ABSTRACT
BACKGROUND: The quality and duration of analgesia is improved when a local anesthetic is combined with alpha 2 adrenergic agonist. Though, the effects of clonidine on local anesthetics have been extensively studied, there are limited studies demonstrating the effects of epidural dexmedetomidine on local anesthetics. The aim of our study is to compare the effect of clonidine and dexmedetomidine when used as an adjuvant to epidural ropivacaine in lower abdominal and lower limb surgeries. MATERIALS AND METHODS: Patients were randomized into two groups-group ropivacaine with clonidine (RC) received 15 ml of 0.75% ropivacaine with 1 µg/kg clonidine and group ropivacaine with dexmedetomidine (RD) received 15 ml of 0.75% ropivacaine with 1 µg/kg dexmedetomidine epidurally. Onset of sensory analgesia using cold swab, onset of motor blockade using Bromage scale, time to 2 dermatome regression of sensory level, time to first demand for analgesia, sedation using Ramsay sedation scale, intra operative hemodynamic parameters and complications were assessed. RESULTS: The onset (RD-8.53 ± 1.81, RC-11.93 ± 1.96) and duration of sensory blockade (RD-316 ± 31.5, RC-281 ± 37, sedation were found to be significantly better in the dexmedetomidine group. No significant difference was found in terms of onset of motor blockade and hemodynamic changes. CONCLUSION: Dexmedetomidine at doses of 1 µg/kg is an effective adjuvant to ropivacaine for epidural anesthesia, which is comparable to clonidine.
ABSTRACT
BACKGROUND: Truview(PCD) laryngoscope is specially designed to aid positioning of the endotracheal tube as well as to record entry of the tube into glottis. Aim of the study is to compare the view of glottic opening and ease of intubation between Truview(PCD) laryngoscope and Macintosh laryngoscope in patients undergoing general anesthesia (GA). METHODOLOGY: Two hundred patients undergoing elective surgery, under GA were randomized into two groups, Group TV and Group ML. In Group TV, Trueview(PCD) laryngoscope was used initially to visualize the vocal cords for Cormack and Lehane grading (CLG) and to spray the vocal cords with 10% lignocaine. Then the patient was ventilated for 1 min and Macintosh laryngoscope was used to visualize the vocal cords for CLG and proceed with intubation. In Group ML, Macintosh laryngoscope was used initially and later Truview(PCD) laryngoscope. Time to intubation, CLG, number of attempts and hemodynamic parameters were recorded. RESULTS: Ninety-six and 89 patients had CLG1 visualization when Truview(PCD) laryngoscope was used as 1(st) and 2(nd) device respectively compared to 41 and 68 with Macintosh laryngoscope (P = 0.00). Four patients had CLG 4 visualization with Macintosh laryngoscope that turned out to be grade II visualization with Truview(PCD) laryngoscope (P = 0.00). Mean time taken for intubation with Truview(PCD) and Macintosh laryngoscope was 21.10 ± 5.64 s and 15.79 ± 2.76 s respectively (P = 0.00). CONCLUSION: Better visualization with lesser CLG was found with Truview(PCD) laryngoscope but it took longer time for intubation than Macintosh laryngoscope. The hemodynamic response to intubation was significantly less with the use of Truview(PCD) laryngoscope when compared to that of Macintosh laryngoscope.