Vimal Dangi

Abstract

Background: Adjuvants play an important role in the intraoperative and post-operative analgesia. Spinal Anaesthesia is very common among gynaecological surgeries. Bupivacaine is the most common drug used for in gynaecological surgeries. So, addition of Clonidine or Dexmedetomidine as adjuvant can decrease post-operative analgesia. Materials and Methods: A randomised controlled trial was done to compare the two groups of Dexmedetomidine and Clonidine along with Bupivacaine. A total of 100 patients were divided into 50 each randomly into two groups and intrathecal medication were given as per the group allotted. Results: Time of onset of sensory and motor block was much faster in Dexmedetomidine group than Clonidine group. The two segment regression was slower in Dexmedetomidine group compared to Clonidine group. The time taken for two segment regression was 590 ±15 minutes and 361± 18 minutes respectively and was found to be statistically significantOnset of motor block according to Bromage grade 3 was 4.3 ±1.2 minutes and 5.14 ±1.4 among Dexmedetomidine and Clonidine group respectively. The mean values of mean arterial pressures and heart rate were similar throughout the inter operative and post-operative time duration. Conclusion: Planning and managing postoperative analgesia starts from pre anaesthetic evaluation. So Dexmedetomidine when used along with Bupivacaine intrathecally has better postoperative pain relief as compared with Clonidine and Bupivacaine.   Keywords: Dexmedetomidine, Gynaecological surgeries, Clonidine

Open full article page

Abstract

Background & Method: The present study entitled “To evaluate Histopathological changes in Placenta of IUGR” was conducted in the Department of Obstetrics and Gynaecology. A total of 400 patients were studied. Out of them 200 were normal patients without IUGR and 200 with IUGR. These patients were evaluated with the help of semistructured proforma consisting of various socio-demographic and clinical variables. Result: Number of LSCS deliveries in IUGR patients (59) is significantly more than control group (33). The number of syncytial knot formation (>10) in IUGR is 169 compared to 153 of control and hence is statistically insignificant. Cytotrophoblastic proliferation (>10) in IUGR (126) is significantly more than (92) in the control group. Number Of area fibrinoid necrosis in villi > 5 in IUGR group is 57 compared to control group (29) (significantly higher) No. of hylinized areas (> 5) in IUGR (101) is significantly higher than in control group (68). Conclusion: Histopathological findings in low power field like syncytial knot formation, cytotrophoblastic cellular proliferation, calcification and hyalinisation of villi are also found as normal aging changes in placenta but it occur early and more frequently per low power field in IUGR group. To conclude, these morphological & histological findings of placenta are the etiological basis for Intra uterine growth restriction. Keywords: Histopathological, Placenta & IUGR.

Open full article page

Abstract

Background: Preanesthetic medication is important among the paediatric patients undergoing surgeries. A good preanesthetic medication reduces the anxiety and the post-operative pain among paediatric patients. Materials and Methods: A randomised controlled trial was done to compare the two groups of Dexmedetomidine, and Midazolam given as preanesthetic medication intranasally. Results: Both the groups had comparable baseline values before premedication but there was a significant difference in the vital parameters of heart rate and systolic blood pressure after medication. The mean Parental Separation Anxiety Scale was found to be 1.4 ± 0.85 and 2.5 ± 0.98 among Dexmedetomidine and Midazolam group respectively. This was found to be significant (p < 0> Conclusion: Dexmedetomidine when given as preanesthetic medication intranasally significantly controls the vitals within the normal range and produces better parental separation anxiety scores and mask acceptance scores as compared to Midazolam. Keywords: Dexmedetomidine, Gynaecological surgeries, Clonidine.

Open full article page