Comparative Study between Dexamethasone and Tramadol As an Adjuvant to Ropivacaine Vs Ropivacaine Alone In USG Guided Supraclavicular Block in Upper Limb Surgeries

Background: Brachial plexus block provides superior quality of intraoperative and postoperative analgesia and stable hemodynamics over general anesthesia. Various adjuvants have been used to prolong effects of local anesthetics like epinephrine, midazolam, magnesium sulfate, alpha-2 agonists i.e. Clonidine and dexmedetomidine, dexamethasone and tramadol. Aims & Objective: To compare the efficacy of tramadol and dexamethasone on the characteristics of the block and its effect on postoperative analgesia when added as an adjuvant to ropivacaine in USGguided supraclavicular brachial plexus block. Materials & Methods: Eighty patients belonging to American Society of Anaesthesiologists (ASA) Grade I, II and III, aged between 20 to 55 years, scheduled for undergo elective upper limb surgeries under supraclavicular brachial plexus block were enrolled in this study. Patients were equally divided into two groups : group S received 0.5% ropivacaine 30ml with Dexamethasone 2ml (8mg) and tramadol 2ml (100 mg) And group C received 0.5% ropivacaine 30ml with + normal saline 4ml. Onset and duration of sensory and motor block , duration of postoperative analgesia and any complications were observed. Results: In our study both groups were comparable with respect to their demographic profile of patients, duration of surgery and ASA status. Onset of sensory block was earlier in group S than group C (3.15 ± 0.69 minutes and 7.55± 0.89 minutes respectively, p =0.004). Onset and duration of motor block and postoperat ive analgesia were longer in group S as compared to group C (5.01± 1.33 & 12.32± 0.75 minutes respectively, P= 0.001 and 14.44± 0.635 and 8.24± 0.873hours respectively, p =0.001 for motor block and 16.53± 0.635 and 10.45 ± 0.681 minutes respectively, p= 0.001for postoperative analgesia). No ignificant side effects were noted. Conclusion: Dexamethasone and tramadol when added to ropivacaine in supraclavicular brachial plexus lock prolongs onset and duration of sensory and motor block and postoperative analgesia significantly with minimal side effects

Comparison of Effectiveness of Dexmedetomidine and Tramadol in the Treatment of Post-Neuraxial Anaesthesia Shivering

Background: Shivering is a common problem encountered after neuraxial anaesthesia and is most likely due to altered afferent thermal input from the blocked region. Tramadol a centrally acting analgesic drug, is effective in the treatment of post-anaesthetic shivering after general and neuraxial anaesthesia, by inhibiting the neuronal reuptake of noradrenaline and 5-hydroxytryptamine (5-HT), facilitates 5-HT release and activates the μ-opioid receptors. Dexmedetomidine, a potent alpha 2-adrenergic receptor agonist, acts by decreasing the vasoconstriction and is known to reduce the shivering threshold. Materials & Methods: This was a prospective, randomised, double-blinded study included 100 patients of either genders, aged 20–65 years with ASA status I-II scheduled to undergo elective surgery under spinal anaesthesia. They were then randomly allocated to receive either intravenous dexmedetomidine 0.5 μg/kg or tramadol 0.5 mg/kg. The response rate to treatment, the degree of sedation and the side-effects were recorded. Results: The response rate to treatment and bradycardia was more in the dexmedetomidine group, whereas, nausea and vomiting were observed more in tramadol group and diferrence was significant when compared between groups. Sedation score was comparable between two groups. Conclusion: Dexmedetomidine is superior to tramadol for shivering treatment, due to higher effective rate of shivering control, earlier onset of action and lesser recurrence of shivering and lower incidences of nausea and vomiting. However, dexmedetomidine is also associated with higher incidences of hypotension and bradycardia than tramadol

Comparative Study between Intranasal Midazolam and Ketamine as a Premedication in Pediatric Surgical Patients

Background: The preoperative period is a stressful event, especially in the pediatric patients. The goals of preanesthetic medication for children include allaying patient anxiety and facilitating the smooth induction of anaesthesia. For providing premedication to pediatric surgical patients, various drugs and many routes have been studied. Midazolam, a GABA receptor inhibitor, is the most commonly used sedative drug for premedication in children. It provides effective sedation, anxiolysis, and varying degrees of anterograde amnesia. Ketamine is a phencyclidine derivative that antagonizes the N-methyl D-aspartate (NMDA) receptor which produces sedation with a trance-like state, analgesia, and preserves upper airway muscle tone and respiratory drive. Intranasal route is one of the preferred route because of the ease of administration.Aims & objectives: In this study, we compared the effects of intranasal midazolam and ketamine on preoperative sedation, parenteral separation, response to intravenous cannulation and mask acceptance in paediatric patients. Materials & Methods: Sixty children classified as ASA physical status I & II, aged between 2- 10 years, who were scheduled to undergo an elective surgeries, were enrolled for a prospective, randomized, and double-blind controlled trial. All of the children received intranasal premedication approximately 30 min before the induction of anaesthesia. Group M (n = 30) received 0.2 mg/kg of intranasal midazolam, and Group K (n = 30) received intranasal ketamine 5mg/kg. All of the patients were anesthetized with nitrous oxide, oxygen, and sevoflurane, administered via a face mask. Results: No significant differences were observed in demographic, hemodynamic, and respiratory parameters, however significant tachycardia was observed in the ketamine group. Intranasal ketamine results in more successful parental separation and yields a higher sedation score (3.87± 0.66) compared to midazolam group (2.62± 0.69) at 30 minutes, with negligible side effects. Venous cannulation and face mask acceptance was also better in the ketamine group with a significantly higher percentage of patients with satisfactory venous cannulation and face mask acceptance (p<0.05). Conclusion: Intranasal ketamine is superior in decreasing anxiety upon separation from parents and providing satisfactory conditions during mask induction and venous cannulation. No adverse effects of the premedication drugs were observed in any of the groups

Management of Root-Knot Nematode, <em>Meloidogyne Incognita</em> Dreaded Invading in Pointed Gourd (<em>Trichosanthes dioica</em> Roxb.) Crop Prone to Eastern U.P of India

Pointed gourd belongs to cucurbitaceae family and is extensively cultivated in eastern Uttar Pradesh (10000 Hectares), Bihar (14000 hectares), West Bengal, Assam, Orissa, Madhya Pradesh, Maharashtra and Gujrat. Its plants are perennial in nature and can survive for several years even if left uncared. This crop occupies large area of land in India. The system of cultivation varies from region to region such as trained on pandals or ardours especially during the rainy season in southern and western India. However, it is most susceptible to root-knot nematode, Meloidogyne incognita, the population level or density of root-knot nematodes were found in the range of 15–100 per cent of the root and soil samples. This nematode induces severe damage to pointed gourd on coarse-textured sandy soils, particularly during droughts stress. Crop failure is noticed at earlier stage of vines. In view of fact it is necessary to evolve the integrated strategies for management of root-knot nematode in this viny crop

Nutrient Changes in Berries of “Anab-e-Shahi” and “Perllete” Varieties of Grapes with Advancing Phenology in the Growing Season

Understanding how nutrients accumulate and change throughout the developmental stages according to the BBCH scale can be a very effective technique for developing fertilization programmes for high-quality, marketable grape production. Accordingly, the macro- and micronutrient concentrations at different growth stages were analyzed for two commercial grape cultivars, viz., “Anab-e-Shahi” and “Perlette”, by using an extended BBCH scale. The results show nitrogen content was reduced during the sampling period (D1 to D6) from 1.76 percent to 1.09 percent. Potassium concentration in developing berries kept on increasing from 0.15%, at principal growth stage 7 with BBCH code 73 (D1), to 0.26% at principal growth stage 8 code 89 (D6). The lowest phosphorus content of 253.88 ppm and the highest of 338.43 ppm were found in growth stages D1 and D6, respectively. The berry Ca however showed an increase first and thereafter decreased to 225.18 ppm at harvest. Mg content also recorded a similar trend from stages D1 to D6 of the BBCH scale and decreased to 116.08 ppm at D6. B and Cu concentrations increased from D1 to D6, and Mn and Zn increased first and decreased thereafter until harvest. No specific trend was recorded in Fe concentration. The concentration of nutrients in berries at different developmental stages can be used as the standard reference for growing berries using proper fertilization