Morrisrobertson0056

This study aims to evaluate the analgesic effect of ultrasound-guided erector spinae plane block (ESPB) in paediatric lower abdominal surgeries.

Randomised, prospective trial. Forty patients, aged 2-10 years with the American Society of Anesthesiologists Score of I and II scheduled for elective lower abdominal surgery were included in the study.

Patients were randomised into two groups as control group and ESPB group. Ultrasound-guided erector spinae plane block at L1 vertebral level was performed preoperatively using 0.5 ml/kg 0.25% bupivacaine (max 20 ml) for the patients in ESPB group. Analgesic requirements and time to first analgesic requirement were recorded and Face, Legs, Activity, Cry and Consolability (FLACC) scores for pain were recorded at 0, 1, 2, 3, 6, 12 and 24 h postoperatively.

Forty patients were included in the final analyses. Significant difference was determined between the groups on post-operative morphine requirement and FLACC scores at 3 h and 6 h postoperatively (

< 0.05). Significant difference was also determined in time to first dose of rescue analgesia between the groups (

< 0.05).

This study shows that the ESPB provides adequate post-operative analgesia in paediatric patients undergoing lower abdominal surgery.

This study shows that the ESPB provides adequate post-operative analgesia in paediatric patients undergoing lower abdominal surgery.

Rapid emergence with low soluble inhalational agents (IA) is offset by a significant association with emergence agitation (EA). Research on the influence of elimination methods of IA on recovery characteristics is very few. We conducted this study to compare the recovery characteristics of slow elimination (SE) of desflurane with purging technique.

Forty-five participants, 18-60 years, undergoing elective laparoscopic surgeries were randomised either into Group-P (

= 23) or Group-SE (

= 22). A standardised induction-maintenance protocol including desflurane and fresh gas flow (FGF) of 0.8 l/min was followed. During recovery, the FGF was increased in Group-P to 10 L/min and in Group-SE it was continued at 0.8 L/min. The decrement in end-tidal concentration of desflurane, time for emergence and extubation, EA and time for psychomotor recovery were noted.

Time for emergence (Group-SE 22.8 ± 9 vs. Group-P 5.6 ± 1.5 min;

= 0.000) and emergence to extubation duration (Group-SE 128 ± 36 s vs. Group-P 11.5 ± 1.7 s;

= 0.000) were longer in the Group-SE than in Group-P. EA occurred in 22.7% patients in Group-SE and in 4.3% patients in Group-P (

= 0.07). Psychomotor recovery to baseline values was seen in more number of patients in Group-SE than Group-P at 30 min. There was no difference between the groups at 60 min post-extubation.

Slow elimination using FGF of 0.8 L/min significantly prolongs emergence even with low soluble agent like desflurane. SE is not beneficial in decreasing the incidence of EA or hastening psychomotor recovery. Purging technique is, therefore, a better-suited technique with fewer complications for eliminating desflurane.

Slow elimination using FGF of 0.8 L/min significantly prolongs emergence even with low soluble agent like desflurane. SE is not beneficial in decreasing the incidence of EA or hastening psychomotor recovery. Purging technique is, therefore, a better-suited technique with fewer complications for eliminating desflurane.

To assess and compare the effect of bilateral continuous rectus sheath infusion (CRSB) for postoperative analgesia with continuous thoracic epidural infusion (TEA) in patients undergoing midline incision laparotomies.

A prospective, randomised study involving sixty patients with Indian Society of Anesthesiologists (ASA) grade I to III, planned for elective laparotomy were enrolled for the study. Patients were randomly allocated into two groups. In the TEA group, an epidural was sited before induction of general anaesthesia (GA), whereas in the CRSB group, bilateral ultrasound-guided RSB catheters were placed at the end of the surgical procedure, before extubation. Both groups received continuous 0.2% Ropivacaine infusion for postoperative analgesia. They were followed for two post-operative days (POD), for the opioid requirement and post-operative pain at rest, coughing, and moving. Age and body mass index (BMI) were compared using independent

-test and visual analogue scale (VAS) scores were compared by the Mann-Whitney test between the two groups. Opioid consumption, gender, and type of surgery were compared using the Chi-Square test. Statistical analysis was done using Statistical Package for Social Sciences (SPSS 21.0).

Opioid consumption in both groups was comparable, for the first two post-operative days with no statistically significant difference. check details Pain scores were comparable among the groups at all times except postoperative day (POD) 0 (4 h and 12 h postop) and POD 2 (8 AM and 12 PM), where lower pain scores were observed in CRSB Group.

As a part of the multimodal analgesia technique, CRSB offers a reliable, safe, and effective alternative to TEA.

As a part of the multimodal analgesia technique, CRSB offers a reliable, safe, and effective alternative to TEA.

Myocardial injury after non-cardiac surgery (MINS) is associated with high postoperative mortality. We sought to examine the intraoperative variables associated with MINS among high-risk patients undergoing abdominal surgery at a South Indian Centre.

A retrospective analysis of patients who underwent abdominal surgery, aged >45 years with one of five factors hypertension, diabetes mellitus, previous coronary artery disease (CAD), stroke, or peripheral vascular disease or all patients >65 years of age was undertaken. Forty-six patients with raised troponin Group

(Trop I > 0.03 ng/d) were compared with 125 troponin-negative patients Group N (Trop I < 0.012 ng/dL) as well as 51 with intermediate levels Group I (Trop I > 0.012 and < 0.03 ng/dL). We evaluated the association of pre and intraoperative factors on MINS using logistic regression to identify the explanatory variables.

Demographics were similar among the three groups. In-hospital mortality was significantly higher in group

(

= 0.