: Pain modulation is very important after operation, particularly for women who undergo
caesarean section. A pain-free postoperative period is essential following a caesarean
section so new mothers may care for and bond with their neonates. The consequences of the
improper pain management which raise the healthcare costs and prolong the recovery process.
Intrathecal adjuvants are often administered during this procedure to provide significant
analgesia, but they may also have bothersome side effects. Intrathecal midazolam and
magnesium sulfate produces effective postoperative analgesia with no significant side
effects.
Objectives: This prospective, randomized, double-blind study was designed to compare the
analgesic efficacy and safety of intrathecal midazolam vs. Magnesium sulfate vs plain
bupivacaine as an adjunct to bupivacaine in pregnancy patients scheduled for elective
caesarean section.
Caudal analgesia along with general anesthesia is a very popular regional technique for
prolonged postoperative analgesia in different pediatric surgical procedures where the
surgical site is sub-umbilical. Caudal anesthetics usually provide analgesia for
approximately 4-6 hours.
Recently, the use of spinal anesthesia in infants and children requiring surgeries of
sub-umbilical region is gaining considerable popularity worldwide.
– The ease of performance and the safety regarding cardio-respiratory functions makes spinal
anesthesia as an alternative to general anesthesia in infants and children undergoing
surgeries of sub-umbilical regions.
Transversus abdominis plane (TAP) block provides effective analgesia and is now a standard of
care for analgesia after cesarean section. There is no information on levobupivacaine
pharmacokinetics post TAP after pregnancy.
Objective: Generate a pharmacokinetic levobupivacaine model and its effect on the
electrocardiogram (ECG).
Method: The investigators will study 12 healthy term pregnant patients, scheduled for
elective cesarean section under spinal anesthesia. A bilateral TAP block is performed with 20
ml 0.25% levobupivacaine with epinephrine 5 ug/ml. Sensory block will be assessed at 1-2-6
and 12 hours post puncture. 2 ml of venous blood will be obtained at 2-5-10-30-45-60-90 and
180 minutes. With a Holter machine we will study the effect of levobupivacaine plasma levels
and the QTc changes.
This study compares efficacy of transversus abdominis plane block and ilioinguinal nerve
block for postoperative pain in patients undergoing inguinal herniorraphy with spinal
anesthesia. One-third of the patients will receive standard postoperative pain
regimen(control group), one-third will receive a transversus abdominis plane block (with
ultrasound guidance) and the last group will receive an ilioinguinal nerve block(with
ultrasound guidance) in addition to standard postoperative pain regimen. This study is a
Randomized prospective open-label controlled study.
