The Ideal Secrets And Techniques For Megestrol Acetate

The epidural space was identified at L2�CL3 interspace with 18 G Tuohy needle using loss of resistance technique under strict asepsis, and a 20 G epidural catheter was then advanced into the epidural space. Correct placement of epidural catheter was verified with a test dose of 3 ml of lignocaine (2%) with adrenaline (1: 200,000). Group C received injection clonidine 150 ��g, diluted to 5 ml in normal saline (NS) via epidural catheter 10 min before SAB. Group S received 5 ml NS 10 min before SAB. Hyperbaric bupivacaine 0.5%, 15 mg Gemcitabine (3 ml) was given intrathecally to both groups at L3�CL4 interspace using 27G Quincke needle. Sensory block was assessed bilaterally using loss of sensation to pinprick with a short hypodermic needle in midclavicular line. Motor blockade was assessed using modified Bromage scale [9] (0: No motor block; 1: Inability to raise extended legs; 2: Inability to flex knees; 3: Inability to flex ankle joints). Surgery was commenced after sensory block at T6 dermatome was attained. In this study, onset of sensory block was defined as time taken to achieve loss of sensation to pinprick at L1 dermatome level following SAB. Time taken to achieve Bromage 3 following SAB was defined as onset of motor block. Time taken for two segment regression Birinapant molecular weight of sensory block was noted, and time taken for motor block to recede from Bromage 3 to Bromage 0 was recorded as the duration of motor block. Basal heart rate (HR), respiratory rate, non-invasive arterial blood pressure and oxygen saturation were recorded before placement of epidural catheter and every 5 min till the end of surgery. Intra- and post-operative sedation was assessed using Ramsay Sedation Score [10] (1: Anxious or restless or both, 2: Co-operative, oriented and tranquil, 3: Responding to commands, 4: Asleep, brisk response to light, glabellar tap or auditory stimuli, 5: Asleep, sluggish response, 6: Asleep, unarousable). Post-operatively, pain was assessed using visual analogue scale [11] (VAS) (0: No pain, 2�C4: Mild pain, 5�C7: Moderate pain, 8�C10: Worst pain). Duration of analgesia was the time from Megestrol Acetate onset of sensory block at L1 till the patient complained of pain. Rescue analgesic injection tramadol 2 mg/kg was given via epidural catheter when patient requested for analgesic or VAS >4. Sedation score, VAS and haemodynamic parameters were observed at 30 min, 60 min, 2nd, 3rd, 4th, 5th and 6th h post-operatively. Hypotension was defined as systolic blood pressure 30% decrease in baseline mean arterial pressure, treated with IV crystalloid 250 ml bolus and injection mephentermine 6 mg IV. Bradycardia was defined as HR