Post spinal anaesthesia shivering- incidence and associated risk factors in patients undergoing lower limb and abdominal surgeries

Background: This study was conducted to evaluate the incidence of shivering and likely associated risk factors following spinal anaesthesia in patients undergoing lower abdominal and lower limb surgeries.Methods: The present study was conducted in MMIMSR, Department of anaesthesia from December 2016 to September 2018. It was an observational study which was conducted over a period of 2 years. Patients who were scheduled to undergo elective lower abdominal and lower limb surgeries under spinal anaesthesia were included in study.Results: The present study depicts a high incidence of post spinal shivering, which was 42.8%. Majority of the patients belonged to the young age group between 20-30 years. The mean time of onset of shivering, was around 25 mins. Duration of shivering was observed between 15-75 minutess with a mean of 43.75 and SD±19.39.Conclusions: Shivering is one of the distressing complications of spinal block, which may be deleterious to the patients with poor cardio-respiratory reserve

Comparison of Analgesic Efficacy of Caudal Block and Ultrasound Guided TAP Block In Pediatric Patients Undergoing Lower Abdominal Surgeries

Background: Caudal block is the most frequently used regional anesthetic for pediatric analgesia, technique with the disadvantage of limited duration of action associated with an undesired motor blockade and other complications. Recently, the transversus abdominis plane (TAP) block has been described as an effective technique to reduce postoperative pain intensity and morphine consumption after lower abdominal surgery. Materials & Methods: This prospective, randomized, controlled study included 40 children aged between 1 to 10 years, scheduled for elective lower abdominal surgery and divided into two groups in a double-blinded randomized manner. Group A (n=20): received single caudal dose with isobaric bupivacaine 0.25% (1.25ml/kg) and Group B (n=20): received an ultrasound guided TAB block with isobaric bupivacaine 0.25% (0.3ml/kg). The primary outcomes were the time to first analgesia in minutes and the analgesic doses (intravenous acetaminophen and rectal diclofenac) required during the first 24 h postoperatively. The secondary outcome measures included FLACC pain scale score and intraoperative hemodynamic variables. Results: No significant difference between two groups regarding demographic data and intraoperative hemodynamic values. Group B (TAP block) had a significantly longer time to first analgesia (638.50 ± 63.8 vs 268.53 ± 58.15 min) and required significantly lower doses of acetaminophen (320.5 ± 151.05 vs 653.05 ± 105.52 mg) and rectal diclofenac (0, 0, 0 vs. 0, 0, 25 mg) than group A (Caudal block). FLACC pain scale score was significantly lower in group B than in group A (P < 0.05) at 2, 4, 6, 8, 10, 12, 16, 18, 20, and 24 h postoperatively. Conclusion: TAP block provided superior analgesia compared with single dose caudal block injection with isobaric bupivacaine 0.25% in the first 24hours after surgery