Comparison of incidence of postdural puncture headache with 25[gram] quincke babcock spinal needle versus 27[gram] quincke babcock spinal needle in caesarean section

To compare the incidence of post dural puncture headache by using Quincke Babcock spinal needles of 25 G and 27 G in obstetrical patients. This comparative study was conducted in Obstetrics Units, Nishtar Hospital, Multan during the period. of 6 months i.e. from September 2004 to March 2005. A total of 80 patients were included in the study and divided into two groups. Out of the 80 patients, 9 were complicated by headache post-operatively. The overall incidence of PDPH was 15% in group-A, 7.5% in group-B. The difference in PDPH between groups was not statistically significant. The mean duration of headache was found to be 27.77 hours. In 5 patients out of 9, the duration of headache lasted less than 24 hrs. In 3 patients duration of headache was between 24-48 hours. in only one patient, the duration of headache was more than 48 hours. All the patients who developed PDPH had mild to moderate headache. In 8 patients out of 9 patients who had PDPH in the present study, the site was occipital region. Only one patient had generalized headache. Onset of headache was 24 hours to 72 hours after dural puncture. The incidence was found to be minimum with 27 Gauge Quincke Babcock spinal needle because the smaller the needle diameter the lesser the risk of cost dural puncture headache

Single versus multimodel analgesia in laparoscopic cholecystectomy

Evaluate the analgesic effect of single vs multimodel analgesics in postoperative pain in Laparoscopic Cholecystectomy and investigates whether. Prophylactic treatment with multimodel nociceptive blockade will delay the onset of postoperative pain. Decrease analgesic requirement, speed recovery time, and facilitate same. Day discharge in this surgical population. This experimental comparative study was conducted in General Operation Theatre of Nishtar Hospital, Multan during the period from May 2004 to November 2004. Sixty patients were included in the study and divided in 2 equal groups of 30 each using non-probability convenience sampling technique. Group-A:-Preoperatively at 45 minutes before induction of anesthesia an intramuscular [IM] bolus injection of Ketorolac 0.5mg/kg was given. Group-B:-Preoperatively at 45 minutes before induction of anesthesia, an intramuscular [IM] bolus injection of 0.5mg/kg Ketorolac+2mg/kg body weight of Tramadol [IM]+Local infiltration with 0.5% injection Bupivacaine was done 10 minutes before incision. in Group A, who received Inj. of Ketorolac 0.5 mg/kg, 14 patients [46.7%] had mild pain, 3 patients [10%] had moderate, 6 patients [20%] had severe and 7 patients [23.3%] had no pain. While in group B who received Ketorolac+Tramadol+0.5% of bupivacaine infiltration, the degree of postoperative pain relief I was greater than the Group A in which 14 patients [46.7%] had mild pain, 3 [10%] had moderate and 13 patients [43.3%] had no pain. There was no case having severe postoperative pain in group B. Multimodal analgesia has much more advantage over single analgesia in patients undergoing Laparoscopic Cholecystectomy