.2% ropivacaine 1 ml/kg is suggested to be the optimal dose, for prevention of EA and meaningful prolongation of postoperative analgesia with minimal side-effects.
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Bupivacaine has been the most frequently used local anaesthetic in brachial plexus block, but ropivacaine has also been successfully tried in the recent past. It is less cardiotoxic, less arrhythmogenic, less toxic to the central nervous system than bupivacaine, and it has intrinsic vasoconstrictor property. The effects of clonidine have been studied in peripheral nerve blockade. The purpose of this study was to evaluate the effects of clonidine on nerve blockade during brachial plexus block with ropivacaine using peripheral nerve stimulator. ⋯ The addition of 75 μg of clonidine to ropivacaine for brachial plexus block prolongs motor and sensory block and analgesia without significant side effects.
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Resuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Google Scholar, and bibliographies of published studies were conducted using a combination of key-words. ⋯ Initially during resuscitation, fresh frozen plasma, packed red blood cells (PRBCs) and platelets should be transfused in the ratio of 1:1:1 in severely injured patients. Fresh whole blood can be an alternative in patients who need a transfusion of 1:1:1 thawed plasma, PRBCs and platelets. Close monitoring of bleeding and point of care coagulation tests are employed, to allow goal-directed plasma, PRBCs and platelets transfusions, in order to decrease the risk of transfusion-related acute lung injury.