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Indian Journal of Anesthesia and Analgesia

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Comparison of Postoperative Analgesia Following Epidural Bupivacaine and Epidural Bupivacaine with Verapamil in Orthopaedic Lower Limb Surgeries

Dilip Chandar D , Suresh Kumar K1 , Dilip Chandar D2 , Deepa Lakshmi3 , Shanmuga Piriya K4 , Meenakshi R5

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Indian Journal of Anesthesia and Analgesia 6(5):p 1834-1839, September-October 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.49

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Suresh Kumar K, Dilip Chandar D, Deepa Lakshmi et al. Comparison of Postoperative Analgesia Following Epidural Bupivacaine and Epidural Bupivacaine with Verapamil in Orthopaedic Lower Limb Surgeries. Indian J Anesth Analg. 2019;6(5 P-II):1834-1839.

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Abstract

Introduction: Various attempts have been made to prolong neuraxial blockade. Calcium channel blockers have shown to inhibit pain pathway. In this study verapamil was added along with local anesthetic via epidural route. Materials and Methods: A double-blind randomized controlled study done with 40 ASA I and II patients undergoing elective lower limb orthopedic surgery by randomly allocating them into two groups each consisting of 20 patients. Under aseptic precautions epidural catheter was placed in L2–L3 interspace in all patients. Patients belonging to Group P received 12 ml of Inj. Bupivacaine 0.25% + 2 ml of normal saline and Patients belonging to Group V received 12 ml of Inj. Bupivacaine 0.25% + 5 mg of Inj.Verapamil diluted to 2 ml. And further supplementary doses were done with 6 ml of 0.25% Bupivacaine every 60 minutes. The intraoperative and postoperative vitals were monitored and intensity of pain was measured by using the verbal rating pain scale at 2, 6, 12, 24, 48 hour intervals. Results: The observations were analyzed using student t test. The postoperative pain score (verbal rating scale) was found to be low at all time intervals (2, 6, 12, 24, and 48 hrs) in Group V when compared to Group P. Significantly low-pain scores were observed at 2, 6, 12 and 48 hours intervals in patients belonging to Group V (p < 0.01 at 2, 6, and 48 hours intervals and p <0.05 at 12 hours interval) than Group P. Conclusion: Pain relief was significantly better (p < 0.05) in patients who received epidural bupivacaine with verapamil mixture than the patients who received epidural bupivacaine with placebo.

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Suresh Kumar K, Dilip Chandar D, Deepa Lakshmi et al. Comparison of Postoperative Analgesia Following Epidural Bupivacaine and Epidural Bupivacaine with Verapamil in Orthopaedic Lower Limb Surgeries. Indian J Anesth Analg. 2019;6(5 P-II):1834-1839.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.49

Keywords

Epidural; Verapamil; Additive; Calcium channel blocker.

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