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Intra-Operative Efficacy of General Anaesthesia vs General Anaesthesia with Paediatric Epidural Anaesthesia: A Clinical Comparative Study

Uma B.R., Professor, Department of Anaesthesiology, JJM Medical College, Davangere, Karnataka 577004, India. , Uma B.R.1 , Priyadarshini M. Bentur2

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Indian Journal of Anesthesia and Analgesia 5(1):p 93-98, January-February 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5118.14

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Abstract

Background: Paediatric epidural anaesthesia (PEA) is very safe and effective and in combination withGeneral anaesthesia (GA) offers the advantages of reduced GA drugs, stable haemodynamics and excellent analgesia extended into the post-operative period. Aims: To evaluate the efficacy of GA+PEA in comparison to GA with regard to (i) Haemodynamic parameters (ii) dose requirement of Neuromuscular Blocking Agents (NMB) (iii) Quality of surgical relaxation. Material and Methods: 80 children of ASA statusI & II (2 to 12 yrs), scheduled for elective surgeries were randomly assigned to GA or GA+PEA groups. Both the groups received routine GA. In GA+PEA, an epidural catheter was inserted and Bupivacaine 0.25% was administered intraoperatively. Haemodynamic parameters, doses of NMB and quality of surgical relaxation (graded by surgeon) were recorded. Statistical Analysis: Chi-square test, student-t test and repeated measures ANOVA test were used to analyse categorical, demographic and haemodynamic parameters respectively. A p-value<0.05 was considered significant. Results: Rise in heart rate (HR) and mean arterial pressure (MAP) from base-line was significantly lower in GA+PEA with p value of 0.017 and <0.001 respectively. Doses of NMB agents required in GA+PEA were significantly lower with p value <0.001. The grading of quality of surgical relaxation was same in both the groups. Conclusion: GA+PEA is more favourable for patients with regard to stable haemodynamics, reduced requirement of NMB agents with equally good surgical relaxation when compared to GA alone.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5118.14

Keywords

Paediatric Epidural Anaesthesia; General Anaesthesia; Intraoperative; Haemodynamic Parameters; Muscle Relaxant Doses; Surgical Muscle Relaxation. 

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