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Malhotra, Naveen
- Intermittent Versus Continuous Epidural Infusion Technique for Post Operative Analgesia
Authors
1 Kanika Department of Anaesthesiology and Critical Care, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, IN
Source
Northern Journal of ISA, Vol 1, No 1 (2016), Pagination: 24-28Abstract
Background and Aim: A consensus is yet to evolve over which of the two techniques, continuous epidural infusion or intermittent epidural bolus is better for post-op pain relief. The present study was undertaken to compare the efficacy of postoperative pain relief between continuous and bolus administrations of epidural bupivacaine and fentanyl solution. Material and Methods: The prospective, randomized study was conducted in 60 ASA I and ASA II patients of either sex, 20-50 years age scheduled for orthopedic lower limb surgery. Combined spinal epidural anaesthesia was administered to all the patients. Following an epidural loading dose of 10 ml of 0.0625% bupivacaine with fentanyl 1.5 μg ml-1 post-operatively, group I (n = 30) patients received intermittent bolus of 10 ml of 0.0625% bupivacaine with fentanyl 1.5 μg mlml-1 at an hourly interval for 24 hours and group II (n = 30) patients received same drug combination through continuous epidural infusion technique at a rate of 10 ml hr-1 for 24 hours. Following variables were assessed during the study period of 24 hours: Pulse rate, blood pressure, respiratory rate, pulse oximetry (SpO2), pain score (VAS), pruritus score, sedation score, sensory block and motor block. All the parameters were analysed statistically by adopting appropriate statistical tests. Results: On comparison, pain scores were statistically not significant in both groups (p>0.05). When compared within the respective groups, variation in pain score, both at rest and on movement, from the baseline value (zero hours postoperatively) were statistically not significant at all the time intervals in both the groups (p>0.05). Fifteen patients in the group I and five patients in group II required rescue analgesia (p<0.05). Thirteen patients (46.6%) in group I and 19 patients (63.33%) in group II assessed pain relief as excellent at the end of 24 hours of epidural analgesia (p<0.05). No adverse effects were observed in any of the patients. Conclusion: Continuous epidural infusion of a combination of bupivacaine and fentanyl provides better postoperative analgesia requiring less rescue analgesia than intermittent epidural bolus technique.
Keywords
Bupivacaine, Continuous Epidural Infusion, Epidural Analgesia, Fentanyl, Intermittent Epidural Bolus, Postoperative Analgesia.Full Text
References
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- Enhancing Motivation and Minimizing Constraints in Research Academics:An Acute Need for a Growing Specialty
Authors
1 Department of Anaesthesiology and Intensive Care, GSMCH, Banur, Patiala - 140506 Punjab, IN
2 Department of Anaesthesiology and Intensive Care, PGIMS, Rohtak – 124514, Haryana, IN
Source
Northern Journal of ISA, Vol 3, No 1 (2018), Pagination: 1-3Abstract
In 1946, when Sir Morton demonstrated the ETHER SHOW, nobody would have thought in their wildest of dreams that such innovation will mark the beginning of a much safer surgical atmosphere. It was his motivation, innovative thinking, and dedication that led to birth of a newer specialty, The Anaesthesia. The next few decades saw more of such innovations which led to the further development and advancement of our specialty. However, during all these times research academics played a minimal role and it was mainly the motivation and dedication of individuals which helped in advancement of the specialty with their hard work.References
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