Anesthesia, essays and researches
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Ventral hernia is a commonly performed surgical procedure in adults. Laparoscopic intraperitoneal onlay mesh repair (IPOM) of ventral hernia is procedure of choice. IPOM of ventral hernia is associated with significant pain. Hence, our aim was to study the efficacy of instilling preemptive local analgesia for reducing postoperative pain in patients undergoing laparoscopic ventral hernia repairs. ⋯ Our study demonstrated that supplementing US-guided transversus abdominis plane (TAP) block to conventional systemic analgesics resulted in decreased VAS scores and decreased requirement of rescue analgesics. The patients ambulated early had earlier appearance of bowel sounds and decreased length of hospital stay. There was also decreased incidence of nausea and vomiting. TAP block for laparoscopic IPOM surgery significantly decreases postoperative pain and opioid requirement in patients.
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Conscious sedation is the key for successful AFOI. This trial was conducted to compare the effectiveness of dexmedetomidine and low dose of ketamine against propofol and low dose ketamine. ⋯ The concomitant administration of low dose of ketamine with dexmedetomidine had better intubation time and sedation scores with higher patient satisfaction scores than the combination of propofol and low dose of ketamine.
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Axillary brachial plexus block (ABPB) is safest among other methods of brachial plexus block because of its ease and reliability. The two approaches of ultrasonography-guided ABPB are perivascular (PV) and perineural (PN). ⋯ Ultrasound-guided PV axillary plexus block is better than PN axillary plexus block with respect to performance time and number of needle passes; but onset time was shorter in PN block, with precaution eliminating the risk of complications.
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Clonidine, an alpha2 agonist, when added to local anesthetics in different regional and neuraxial blocks reduces the onset time, improves the efficacy, and increases the duration of postoperative analgesia. ⋯ The inclusion of 100 μg of clonidine with bupivacaine in ultrasound-guided supraclavicular brachial plexus blocks prolongs both sensory and motor blockade. It also provides significant postoperative analgesia and mild sedation which is beneficial in the immediate stressful postoperative period.
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Retracted Publication
Evaluation of Ultrasound-Guided Erector Spinae Plane Block and Oblique Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy: Randomized, Controlled, Prospective Study.
Oblique subcostal transversus abdominis plane block (OSTAP) is a recently described regional anesthetic technique used in upper abdominal surgeries such as laparoscopic cholecystectomy (LC). Erector spinae plane block (ESPB) has also been reported for postoperative analgesia in LC. ⋯ Bilateral ultrasound-guided ESPB and OSTAP performed at the end of LC lead to akin analgesia requirement and improve the quality of multimodal analgesia.