ABSTRACT
To assess the efficacy and safety of combination of caudal bupivacaine anesthesia and diclofenac sodium suppository for postoperative analgesia in pediatric patients. Interventional study. Imam Clinic [a private hospital] North Nazimabad Karachi. from May 2004 to March 2007. All pediatric patient ASA physical one and two between the ages 6 months to 12years of either sex undergoing infra umbilical surgery received caudal block with bupivacaine 0.25% in a dose of 0.5ml/Kg and diclofenac sodium suppository 1mg/Kg rectally. Patients in whom caudal analgesia was contra indicated or failed were excluded from the study. Postoperative pain was assessed using observers' pain scale and self report of pain by child when he was greater than 2 years age. Postoperative complications were also recorded. During the study period, 99 patients undergoing different infra umbilical procedures [hernia, hypospadias repair, PPV ligation, circumcision, orchidopexy etc] received combination of caudal bupivacaine analgesia and rectally administered diclofenac sodium for post- operative analgesia. There were 94 male patients. In all patients caudal block remained successful. All patients were pain free and none of them required additional/rescue analgesia. Postoperative nausea and vomiting were reported in 3 patients. No other side effects like retention of urine, respiratory depression etc was observed postoperatively. Combination of single shot caudal block with bupivacine 0.25% in a dose of 0.5 ml/Kg and rectal diclofenac sodium for postoperative analgesia in pediatric patient is a simple, safe and effective procedure
Subject(s)
Humans , Male , Female , Diclofenac , Anesthesia, Caudal , Administration, Rectal , Analgesia , Pain, Postoperative/drug therapy , PediatricsABSTRACT
Abdominoplasty known more commonly as a "tummy tuck" is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. Mesh repair of incisional hernias along with fat reduction of abdominal wall is still a procedure not very frequently done in our country. A study was conducted in Sindh Govt. Qatar Hospital during the period of three years [2000 to 2003] to evaluate the outcome of this procedure and complications. Total of 56 patients were operated, most of them were females [47] and many [23] have recurrent incisional hernias of abdominal wall. The overall results were satisfactory with uneventful recovery in 95% and low rate of complications which is .5%. And mesh rejection seen only in 1 patient
ABSTRACT
To evaluate the efficacy of 0.1% Bupivacaine versus 0.2% Bupivacaine with fentanyl 2 microg/ml via epidural for analgesia in labour. Randomized study. Single centre study of 80 patients conducted at gynae unit of Imam Clinic and General Hospital Karachi. from Jan 2002 to April 2005. In a randomized study, 80 nulliparous parturients in labour had epidural analgesia initiated with 0.2% bupivacaine and fentanyl and were then randomized to receive either 0.1% Bupivacaine with fentanyl 2microg/ml at 10m1 /hr [Group B1.n = 38] or 0.2% Bupivacaine with fentanyl 2microg/ml at 8ml/hr [group B2 n= 39] as epidural infusions. Bupivacaine 0.2% 5m1 as an epidural bolus was provided on request as Supplementary analgesia. There were no significant differences between the visual analogue pain scores either with respect to motor or sensory block. The amount of local anaesthetic used was lower in 0.1% Bupivacaine group then in 0.2% Bupivacaine group [P = 0.001] Side effects, patient satisfaction, labor outcome and neonatal outcome were similar in both groups. Epidural infusions of 0.1% Bupivacaine with fentanyl 2 microg/mI at 10-m1/ hr provided adequate analgesia in the first stage of labour. The level of analgesia was similar to that obtained using 0.2% Bupivacaine with fentanyl 2 microg/ml and with no differences with regard to sensory or motor block
ABSTRACT
To compare the level of Pre-Operative anxiety in patients reporting 24 to 72 hours before Surgery in Government Hospital, with patients assessed 24 to 72 hours before Surgery in Private Hospital. Comparative study. Out patient Anaesthesia clinic at Karachi Medical and Dental College, Abbasi Shaheed Hospital and Imam Clinic and General hospital North Nazimabad Karachi from January 2004 to October 2004. Two groups of 20 patients each were studied who underwent Abdominal hysterectomy. Group-A patients were assessed in Pre-Anaesthesia out patient Clinic 24 to 72 hours before admission in Abbasi Shaheed Hospital [Government hospital] and Group-B had Pre-Anaesthesia assessment 24 to 72 hours before surgery in private sector hospital. The visual analogue scale of anxiety [VAS] was used to assess anxiety in patients participated in study and p-value was derived by using independent t-test: The median anxiety score is 4[2-6] in Group A and 6[4-9] in Group-B. This anxiety score [VAS] is significantly lower Group-A when compared with Group-B [P< 0.01]. We conclude that Pre-Anaesthetic assessment in Anaesthesia clinic 24 to 72hours before Surgery in Government Sector hospital reduces Pre-Operative anxiety more when compared with an Pre-Anaesthesia assessment in private sector hospital