COMPARISON OF ROPIVACAINE AND LIDOCAINE SENSORY AND MOTOR BLOCK AND POST OPERATIVE ANALGESIC REQUIREMENT IN INTRA- VENOUS REGIONAL ANESTHESIA
|
|
- Mildred Gilmore
- 5 years ago
- Views:
Transcription
1 COMPARISON OF ROPIVACAINE AND LIDOCAINE SENSORY AND MOTOR BLOCK AND POST OPERATIVE ANALGESIC REQUIREMENT IN INTRA- VENOUS REGIONAL ANESTHESIA Salah M. kamal Department of Anesthesia and Intensive care, Faculty of Medicine, (boys) Al Azhar University, Cairo, Egypt. ABSTRACT Objectives:This study was conducted to compare the analgesic and motor block efficacy and the post operative analgesic requirement of ropivacaine with that of Lidocaine in intravenous regional anesthesia. Methodology: Sixty patients of ASA physical status I and II, aged years undergoing ambulatory surgery in the forearm and hand were randomly allocated into two equal groups 30 patients each. Patients in each group received either 30 ml of 1% lidocaine or 30 ml of 0.2% ropivacaine. The onset, duration and recovery times of sensory and motor block, time to the request for first analgesic requirement, incidence of rescue medication and total analgesic consumption in first 24 hours were recorded. Results: The result obtained revealed that, the recovery time of sensory block was significantly prolonged in ropivacaine group than in lidocaine group, but the onset of sensory block was delayed in ropivacaine group as compared to patients in lidocaine group. No significant difference between the groups as regard the motor block onset, but the motor recovery time was significantly prolonged in ropivacaine group compared to lidocaine group. Time to the request for first analgesic was significantly more prolonged and the incidence of rescue medication and total analgesic consumption was significantly lower in patients receiving ropivacaine than in those receiving lidocaine. Conclusion: It was found that ropivacaine is a good 399
2 Salah M. kamal alternative to Lidocaine for intravenous regional anesthesia and provides a more prolonged post-tourniquet release pain relief as compared to Lidocaine. Key words: Ropivacaine; Intravenous regional anesthesia; sensory; motor; Lidocaine; INTRODUCTION Intravenous regional anesthesia (IVRA) was first described by August Bier in 1908, who discovered a very effective method for complete anesthesia and motor paralysis of the hand and forearm and called it Direct Vein Anesthesia 1. He used procaine, the first safe injectable local anesthetic that had been synthesized in However, the technique did not become popular until it was reintroduced by Holms in1963 using lidocaine as an anesthetic agent. IVRA is suitable for operations of the distal extremities, in situations where it is safe and easy to apply an occlusive tourniquet. It is mainly used for surgical procedures of the upper extremity, but it can also be used for procedures involving the lower extremity 1. IVRA is defined as a technique of producing surgical anesthesia by intravenous injection of local anesthetic into a limb whose circulation has been interrupted by a tourniquet. In addition, it is a simple, safe (2), reliable (3), and an effective technique that can easy be controlled by anesthesiologist. This technique has some disadvantages as, local anesthetic (LA) toxicity, slow onset, poor muscle relaxation, tourniquet pain which is dull aching sensation arising from the tourniquet site due to ischemia of muscles and nerves. This pain limits this technique to surgeries lasting for less than 90 min. 4, 5. In addition, it provides only minimal postoperative pain relief after tourniquet release 6. IVRA is often a safer option than general anesthesia; particularly if the patient is elderly, or has cardiovascular, respiratory or any other medical disorders. 7 In fact it is ideal anesthetic technique for short surgical procedures involving distal extremities on day care basis
3 The ideal drug for IVRA should have rapid onset of action, reduced dose of local anesthetic, prolonged analgesia after removal of tourniquet and wide safety margin. So, the lidocaine is the most widely used local anesthetic for IVRA. However, ropivacaine is a newly amide local anesthetic that is structurally related to bupivacaine with duration of anesthesia almost as long as that of bupivacaine, however, with less central nervus system (CNS) and cardiovascular system (CVS) toxicity because it is pure S- enuntiomer. 9 Bupivacaine has been used for intravenous regional anesthesia and provides sustained analgesia after tourniquet release. However, reports of seizures and cardiac arrest after intravascular absorption have resulted in eventual discontinuation of bupivacaine for IVRA The clinical use of ropivacaine is well established in epidural anesthesia and peripheral nerve blocks. Therefore, the use of a local anesthetic that would provide longer lasting post tourniquet release analgesia and with least incidence of toxic effects prompted the effort to study the effectiveness of ropivacaine in intravenous regional anesthesia. METHODOLOGY This study was conducted in Al-Husain hospital, Faculty of medicine, Al Azhar University, Cairo, Egypt, from January 2010 to April After institutional ethical committee approval and written informed consent, a total number of 60 patients ASA physical status I and II, aged 20 to 50 years undergoing ambulatory surgery in forearm and hand were recruited in the study. The patients were randomly divided into two groups. As this study was not blinded and the group size was specific, randomization was done on the basis of allocating alternate patient to either of the groups. Lidocaine Group (Group L): Patients in this group received 30 ml of lidocaine 1% (2mg/kg) this group consisted of 30 patients. 401
4 Salah M. kamal Ropivacaine Group (Group R): Patients in this group received 30 ml of ropivacaine 0.2% (2mg/kg). This group also consisted of 30 patients. All the patients were clinically evaluated and investigated before undergoing surgery as per the protocol. Exclusion criteria conclude patients with Raynaud s disease, sickle cell disease, myasthenia gravis, uncompensated cardiac disease, diabetes mellitus, liver and renal insufficiency and those with history of allergic reaction to lidocaine or ropivacaine. The tourniquet was checked for any leaks. All the drugs and equipment needed for resuscitation were kept available before start of anesthesia. On admission to the operating room, non-invasive blood pressure, electrocardiogram and peripheral oxygen saturation monitoring was started. Intravenous access using 20G cannula was established in the non surgical arm and an intravenous infusion of crystalloid was started. The operative arm was cannulated by a 22 G cannula in the dorsum of the hand then elevated for 5 minutes, and using an Esmarch bandage, the venous blood of the arm was emptied. Then, a double-pneumatic tourniquet was applied. The proximal tourniquet was inflated to a pressure of 100 mmhg higher than systolic blood pressure. Isolation of the arm was confirmed by inspection, lack of radial pulse, and failure of pulse oximetry tracing of the ipsilateral index finger. After inflation of the proximal pneumatic tourniquet and release of the Esmarch bandage, patients in group L (n= 30) received 1% lidocaine 2 mg/kg for IVRA, patients in group R (n = 30) received 0.2% ropivacaine 2 mg/kg and in all groups normal saline was added to make up a total volume of 30 ml. The prepared solutions were administered over 60 second by an anesthesiologist who was blinded to the drug being administered. After anesthesia was achieved, the distal tourniquet was inflated to 100 mmhg higher than systolic pressure, and the proximal tourniquet was deflated. Time at 402
5 inflation of tourniquet and drug administration was noted. The distal tourniquet was not deflated before 30 min and was not inflated for more than 90 min. Tourniquet deflation was carried out by cyclic deflation at 10 second intervals. Sensory block was assessed by pinprick test using 22G gauge shortbeveled needle every 30s after injection of drug to note the time of onset, and after tourniquet deflation to note the time of return of sensations. The patient s response was evaluated in the dermatomal sensory distribution of the ulnar, median, and radial nerves. Sensory block onset time was the time from injection of the study drug until sensory block in all dermatomes. Duration of sensory block was taken as the time interval from cessation of pinprick sensation in all dermatomes until the return of pinprick sensation. Motor block was assessed by testing hand grip strength and muscle power. Individual muscle groups were tested as follows: thumb opposition (median nerve), little finger flexion and finger abduction-adduction (ulnar nerve), wrist extension (radial nerve), and elbow flexion (musculocutaneous nerve), every minute after administration of drug to note the time of onset, and after deflation of tourniquet to assess the time of return of motor functions. Complete motor block was recorded when no voluntary movement was possible. Motor block onset time was the time from injection of drug until complete motor block was achieved. Duration of motor block was the time interval from cessation of finger and wrist movements until return of these movements. Recovery time of sensory block is the time from tourniquet deflation to the return of pain in all dermatomes and it was determined by pinprick test. However, the recovery time of motor block is the time from tourniquet deflation to the return of fingers movement. 403
6 Salah M. kamal Pain was assessed for postoperative pain up to 24 hours using the visual analogue scale (VAS) where a score of zero was given for no pain and 10 for worst pain imaginable. Patients were advised to receive 50 mg of nonsteroidal anti-inflammatory drug (diclofenac sodium) intramuscular (IM) at VAS of more than 3 as rescue medication. Time to the request for first analgesic after tourniquet deflation and total analgesic consumption in 24 hours was noted in all patients. Statistical Analysis: Statistical presentation and analysis of the present study was conducted, using the mean, standard Deviation, student t-test and chi-square by SPSS V10. x Mean = n Where = sum & n = number of observations. Standard Deviation [SD] : SD x - x n 1 2 Student t-test [Unpaired]: t SE X X 2 2 SE 2 2 Where: X 1 = Mean of the first group. X 2 = Mean of the second group. SE 1 = Standard error of the first group. SE 2 = Standard error of the second group. 404
7 Unpaired Student T-test was used to compare between tow groups in quantitative data. Chi-square The hypothesis that the row and column variables are independent, without indicating strength or direction of the relationship. Pearson chi-square and likelihood-ratio chi-square. Fisher's exact test and Yates' corrected chi-square are computed for 2x2 tables. P value <0.05 was considered statistically significant RESULTS Demographic data of the groups were statistically comparable for age, weight, height, and sex ratio with no significant difference between the two groups. [Table 1]. Table 1. Demographic data, patient characteristics, and types of surgeries Ropivacaine 0.2% P value Lidocaine 1% (n = 30) (n = 30) Age (yrs) 41.4 ± ± Gender (F/M) (n) 12/8 10/ Weight (kg) ± ± Height (cm) ± ± Type of surgery tenolysis carpal tunnel release ganglionectomy Surgical times (min) Data are means ± SD. 28.1± ±
8 Salah M. kamal There was no significant difference as regard the onset of anesthesia between the groups after injection of the studied drugs it was 7.1±3.3 min and 6.2± 2.8 min in ropivacaine and lidocaine group respectively, However the recovery of sensory block was significantly prolonged in ropivacaine group compared to lidocaine group it was (12.5 ± 4.6 min) and at (10.3 ± 1.4 min) respectively. [Table 2] Fig 1. Table 2. Interval between local anesthetic injection and surgical incision, onset of sensory block, sensory recovery time and total tourniquet times. Ropivacaine 0.2% (n = 30) Lidocaine 1% (n = 30) P value Interval between local anesthetic injection and surgical incision (min) 13.1± ± Sensory block onset (min) 7.1 ± ± Sensory recovery time (min) 12.5 ± ± 1.4 <0.05* Total tourniquet times (min) 45.8 ± ± Sensory block onset (min) Ropivacaine 0.2% Lidocaine 1% Sensory recovery time (min) Fig 1. Sensory block onset and recovery time 406
9 There was no significant difference between the groups as regard motor block onset time it was started after (9.8 ± 1.3) min. and (10.2 ± 1.5) min. in lidocaine and ropivacaine group respectively. However there was statistical significant difference between the groups as regard the motor block recovery time it was (7.1 ± 1.5min) and (9.0 ± 1.6 min) in lidocaine and ropivacaine group respectively. [Table 3], Fig 2. Table 3. motor block onset and recovery time Motor block onset time (min) Motor block recovery time (min) Ropivacaine 0.2% (n = 30) 10.2 ± 1.5 Lidocaine 1% (n = 30) P value 9.8 ± ± ± 1.5 <0.001* Ropivacaine 0.2% Lidocaine 1% Motor block onset time (min) Fig 2. motor block onset and recovery time. Motor block recovery time (min) The time to the request for first analgesic was also significantly prolonged in ropivacaine group as compared to lidocaine group. None of the patients from either group required rescue analgesic intraoperatively. The total number of patients requiring analgesics was significantly less in ropivacaine group, 53 %( 16) compared to lidocaine group (80%) 24 patients 407
10 Salah M. kamal requiring an analgesic dose of nonsteroidal anti inflammatory over 24 hour. [Table 4]. Table 4: Showing number of patients requiring analgesic Total no of Group n (%) P value patients ropivacaine 16(53%) 30 <0.05* lidocaine 24(80%) 30 Total analgesic consumption (diclofenac sodium 50mg) in 24 hours, in ropivacaine group was 800 mg and 1200 mg in lidocaine group. DISCUSSION All Regional anesthesia is based on the concept that pain is carried by the nerve fibers which are amenable to be interrupted anywhere along their pathway. Local anesthetics such as lidocaine and prilocaine are commonly administered for IVRA. However, lidocaine, the most often used local anesthetic for IVRA has a relatively short duration of action which may affect the duration of intraoperative and post tourniquet release analgesia and tourniquet tolerance. 9 Theoretically it would be beneficial to use long acting drugs such as bupivacaine, but it is considered too risky for IVRA because it binds to sodium channels of the myocardium and may lead to irreversible cardiac arrest if the bupivacaine escapes into the systemic circulation 11. Ropivacaine has a similar duration of action as that of bupivacaine, but with less depression of cardiac conduction presumably because it is a pure S-enantiomer. 9 Data from this study show that ropivacaine 0.2% produce anesthesia of similar quality to that achieved with a conventional dose of lidocaine during IVRA but with more long-lasting residual analgesia. In current study the two groups did not differ with respect to age, gender, duration of surgery and the average period of tourniquet inflation. 408
11 There was no significant difference in onset of motor block between the two groups, this result correlate with those of Ibrahim Asik et al 12 and Peter AG et al 13 who also found no significant difference in onset of motor block between the two groups and they found no significant difference in the duration of motor block. However this result contradict with the result in this study where it was found that, the duration of motor block was significantly prolonged in ropivacaine group than in lidocaine group, and this result correlate with those of MacMillan et al 14 who found that, motor block was prolonged with ropivacaine. The onset of sensory block was delayed (7.1± 3.3 min) in ropivacaine group as compared to Lidocaine group where it was quicker (6.2± 2.8 min) on the average. The rapid onset of sensory block with lidocaine may be attributed to its pka value (7.86) 15 which is close to physiological ph. Due to this property, the ionized fraction of Lidocaine increases, leading to a quicker penetration into nerves and rapid onset as compared to ropivacaine. The recovery time of sensory block in ropivacaine group was significantly prolonged as compared to Lidocaine group, the longer duration of residual analgesia after tourniquet release with ropivacaine may be attributed to more complete and persistent binding and slower release into systemic circulation. 16 The potency of ropivacaine is 3 times that of lidocaine. 16 and the concentration used was 0.2% solution as it closely achieves equipotency with the typically used concentration of lidocaine for IVRA. The terminal half life of ropivacaine after IV administration is longer (108 min) 17 as compared to lidocaine, which also leads to its prolonged action. The results obtained in this study correlate with those of Ibrahim Asik et al 12 and Peter AG et al 13 who found that recovery time of sensory block was significantly prolonged in ropivacaine group. 409
12 Salah M. kamal In current study, it was found that, time to the request for first analgesic was also prolonged in ropivacaine group and the incidence of rescue analgesic and total analgesic consumption were significantly lower in patients who received ropivacaine. It correlates with the result found by Peter AG 13 and Ibrahim Asik 12 in their studies. In the present study no seizures or cardiotoxic effects were observed in any group with the doses used and this correlates with the results obtained by Peter G et al 18 in their study upon central nervous system side effects and the result of Atanassoff et al 19 who reported a lower incidence of CNS side effects in volunteers who received IVRA with 40 ml. of ropivacaine 0.2% versus lidocaine. This may be attributed to the less lipid solubility of ropivacaine, where it was intermediate between that of lidocaine and bupivacaine and about one half to one third that of bupivacaine. 20 the low lipid solubility of ropivacaine explains its higher threshold for CNS. Ropivacaine is extensively (94%) bound to plasma proteins and as the systemic toxicity is related to unbound drug concentration, the clinical safety profile of ropivacaine may be more favorable 21. CONCLUSION In conclusion, Ropivacaine is a long-acting local anesthetic with a marked differential blockade between sensory and motor fibers, and it provide prolonged recovery time of sensory block and a lesser need for rescue analgesics make ropivacaine an effective alternative to lidocaine in IVRA. 410
13 REFERENCES 1. Brown BL, and Fink BR. The history of neural blockade and pain management. In: Cousins MJ, Bridenbaugh PO, editors. Neural blockade in Clinical Anesthesia and Management of Pain. 3rd ed.philadelphia: Lippincott-Raven; p Catteral WA, and Mackie K. Local Anesthetics: in: Hardman JG, Limbird LE, Gilman AF, eds.; the pharmacological basis of therapeutics, 10 th edition. New York, NY: McGraw-Hill; 2001: Chan VWS, Weisbrod MJ, Kaszas Z, and Dragomir C. Comparison of ropivacaine and Lidocaine for Intravenous Regional Anesthesia in volunteers. A Preliminary Study on Anesthetic Efficacy and Blood Level. Anesthesiology 1999;90: Heath ML : Deaths after intravenous regional anesthesia. BMJ 1982;285: Albright GA. Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. Anesthesiology 1979; 51: Henderson AM. Adverse reaction to bupivacaine: Complication of intravenous regional analgesia. BMJ 1980; 281: Ware RJ. Intravenous regional analgesia using bupivacaine. A double blind comparison with lignocaine. Anesthesia 1979; 34: Evans CJ,Dewar JA,Boys RN, and Scot DB: Residual nerve block following intravenous regional anesthesia : Br. J Anaesth 1974;46: Reiz S, Haggmark S, Johansson G, and Nath S. Cardiotoxicity of ropivacaine: a new amide local anesthetic agent. Acta Anaesthesiology Scand 1989;33: Arlander E, Ekström G, Alm C, Carrillo JA, Bielenstein M, Böttiger Y, et al. Metabolism of ropivacaine in humans is mediated by CYP1A2 and to a 411
14 Salah M. kamal minor extent by CYP3A4:An interaction study with fluvoxamine and ketoconazole as in vivo inhibitors. Clin Pharmacol Ther 1998;64: Knudsen K, Beckman Suurkula M, Blomberg S, Sjovall J, and Edvardsson N. Central nervous and cardiovascular effects of IV infusions of ropivacaine, bupivacaine and placebo in volunteers. Br J Anaesth 1997;78: Asik I, Kocum AI, Goktug A, Turhan KS, and Alkis N. Comparison of ropivacaine 0.2% and 0.25% with lidocaine 0.5% for intravenous regional anesthesia. Journal of Clinical Anesthesia 2009;21: Peter AG, Carlos O, Bande MC, Hartmannsgruber MW, and Halaszynski MT. Ropivacaine 0.2% and lidocaine 0.5% for intravenous regional anesthesia in outpatient surgery. Anesthesiology 2001; 95(3): MacMillan LB, Kitto KF, The effect of continuous lumbar epidural infusion of ropivacaine (0.1%, 0.2%, and 0.3%) and 0.25% bupivacaine on sensory and motor block in volunteer: a double blind study.regional anesthesia 2010,21: Clark N. Intravenous regional anesthesia Bier s block. Update in Anesthesia 2002; 15: Simpson D, Curran MP, Oldfield V, and Keating GM. Ropivacaine : A review of its use in regional anesthesia and acute pain management. Drugs 2005; 65: Hartmanns gruber MW, Silverman DG, Halaszynski TM, Bobart V, Brull SJ, Wilkerson C, et al. Comparison of ropivacaine 0.2% and Lidocaine 0.5% for intravenous regional anesthesia in volunteers. Anesthesia Analg.1999; 89: Peter G Atanassoff PG, and Maximilian WB Hartmannsgruber. Central nervous system side effects are less important after iv regional 412
15 anesthesia with ropivacaine 0.2% compared to lidocaine 0.5% in volunteers. Can J Anesth 2002; 49: Atanassoff PG, Ocampo CA, Bande MC, Hartmannsgruber MW, and Halaszynski TM. Ropivacaine 0.2% and lidocaine 0.5% for intravenous regional anesthesia in outpatient surgery. Anesthesiology 2001; 95: Agasti TK. Local anesthetic agents: Text book of Anesthesia for postgraduates by TK Agasti 1 st edition, Jaypee brothers med publisher, New Delhi-India- 2011, chapter 13:p Greengrass R, Steele S, Moretti G, Grant S, Klein S, and Nielsen K. Peripheral nerve blocks. Textbook of Regional Anesthesia and acute pain management, McGraw Hill Professional, 2009:p
Methods. Anesthesiology, V 95, No 3, Sep Downloaded From: on 07/19/2018
Anesthesiology 2001; 95:627 31 2001 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc. Ropivacaine 0.2% and Lidocaine 0.5% for Intravenous Regional Anesthesia in Outpatient
More informationA COMPARATIVE STUDY OF LIGNOCAINE 0.5% AND ROPIVACAINE 0.2% FOR INTRAVENOUS REGIONAL ANESTHESIA FOR ELECTIVE UPPER LIMB SURGERY
A COMPARATIVE STUDY OF LIGNOCAINE 0.5% AND ROPIVACAINE 0.2% FOR INTRAVENOUS REGIONAL ANESTHESIA FOR ELECTIVE UPPER LIMB SURGERY S. Asrar 1, Devesh S 2, Vidushi S 3, Meenaxi S 4*, Anumeha J 5 Department
More informationWITH ISOBARIC BUPIVACAINE (5 MG/ML)
, 49, 2013, 3 63 (5 MG/ML) (5 MG/ML).,.,.,..,..,, SPINAL ANESTHESIA: COMPARISON OF ISOBARIC ROPIVACAINE (5 MG/ML) WITH ISOBARIC BUPIVACAINE (5 MG/ML) D. Tzoneva, Vl. Miladinov, Al. Todorov, M. P. Atanasova,
More informationEffectiveness of Low Dose Lidocaine With and Without Tramadol for Intravenous Regional Anesthesia: A Randomized Prospective Study
Med. J. Cairo Univ., Vol. 81, No. 1, September: 665-669, 2013 www.medicaljournalofcairouniversity.net Effectiveness of Low Dose Lidocaine With and Without Tramadol for Intravenous Regional Anesthesia:
More informationDexamethasone Improves Outcome Of Infraclavicular Brachial Plexus Block
Tanta Medical Journal Vol. (6), April 2008 Original Article ABSTRACT Dexamethasone Improves Outcome Of Infraclavicular Brachial Plexus Block Mohamed Samy Seddik Department of Anesthesia & Intensive Care,
More informationAssistant Professor, Anaesthesia Department, Govt. General Hospital / Guntur Medical College, Guntur, Andhra Pradesh, India.
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 15, Issue 8 Ver. I (August. 2016), PP 87-91 www.iosrjournals.org A Comparative Study of 0.25% Ropivacaine
More informationComparison Of 0.5%Bupivacaine And 0.5% Bupivacaine Plus Buprenorphine in Brachial Plexus Block
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 15, Issue 1 Ver. VIII (Jan. 2016), PP 01-08 www.iosrjournals.org Comparison Of 0.5%Bupivacaine And 0.5%
More informationIntravenous Regional Anesthesia with Drug Combinations of Lidocaine, Ketamine, and Atracurium
ISPUB.COM The Internet Journal of Anesthesiology Volume 18 Number 1 Intravenous Regional Anesthesia with Drug Combinations of Lidocaine, Ketamine, and Atracurium G Mir, A Naqeeb, T Waani, A Shora Citation
More informationRegional Anesthesia. Fatiş Altındaş Dept. of Anesthesiology
Regional Anesthesia Fatiş Altındaş Dept. of Anesthesiology Regional anesthesia - Definition Renders a specific area of the body, e.g. foot, arm, lower extremities insensating to stimulus of surgery or
More informationThe Analgesic Effect of Ondansetron when Added to Lidocaine for Intravenous Regional Anesthesia
International Journal of Multidisciplinary and Current Research ISSN: 2321-3124 Research Article Available at: http://ijmcr.com The Analgesic Effect of Ondansetron when Added to Lidocaine for Intravenous
More informationTHE EFFECT OF NITROGLYCERIN AS AN ADJUVANT TO LIDOCAINE IN INTRAVENOUS REGIONAL ANESTHESIA
THE EFFECT OF NITROGLYCERIN AS AN ADJUVANT TO LIDOCAINE IN INTRAVENOUS REGIONAL ANESTHESIA Rahman Abbasivash *, Ebrahim Hassani *, Mir Moussa Aghdashi **, and Mohammad Shirvani *** Implication Statement
More informationOriginal Article INTRODUCTION. Abstract
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2016/600 Randomized Clinical Comparison of Epidural Bupivacaine with Fentanyl and Epidural Levobupivacaine with Fentanyl
More informationComparative Study of Equal Doses of Intrathecal Isobaric Bupivacaine and Isobaric Ropivacaine for Lower Limb Surgeries and Perineal Surgeries
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2017/229 Comparative Study of Equal Doses of Intrathecal Isobaric Bupivacaine and Isobaric Ropivacaine for Lower Limb Surgeries
More informationCOMPARATIVE ANAESTHETIC PROPERTIES OF VARIOUS LOCAL ANAESTHETIC AGENTS IN EXTRADURAL BLOCK FOR LABOUR
Br.J. Anaesth. (1977), 49, 75 COMPARATIVE ANAESTHETIC PROPERTIES OF VARIOUS LOCAL ANAESTHETIC AGENTS IN EXTRADURAL BLOCK FOR LABOUR D. G. LITTLEWOOD, D. B. SCOTT, J. WILSON AND B. G. COVINO SUMMARY Various
More informationINTRAVENOUS REGIONAL ANESTHESIA (BIERS BLOCK);
; TO COMPARE THE ANALGESIC EFFECTS OF COMBINATION OF 0.5% LIDOCAINE PLUS KETROLAC IN INTRAVENOUS REGIONAL ANESTHESIA TECHNIQUE WITH THOSE OF LIDOCAINE 0.5 % ALONE TO PREVENT POST OPERATIVE PAIN ORIGINAL
More informationOriginal article: Supraclavicular block with 0.5% levobupivacaine and 0.5% ropivacainecomparative
Original article: Supraclavicular block with 0.5% levobupivacaine and 0.5% ropivacainecomparative study Dr.V.Sai Dilip 1, Dr.G.Chandra Sekhar 1, Dr.Gopala Krishna Murthy 1, Dr.A.S.Kameswara Rao 1, Dr.K.Sivaji
More informationContinuous interscalene infusion and single injection using levobupivacaine for analgesia after surgery of the shoulder
Upper limb Continuous interscalene infusion and single injection using levobupivacaine for analgesia after surgery of the shoulder A DOUBLE-BLIND, RANDOMISED CONTROLLED TRIAL J. Kean, C. A. Wigderowitz,
More informationISSN X (Print) Original Research Article. DOI: /sjams *Corresponding author Suresh T
DOI: 10.21276/sjams.2016.4.8.7 Scholars Journal of Applied Medical Sciences (SJAMS) Sch. J. App. Med. Sci., 2016; 4(8A):2762-2766 Scholars Academic and Scientific Publisher (An International Publisher
More informationAnesthetic Efficacy of Different Ropivacaine Concentrations for Inferior Alveolar Nerve Block
SCIENTIFIC REPORT Anesthetic Efficacy of Different Ropivacaine Concentrations for Inferior Alveolar Nerve Block Eman El-Sharrawy, MBBCh, MSc, MD,* and John A. Yagiela, DDS, PhD *Faculty of Dentistry, Tanta
More informationimprove local aesthetic effects in Bier's Block? a double blind placebo controlled study".
Title of the article: Does the use of nitro-glycerine patch improve local aesthetic effects in Bier's Block? a double blind placebo controlled study". Type of article: Original Ahmed Said Elgebaly, MD.
More informationControlled Trial of Wound Infiltration with Bupivacaine for Post Operative Pain Relief after Caesarean Section
Bahrain Medical Bulletin, Vol.23, No.2, June 2001 Controlled Trial of Wound Infiltration with Bupivacaine for Post Operative Pain Relief after Caesarean Section Omar Momani, MD, MBBS, JBA* Objective: The
More informationHyperbaric 2% Lignocaine In Spinal Anaesthesia An Excellent Option For Day Care Surgeries
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861. Volume 13, Issue 2 Ver. III. (Feb. 2014), PP 09-13 Hyperbaric 2% Lignocaine In Spinal Anaesthesia An Excellent
More informationComparison of Bier's Block and Systemic Analgesia for Upper Extremity Procedures: A Randomized Clinical Trial
J Arch Mil Med. 1 August; (3): e1977. Published online 1 August 3. DOI: 1.81/jamm.1977 Research Article Comparison of Bier's Block and Systemic Analgesia for Upper Extremity Procedures: A Randomized Clinical
More informationASSESSMENT OF THE ROLE OF DEXAMETHASONE AS AN ADJUVANT IN SUPRACLAVICULAR BLOCK FOR UPPER LIMB SURGERIES
ORIGINAL ARTICLE ASSESSMENT OF THE ROLE OF DEXAMETHASONE AS AN ADJUVANT IN SUPRACLAVICULAR BLOCK FOR UPPER LIMB SURGERIES Priyesh Bhaskar, Mamta Harjai (e) ISSN Online: 2321-9599 (p) ISSN Print: 2348-6805
More informationOriginal Article. MA Qadeer Khan 1, B Syamasundara Rao 2, SA Aasim 3 INTRODUCTION MATERIALS AND METHODS
Original Article A Comparative Evaluation of 0.5% Hyperbaric Ropivacaine with 0.5% Hyperbaric Bupivacaine for Sub-Arachnoid Block for Elective below Umbilical Surgeries MA Qadeer Khan 1, B Syamasundara
More informationStudy of effect of addition of Ketamine and Atracurium to Lidocaine in Intravenous Regional Anaesthesia
Original article: Study of effect of addition of Ketamine and Atracurium to Lidocaine in Intravenous Regional Anaesthesia Dr. Neeta M. Charwande 1, Dr. Pravin S. Thorat 2, Dr. H S Rawat 3, Dr. Avinash
More informationBier s block is a frequently used intravenous regional. Original Article Journal of Kathmandu Medical College, Vol. 2, No. 1, Issue 3, Jan.-Mar.
Original Article, Vol. 2, No. 1, Issue 3, Jan.-Mar., 2013 Tabdar S 1, Lama S 2, Kadariya ER 3 1 Assistant Professor, 2 Lecturer, Department of Anaesthesiology and Intensive Care Kathmandu Medical College
More information(Senior Resident, Dept of Anaesthesia, Dr. D. Y. Patil Medical College, Dr. D. Y. Patil Vidyapeeth [DPU], Pune)
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 4 Ver. IX (April. 2017), PP 25-29 www.iosrjournals.org To Compare the Efficacy of Dexamethasone
More informationOverview. Normally, the process is completely reversible.
Overview Local anesthetics produce a transient and reversible loss of sensation (analgesia) in a circumscribed region of the body without loss of consciousness. Normally, the process is completely reversible.
More informationThe impact of Verapamil addition to Ketamine and Lidocaine Intravenous regional Anesthesia: A Randomized controlled study
Original Research Article The impact of Verapamil addition to Ketamine and Lidocaine Intravenous regional Anesthesia: A Randomized controlled study Sarat Babu Chevuri 1*, Vijay Rekha 1 1 Associate Professor
More informationPre-operative Care For Surgery of Forearm Fracture. WONG Mei Chee OT (CMC)
Pre-operative Care For Surgery of Forearm Fracture WONG Mei Chee OT (CMC) Pre-operative Nursing Considerations for Surgery of Forearm Fracture 1. Patient s problems - Diagnosis: Clinical features, x-ray
More informationEVALUATION OF THE TOURNIQUET LEAK DURING FOREARM INTRAVENOUS REGIONAL ANESTHESIA
EVALUATION OF THE TOURNIQUET LEAK DURING FOREARM INTRAVENOUS REGIONAL ANESTHESIA - Manual vs Automatic Pump Injection - Roshdi Roshdi Al-Metwalli * Summary Background: The present study was conducted to
More informationRegional Anaesthesia of the Thoracic Limb
Regional Anaesthesia of the Thoracic Limb Trauma and inflammation cause sensitization of the peripheral nervous system and the subsequent barrage of nociceptive input (usually by surgery) produces sensitization
More informationThe use of a muscle relaxant to supplement local anaesthetics for Bier's
Archives of mergency Medicine, 1988, 5, 79-85 The use of a muscle relaxant to supplement local anaesthetics for Bier's blocks R. McGLON,1 F. HYS2 & P. HARRIS3 'The General Infirmary, Leeds, 2Accident and
More informationMr David A McDonald Service Improvement Manager Whole System patient Flow Improvement Programme Scottish Government
Mr David A McDonald Service Improvement Manager Whole System patient Flow Improvement Programme Scottish Government Introduction Brief update Two main topics Use of Gabapentin Local Infiltration Analgesia
More informationLocal Anaesthetic Systemic Toxicity (LAST)
Local Anaesthetic Systemic Toxicity (LAST) Part II Course, June 2012 Dr Michael Barrington St Vincent s Hospital, Melbourne History LAST quickly became noted as a serious complication after introduction
More information4 ORIGINAL ARTICLE ANESTESHIA. Hosein Kimiaei Asadi I, Dariush Mehri II
4 ORIGINAL ARTICLE ANESTESHIA The analgesic effect of nitroglycerin added to lidocaine on quality of intravenous regional anesthesia in patients undergoing elective forearm and hand surgery 1 Hosein Kimiaei
More informationEfficacy Of Ropivacaine - Fentanyl In Comparison To Bupivacaine - Fentanyl In Epidural Anaesthesia
ISPUB.COM The Internet Journal of Anesthesiology Volume 33 Number 1 Efficacy Of Ropivacaine - Fentanyl In Comparison To Bupivacaine - Fentanyl In Epidural Anaesthesia S Gautam, S Singh, R Verma, S Kumar,
More informationComparative Study of Epidural 0.75% Ropivacaine and 0.5% Levobupivacaine in Lower Limb Surgeries with Respect to Block Characteristics
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2017/23 Comparative Study of Epidural 0.75% Ropivacaine and 0.5% Levobupivacaine in Lower Limb Surgeries with Respect to
More informationLocal anaesthetics. Dr JM Dippenaar
Local anaesthetics Dr JM Dippenaar Chemical structure Lipophilic phenol ring + Amide/Ester bridge + Hydrophilic chain Local anesthetic drugs Amides Esters Lignocaine Cocaine Bupivacaine PABA esters Ropivacaine
More informationASA Closed Claims Project: Regional Anesthesia Claims 1990 or later Lorri A. Lee MD Department of Anesthesiology University of Washington, Seattle, WA
ASA Closed Claims Project: Regional Anesthesia Claims 1990 or later Lorri A. Lee MD Department of Anesthesiology, Seattle, WA OVERVIEW 1. Closed Claims Project 2. Peripheral Nerve Blocks 3. Neuraxial Claims
More informationLocal anesthetic infiltration is not effective in decreasing post- Cesarean section skin pain severity. Iman Fayez Anees
Rawal Medical Journal An official publication of Pakistan Medical Association Rawalpindi Islamabad branch Established 1975 Volume 36 Number 2 March- June 2011 Original Article Local anesthetic infiltration
More informationLocal Anesthetics. Xiaoping Du Room E417 MSB Department of Pharmacology Phone (312) ;
Local Anesthetics Xiaoping Du Room E417 MSB Department of Pharmacology Phone (312)355 0237; Email: xdu@uic.edu Summary: Local anesthetics are drugs used to prevent or relieve pain in the specific regions
More informationCARPAL TUNNEL RELEASE BLOCK Author John Hyndman
Questions CARPAL TUNNEL RELEASE BLOCK Author John Hyndman Web Editor Kirsten Fehrmann - kirstenfehrmann@hotmail.com 1) Why does a LA solution containing Epinephrine cause pain on injection and what can
More informationLocal Anesthetics. ester or amide linkage. lipophilic. hydrophilic MII Susan E. Robinson O CH 2 CH 2 N CH 2 CH 3 H 2 N
Local Anesthetics MII 2009 Susan E. Robinson H 2 N lipophilic C ester or amide linkage CH 2 CH 2 N hydrophilic CH 2 CH 3 CH 2 CH 3 1 H 2 N lipophilic C ester or amide linkage CH 2 CH 2 N hydrophilic CH
More informationIntra-articular Adjuvant Analgesics Following Knee Arthroscopy: Comparison between Dexmedetomidine and Fentanyl
Intra-articular Adjuvant Analgesics Following Knee Arthroscopy: Comparison between Dexmedetomidine and Fentanyl 1 Mostafa El-Hamamsy, 2 Mohsen Dorgham 1 Anaesthesia Dept., Faculty of Medicine, El-Fayoum
More informationThe intensity of preoperative pain is directly correlated with the amount of morphine needed for postoperative analgesia
The intensity of preoperative pain is directly correlated with the amount of morphine needed for postoperative analgesia This study has been published: The intensity of preoperative pain is directly correlated
More informationEpidural Analgesia in Labor - Whats s New
Epidural Analgesia in Labor - Whats s New Wichelewski Josef 821 Selective neural blockade has many clinical applications in medicine but nowhere has its use been so well accepted than in the field of Obstetrics.
More informationREVISTA BRASILEIRA DE ANESTESIOLOGIA
Rev Bras Anestesiol. 2013;63(4):311-316 REVISTA BRASILEIRA DE ANESTESIOLOGIA Official Publication of the Brazilian Society of Anesthesiology www.sba.com.br SCIENTIFIC ARTICLE Comparison of Lornoxicam and
More informationEfficacy and Safety of Sublingual Sufentanil 30 mcg for the Management of Acute Pain Following Ambulatory Surgery. Pamela P.
Efficacy and Safety of Sublingual Sufentanil 30 mcg for the Management of Acute Pain Following Ambulatory Surgery Pamela P. Palmer, MD, PhD Disclosures for Dr. Pamela Palmer AcelRx employee Currently own
More informationSign up to receive ATOTW weekly
PERIPHERAL NERVE BLOCKS GETTING STARTED ANAESTHESIA TUTORIAL OF THE WEEK 134 PUBLICATION DATE 18/05/09 Dr Kim Russon, Consultant Anaesthetist Dr Helen Findley, ST3 Anaesthetics Dr Zoe Harclerode, ST3 Anaesthetics
More informationComparison of 0.5% Lignocaine with Tramadol and with Nalbuphine for Day Care IVRA in Upper Limb: an Interventional Study
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 15, Issue 9 Ver. VIII (September). 2016), PP 99-105 www.iosrjournals.org Comparison of 0.5% Lignocaine
More informationComparative Study of Intrathecal Ropivacaine and Levobupivacaine With Fentanyl And Magnesium As Adjuvants For Lower Abdominal Surgeries
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-853, p-issn: 2279-861. Volume 13, Issue 5 Ver. II. (May. 214), PP 39-43 Comparative Study of Intrathecal Ropivacaine and Levobupivacaine
More informationlog = pk a -ph log = = 0.2 log = = 1.1 log [1.5] = 0.2 log [12.6] = 1.1 Local anesthetics act in a frequency-dependent manner
Local Anesthetics MII 2008 Susan E. Robinson 2 N 2 2 N 2 2 2 N duration of action potency 2 2 N 2 2 2 N 2 2 N metabolism chemical stability hypersensitivity 2 2 2 N 2 2 N 2 2 mechanism onset of action
More informationRegional Anaesthesia for Children
Regional Anaesthesia for Children Indispensable! but also safe? PD Dr. med. Jacqueline Mauch Outline Significance of regional anaesthesia in paediatric surgery Risks and complications of regional anaesthesia
More informationInternational Journal of Drug Delivery 5 (2013) Original Research Article
International Journal of Drug Delivery 5 (2013) 239-244 http://www.arjournals.org/index.php/ijdd/index Original Research Article ISSN: 0975-0215 Comparative study of duration of analgesia with epidural
More informationComparison of local anesthetic effects of Tramadol and Lidocaine used subcutaneously in minor surgeries with local anesthesia
Comparison of local anesthetic effects of Tramadol and Lidocaine used subcutaneously in minor surgeries with local anesthesia S. Vahabi **, M. Heidari **, M. Ahmadinejad ***, J. Akhlaghi **** and M. Birjandi
More informationA comparative study of Ropivacaine and Bupivacaine in combined spinal epidural anaesthesia and Post- operative analgesia
Original article: A comparative study of Ropivacaine and Bupivacaine in combined spinal epidural anaesthesia and Post- operative analgesia Dr. K. Hemnath Babu 1, Dr. Shashikanth G. Somani 2, Dr. (Col)
More informationLocal anaesthetic agents
Local anaesthetic agents 1 Lecture Objectives: Awn khawaldeh 1.Definition 2. Classification of Local Anaesthetic Agents 2.1. Comparison between the two Classes. 3. Mode of action 4. composition of Local
More informationComparison of Bolus Bupivacaine, Fentanyl, and Mixture of Bupivacaine with Fentanyl in Thoracic Epidural Analgesia for Upper Abdominal Surgery
Original Article DOI: 10.17354/ijss/2016/156 Comparison of Bolus Bupivacaine, Fentanyl, and Mixture of Bupivacaine with Fentanyl in Thoracic Epidural Analgesia for Upper Abdominal Surgery Sachin Gajbhiye
More informationSingle-cuff forearm tourniquet in intravenous regional anaesthesia results in less pain and fewer sedation requirements than upper arm tourniquet
British Journal of Anaesthesia 111 (2): 271 5 (2013) Advance Access publication 18 March 2013. doi:10.1093/bja/aet032 Single-cuff forearm tourniquet in intravenous regional anaesthesia results in less
More informationComparison of analgesic properties of perineural and systemic dexamethasone in patients undergoing upper limb surgeries under supraclavicular block
Original Research Article Comparison of analgesic properties of perineural and systemic dexamethasone in patients undergoing upper limb surgeries under supraclavicular block Sathyan Natarajan 1*, Karthikeyan
More informationDr. Georgi Valchev Fellow in regional anaesthesia UZ Leuven
Dr. Georgi Valchev Fellow in regional anaesthesia UZ Leuven 55 years old woman Latarjetprocedure ASA-1, 49 kg. NKDA Informed consent for RA ISB with catheter uneventful throughout, rate 4/4/60 according
More informationOriginal Article COMPARATIVE EVALUATION OF ADDING CLONADINE V/S DEXMEDETOMIDINE DURING BIER S BLOCK IN UPPER LIMB ORTHOPAEDIC SURGERIES
Original Article COMPARATIVE EVALUATION OF ADDING CLONADINE V/S DEXMEDETOMIDINE DURING BIER S BLOCK IN UPPER LIMB ORTHOPAEDIC SURGERIES Veena chatrath 1, Radhe sharan 2, Sumit soni 3*, Chandni kansal 4
More informationDOI: / Page. 1 Dr. Seetharamaiah.S., 2 Dr. G.R.Santhilatha, 3 Dr. T.Venugopala rao, 4 Dr. Venugopalan.
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 14, Issue 9 Ver. VII (Sep. 2015), PP 44-48 www.iosrjournals.org To evaluate the efficacy of Inj. Dexmedetomidine
More informationJOURNAL OF PHARMACEUTICAL AND BIOMEDICAL SCIENCES
JOURNAL OF PHARMACEUTICAL AND BIOMEDICAL SCIENCES Singh R, Bisoi P, Mohanty SN, Debata PC. Study On Effect of Dexmedetomidine When Added To Bupivacaine On The Onset Time And Duration Of Block In Supraclavicular
More informationIntrathecal 0.75% Isobaric Ropivacaine Versus 0.5% Heavy Bupivacaine for Elective Cesarean Delivery: A Randomized Controlled Trial
Intrathecal 0.75% Isobaric Ropivacaine Versus 0.5% Heavy Bupivacaine for Elective Cesarean Delivery: A Randomized Controlled Trial Surjeet Singh, 1 V.P. Singh, 2 Manish Jain, 3 Kumkum Gupta, 3 Bhavna Rastogi,
More informationResearch Article A Comparative Study of Interscalene and Supraclavicular Approach of Brachial Plexus Block on Upper Limb Surgeries
Cronicon OPEN ACCESS ANAESTHESIA Research Article A Comparative Study of Interscalene and Supraclavicular Approach of Brachial Plexus Block on Upper Limb Surgeries Susmita Bhattacharyya, KalyanBrata Mandal,
More informationAnesthesia for Total Hip and Knee Arthroplasty
Anesthesia for Total Hip and Knee Arthroplasty Typical approach Describe anesthesia technique Rather Describe issues with THA and TKA How anesthesia can modify Issues Total Hip Total Knee Blood Loss ++
More informationJ of Evolution of Med and Dent Sci/ eissn , pissn / Vol. 3/ Issue 74/Dec 29, 2014 Page 15535
RANDOMISED CLINICAL TRIAL TO COMPARE THE EFFECT OF PRETREATMENT OF KETAMINE AND LIGNOCAINE ON PROPOFOL INJECTION PAIN Hanumanthappa V. Airani 1, Bhagyashree Amingad 2, Chandra Kumar B. M 3 HOW TO CITE
More informationComparative Efficacy of Levobupivacaine and Ropivacaine for Epidural Block in Outpatients with Degenerative Spinal Disease
Pain Physician 2014; 17:525-529 ISSN 1533-3159 Prospective Trial Comparative Efficacy of Levobupivacaine and Ropivacaine for Epidural Block in Outpatients with Degenerative Spinal Disease Takashi Egashira,
More informationAn Epidural Initial Dose is Unnecessary in Combined Spinal Epidural Anesthesia for Caesarean Section
Original An Epidural Initial Dose is Unnecessary in Combined Spinal Epidural Anesthesia for Caesarean Section Takashi Hongo, Akira Kitamura, Motoi Yokozuka, Chol Kim and Atsuhiro Sakamoto Department of
More informationThe use of Pudendal Nerve Block in Hemorrhoidectomy Operations: A Prospective Double Blind Placebo Control Study
Kasr El Aini Journal of Surgery VOL., 10, NO 3 September 2009 97 The use of Pudendal Nerve Block in Hemorrhoidectomy Operations: A Prospective Double Blind Placebo Control Study Sherif Adly and Mohamed
More informationInduction position for spinal anaesthesia: Sitting versus lateral position
11 ORIGINAL ARTICLE Induction position for spinal anaesthesia: Sitting versus lateral position Khurrum Shahzad, Gauhar Afshan Abstract Objective: To compare the effect of induction position on block characteristics
More informationHTX-011, a Proprietary, Unique, Long-Acting Local Anesthetic, Reduces Acute Postoperative Pain Intensity and Opioid Consumption Following Bunionectomy
HTX-011, a Proprietary, Unique, Long-Acting Local Anesthetic, Reduces Acute Postoperative Pain Intensity and Opioid Consumption Following Bunionectomy Eugene Viscusi, 1 Oscar DeLeon-Casasola, 2 TJ Gan,
More informationLocal Anesthetics. Dr. Hiwa K. Saaed, PhD Pharmacology & Toxicology College of Pharmacy, University of Sulaimani Local anesthetics (LAs)
Local Anesthetics Dr. Hiwa K. Saaed, PhD Pharmacology & Toxicology College of Pharmacy, University of Sulaimani 2018-2019 LAs are drugs that: Local anesthetics (LAs) Øblock nerve conduction of sensory
More informationThe analgesic effect of lornoxicam when added to lidocaine for intravenous regional anaesthesia
British Journal of Anaesthesia 97 (3): 408 13 (2006) doi:10.1093/bja/ael170 Advance Access publication July 15, 2006 The analgesic effect of lornoxicam when added to lidocaine for intravenous regional
More informationUneventful recovery following accidental epidural injection of dobutamine
1 Case report Uneventful recovery following accidental epidural injection of dobutamine Bastiaan M. Gerritse, M.D., Ph.D., Daan de Vos, R.N.A, Anton W. Visser, M.D., Ph.D. Department of Anesthesiology,
More informationORIGINAL ARTICLE. Srivastava Meghana 1, Arora Garima 2, Santpur Madhavi 3, Kanwal Preet 4, Bansal Karishma 4 ABSTRACT
ORIGINAL ARTICLE ANAESTHESIA, PAIN & INTENSIVE CARE www.apicareonline.com Efficacy of bupivacaine and ropivacaine for postoperative analgesia in continuous epidural infusion in lower limb surgeries under
More informationGUIDELINES FOR PERIPHERAL NERVE / PLEXUS BLOCK CATHETER MANAGEMENT DEPARTMENT OF ANAESTHESIOLOGY AND INTENSIVE CARE HOSPITAL KUALA LUMPUR
GUIDELINES FOR PERIPHERAL NERVE / PLEXUS BLOCK CATHETER MANAGEMENT DEPARTMENT OF ANAESTHESIOLOGY AND INTENSIVE CARE HOSPITAL KUALA LUMPUR INTRODUCTION Regional block provides superior pain relief, compared
More informationPlantar Flexion Seems More Reliable than Dorsiflexion with Labat s Sciatic Nerve Block: A Prospective, Randomized Comparison
Plantar Flexion Seems More Reliable than Dorsiflexion with Labat s Sciatic Nerve Block: A Prospective, Randomized Comparison Manuel Taboada, MD*, Peter G. Atanassoff, MD, Jaime Rodríguez, MD, PhD*, Joaquín
More informationS Kannan, Prem Kumar. Assistant Professor, Saveetha Medical College and Hospital, Chennai.
Original Article CLINICAL COMPARISON OF TWO DIFFERENT VOLUMES OF 0.5% BUPIVACAINE FOR CLAVICULAR SURGERIES USING COMBINED INTERSCALENE AND SUPERFICIAL CERVICAL PLEXUS BLOCK 2 S Kannan, Prem Kumar,2 Assistant
More information3.2 Local Anaesthetic Techniques. Local anaesthetic pharmacology and toxicity. LA Structure. Most are weak bases - esters or amides - of the form:
3.2 Local Anaesthetic Techniques Local anaesthetic pharmacology and toxicity LA Structure Most are weak bases - esters or amides - of the form: Esters: Long G groups have increased toxicity, shorter ones
More information*Corresponding Author: Mahadevappa Gudi
Int. J. Pharm. Med. & Bio. Sc. 2014 Mahadevappa Gudi and Shiddalingesh Salimath, 2014 Research Paper ISSN 2278 5221 www.ijpmbs.com Vol. 3, No. 4, October 2014 2014 IJPMBS. All Rights Reserved A SINGLE
More informationComparison of fentanyl versus fentanyl plus magnesium as post-operative epidural analgesia in orthopedic hip surgeries
Original Research Article Comparison of fentanyl versus fentanyl plus magnesium as post-operative epidural analgesia in orthopedic hip surgeries P V Praveen Kumar 1*, Sreemanth 2 1 Associate Professor,
More informationInternational Journal of Clinical And Diagnostic Research ISSN Volume 3, Issue 2, Mar-Apr 2015.
Anesthesiology Original Research International Journal of Clinical And Diagnostic Research ISSN 2395-3403 Volume 3, Issue 2, Mar-Apr 2015. Glorigin Lifesciences Private Limited. COMPARISON OF DEXMEDETOMIDINE
More informationType of intervention Anaesthesia. Economic study type Cost-effectiveness analysis.
Comparison of the costs and recovery profiles of three anesthetic techniques for ambulatory anorectal surgery Li S T, Coloma M, White P F, Watcha M F, Chiu J W, Li H, Huber P J Record Status This is a
More informationSection: Anaesthesia. Original Article INTRODUCTION
DOI: 10.21276/aimdr.2016.2.5.AN4 Original Article ISSN (O):2395-2822; ISSN (P):2395-2814 Randomized Clinical Comparison of Three Different Doses of Bupivacaine with Fentanyl for TURP-Search for Optimal
More informationComparison of ropivacaine and bupivacaine in extradural analgesia for the relief of pain in labour
British Journal of Anaesthesia 1995; 74: 261-265 Comparison of ropivacaine and bupivacaine in extradural analgesia for the relief of pain in labour A. F. MCCRAE, H. JOZWIAK AND J. H. MCCLURE Summary Forty
More informationCOMPARISON OF THE EFFECT OF TWO DIFFERENT DOSES OF 0.75% GLUCOSE-FREE ROPIVACAINE FOR SPINAL ANESTHESIA FOR LOWER LIMB AND LOWER ABDOMINAL SURGERY
Two doses of ropivacaine for spinal anesthesia COMPARISON OF THE EFFECT OF TWO DIFFERENT DOSES OF.75% GLUCOSE-FREE ROPIVACAINE FOR SPINAL ANESTHESIA FOR LOWER LIMB AND LOWER ABDOMINAL SURGERY John On-Nin
More informationIntravenous Dezocine for Postoperative Pain: A Double-Blind, Placebo-Controlled Comparison With Morphine
Intravenous for Postoperative Pain: A Double-Blind, Placebo-Controlled Comparison With Morphine Uma A. Pandit, MD, S aria P. Kothary, MD, and Sujit K. Pandit, MD, PhD, a new mixed agonist-antagonist opioid
More informationRegional Anesthesia. procedure if required. However, many patients prefer to receive sedation either during the
1 Regional Anesthesia Regional anaesthesia (or regional anesthesia) is anesthesia affecting only a large part of the body, such as a limb or the lower half of the body. Regional anaesthetic techniques
More informationOriginal Article INTRODUCTION. Abstract
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2018/95 Comparative Evaluation of Ropivacaine and Lignocaine with Ropivacaine, Lignocaine, and Clonidine Combination during
More informationSubspecialty Rotation: Anesthesia
Subspecialty Rotation: Anesthesia Faculty: John Heaton, M.D. GOAL: Maintenance of Airway Patency and Oxygenation. Recognize and manage upper airway obstruction and desaturation. Recognize and manage upper
More informationComparison of ropivacaine 0.75% and bupivacaine 0.5% in peribulbar block for cataract surgery.
ISPUB.COM The Internet Journal of Anesthesiology Volume 23 Number 2 Comparison of ropivacaine 0.75% and bupivacaine 0.5% in peribulbar block for cataract surgery. L Trivedi, H Trivedi, D Tripathi, P Jha,
More informationCOMPARISON OF INTRATHECAL ISOBARIC ROPIVACAINE WITH HYPERBARIC BUPAVICAINE FOR SPINAL ANAESTHESIA IN LOWER LIMB SURGERIES ABSTRACT
COMPARISON OF INTRATHECAL ISOBARIC ROPIVACAINE WITH HYPERBARIC BUPAVICAINE FOR SPINAL ANAESTHESIA IN LOWER LIMB SURGERIES 1 1 Tasneem Alam, Akhtar Hussain ABSTRACT Background: Spinal anesesia, is one of
More informationAddition of Adrenaline to Chloroprocaine Provides a Moderate Duration Time for Epidural Anaesthesia in Elective Caesarean Section
The Journal of International Medical Research 2012; 40: 1099 1107 Addition of Adrenaline to Chloroprocaine Provides a Moderate Duration Time for Epidural Anaesthesia in Elective Caesarean Section SW FENG,
More informationCOMBINED SPINAL AND EPIDURAL ANAESTHESIA (CSEA) USING SEPARATE INTERSPACE TECHNIQUE
COMBINED SPINAL AND EPIDURAL ANAESHESIA (CSEA) USING SEPARAE INERSPACE ECHNIQUE Shreepathi Krishna Achar* 1, Vinoda Venkata Rao Assistant Professor, Department of Anaesthesiology, Kasturba Medical College,
More informationLOCAL ANAESTHESIA IN FIRST TRIMESTER SURGICAL ABORTION. Regina-Maria Renner MD MPH
LOCAL ANAESTHESIA IN FIRST TRIMESTER SURGICAL ABORTION Regina-Maria Renner MD MPH FIAPAC October 20, 2012 Disclosures none Objectives Provide an introduction to pain pathways Provide background regarding
More information