Abstract:
INTRODUCTION:Crippling postoperative pain linked with lumbar discectomies not only shackles patient's normal daily activities but also lengthens their hospital stay. So, allaying postoperative pain in these patients has become a substantive component in neuroanesthesia to expedite neurological recovery. Wound infiltration with local anesthetics is widely used to optimize postoperative pain. Different adjuvants like dexmedetomidine and tramadol when added to local anesthetics prolongs postoperative analgesia. The aim of this trial was to evaluate the analgesic efficacy of tramadol and dexmedetomidine when added to ropivacaine for wound infiltration in lumbar discectomies. METHODOLOGY:This study was prospective, randomized, double-blind, controlled in nature conducted among 45 adult patients belonging to American Society of Anesthesiologists' physical status 1 and 2, of either sex aged between 30 and 70 years undergoing elective lumbar discectomies. They were randomly allocated into 3 equal groups: group R received 100 mg of 0.5% ropivacaine (20 mL) and 2 mL normal saline, group RT received 100 mg of 0.5% ropivacaine (20 mL) and 2 mg/kg tramadol (2 mL), and group RD received 100 mg of 0.5% ropivacaine (20 mL) and 0.5 μg/kg dexmedetomidine (2 mL) (total volume, 22 mL). Visual analog scale at 0, 2, 4, 6, 12, 18, and 24 hours; time to first rescue analgesia, total supplemental analgesic consumption and side effects (if any) were assessed during first 24 hours postoperatively. RESULTS:The median time to first rescue analgesia (median; 95% confidence interval [CI]) in group RD was 930 (854.3 to 1005.7) minutes. This was significantly longer (P=0.000) than group RT (420 [366.3 to 473.7] min) or group R (270 [243.2 to 296.8] min). Postoperative diclofenac consumed (median [interquartile range]) was 150 (150 to 200) mg in group R, 150 (75 to 150) mg in group RT and 75 (75 to 150) mg in group RD (P=0.008). Significant differences in mean visual analog scale scores were observed among the 3 groups at hours 0 (P=0.033), 2 (P=0.001), 4 (P=0.000), 6 (P=0.001), and 24 (P=0.013). No statistical significant side effects could be discerned among the groups. CONCLUSIONS:We concluded that wound infiltration with combined ropivacaine and dexmedetomidine found to be significantly superior for postoperative analgesia compared with either combined ropivacaine and tramadol or ropivacaine alone for lumbar discectomies.
journal_name
J Neurosurg Anesthesioljournal_title
Journal of neurosurgical anesthesiologyauthors
Mitra S,Purohit S,Sharma Mdoi
10.1097/ANA.0000000000000422subject
Has Abstractpub_date
2017-10-01 00:00:00pages
433-438issue
4eissn
0898-4921issn
1537-1921journal_volume
29pub_type
杂志文章,随机对照试验abstract::During the past 5 years, the surgical repair for sagittal synostosis has been modified to a more complex and involved procedure. This led to a retrospective evaluation of the current transfusion practice in a large series of craniosynostosis repairs. The charts of 76 patients (81 surgical procedures) undergoing cranio...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199907000-00002
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abstract::The affect of L-644,711, an anion transport inhibitor, on ischemic brain injury and edema was investigated. Spontaneously hypertensive rats were given one of the following doses of intrathecal L-644,711 during 180 min of middle cerebral artery occlusion and 120 min of reperfusion: control, vehicle only; dose I, 100 mi...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199112000-00003
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abstract::The function of the central nervous system-and other organs-depends upon preservation of ionic gradients across cell membranes. In nervous tissue, the ion gradients are especially important since generation of action potentials and synaptic processes relies on transfer of ions across the plasma membrane. This report d...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-198912000-00010
更新日期:1989-12-01 00:00:00
abstract::We provide a synopsis of innovative research, recurring themes, and novel experimental findings pertinent to the care of neurosurgical patients and critically ill patients with neurological diseases. We cover the following broad topics: general neurosurgery, spine surgery, stroke, traumatic brain injury, monitoring, a...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/ANA.0000000000000489
更新日期:2018-04-01 00:00:00
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00008506-199707000-00001
更新日期:1997-07-01 00:00:00
abstract::Translocation of cerebrospinal fluid (CSF) between the intracranial and spinal subarachnoid space was blocked by ligating the cervical spinal core in eight cats under pentobarbital and nitrous oxide anesthesia, and the effects of cerebral venous congestion on the pressure-volume index (PVI), a measure relating the cha...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199304000-00009
更新日期:1993-04-01 00:00:00
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000029
更新日期:2014-07-01 00:00:00
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journal_title:Journal of neurosurgical anesthesiology
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doi:10.1097/ANA.0b013e31822ff779
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199006000-00009
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abstract::Disseminated intravascular coagulation (DIC) is reported in neurosurgical patients; however, the incidence of DIC after craniotomy procedures is unknown. Using a surgical database, we identified 3164 patients who underwent primary craniotomy at Mayo Clinic Rochester between January 1, 2000 and December 31, 2004. Poten...
journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
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journal_title:Journal of neurosurgical anesthesiology
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abstract::The "Lund concept" involving a "volume-targeted" strategy for intracranial pressure control originated in the University of Lund, Sweden, more than 20 years ago and has remained controversial ever since. It is based on the premise that the blood-brain barrier is disrupted after traumatic brain injury and cerebral auto...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,评审
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更新日期:2011-10-01 00:00:00
abstract::The thromboxane receptor antagonist SQ29548 was administered to mongrel dogs after an 11-min period of global cerebral ischemia to test the hypothesis that it would improve delayed postischemic cerebral hypoperfusion (PIH) during concurrent elevations in cerebral venous thromboxane B2 (TxB2), the stable metabolite of ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
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abstract:BACKGROUND:Hyperosmolar solutions have been used in neurosurgery to modify brain bulk and prevent neurological deterioration. The purpose of the study was to compare the effects of equivolume, equiosmolar solutions of mannitol and hypertonic saline (HTS) on brain relaxation and postoperative complications in patients u...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000438
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199601000-00008
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abstract::The effects of flumazenil (a benzodiazepine antagonist) on autoregulation of cerebral blood flow (CBF) were examined in dogs receiving midazolam and in dogs not receiving midazolam. Both groups were anesthetized with halothane (0.3% end-expired) and nitrous oxide (66%) in oxygen. Auto-regulation of CBF was assessed by...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
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更新日期:1994-10-01 00:00:00
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
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更新日期:2015-10-01 00:00:00
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pub_type: 杂志文章
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