scholarly journals A Comparison of the Effects of Spinal Anaesthesia between Sitting and Lateral Positions in Patients Undergoing Hysterectomy Surgery

2021 ◽  
pp. 66-72
Author(s):  
Karan Morje ◽  
Manna Debnath ◽  
Akhlaque Ahmad ◽  
Santosh Ojha
Keyword(s):  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
P Value ◽  
Chi Square ◽  
Post Dural Puncture Headache ◽  
Significant Difference ◽  
Prospective Comparative Study ◽  
Lateral Decubitus ◽  
American Society ◽  
Post Operative Nausea

Aim: The main purpose of this present study is to determine the effects of sitting (S) and lateral (L) position during spinal anaesthesia on patient satisfaction, Post dural puncture headache (PDPH), Post-Operative Nausea and Vomiting (PONV). Study Design: Prospective comparative study Place and Duration of Study: Charusat Healthcare and Research foundation (CHRF), Changa, Gujarat, between September 2021 to November 2021. Methodology: A total of 50 female volunteers who were above the age of 18 years, had an American Society of Anaesthesiologist (ASA) status of I & II and those who have undergone hysterectomy surgery are included in this study. The patients were categorized into two groups, group S (n=25) and group L (n=25). Patients were asked about PONV 4 hours after surgery and the possibility of PDPH on post-operative days 1 and 2. The study was analysed by using descriptive statistics, chi-square and Kruskal-Wallis test. Results: When comparing the incidence of PDPH on post-operative day 1 and day 2, there is a statistically significant difference between the Sitting (group S) and Lateral decubitus (group L) groups (P-value= 0.14 and.001). On the other hand, there is no statistical significant difference found for PONV when compared between both the groups (P- value= .776). Conclusion: Spinal anaesthesia with lateral decubitus position has better outcomes than sitting position for the incidence of Post dural puncture headache. However, there is no difference in both groups for PONV.

scholarly journals To Compare the Incidence of Post-Dural Puncture Headache Using 25G Quincke and 25G Whitacre Spinal Needles in Patients Undergoing Lower Segment Caesarean Section

2021 ◽  
Vol 10 (14) ◽  
pp. 1014-1019
Author(s):  
Aditya Rameshbabu Devalla ◽  
Sanjot S. Ninave ◽  
Amol P. Singam
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Lower Segment ◽  
Early Ambulation ◽  
Post Dural Puncture Headache ◽  
Lower Segment Caesarean Section ◽  
Key Words Spinal Anaesthesia ◽  
American Society ◽  
Obstetric Surgery

BACKGROUND Spinal anaesthesia is the first preference of anaesthesia in obstetric surgery. Post dural puncture headache (PDPH) is more common after C-section in young parturients. In the present world which is developing and fast-paced, brisk recovery along with minimal side effects & importantly early ambulation are now the need of the hour. This headache is more worrying to the mother who is required to tend to the newborn baby. This study compared the incidence of PDPH subsequent to subarachnoid blockade for lower segment Caesarean section (LSCS) 25G Whitacre & 25G Quincke needles. We wanted to compare the incidence of PDPH using 25G Quincke and 25G Whitacre spinal needles in patients undergoing LSCS. METHODS Two hundred (ASA II) American Society of Anaesthesiologists 11 females who were pregnant and in the age group of 20 - 50 years, planned to get sub-arachnoid blockade for C-section, were assigned randomly into two equal groups (N = 100 each). Both groups received spinal anaesthesia with 25-gauge Quincke and 25 gauge Whitacre needle. Postoperatively, incidence, site, onset, severity and duration of headache was studied. RESULTS The incidence of post spinal headache was 6 % in the Quincke group. No patients in Whitacre group had PDPH. The number of lumbar punctures required for successful sub arachnoid block was recorded in both the groups. 92 % patients from group Q and 88 % patients from group W required only one puncture. 8 % patients from group Q and 12 % patients from group W required two punctures. CONCLUSIONS It is prudent to conclude that 25G Whitacre spinal needle is a better alternative to 25G Quincke needle for reducing the incidence of post dural puncture headache in patients undergoing lower segment Caesarean section. KEY WORDS Spinal Anaesthesia, Post Dural Puncture Headache, Caesarean Section

Frequency of Post Dural Puncture Headache with Quincke 25g and Quincke 27g Spinal Needle after Spinal Anaesthesia

2021 ◽  
Vol 15 (11) ◽  
pp. 3116-3118
Author(s):  
Gulsher . ◽  
Riffat Zahid ◽  
Syed Mehmood Ali ◽  
Muhammad Naveed Shahzad ◽  
Amer Latif ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Dural Puncture ◽  
P Value ◽  
Chi Square ◽  
Post Dural Puncture Headache ◽  
Group I ◽  
Chi Square Test ◽  
Randomized Control ◽  
Group Ii ◽  
The Difference

Objective: To compare the frequency of post dural puncture headache with Quincke 25G and Quincke 27G of spinal needles for spinal anesthesia. Design of the Study: It’s a Randomized control trial. Study Settings: This study was carried out Department of anesthesiology and Intensive Care Unit, Shaikh Zayed Hospital Lahore from 29-08-2020 to 01-03-2021. Material and Methods: In this prospective study 100 patients were enrolled who were decided to undergo spinal anesthesia. Two groups were made by randomization. In patients of group I, anesthesia was administered by using 25G quincke needle while 27G quincke needle was used for patients in group II. Evaluation of patients was with regard to development of postoperative PDPH within 3-days. Groups were compared by using Chi-square test and a P-value<0.05 was taken statistically significant. Results of the Study: PDHD was seen in 14 (28%) patients in group I and in 4 (8%) patients in group II. Statistically, the difference between the two groups was significant (p<0.05).. Conclusion: Due to less frequency of PDPH with 27G needle, it should be given preference for applying spinal anesthesia over 25G needle. Keywords: Spinal anesthesia, post dural puncture headache; quincle needle.

scholarly journals Comparison of aprepitant and dexamethasone versus metoclorpramide and dexamethasone for prevention of post-operative nausea and vomiting in patients undergoing laparoscopic cholecystectomy.

2021 ◽  
Vol 29 (01) ◽  
pp. 7-12
Author(s):  
Zerwah Muhammad Qayum ◽  
Aftab Hussain ◽  
Muhammad Akram ◽  
Muhammad Asif Saleem ◽  
Rehana Feroze ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Nausea And Vomiting ◽  
P Value ◽  
Significant Difference ◽  
Group A ◽  
Prospective Comparative Study ◽  
Elective Laparoscopic Cholecystectomy ◽  
Post Operative Nausea ◽  
Age Range ◽  
Study Setting

Objective: To compare the efficacy of aprepitant and dexamethasone versus metoclopramide and dexamethasone combination in prevention of post-operative nausea and vomiting in females undergoing laparoscopic cholecystectomy. Study Design: Prospective Comparative study. Setting: Department of Anesthesia, CMH Lahore. Period: October 2019 to April 2020. Material & Methods: A total of 140 female patients planned for laparoscopic cholecystectomy under general anesthesia, of age ranges from 35-65 years and ASA classification I and II were recruited for the study and were divided into two equal groups. In group A (n=70), patients were given oral aprepitant 80 mg with once sip of water one hour prior to induction and dexamethasone 8 mg upon induction. In group M (n=70), patients were given a placebo one hour prior to induction and intravenous metoclopramide 10 mg and dexamethasone 8 mg upon induction. Results: Age range in this study was from 37 to 65 years with mean age of 46.82 ± 7.29 years. The mean age of patients in group A was 45.73 ± 6.77 years and in group M was 47.91 ± 7.66 years with p-value of 0.076. In our study, significant difference was found between the efficacy of two groups of drugs. The efficacy of aprepitant and dexamethasone was found in 62 (88.57%) patients, while with metoclopramide and dexamethasone, it was found in 51 (72.86%) patients with p-value of 0.031. Conclusion: it is concluded that aprepitant and dexamethasone combination has higher efficacy as compared to metoclorpromide and dexamethasone in prevention of post-operative nausea and vomiting in elective laparoscopic cholecystectomy.

scholarly journals Influence of demographic profiles and spinal anaesthesia procedures on patients with treated and untreated coffee related to post dural puncture headache pain score

2021 ◽  
Vol 8 (3) ◽  
pp. 363-370
Author(s):  
Jyotsana ◽  
Sreeja L
Keyword(s):  
Pain Score ◽  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Control Group ◽  
Post Dural Puncture Headache ◽  
Demographic Profiles ◽  
Pain Scores ◽  
Significant Difference ◽  
And Control ◽  
Interventional Group

Post Dural Puncture Headache (PDPH) is an iatrogenic complication of spinal anaesthesia (SP) and has devastating consequences. To assess the effect of Coffee on occurrence of PDPH in post-operative patients of Interventional and control groups by comparing the mean PDPH pain scores related to demographic profiles and spinal anaesthesia procedures. An experimental approach in which 60 patients were recruited from the accessible population and was further allocated randomly to Interventional (30) and Control (30) groups. The patients were compared the demographical profiles viz. age, education and marital status and spinal anaesthesia procedures viz. surgery types, needle size and amount of fluid intake related to PDPH pain scores by Numerical Rating Scale after administration of three doses (130mg caffeine in 150ml) of coffee at intervals of 12hrs in Interventional group and only routine care in control group. The main findings in this study were that the incidence of PDPH is lower in Interventional group compared to control group with statistically significant difference (P&#60;0.001) but it is not influenced by demographic profiles as well as SP procedures in Interventional group compared to control group without statistically significant observation after 24 hrs, 48hrs and 72hrs NRS pain score, respectively.The use coffee is an effective, safe, non-invasive treatment for prevention of PDPH.

scholarly journals Effective dose of propofol for smooth induction in midazolam premedicated and in unpremedicated children

2018 ◽  
Vol 6 (8) ◽  
pp. 2767
Author(s):  
Veena Shukla ◽  
Harpreet Kaur
Keyword(s):  
Effective Dose ◽  
Anaesthetic Agent ◽  
Controlled Study ◽  
Repeat Dose ◽  
Chi Square ◽  
Drug Of Choice ◽  
Significant Difference ◽  
Chi Square Test ◽  
American Society ◽  
Post Operative Nausea

Background: Propofol, an intravenous (IV) anaesthetic agent, is widely used in paediatric day care surgeries. Present study was conducted to determine clinically effective dose of Propofol for smooth induction in children.Methods: This randomized controlled study was conducted in 100 children of American Society of Anaesthesia (ASA) grade I and II, posted for short genitourinary surgeries. Group P patients received premedication with injection glycopyrrolate and midazolam IV. Group U patients were unpremedicated. Both groups were split in five subgroups with ten patients in each as per propofol dose of 2.0, 2.5, 3.0, 3.5, and 4.0mgkg-1 respectively. Following observations were made-pain on injection site, facemask tolerance, repeat dose and total dose of Propofol required for smooth induction, time of recovery and complications like post-operative nausea and vomiting (PONV). All data was analyzed by using chi square test and student t test.Results: Demographic profile showed no significant difference. Mean dose of Propofol in group P was 3.29±0.51 mg kg-1 while for group U was 3.70±0.57mg kg-1. Facemask tolerance was maximum in group P5 (100%) followed by (80%) in U5. Mean dose of Propofol required for younger children 1-3 years (group P 3.46±0.43 mgkg-1 v/s group U 3.94±0.48 mgkg-1) was much higher than dose required for 7-10 years (group P 3.13±0.52 mgkg-1 and group U 3.18±0.59 mgkg-1) for both groups. Recovery time after anaesthesia was delayed in group P and complications were more in group U.Conclusions: Propofol is the drug of choice for paeditric ambulatory surgery. Midazolam premedication enhances the benefits.

scholarly journals Efficacy of Tramadol and Fentanyl when used Intrathecally for Prevention of Shivering in Endoscopic Urosurgical Cases- A Randomised Control Trial

2020 ◽  
Author(s):  
Supriya S Kulkarni ◽  
Leena Shibu Paulose ◽  
Shilpa Y Gurav ◽  
Sandeep K Gore ◽  
Ks Reddy
Keyword(s):  
Spinal Anaesthesia ◽  
Randomised Control Trial ◽  
Control Group ◽  
P Value ◽  
Side Effect Profile ◽  
Huge Amount ◽  
Variance Test ◽  
Significant Difference ◽  
American Society ◽  
Control Study

Introduction: Shivering is an undesired complication seen perioperatively with incidence of 40 to 70% under spinal anaesthesia. This further increases in patients undergoing endoscopic urosurgical procedures where huge amount of cold irrigating solution is used. Aim: To compare the anti-shivering effect of intrathecal tramadol with intrathecal fentanyl given as an additive in spinal anaesthesia in endoscopic urosurgical cases. Materials and Methods: It was a randomised control study. Total 105 patients of American Society of Anaesthesiologists (ASA) grade I and II posted for various endoscopic urosurgeries were included in the study and divided into three groups by computerised randomisation. Group T received injection bupivacaine 0.5% heavy 15 to 20 mg (3 to 4 mL) plus 20 mg (0.4 mL) tramadol in spinal anaesthesia, Group F received injection bupivacaine 0.5% heavy 15 to 20 mg (3 to 4 mL) plus 25 microgram (0.5 mL) fentanyl in spinal anaesthesia and Group C received injection bupivacaine 0.5% heavy 15 to 20 mg (3 to 4 mL) plus 0.5 mL normal saline. Incidence and grade of shivering was recorded in each group. The data was analysed using statistical package SPSS version 21.0. Mean and SD were calculated for the quantitative variables. Analysis of variance test was used to compare the means of three groups with respect to each of the parameters. Results: Significant difference was observed among three groups in respect of incidence of shivering intraoperatively and postoperatively both. Least incidence of shivering was observed in tramadol intraoperatively with a p-value <0.05. Also, tramadol group had least shivering postoperatively with a p-value <0.05. Also, the grade of shivering in control group was significantly higher (p-value <0.05) than that of both group F and group T. There was no statistically significant difference among the three groups in respect of sedative score, itching, nausea, vomiting and respiratory depression (p-value >0.05). Conclusion: Intrathecal tramadol is more effective than intrathecal fentanyl in prevention of shivering in patients undergoing endoscopic urological surgeries and also has low side effect profile.

scholarly journals Comparison of 27 G Quincke and 25 G Quincke Needles for Post Dural Puncture Headache in Caesarean Section

2016 ◽  
Vol 12 (1) ◽  
pp. 17-21
Author(s):  
Md Anisul Islam ◽  
Amena Begum ◽  
SM Shahida
Keyword(s):  
Caesarean Section ◽  
Failure Rate ◽  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Intraoperative Complications ◽  
Armed Forces ◽  
Post Dural Puncture Headache ◽  
Uncomplicated Pregnancy ◽  
Significant Difference ◽  
Group B

Introduction: Although modern anaesthesiology has made great progress in the last decades and spinal anaesthesia is popular for its effectiveness, Post Dural Puncture Headache (PDPH) is a significant and well known complication of spinal anaesthesia that may be incapacitating for patients. A few decades ago less refined and thicker spinal needles were being used and the incidence of PDPH was high. But within the last 15 years more refined and thinner needles have been used and the incidence of PDPH is grossly reduced. Objective: To compare the incidence and severity of post dural puncture headache using 25 G Quincke and 27 G Quincke needle during spinal anaesthesia in case of caesarean section. Materials and Methods: This randomized prospective study was carried out in the Border Guard Hospital, Dhaka, during the period of January to July, 2015. Patients were selected randomly from the age group of 20-35 years having a pregnancy of at least 34 weeks gestation with a single uncompromised fetus and uncomplicated pregnancy. Patients with a history of migraine, convulsion, cerebrovascular accident, Pre-eclampsia, eclampsia, spinal deformity, coagulopathy or previous neurological disease were excluded. They were randomly allocated into two groups. Each group consisting of 50 patients. Data was collected by interviewing and observation results. Data were processed and analyzed by using statistical test. Results: There was no statistically significant difference found in age, height, weight and ASA status between two groups. 27G Quincke needle had significantly higher failure rate of successful lumber puncture in first attempt than the 25G Quincke needle (20% vs 6%, P<0.05). There was no difference difference regarding the incidence of intraoperative complications between two groups. The overall incidence of PDPH was 2(4%) in group A and 12 (24%) in group B (P<0.05). Decreased severity of headache was noted in the 27G group Quincke needle. There was no difference regarding the duration of headache in between two groups. Conclusion: This study suggests that the risk of PDPH was much lower in 27G Quincke needle as compared to 25G Quincke needle though it had a higher failure rate of successful lumber puncture in first attempt. For spinal anaesthesia 27G Quincke needle should be used. Journal of Armed Forces Medical College Bangladesh Vol.12(1) 2016: 17-21

A Study to Evaluate the Effectiveness of Webinar on Knowledge Regarding the Strategies to Prevent Covid 19 among Nursing Students of SIIHS, Honavar, Uttara Kannada

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Sagaya Arockiya Mary. A ◽  
Susai Mari.A ◽  
Wincy. C ◽  
Thirumurugan. M ◽  
Verginia Dsouza ◽  
...  
Keyword(s):  
Nursing Students ◽  
Student Nurses ◽  
Sampling Technique ◽  
Knowledge Score ◽  
P Value ◽  
Sufficient Information ◽  
Knowledge Level ◽  
Chi Square ◽  
Significant Difference ◽  
Post Test

Background: The one virus stumbled the whole universe is the novel corona virus and impacted physical, emotional and social health status of almost every individual in the world irrespectively. Since the existence of Covid-19 till now it is been noticed that student nurses also affected by this fatal viral infection during their clinical practice. Objectives: The study focused on evaluating the effectiveness of webinar on knowledge regarding the strategies to prevent Covid -19 among student nurses of SIIHS, Honavar, Uttara Kannada. The study aimed at enhancing the knowledge level and influences others through effective health teaching at clinical areas and even in community settings. Methodology: An evaluative approach with pre- experimental, non-randomized, one group pre and post-test research design was adapted. The sample size was 294, purposive sampling technique was adapted. Data collected through testmoz web page and webinar was conducted by google meet app for one week. Data analysed by descriptive and statistical methods (chi-square and z-test) and interpreted by graphs. Results: The findings show that in pre-test 10(3.41%) had poor, 127(43.19%) had average, 157(53.40%) Good and 00% excellent knowledge level whereas in post-test 00% had Poor, 59(20.06%) Average, 176(59.86%) Good and 59 (20.06%) had excellent knowledge level. The pre-test mean score was 23.1 (46.2 %.) and of post-test was 35.6 (71.2%). The computed z’-test value showing significant difference in the pre (x?1=23.1) and post-test (x?2=35.6) knowledge score (p=1.18357, < z= -5.1679, critical z score=-1.6449 ? =0.05 level of significance). Hence the p value is greater than the z value (p(x?Z) = 1.18357e-7), it indicates the webinar was effective and the null hypothesis (H0) is rejected. Conclusion: The study was concluded as the webinar was highly effective and influenced the participant to gain sufficient information on prevention and the spread of Covid 19. Hopefully this enables them to apply

A Comparative Study between Ketamine and Lidocaine ro Decrease Propofol Injection Pain During Induction of Anesthesia

2021 ◽  
Vol 6 (1) ◽  
pp. 1304-1309
Author(s):  
Bikash Khadka ◽  
Nil Raj Sharma
Keyword(s):  
Comparative Study ◽  
Venous Occlusion ◽  
Verbal Response ◽  
Injection Pain ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Lidocaine Group ◽  
Mild Pain ◽  
Significant Difference

Introduction: Pain during the injection of anesthetic agents may be distressing and can reduce the acceptability of an otherwise useful agent such as propofol during daycare surgeries. Lidocaine and ketamine both are used as pre-treatment to decrease propofol induced pain. This study aims to compare the effectiveness of ketamine injection to decrease propofol-induced pain in comparison to lidocaine injection. Methodology: This is a prospective cross-sectional comparative study. Eighty-nine cases were divided into two groups where group K received ketamine 2 ml (0.2 mg/kg) whereas group L received lidocaine 2% 2ml (0.5 mg/kg) after venous occlusion with rubber tourniquet. One-fourth dose of propofol was injected 1 min after release of tourniquet and pain accessed at 0, 1, and 2 minutes of propofol injection with a verbal response and behavioral signs. Chi-square test and paired T-test were used and a p-value less than 0.05 was considered significant. Result: Regarding hemodynamic, oxygenation, and adverse effects there was no significant difference. Immediately after propofol injection, only 1 patient of the ketamine group had mild pain (2.22%) while 12 patients from the lignocaine group had mild pain (27.27%) with a p-value of 0.009. Also after 2 minutes of propofol injection, only 12 cases had mild pain i.e. 13.48% (1 from ketamine group i.e. 2.22% and 11 from lidocaine group i.e. 25%) with p-value of 0.002. Conclusion: Our study helps prove low-dose ketamine is more effective in reducing the incidence and severity of pain on injection of propofol in comparison to Lidocaine with better hemodynamic stability. 

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