No abstract

Introduction: Anaesthesia for these patients undergoing for interventional procedures in paediatric patients with congenital cardiac anomalies remains a challenge for the anaesthesiologist. There are no specific techniques to follow and anaesthetic procedure is modified according to the cardiac anomalies, clinical condition of the patients and the cardiologist’s requirements. Basically the anaesthesiologist can either provide sedation or general anaesthesia. Objective: The aim of this study was to compare the sedation level, haemodynamic effects and recovery patterns in paediatric patients undergoing sedation for cardiac catheterization either with dexmedetomidine-ketamine or propofol-ketamine combination. Materials & Methods: Sixty patients between the ages of 1 to 12 years were scheduled for cardiac catheterization at Cardiac Catheterization Laboratory of Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, India for a period of six months (April to September 2012) for evaluation and intervention of congenital heart disease. Patients were randomly divided into 2 groups of 30 each. All patients were premedicated with intravenous midazolam (0.05mg/kg upto 2 mg) and glycopyrrolate (10 ?g/kg) 5 minutes before the procedure and anaesthesia was induced with ketamine 1mg/kg. The dexmedetomidine-ketamine group (group D, n=30), received dexmedetomidine 1?g/kg over 10 minutes. 19 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 Propfol-ketamine group (group P, n=30) received 50?g/kg/min of propofol by infusion. Heart rate (HR), Systolic Blood Pressure ( SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP), peripheral oxygen saturation (SpO2), respiratory rate (RR), and modified Steward score of all patients was recorded at baseline, after induction and every 10 minutes thereafter. The time to reach a modified Steward score of >or=6 was recorded. Results: Recovery time was significantly less in group P (mean 39±12.32mins) than in group D (mean 48±15.15mins). Statistical significant difference (p<0.05) was found between group D and P regarding systolic blood pressure (64.48 ± 11.21mmHg vs 56.06 ± 10.13mmHg), diastolic blood pressure (40.08 ± 8.00 mmHg vs 35.05 ± 6.64 mmHg) and mean arterial pressure (48.32 ± 8.34 mmHg vs 42.39 ± 7.98 mmHg). For maintenance less additional ketamine was required in group D (22.76±11.87mg) than group P (25.10±20.73mg) but this was not statistically significant. Conclusion: Clinical outcome of both groups was similar and there was no significant difference in the recovery patterns and haemodynamic status and hence it is concluded that either of the techniques is suitable for children undergoing catheterization and interventional procedures. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22898 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

No abstract

A prospective study was carried on 120 patients undergoing surgical operations lasting less than 90 minutes. The incidence of postoperative sore throat, dysphasia and hoarseness of voice with 2% lidocaine (Group L) as endotracheal cuff inflating agent was compared with that with distilled water (Group D) and air (Group A). Seventy two percent of lidocaine group in comparison to 60% distilled water group and 37% air group experienced none of the above complications during the entire study period. Only 5% in lidocaine group had sore throat after 22-24 hours compared to 20% in the distilled water group and 45% in the air group. Twenty three percent complained of dysphasia in both lidocaine and distilled water group after 1-3 hours compared to 45% in air group. After 22-24 hours it completely resolved in lidocaine group compared to 20% persisting in the other two groups. Twenty three percent complained of hoarseness in lidocaine group as compared to 35% and 55% in distilled water and air groups respectively after 1-3 hours. This completely resolved in lidocaine group but persisted in 20% and 45% in the distilled water and air group respectively after 22-24 hours. The results showed an advantage in using lidocaine as an endotracheal tube cuff inflating agent in reducing postoperative sore throat, dysphasia and hoarseness in comparison to distilled water and air.

Background: Moderate to severe pain develop after knee surgery results prolong hospital stay and delay return to normal daily activities. Various analgesic modalities have been used for postoperative analgesia in patients undergoing knee surgery. Both femoral nerve block (FNB) block and fascia iliaca compartment block (FIB) are used routinely for postoperative pain relief in patients undergoing knee surgery. Objectives: To compare the efficacy of postoperative analgesia of FNB & FIB in postoperative period among patients undergoing knee surgery under sub- arachnoid block. Methods: This Randomized Clinical Trial was performed in Combined Military Hospital (CMH), Dhaka from July 2020 to December 2020. Forty patients scheduled for routine knee surgery under sub-arachnoid block belonging to ASA class I, II and III were included in the study and randomly divided into two groups with 20 patients in each group. At the end of surgery, In Group A (n= 20) femoral nerve block was employed & in Group B (n=20) fascia iliaca compartment block was employed. Results: Significant relief of pain occurred in recovery room in group B than group A (3.67±0.802 vs 4.3±0.877; p<0.05). This improvement was noticed in group B at 6 and 24 hours follow up (p<0.05 in all follow up). Post-operative analgesic consumptions was also lower in group B at 1, 12 & 24 hours follow up (p<0.05 in all follow up). Demographic characteristics were similar across the two groups in terms of age, sex, BMI and ASA grading (p>0.05 in all cases). No significant difference was noted in both pre-operative, post-operative and recovery room heart rate (p>0.05) and mean arterial pressure (p>0.05). Complication was similar in both groups. Conclusion: Fascia iliaca compartment block (FIB) for management of post-operative analgesia in knee surgery is more effective than femoral nerve block (FNB).