Anesthesia, essays and researches
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Pregabalin and clonidine have anti-nociceptive properties. This study assesses their efficacy in prolonging the analgesic effect of spinal anesthesia and post-operative analgesic requirement in patients undergoing vaginal hysterectomy. ⋯ Oral pregabalin (150 mg) prolongs the post-operative pain relief after spinal anesthesia but produces less sedation compared with oral clonidine (150 μg).
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The case report here is a case of cesarean operation under subarachnoid block, which resulted after a failed lumber puncture, known to be "dry tap." The result is that it was uneventful surgery without any additive anesthetics being required after injecting 2.2 ml Bupivacaine 0.5% (H). Although cases have been reported with mixed experiences of dry tap and different causes are also explained, but still there is a need to find few other reasons for "dry tap." Hence, thought to present the case for putting forward a question that if there is any more cause for dry tap.
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The aim of the present study is to substantiate and compare the quality and extent of nerve block by using intrathecal bupivacaine or extradural bupivacaine alone and in combined spinal-epidural (CSE) technique using smaller dose of intrathecal bupivacaine and extradural injection of a smaller dose of bupivacaine or normal saline. ⋯ Quality of nerve block in combined technique using bupivacaine both intrathecally and extradurally is better and associated with lower side-effect compared with intrathecal heavy bupivacaine or extradural isobaric bupivacaine alone.
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Post-operative nausea and vomiting (PONV) pose unique challenges in neurosurgical patients that warrant its study separate from other surgical groups. ⋯ Single dose administration of granisetron 1 mg or ondansetron 4 mg at the time of dural closure with dexamethasone 8 mg provide an effective and superior prophylaxis against vomiting compared with dexamethasone alone without interfering with post-operative recovery and neurocognitive monitoring and hence important in post-operative neurosurgical care.
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Caudal analgesia is the most commonly used technique providing intra- and postoperative analgesia for various pediatric infraumbilical surgical procedures but with the disadvantage of short duration of action after single injection. Caudal dexamethasone and magnesium could offer significant analgesic benefits. We compared the analgesic effects and side-effects of dexamethasone or magnesium added to caudal ropivacaine in pediatric patients undergoing inguinal hernia repair. ⋯ The addition of dexamethasone or magnesium to caudal ropivacaine significantly prolonged the duration of postoperative analgesia in children undergoing inguinal hernia repair. Also the time to 1(st) analgesic dose was longer and the need for rescue postoperative analgesic was reduced and without increase in incidence of side effects.