Journal on Recent Advances in Pain

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2015 | September-December | Volume 1 | Issue 2

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EDITORIAL

R Gurumoorthi

Platelet Rich Plasma, Platelet Lysate, Freeze-dried Platelets and Next

[Year:2015] [Month:September-December] [Volume:1] [Number:2] [Pages:2] [Pages No:65 - 66]

   DOI: 10.5005/jp-journals-10046-0013  |  Open Access |  How to cite  | 

3,970

RESEARCH ARTICLE

Ashutosh Singh, Anoop Singh Negi, Mayank Gupta

Comparison of Effect of Intrathecal Buprenorphine vs Clonidine as an Adjuvant to Hyperbaric Bupivacaine on Subarachnoid Block Characteristics

[Year:2015] [Month:September-December] [Volume:1] [Number:2] [Pages:6] [Pages No:67 - 72]

   DOI: 10.5005/jp-journals-10046-0014  |  Open Access |  How to cite  | 

Abstract

Background and aims

There are very few reported clinical trials with direct comparison of buprenorphine and clonidine on subarachnoid block characteristics. The aim of the present study was to compare the effect of buprenorphine 75 μg and clonidine 37.5 μg as an adjuvant to 15 mg of 0.5% bupivacaine in lower limb surgeries with respect to the subarachnoid block characteristics, postoperative analgesia and side-effects.

Methods

One hundred patients of 15 to 60 years, either sex and American Society of Anesthesiologist (ASA) I/II undergoing elective lower limb surgeries under planned spinal anesthesia were included and randomly allocated into two equal groups (n = 50 each) to receive 3 ml of intrathecal 0.5% bupivacaine (heavy) with either clonidine 37.5 μg (group C) or buprenorphine 75 μg (group B) to a total volume of 3.25 ml. The patients were evaluated with respect to various sensory and motor block characteristics, duration of postoperative analgesia and adverse effects.

Result

Both the groups were comparable with respect to demographic profile. There was significant prolongation in the duration of sensory block (119.26 ± 24.56 vs 79.40 ± 15.67; p = 0.0), motor block (277.90 ± 37.56 vs 198.80 ± 42.21; p = 0.0) and postoperative analgesia (355.80 ± 63.85 vs 283.20 ± 51.84; p = 0.0) in group C compared with group B. There was clinically significant earlier onset of maximum sensory block (9.20 ± 5.69 vs 11.90 ± 4.78; p = 0.018) and motor block (5.10 ± 3.39 vs 11.90 ± 4.78; p = 0.018) in group C compared with group B however the results were statistically significant only for time to attain maximum sensory block. The incidence of shivering was significantly lower in group C compared with group B.

Conclusion

Intrathecal 37.5 μg clonidine seems to be an attractive alternative to 75 μg buprenorphine as an adjuvant to spinal bupivacaine in terms of duration of sensory and motor blockade, postoperative analgesia and having less side-effects.

How to cite this article

Negi AS, Gupta M, Singh A. Comparison of Effect of Intrathecal Buprenorphine vs Clonidine as an Adjuvant to Hyperbaric Bupivacaine on Subarachnoid Block Characteristics. J Recent Adv Pain 2015;1(2):67-72.

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RESEARCH ARTICLE

Usha Bafna, Sindhu Sapru, Mamta Khandelwal, Varsha Kothari, Rajni Mathur

Comparison of Clonidine and Dexmedetomidine as an Adjuvant to 0.5% Ropivacaine in Supraclavicular Brachial Plexus Block: A Prospective, Randomized, Double-blind and Controlled Study

[Year:2015] [Month:September-December] [Volume:1] [Number:2] [Pages:5] [Pages No:73 - 77]

   DOI: 10.5005/jp-journals-10046-0015  |  Open Access |  How to cite  | 

Abstract

Background

Brachial plexus blockade is the cornerstone of regional anesthesia practice. This study was done to compare clonidine and dexmedetomidine as an adjuvant to 0.5% ropivacaine in supraclavicular brachial plexus block (SCB).

Materials and methods

A prospective, randomized, double-blind study was done in 120 patients of American Society of Anaesthesiologist (ASA) grade I and II undergoing elective upper limb surgery under SCB. Patients were randomized into three groups. Group 1 (n = 40) received 30 ml of 0.5% ropivacaine, group 2 (n = 40) received 30 ml of 0.5% ropivacaine with 2 mg/kg clonidine, and group 3 (n = 40) received 30 ml of 0.5% ropivacaine with 1 mg/kg dexmedetomidine. Onset and recovery time of sensory and motor block, duration of analgesia and quality of block, hemodynamic variables, and level of sedation were studied in the three groups.

Results

Sensory and motor block onset times were shorter in group 3 than in group 1 and 2 (p < 0.0001). Sensory and motor block durations and duration of analgesia were longer in group 3 than in groups 1 and 2 (p < 0.0001). Blood pressure and heart rate were lower in group 3 as compared to groups 1 and 2 (p < 0.0001). The number of patients achieving grade IV quality of block was higher in group 3 as compared to the other groups.

Conclusion

Dexmedetomidine when added in SCB shortened the onset of sensory and motor block and enhances the duration of sensory and motor block and duration of analgesia without significant side effects.

How to cite this article

Bafna U, Sharma G, Sapru S, Khandelwal M, Kothari V, Mathur R. Comparison of Clonidine and Dexmedetomidine as an Adjuvant to 0.5% Ropivacaine in Supraclavicular Brachial Plexus Block: A Prospective, Randomized, Double-blind and Controlled Study. J Recent Adv Pain 2015;1(2):73-77.

3,382

RESEARCH ARTICLE

Mohammad Ilyas, Dilip Chandar

Comparison of Suprascapular Nerve Block (A Novel Technique) and a Combination of Suprascapular Nerve Block Plus Intra-articular Injection in Chronic Shoulder Pain

[Year:2015] [Month:September-December] [Volume:1] [Number:2] [Pages:5] [Pages No:78 - 82]

   DOI: 10.5005/jp-journals-10046-0016  |  Open Access |  How to cite  | 

Abstract

Background

Both suprascapular nerve block (SSNB) and intra-articular injection are effective methods for the treatment of chronic shoulder pain. Recently, intra-articular steroid injection (IAI) and SSNB have become popular.

Aims and objectives

To assess and compare the relative effectiveness of a novel technique of SSNB and combined SSNB and IAI steroid on relief of chronic shoulder pain.

Materials and methods

A total of 40 patients were randomized to the two groups. Group A received SSNB by our novel technique, and group B received combined SSNB and IAI. Visual analog scale (VAS) for pain and shoulder pain disability index (SPADI) were assessed before giving the blocks and IAI and at both the follow-up visits, i.e. at 1 and 4 weeks.

Result

Significant improvements were seen in all pain scores and disability in the shoulders in both the groups. Improvements in pain and disability scores were clinically and statistically significant.

Conclusion

Combined IAI and SSNB were found to be better than SSNB alone.

How to cite this article

Chansoria M, Das G, Ilyas M, Singh R, Chandar D, Vyas N. Comparison of Suprascapular Nerve Block (A Novel Technique) and a Combination of Suprascapular Nerve Block Plus Intra-articular Injection in Chronic Shoulder Pain. J Recent Adv Pain 2015;1(2):78-82.

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REVIEW ARTICLE

Breakthrough Pain

[Year:2015] [Month:September-December] [Volume:1] [Number:2] [Pages:4] [Pages No:83 - 86]

   DOI: 10.5005/jp-journals-10046-0017  |  Open Access |  How to cite  | 

Abstract

Introduction

Breakthrough pain has been defined in recent guidelines as ‘transitory exacerbations of pain that occur on a background of stable pain otherwise adequately controlled by around-the-clock opioid therapy’ or as ‘a transient exacerbation of pain that occurs either spontaneously, or in relation to a specific predictable or unpredictable trigger, despite relatively stable and adequately controlled background pain.’

Types and diagnosis

In general, breakthrough pain can be characterized as incident pain, spontaneous pain, or end-of-dose pain. Assessment is a key step toward adequately managing breakthrough pain in cancer, which is an extraordinarily heterogeneous condition involving different underlying diseases, clinical features and natural histories.

Conclusion

All of the evidence-based guidelines on managing idiopathic breakthrough pain in cancer include rapid-acting opioids as a treatment option, most of which also include fentanyl formulations. A continuity of care is the key to provide the best possible outcome.

How to cite this article

Chansoria M, Upadhyay R, Vyas N. Breakthrough Pain. J Recent Adv Pain 2015;1(2):83-86.

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REVIEW ARTICLE

Rammurthy Kulkarni

Clinical Evaluation of Upper and Mid Back Pain

[Year:2015] [Month:September-December] [Volume:1] [Number:2] [Pages:3] [Pages No:87 - 89]

   DOI: 10.5005/jp-journals-10046-0018  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Kulkarni R. Clinical Evaluation of Upper and Mid Back Pain. J Recent Adv Pain 2015;1(2):87-89.

6,259

RESEARCH ARTICLE

Sayantan Mukhopadhyay, Arindam Hazra

Fluoroscopy-guided Lumbar Sympathetic Block with Bupivacaine and Depot Methyl Prednisolone for Pain Relief in Buerger's Disease—Our Experience

[Year:2015] [Month:September-December] [Volume:1] [Number:2] [Pages:5] [Pages No:90 - 94]

   DOI: 10.5005/jp-journals-10046-0019  |  Open Access |  How to cite  | 

Abstract

Background

Buerger's disease (BD) is a common peripheral vascular disease resulting in severe rest pain, leg ulcer, and claudication pain leading to decreased quality of life and disability. Lumbar chemical sympathectomy is now being used to relieve pain in BD.

Purpose of this study was to assess the effectiveness of lumbar sympathetic block (LSB) in relieving rest pain, ulcer healing, decreased swelling and improvement in claudication distance (CD) for a considerable period.

Materials and methods

This was a prospective observational study on thirty-two consecutive patients, who attended our pain clinic. Each patient received LSB bilaterally under fluoroscopy at L3 level with bupivacaine (0.25%) 10 ml and depot methylprednisolone (20 mg) on each side. As per our departmental protocol, the procedure was repeated for three times at an interval of 6 weeks. We compared the pain by visual analog scale (VAS), CD, healing of leg ulcer, pedal swelling following each injection.

Results

Visual analog scale and claudication distance were improved significantly after second and third compared to first intervention (p < 0.05) but no significant differences observed between second and third intervention. Healing of leg ulcers and decreased pedal swelling were observed after each block.

Conclusion

Multiple doses of fluoroscopy guided LSB with bupivacaine and depot methyl prednisolone is safe and effective in relieving rest pain, improving CD, promoting ulcer healing in patients of BD when conservative therapies are ineffective but how many doses will be optimal is still a matter of debate.

How to cite this article

Bhattacharya D, Mukhopadhyay S, Hazra A. Fluoroscopy-guided Lumbar Sympathetic Block with Bupivacaine and Depot Methyl Prednisolone for Pain Relief in Buerger's Disease—Our Experience. J Recent Adv Pain 2015;1(2):90-94.

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CASE REPORT

Rammurthy Kulkarni

A Case of Symptomatic Lumbar Perineural Cyst

[Year:2015] [Month:September-December] [Volume:1] [Number:2] [Pages:2] [Pages No:95 - 96]

   DOI: 10.5005/jp-journals-10046-0020  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Kulkarni R. A Case of Symptomatic Lumbar Perineural Cyst. J Recent Adv Pain 2015;1(2):95-96.

4,447

CASE REPORT

Ashok Jadon

Bipolar Radiofrequency Ablation of Genicular Nerves in Patients with Pacemaker

[Year:2015] [Month:September-December] [Volume:1] [Number:2] [Pages:3] [Pages No:97 - 99]

   DOI: 10.5005/jp-journals-10046-0021  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Jadon A. Bipolar Radiofrequency Ablation of Genicular Nerves in Patients with Pacemaker. J Recent Adv Pain 2015;1(2):97-99.

3,772

RESEARCH ARTICLE

Sonai Dutta Kakoti

Changing Paradigms in Understanding Pain: The Role of Networks, Genomics and Proteomics

[Year:2015] [Month:September-December] [Volume:1] [Number:2] [Pages:1] [Pages No:100 - 100]

   DOI: 10.5005/jp-journals-10046-0022  |  Open Access |  How to cite  | 

5,667

RESEARCH ARTICLE

Dilip Chandar

Evaluation of Transversus Abdominis Plane Block for Analgesia after Cesarean Section

[Year:2015] [Month:September-December] [Volume:1] [Number:2] [Pages:1] [Pages No:101 - 101]

   DOI: 10.5005/jp-journals-10046-0023  |  Open Access |  How to cite  | 

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