A clinical comparative study of ropivacaine versus ropivacaine with fentanyl by continuous epidural infusion for post-operative analgesia and ambulation in patients undergoing major gynecological surgery

Background: To compare the effect of continuous epidural infusion of ropivacaine versus ropivacaine-fentanyl for post-operative analgesia and ambulation in patients undergoing major gynaecological surgeries.Methods: A total of 60 patients of age 20 to 50 yrs of body mass index (BMI) within normal range (18.5to24.9 kg/m2) posted for major gynecological surgeries were divided into two equal groups (Group R and RF) in a prospective, randomized, double-blind fashion. In Group RF (n=30) 0.1% Ropivacaine with 2µg/ml Fentanyl and in Group R (n =30) 0.1% ropivacaine were used. General anaesthesia was given to all patients. Continuous epidural infusion using elastomeric pump was started at ‘0’ post-operative hours at 6ml/hour. Post -operative pain (Visual Analogue Scale Score), ambulation (James Modified Bromage Scale) and side effects were noted at 0, 2, 4, 6, 12, 18, 24, 36 and 48hrs.Results: The differences in VAS Score of subjects of both the groups were statistically significant(p<0.05) at 18 hrs, 24hrs, 36hrs and 48 hrs and the differences in Modified Bromage Scale of subjects of the groups were statistically similar at most of the time intervals. Also, the side effects were statistically similar between the groups.Conclusions: Author concluded that ropivacaine-fentanyl is better than ropivacaine alone by continuous epidural infusion for post-operative analgesia in major gynecological surgeries with no statistically significant side effects, effect on ambulation being similar in both the groups

Dexmedetomidine as an adjuvant to 0.75% ropivacaine and 0.5 % levobupivacaine in peripheral nerve stimulator guided supraclavicular brachial plexus block

Background: The aim of study was to assess the effect of Dexmedetomidine as an adjuvant to Ropivacaine 0.75% and Levobupivacaine 0.5% in Peripheral Nerve Stimulator guided supraclavicular brachial plexus block. Methods: The study was a single-center, prospective, randomised experiment in which patients were randomly assigned to one of two groups conducted at SVBP Hospital affiliated with LLRM Medical College, Meerut. The study was done in 80 patients undergoing various elective forearm procedures under peripheral nerve stimulator guided brachial plexus block via supraclavicular route. Result: The mean time of onset of sensory block in Group B (Levobupivacaine + Dexmedetomidine) was found to be slight quicker than Group A (Ropivacaine + Dexmedetomidine) and the difference between both groups was found to be significant (p= 0.042) and the duration of analgesia was significantly (p&lt;0.01) prolonged in Group B than Group A. Conclusions: 0.5 % Levobupivacaine and dexmedetomidine combination have quick onset of sensory and motor blockade and a significant prolongation in duration of sensory blockade than 0.75% Ropivacaine and Dexmedetomidine

A clinical comparative study of ropivacaine versus ropivacaine with fentanyl by continuous epidural infusion for post-operative analgesia and ambulation in patients undergoing major gynecological surgery

Background: To compare the effect of continuous epidural infusion of ropivacaine versus ropivacaine-fentanyl for post-operative analgesia and ambulation in patients undergoing major gynaecological surgeries.Methods: A total of 60 patients of age 20 to 50 yrs of body mass index (BMI) within normal range (18.5to24.9 kg/m2) posted for major gynecological surgeries were divided into two equal groups (Group R and RF) in a prospective, randomized, double-blind fashion. In Group RF (n=30) 0.1% Ropivacaine with 2µg/ml Fentanyl and in Group R (n =30) 0.1% ropivacaine were used. General anaesthesia was given to all patients. Continuous epidural infusion using elastomeric pump was started at ‘0’ post-operative hours at 6ml/hour. Post -operative pain (Visual Analogue Scale Score), ambulation (James Modified Bromage Scale) and side effects were noted at 0, 2, 4, 6, 12, 18, 24, 36 and 48hrs.Results: The differences in VAS Score of subjects of both the groups were statistically significant(p&lt;0.05) at 18 hrs, 24hrs, 36hrs and 48 hrs and the differences in Modified Bromage Scale of subjects of the groups were statistically similar at most of the time intervals. Also, the side effects were statistically similar between the groups.Conclusions: Author concluded that ropivacaine-fentanyl is better than ropivacaine alone by continuous epidural infusion for post-operative analgesia in major gynecological surgeries with no statistically significant side effects, effect on ambulation being similar in both the groups

Valorization of Sour Buttermilk (A Potential Waste Stream): Conversion to Powder Employing Reverse Osmosis and Spray Drying

Reverse osmosis (RO) is known for the economic dewatering of dairy streams without any change in phase. At the household level, surplus milk is fermented and churned to obtain butter, which is subsequently heated to obtain clarified milk fat (ghee). The production of 1 kg ghee generates 15–20 kg sour buttermilk (SBM) as a by-product that is mostly drained. This causes a loss of milk solids and environmental pollution. The processing, preservation and valorization of SBM are quite challenging because of its low total solids (TS) and pH, poor heat stability and limited shelf life. This investigation aimed to transform SBM into a novel dried dairy ingredient. SBM was thermized, filtered, defatted and concentrated at 35 ± 1 °C, employing RO up to 3.62× (12.86%). The RO concentrate was subsequently converted into sour buttermilk powder (SBMP) by employing spray drying. SBMP was further characterized for its physicochemical, reconstitution and functional properties; rheological and morphological characteristics; and amino acid and fatty acid profiling, along with FTIR and XRD spectra. SBMP was “instant soluble-3 s” and exhibited excellent emulsion stability (80.70%), water binding capacity (4.34 g/g of protein), flowability (28.36°) and antioxidant properties. In nutshell, a process was developed for the valorization of sour buttermilk to a novel dairy ingredient by employing reverse osmosis and a spray-drying process