12 research outputs found
Comparative study between nerve stimulator guided technique and ultrasound guided technique of supraclavicular nerve block for upper limb surgery
Background: Peripheral nerve stimulator (PNS) has been the âgold standardâ for peripheral nerve blocks for determining adequate needle placement to produce regional anesthesia/analgesia. Modern ultrasound (US) machines can be used to guide the injection needle while minimizing the risk of injury of adjacent structures.the main objective of the study was to compare nerve stimulator guided technique and ultrasound guided technique of supraclavicular brachial plexus block for upper limb surgeryMethods: This prospective randomized single blind comparative study was conducted in eighty patients under supraclavicular brachial plexus block using 0.5% Ropivacaine at a tertiary care teaching hospital of Rajasthan after taking approval from ethical committee. These patients were randomly allocated in either group PNS (n=40) or group US (n=40). Both the groups were assessed for procedure time, onset and duration of sensory and motor blockade and complications. Results: The procedure time was 8.0±1.53 minutes in group PNS and 6.27±1.10 minutes in group US (pË0.0001). The onset of sensory and motor block was 7.68±1.33 minutes and 9.94±1.28 minutes in group PNS and 6.46±1.02 minutes and 8.10±1.02 minutes respectively in group US (pË0.0001). The time to achieve complete block was 16.11±1.54 minutes in group PNS and 13.74±1.11 minutes in group US (pË0.0001). The duration of sensory and motor block was 7 hours and 6 hours for group PNS and 8 hours and 7 hours respectively in group US. The success rate was 90% in group PNS and 97.5% in Group US.Conclusion: Ultrasound guided technique was found significantly better than PNS for supraclavicular brachial plexus block.
Comparison of prophylactic infusion of phenylephrine and norepinephrine for prevention of hypotension in elective caesarean section under spinal anaesthesia- A randomized controlled study
Background:Post spinal hypotension can have deleterious effects on parturient and foetus in caesarean section if not prevented. Norepinephrine has alpha agonistic activity with weak beta agonistic activity, so may be more effective in maintaining cardiac output of parturient. Aims:To compare the effects of prophylactic infusion of phenylephrine and norepinephrine on cardiac output as a primary outcomeand heart rate, mean arterial pressure, stroke volume, and systemic vascular resistance of parturient, neonatal Apgarscore and umbilical blood gas analysis as secondary outcomes.Method:Eighty six healthy patients undergoing elective caesarean section under spinal anaesthesia were randomized into two groups. Group P received infusion of phenylephrine (100 ”g/ml)intravenous (iv) and Group N received infusion of norepinephrine (5”g /ml) iv just after intrathecal drug administration.The pre-defined algorithm was used to adjust the infusion rate according to mean arterial pressure. All haemodynamic parameters and total volumes of vasopressor upto the time of uterine incision and upto 30 min after starting drug infusion were recorded. Data were compared using unpaired Student t-test and Chi square test. P value less than 0.05 was considered significant. Results: Group N had higher cardiac output at 1 min (p=0.01),3 min(p=0.0001),6 min(p=0.006), 9 min(p=0.001) in comparison to group P. Group P had lower heart rate at 1 min (p=0.0003),3 min(p=0.0001),6 min(p=0.0001), 9 min(p=0.0001) and 12 min(p=0.0078) in comparison to group N. Systemic vascular resistance was higher in group P at 6 min(p=0.004),9 min(p=0.001) and 12 min (p=0.04). Total volume of vasopressor required to maintain mean arterial pressure was higher in group N(p<0.0001). Conclusion: Norepinephrine has greater efficacy to maintain cardiac output, with greater heart rate in comparison to phenylephrineduring spinal anaesthesia for caesarean section
Comparison of analgesic efficacy of perineural dexamethasone in rectus sheath block and intravenous dexamethasone with levobupivacaine in bilateral rectus sheath block for patients undergoing midline abdominal surgery: a randomized controlled trial
Abstract Background Dexamethasone is used in regional analgesia to prolong the duration of analgesia and anaesthesia. The perineural and intravenous (IV) dexamethasone in fascial plane block have conflicting results. The study aimed to compare analgesic efficacy of perineurally and intravenously dexamethasone in rectus sheath block (RSB). This prospective, double-blinded, randomized control study was conducted in 105 patients, equally divided in three groups. All the patients received ultrasound-guided RSB block with 20 ml of 0.25% levobupivacaine on each side. Additionally, in group A, 1-ml normal saline (NS) on each side in RSB block and 2-ml NS IV; in group B, 4-mg dexamethasone on each side in RSB block and 2-ml NS IV; and in group C, 1-ml NS on each side in RSB block and 8-mg dexamethasone IV. The primary objective of the study was the duration of analgesia, and secondary objectives were total morphine consumption in the first 24 h, numeric rating scale (NRS) scores at rest and on cough, complications and patientâs satisfaction score. Results The duration of analgesia was maximum in group B (935.91â±â121.82 min) and then in group C (730.31â±â129.64 min) and group A (418.34â±â29.22 min) (Pâ<â0.0001). The morphine consumption and mean NRS score (at rest and cough) were lowest in group B and then group C and group A (Pâ<â0.0001). Conclusions The perineural dexamethasone as an adjuvant to levobupivacaine prolongs the duration of analgesia with decreased analgesic requirements compared to intravenous dexamethasone in bilateral RSB in patients undergoing midline laparotomy surgery
The Future Landscape of High-Redshift Galaxy Cluster Science
The Decadal Survey on Astronomy and Astrophysics (Astro2020) of the US National Academies of ScienceWe describe the opportunities for galaxy cluster science in the high- redshift regime where massive, virialized halos first formed and where star formation and AGN activity peaked. New observing facilities from radio to X-ray wavelengths, combining high spatial/spectral resolution with large collecting areas, are poised to uncover this population
The Future Landscape of High-Redshift Galaxy Cluster Science
The Decadal Survey on Astronomy and Astrophysics (Astro2020) of the US National Academies of ScienceWe describe the opportunities for galaxy cluster science in the high- redshift regime where massive, virialized halos first formed and where star formation and AGN activity peaked. New observing facilities from radio to X-ray wavelengths, combining high spatial/spectral resolution with large collecting areas, are poised to uncover this population
The Future Landscape of High-Redshift Galaxy Cluster Science
We describe the opportunities for galaxy cluster science in the high- redshift regime where massive, virialized halos first formed and where star formation and AGN activity peaked. New observing facilities from radio to X-ray wavelengths, combining high spatial/spectral resolution with large collecting areas, are poised to uncover this population