title: Multimodal versus Conventional Approach for Postoperative Pain Relief in Oral Cancer Patients.
abstract: BACKGROUND
  Multimodal analgesia includes regional anaesthesia in the form of nerve block may improve recovery along with optimal rehabilitation and early resumption of day-to-day activity following major surgery. Conventional general anaesthesia consists of premedication, induction, intubation and maintenance.
  
  
  OBJECTIVE
  The aim of the study is to compare the multimodal versus conventional approach in oral cancer surgery.
  
  
  METHODS
  The patients were randomly allocated into three groups, 30 patients in each group using the computer generated random table to one of the following groups: Group A: Fentanyl 1 μg/kg, Group B: Fentanyl 1 μg/kg + bupivacaine local infiltration, Group C: Fentanyl 1 μg/kg + bupivacaine local infiltration + Dexemedetomidine infusion (Loading 0.5 μg/kg, Maintenance 0.2μg/kg/hr).
  
  
  RESULTS
  No significant (p>0.05) difference was found in mean arterial pressure and heart rate at different time intervals among the groups. The VAS was lower in Group C than Group B and A. The ramsay sedation scale was higher in Group C than Group B and A. The rescue analgesic for 24 hour was lower in Group C than Group B and A. The time of first time analgesia requirement was significantly (p=0.001) higher in Group C than Group B and A. The rescue analgesic was significantly (p=0.001) lower in Group C (39.29±19.67) than Group B (68.33±18.49) and A (160.83±35.16).
  
  
  CONCLUSIONS
  Multimodal analgesia has beneficial haemodynamic effects during oral cancer surgery with reliable postoperative analgesia and sedation and less postoperative complication. Dose of drugs used in our study is not associated with any major adverse effect.
authors.affiliation: Junior Resident, Department of Anaesthesiology, King George's Medical University , Lucknow, U.P., India .
authors.lastname: Gunjan
authors.affiliation: Professor, Department of Anaesthesiology, King George's Medical University , Lucknow, U.P., India .
authors.forename: Monica
authors.initials: M
authors.lastname: Kohli
authors.affiliation: Ph.D. Scholar, Department of Anaesthesiology, King George's Medical University , Lucknow, U.P., India .
authors.forename: Prithvi Kumar
authors.initials: PK
authors.lastname: Singh
authors.affiliation: Professor, Department of Anaesthesiology, King George's Medical University , Lucknow, U.P., India .
authors.forename: Rajni
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Associate Professor, Department of Anaesthesiology, King George's Medical University , Lucknow, U.P., India .
authors.forename: Ajay Kumar
authors.initials: AK
authors.lastname: Chaudhary
authors.affiliation: Associate Professor, Department of Surgical Oncology, King George's Medical University , Lucknow, U.P., India .
authors.forename: Vijay
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Professor, Department of Anaesthesiology, King George's Medical University , Lucknow, U.P., India .
authors.forename: Jaishri
authors.initials: J
authors.lastname: Bogra
keywords: General anaesthesia; Haemodynamic effects; Multimodal analgesia