الفهرس | Only 14 pages are availabe for public view |
Abstract Morbid obesity is a serious disease resulting in considerable morbidity. Bariatric surgery is an important treatment modality of morbid obesity. This study was carried out on 40 of either sex patients submitted for bariatric surgery. These patients were classified into two groups(GE g and E g) each group 20 patients . In all patients general anaesthesia was induced by thiopentone sodium and succinylcholine and maintained with halothane and N2O/O2 .Muscle relaxation was achieved by atracurium and reversed at the end of operation by neostigmine and atropine. In E group, thoracic epidural blocks were performed using 79ml ropivacaine 0.5% combined with 80ug fentanyl as starting dose followed by 0.02% ropivacaine combined with 4ug/ml fentanyl at a rate of 610ml/h and continued postoperatively up to 24h. All patients were monitored preoperatively for HR, invasive BP, oxygen saturation, blood glucose, plasma cortisol levels and pulmonary function tests. Then intraoperative for HR, invasive blood pressure, oxygen saturation at 15 min interval till the end of surgery. Thirty minutes after start of surgery a blood sample was taken for measurement of blood glucose and plasma cortisol levels. Postoperative monitoring of the above mentioned parameters ,Categorical rating Scale and sedation score at 6h, 12h, 24h . The duration of postoperative analgesia was assessed. This study revealed that the preoperative addition of fentanyl to ropivacaine in thoracic epidural blocks in bariatric surgery prolongs the duration of postoperative analgesia ,decrease stress response , improve pulmonary function with least side effects. |