Comparison of Levobupivacaine with dexmedetomidine in Infraumbilical surgeries
Author(s): Dr. Suresh Kumar Bhargava and Dr. Neena Tiwari
Abstract:Introduction: Due to decreased cardiovascular and central nervous system toxicity, levobupivacaine is a good alternative for spinal anesthesia. Dexmedetomidine when used intrathecally is associated with prolonged motor and sensory block, hemodynamic stability, and less requirement of rescue analgesia in 24 h.
Materials and Methods: We assumed that sevoflurane will provide clinically acceptable conditions for endotracheal intubation comparable to propofol-suxamethonium in children. All patients received diazepam 0.2 mg/kg orally, the night before surgery. The patients were preloaded with Lactated Ringer's solution 15 mL/kg. They were monitored with automated noninvasive blood pressure, pulse oximetry, and electrocardiogram.
Results: In Group LD, increase in VAS was observed at 210 min and the first dose of rescue analgesia was given at 5th h postoperatively. The second dose of recue analgesia was given at 12th h and the third dose was given at 21st h. Postoperative VAS scores at different time intervals were significantly lower in Group LD than Group L, thus indicating superior analgesia. The time of request of the first dose of rescue analgesia was delayed in Group LD as it was demanded at 309.93 ± 23.19 min and in Group L was at 168.30 ± 12.32 min. The difference in the two groups was highly significant (P< 0.001).
Conclusion: Sevoflurane provides clinically acceptable intubating conditions and can be a suitable alternative to propofol-suxamethonium for endotracheal intubation in children.