No abstract

Inadequate pain relief in the postoperative phase is a well-known problem world-wide. Aside from the suffering caused by insufficient pain relief, this is an issue with potential adverse physiological and psychological consequences for patients in addition to financial draw backs for caregivers. Poorly managed pain may interfere with postoperative complications, cause patient suffering and prolong recovery. Patients may anticipate future medical interventions with greater anxiety if pain has not been managed effectively in the past. To assess postoperative hemodynamics of intra peritoneal instillation of Ropivacaine and bupivacaine in Laparoscopic surgeries. The present study was conducted at Sri Manakula Vinayagar Medical College and Hospital, Pondicherry in the Department of Anaesthesia. The double blinded randomized experimental study was conducted from October 2017 to May 2019.The sample size of 50 study subjects was selected using the mean pain score at 3.6 with 80% power and 95% confidence interval. In each of the group 25 study subjects were allotted based on randomization. All patients were instilled with 30 ml of solution in a standardized manner by the operating surgeon under vision before removal of trocar at the end of the surgical procedure. Group R received 30 ml (0.2%) ropivacaine and group B received 30 ml (0.25%) bupivacaine. The drugs were prepared and given to the investigator who was blind to the identity of drugs. The heart rate was found to be comparable between two groups at 10 min, 30 Min, 60 Min, 120 Min, 4 Hrs, 8 Hrs, 12 Hrs and at 24 hrs and the p value was found to be non-significant. The Systolic Blood pressure was found to be statistically significant between the two groups at 10 Min, 30 Min, 60 Min, 120 Min, 4 hrs, 8 Hrs and 12 hrs. Whereas at 24 hrs the difference of Systolic Blood Pressure was found to be non-significant. Heart rate was similar in both the study groups at various time intervals. Systolic blood pressure and diastolic blood pressure was significantly high among patients in Bupivacaine group measures in most of the time intervals, while mean blood pressure differences were inconsistent over the follow up period.

BACKGROUNDA Prospective Randomised Control Trial was done to evaluate the effect of Magnesium Sulfate on haemodynamic parameters in patients undergoing elective laparoscopic abdominal surgeries. MATERIALS AND METHODS80 patients were divided into 2 groups of 40 each. Group A received Magnesium Sulfate 50 mg/kg and Group B received 50 mL Normal Saline. Statistical Analysis used-The statistical difference in age, weight, height of the subjects and haemodynamic parameters such as pulse rate, systolic blood pressure, diastolic blood pressure and sedation were compared. Quantitative data is summarised using mean and standard deviation. The difference in mean between quantitative variable was tested using student's 't' test. RESULTSThe baseline characteristics of the Intervention and Control groups were comparable and there was no significant difference between the groups. Systolic and Diastolic BP were higher in Control group than magnesium group. There was no significant difference in sedation levels in both groups. CONCLUSIONIn our study, we conclude that IV magnesium sulfate, when given before pneumoperitoneum attenuates arterial pressure increase during elective laparoscopic abdominal surgeries. This attenuation is apparently related to reductions in the release of catecholamine, vasopressin or both by magnesium sulfate. We also found that there is no adverse effect of magnesium like sedation or prolonged neuromuscular blockade at the dose we used.