Browsing by Author "Singh, Jeevan"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Publication Comparision of Caudal Ropivacaine, Ropivacaine Plus Ketamine and Ropivacaine Plus Fentanyl Administration for Postoperative Analgesia in Children(Nepal Paediatric Society (JNPS), 2012) Singh, Jeevan; Hamal, Dikshya; Karmacharya, AvishAbstract: Introduction: The purpose of the study was to compare the analgesic quality and duration of Ropivacaine 0.2% with the addition of Fentanyl (1 mcg/kg) with that of Ropivacaine 0.2% and the addition of Ketamine (0.5 mg/kg) and also compare the post complications. Materials and Methods: Ninety children, age one to ten years, undergoing sub-umbilical surgery, were prospectively randomized to one of three groups: caudal analgesia with 0.75 ml/kg of 0.2% Ropivacaine in normal saline (Group R) or caudal analgesia with 0.75 ml/kg of 0.2% Ropivacaine with Ketamine 0.5 mg/kg (Group RK) or caudal analgesia with 0.75 ml/kg of 0.2% Ropivacaine with Fentanyl 1 mcg/kg (Group RF). Post-operative pain was assessed for 24 hours using the FLACC scale. Results: The mean duration of analgesia was significantly longer in Group RK (629.06 ± 286.32 min) than other two groups P < 0.05. The pain score assessed using FLACC scale was compared between the three groups, and children in Group RK had lower pain scores, which was statistically significant. The requirement of rescue medicine was lesser in Group RK. Ketamine in a dose of 0.5 mg/kg added to 0.2% bupivacaine for caudal analgesia, during sub-umbilical surgeries, prolongs the duration of analgesia of Ropivacaine, without any side effects in compare to Ropivacaine alone or Fentanyl. Conclusion: We conclude that Ketamine in a dose of 0.5 mg/kg, added to 0.2% Ropivacaine for caudal analgesia and administered as a 0.75 ml/kg mixture in children, for sub-umbilical surgery, significantly prolongs the duration of post-operative analgesia without any side effects.Publication Comparison of the Single Breath Vital Capacity Technique with the Tidal Volume Technique(Nepal Paediatric Society (JNPS), 2018) Singh, Jeevan; Tandukar, Alex; Kharbuja, KalpanaAbstract: Introduction: The single breath vital capacity (VC) induction and the tidal volume (TV) breathing induction are currently administered for inhalation of anaesthesia with sevoflurane in children. The aim of this study was to determine whether the vital capacity technique achieves more rapid induction of anaesthesia in children compared to the conventional tidal volume technique. Material and Methods: Sixty ASA physical status 1 or 2 children aged between 5 and 15 years, scheduled to undergo elective urological, orthopaedic or visceral surgery under general anaesthesia using inhalational induction with sevoflurane were recruited and randomized to receive either vital capacity induction or tidal volume induction with 8% sevoflurane at 6L/min of O2 followed by laryngeal mask airway insertion or endotracheal intubation with endotracheal tube. Time required for induction, hemodynamic changes, airway tolerance, side-effects, level of satisfaction using a visual analogue scale (0-100) and Smiley scale (0-10) were documented. Results: Induction time was significantly shorter with the vital capacity induction technique than with the tidal volume breathing induction technique (43.8 ± 13.4 seconds vs 70.8 ± 16.4 seconds; P<0.01). The time to central myosis, haemodynamic changes and respiratory events incidences were similar in both the group. Fewer complications occurred with vital capacity group. More than 94% of the children choose the single Breath Vital Capacity method of induction to the tidal volume technique. Conclusion: For inhalation induction of anaesthesia, the vital capacity induction was faster and produced less complication than that of tidal volume breathing technique.