Background and Aims:
Transversus abdominis plane (TAP) block is commonly used to treat post-operative pain after lower abdominal surgeries. The aim of this randomised controlled study was to assess the efficacy of addition of dexmedetomidine or dexamethasone to ropivacaine in TAP block and compare the two for post-operative pain relief in caesarean section.
Methods:
A hundred parturients (18–45 years) undergoing caesarean section under spinal anaesthesia received ultrasound-guided (USG) bilateral TAP block with 50ml of 3mg/kg ropivacaine along with 0.1mg/kg dexamethasone (Group A) or 1μg/kg dexmedetomidine (Group B) in this prospective, randomised, double-blind study. Time to initial self-reporting of post-operative pain, time to first rescue analgesic demand, visual analogue scale (VAS) for pain haemodynamic parameters and adverse effects if any were noted, anda
P
value < 0.005 was considered as statistically significant.
Results:
Time to initial self-reporting of post-operative pain (411.35 vs. 338.20 min,
P
< 0.005) and time to first rescue analgesic (474.30 vs. 407.30 min,
P
< 0.005) were significantly longer in group B as compared to group A. VAS score at the time of initial self-reporting of pain was significantly lower in group B. No significant haemodynamic changes or side-effects were noted.
Conclusion:
Addition of dexmedetomidine to ropivacaine as compared with dexamethasone in bilateral TAP block following caesarean section prolongs the time to initial post-operative pain and time to first rescue analgesic consumption.
Background: The study is to correlate Chest X-ray scoring with the laboratory markers and to determine the oxygen requirement in COVID-19 patients. Methodology: We conducted a retrospective study in COVID confirmed patients in the age group of 18 to 80 years admitted in our health care system. At the time of admission within 24 hours, chest X-ray and blood investigations like complete blood count, C-reactive protein, Lactate Dehydrogenase (LDH), d-dimers, serum ferritin were performed in all the patients. Patients data including his oxygen requirement was collected by electronic medical records. Brixia scoring system was employed to account for the extent and density of airspace opacification. The scoring of the Chest X-ray was correlated to the various blood test. Result: One hundred nine COVID confirmed cases were included in our study. There was a statistically significant correlation between Chest X-ray and age with p = 0.008; chest X-ray and d-dimers with p=0.004. Also patients requiring high oxygen therapy had significantly higher chest X-ray scores (p=0.001) Conclusion: Patient having increased oxygen requirement were found to have higher N/L Ratio, D-dimer and LDH values. Chest X-ray scoring is highly correlated with laboratory findings and disease severity and might be beneficial to speed up the diagnostic workflow in symptomatic patients.
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