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  1. Article ; Online: Effect Of Perineural Administration Of Dexmedetomidine With Bupivacaine Versus Bupivacaine Alone In Ultrasound Guided Supraclavicular Block For Upper Extremity Orthopaedic Operations.

    Khan, Maliha Khalid / Hafeez, Amran / Feroze, Faheem / Tahir, Anjum Atique / Abbasi, Shehzad / Faheem, Muhammad Shaheer Bin / Farooq, Saeed

    Journal of Ayub Medical College, Abbottabad : JAMC

    2024  Volume 35, Issue 3, Page(s) 384–389

    Abstract: Background: During procedures on the upper limbs, the brachial plexus block is usually advised. To increase the length of the block, many medicines have been utilized as adjuvants. The purpose of this study was to compare the effects of dexmedetomidine ... ...

    Abstract Background: During procedures on the upper limbs, the brachial plexus block is usually advised. To increase the length of the block, many medicines have been utilized as adjuvants. The purpose of this study was to compare the effects of dexmedetomidine plus bupivacaine against bupivacaine alone on the onset and duration of the sensory and motor block and the duration of analgesia in the supraclavicular block during upper extremity orthopaedic surgery.
    Methods: Sixty individuals qualified for orthopaedic operations on the upper extremities, ranging in age from 20 to 60 years, participated in this prospective, randomized investigation. The modified Bromage scale and the pinprick method were used to assess the sensory and motor block. Using a visual analogue pain scale, the postoperative pain was evaluated at 0, 6, 12 and 24 hours after surgery.
    Results: In patients receiving only bupivacaine, the mean onset time of sensory and motor block was 32.84 minutes and 26.67 minutes respectively; while in those receiving bupivacaine along with dexmedetomidine, it was 23.38 minutes and 14.81 minutes (p<0.005). In the intervention group (bupivacaine and dexmedetomidine), the period between the first request for analgesia and the duration period of sensory and motor block were both longer (p<0.005). The intervention group experienced less postoperative discomfort for 24 hours (p<0.05).
    Conclusions: Dexmedetomidine added to bupivacaine perineurally prolonged both numbness and immobility while shortening the time it took for sensory and motor blocks to begin. Moreover, dexmedetomidine considerably decreased postoperative pain when combined with bupivacaine for supraclavicular blocks.
    MeSH term(s) Adult ; Humans ; Middle Aged ; Young Adult ; Anesthetics, Local ; Brachial Plexus Block/methods ; Bupivacaine/therapeutic use ; Dexmedetomidine/therapeutic use ; Orthopedics ; Pain, Postoperative/drug therapy ; Pain, Postoperative/prevention & control ; Prospective Studies ; Ultrasonography, Interventional ; Upper Extremity/surgery
    Chemical Substances Anesthetics, Local ; Bupivacaine (Y8335394RO) ; Dexmedetomidine (67VB76HONO)
    Language English
    Publishing date 2024-02-26
    Publishing country Pakistan
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 2192473-9
    ISSN 1819-2718 ; 1025-9589
    ISSN (online) 1819-2718
    ISSN 1025-9589
    DOI 10.55519/JAMC-03-12044
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Comparison Of Hemodynamic Effect Caused By Intrathecal Low Dose Administration Of 0.5% Against 0.75% Hyperbaric Bupivacaine In Patients Undergoing Lower Limb Surgery Under Unilateral Spinal Anaesthesia.

    Khan, Maliha Khalid / Hafiz, Amran / Feroze, Faheem / Tahir, Anjum Atique / Farooq, Saeed / Shaheer Bin Faheem, Muhammad

    Journal of Ayub Medical College, Abbottabad : JAMC

    2024  Volume 35, Issue 4, Page(s) 549–552

    Abstract: Background: Spinal anaesthesia has its unique place in modern anaesthetic practice. In past, most of the surgeries, irrespective of the site of surgery, were performed in general anaesthesia but now in the modern anaesthetic field, spinal anaesthesia ... ...

    Abstract Background: Spinal anaesthesia has its unique place in modern anaesthetic practice. In past, most of the surgeries, irrespective of the site of surgery, were performed in general anaesthesia but now in the modern anaesthetic field, spinal anaesthesia has markedly replaced general anaesthesia, specifically in obstetrics, lower limbs, and abdominal surgeries.
    Methods: A total of 100 patients fit to undergo lower limb surgery between the ages of 20 to 70 years were included in the study. 50 patients were in 0.5% hyperbaric bupivacaine (Group A) while 50 patients were in the 0.75% hyperbaric bupivacaine group (Group B). Patients with a history of allergies to local anaesthetics, ischemic heart disease and contraindications to spinal anaesthesia were excluded. At the end of the injection, the patient was immediately laid down and tilted to 30 degrees lateral on the operative side for unilateral anaesthesia. Mean arterial pressure at baseline, 15, 30, 45 and 60 minutes was recorded by trainee anaesthesia. A baseline was taken of mean arterial pressure measured 15 minutes before induction of spinal anaesthesia in a lying position.
    Results: The mean baseline arterial pressure of patients in group A was 88.72±1.71 mmHg and in group B was 88.94±1.95 mmHg. Mean arterial pressure MAP at 15, 30, 45 and 60 minutes in both groups was as follows; 86.22±2.55 vs 81.78±1.52 mmHg, 83.72±3.36 vs 75.84±1.34 mmHg, 80.02±3.40 vs 70.90±0.97 mmHg and 77.14±4.24 vs 66.06±1.62 mmHg respectively (p-value <0.05).
    Conclusions: This study concluded that the hemodynamic parameters in terms of mean arterial pressure remained more stable by deviating less from the baseline value with the use of a low dose of 0.5% hyperbaric bupivacaine instead of 0.75% hyperbaric bupivacaine in patients undergoing lower limb surgery under unilateral spinal anaesthesia.
    MeSH term(s) Pregnancy ; Female ; Humans ; Young Adult ; Adult ; Middle Aged ; Aged ; Bupivacaine ; Anesthesia, Spinal ; Anesthetics, Local ; Hemodynamics ; Lower Extremity/surgery
    Chemical Substances Bupivacaine (Y8335394RO) ; Anesthetics, Local
    Language English
    Publishing date 2024-02-26
    Publishing country Pakistan
    Document type Journal Article
    ZDB-ID 2192473-9
    ISSN 1819-2718 ; 1025-9589
    ISSN (online) 1819-2718
    ISSN 1025-9589
    DOI 10.55519/JAMC-04-12270
    Database MEDical Literature Analysis and Retrieval System OnLINE

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