Dinesh Naik

Abstract

Background: This study was designed to evaluate the postoperative analgesic efficacy of intravenous dexamethasone, and also to determine the postoperative rescue analgesic consumption, morbidity with respect to surgical technique, quality of oral intake, incidence of postoperative nausea and vomiting (PONV), and discharge from hospital. Materials and Methods: After ethical committee clearance, a prospective randomized double blind study was planned for one year period on 100 pediatric patients, with5-12 years of age, American Society of Anesthesiologists physical class I and II, undergoing elective tonsillectomy with or without adenoidectomy under general anesthesia were included in the study. Patients were randomly allocated into 4 groups and received the study drug intravenously 10 minutes before induction of anesthesia. Group A undergoing sharp snare dissection tonsillectomy received 0.9% normal saline 50ml, group B sharp snare dissection tonsillectomy received dexamethasone 0.15mg/kg diluted in 0.9% normal saline, group C laser tonsillectomy received 0.9% normal saline 50 ml, group D laser tonsillectomy received dexamethasone 0.15mg/kg diluted in 0.9% normal saline. Results: We observed statistically significant difference in mean pain scores (p Single dose intravenous administration of dexamethasone (0.15mg/kg) resulted in reduction of post-operative pain, need for rescue analgesics, reduced incidence of PONV, early return to normal diet and discharge from the hospital.   Keywords: Analgesia, Dexamethasone, Postoperative morbidity, Tonsillectomy.

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Abstract

Introduction: Spinal anaesthesia is most commonly used technique for lower abdominal surgeries. Its main disadvantage remains the short duration of action, hence different additives have been used. Opioids have been used to enhance the clinical efficacy and duration of action of local anesthetic drugs. The present study was aimed to compare the clinical efficiency of fentanyl and nalbuphine as an adjuvant to 0.5% Isobaric levobupivacaine for lower abdominal surgeries. Materials and Methods: After obtaining ethical committee clearance and written consent from patient. ASA grade ?&?? patients aged between 20-60 years undergoing infra umbilical surgeries were selected divided into two groups of 45 each by computerized randomization. Group A received intrathecal fentanyl 25µg(0.5ml) with 3ml(15mg)0f 0.5% Isobaric Levobupivacaine, and group B received intrathecal nalbuphine 0.8mg(0.5ml) with 0.5% Isorbaric levobupivacaine 3ml(15mg). Statistical analysis performed by STATA 11.2. Students t test prior to find the significance difference between the study parameters. Results: The duration of first rescue analgesia required prolonged in group B (430.3+11.13min) compared to group A is 285.97+8.8min with p value of 0.001( Conclusion: Both the groups were equally efficacious with good intraoperative conditions with haemodynamic stability however group B improves the quality of intraoperative and postoperative analgesia with minimal side effects. Keywords: Spinal anaesthesia, Nalbuphine, Levobupivacaine, Fentanyl, Postoperative analgesia.

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