Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Jul 2018
An observational study to evaluate the effect of different epidural analgesia regimens on dynamic pain scores in patients receiving epidural analgesia for postoperative pain relief after elective gynecological surgery.
The primary measure of efficacy of any analgesic regimen is pain relief, but it is important to measure dynamic pain relief rather than pain relief at rest. Epidural analgesia is an effective technique for postoperative analgesia. The drug combinations given therein (local anesthetics with adjuvants such as opioids/alpha-2 agonists), however, remain a personal choice. The aim of this study was to evaluate dynamic pain scores in patients receiving different epidural analgesia regimens for postoperative pain relief after elective gynecological surgery used in our institution. ⋯ Combination of clonidine 2 μg/mL to 0.125% bupivacaine @ 5 mL/h in combined spinal epidural provides better postoperative analgesia as compared to combination of bupivacaine with opioids with greater patient satisfaction and significantly reduced side effects.
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J Anaesthesiol Clin Pharmacol · Jul 2018
Transmuscular quadratus lumborum versus lumbar plexus block for total hip arthroplasty: A retrospective propensity score matched cohort study.
Cadaveric studies have shown that injectate from transmuscular quadratus lumborum block (QLB) can spread to the lumbar plexus. Our aim was to compare analgesic efficacy of transmuscular QLB with lumbar plexus block (LPB) for patients undergoing total hip arthroplasty (THA). ⋯ This study suggests that transmuscular QLB provides similar analgesia to LPB following THA. Prospective studies are needed to confirm this.
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J Anaesthesiol Clin Pharmacol · Jul 2018
Comparison of prophylactic use of ketamine, tramadol, and dexmedetomidine for prevention of shivering after spinal anesthesia.
Shivering after spinal anesthesia is a common complication and can occur in as many as 40%-70% of patients after regional anesthesia. This shivering, apart from its physiological and hemodynamic effects, has been described as even worse than surgical pain. The aim of the study was to evaluate and compare the effectiveness of prophylactic use of intravenous (IV) ketamine, dexmedetomidine, and tramadol for prevention of shivering after spinal anesthesia. ⋯ Dexmedetomidine is effective and comparably better than tramadol or ketamine in preventing shivering after spinal anesthesia. Dexmedetomidine also provides sedation without respiratory depression and favorable surgical conditions. However, with its use a fall in blood pressure and heart rate is anticipated.
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J Anaesthesiol Clin Pharmacol · Jul 2018
Ease of intubation and hemodynamic responses to nasotracheal intubation using C-MAC videolaryngoscope with D blade: A comparison with use of traditional Macintosh laryngoscope.
Nasal intubation with traditional Macintosh laryngoscope usually needs the use of Magill's forceps or external laryngeal manipulation. The primary objective of this study was to assess the ease of intubation during C-MAC videolaryngoscope-assisted nasal intubation using D blade and to compare it with traditional Macintosh laryngoscope-aided nasal intubation. The secondary objectives were comparison of intubation time, attempts, trauma, and hemodynamic stress responses. ⋯ C MAC videolaryngoscope-aided nasotracheal intubation using D blade is superior in view of easier, quicker, and less traumatic intubation compared to the use of traditional Macintosh laryngoscope.
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J Anaesthesiol Clin Pharmacol · Jul 2018
Effect of air, anesthetic gas mixture, saline, or 2% lignocaine used for tracheal tube cuff inflation on coughing and laryngotracheal morbidity after tracheal extubation.
Coughing and sore throat postoperatively are common clinical problems during general anesthesia which can be avoided by various methods including topicalization of airway with local anesthetics, endotracheal tube cuff (ETT) inflation with local anesthetics, use of intravenous drugs such as dexamethasone, maintaining ETT cuff pressure, intubation by an experienced anethesiologist, etc. The aims of the study were to compare postextubation coughing response, mean number of cuff deflations required intraoperatively, and postoperative airway morbidity in terms of sore throat (2 h and 18-24 h), hoarseness of voice, and dysphagia following inflation of ETT cuff with air, anesthetic gas mixture, saline, and 2% lignocaine during general anesthesia. ⋯ ETT cuff inflation with air, anesthetic gas mixture, 2% lignocaine, and saline are comparable in terms of incidence of postextubation cough and postoperative airway morbidity symptoms such as sore throat, hoarseness of voice, and dysphagia.