No abstract

Use of lignocaine and dexmedetomidine in terms of causing hemodymaic variation, sedation and pain management remains a question. Hence this was conducted to compare a bolus dose of dexmedetomidine 0.5mcg/kg/hr to a normal dose of 1.5mg/kg preservative free 2% lignocaine for extubation in patients undergoing craniotomies.This randomized controlled trial was conducted in the department of Anesthesiology at Sri Ramachandra Medical College and Research Institute, Chennai from January 2013 to June 2014. Patients aged between 18-60 years belongs to ASA class I and class II undergoing surgeries were included in the study. A total of fifty cases were included. Statistical analysis was done using SPSS version 17.Hemodynamic parameters showed significant attenuation of hemodynamic response during extubation when compared to lignocaine group and when the same were analyzed within the groups, the attenuation of extubation response was both clinically and statistically significant in both groups. Extubation and emergence time were similar in both the groups. Sedation and pain scores in dexmedetomidine group were low compared to lignocaine group. Single dose of dexmedetomidine given 10 minutes before extubation significantly attenuated the hemodynamic and airway response following extubation as compared to lignocaine given before reversal in patients undergoing craniotomy for intracranial space occupying lesions.

Thoracic epidural anesthesia provides selective blockade for the surgical site, with diminished requirements of opioids and local anaesthetics. If the efficacy of the same is better or equivalent to general anesthesia, the adverse effects with the later can be avoided. Hence this study was conducted to know the effectiveness of thoracic epiduralanesthesia in breast surgeries using 1.5% lignocaine with adrenaline.This prospective cross-sectional study was conducted in the department of Anaesthesiology in association with the Department of Surgery at Raja Muthaiah Medical College and Hospital, Chidambaram from January 2013 to June 2014. Adult female patients aged between 18-60 years belonging to ASA class I, class II and class III undergoing breast surgeries were included in the study. Patients with bleeding diathesis and local infections were excluded from the study. A total of thirty cases were included in the study and efficacy of epidural anaesthesia was determined by monitoring vitals in the peri-operative period. Results were analysed using Statistical package for Social Sciences (SPSS) version 17.Heart rate, blood pressure (both systolic and diastolic) and mean arterial pressure were significantly different with respect to time. Mean duration of rescue analgesia was found to be 127.33±27.62 minutes. Also 10%, 23.3%, 13.3% and 6.7% of cases reported bradycardia, shivering, hypotension and nausea during the intra operative period whereas 10% of cases reported backache and nausea, each during the post-operative period.Thoracic epidural anesthesia for breast surgeries provides good analgesia with minimal amount of drugs without significant complications.