ABSTRACT
To compare the outcome of open versus laparoscopic ventral hernia repair in terms of duration of surgery, post operative pain and length of hospital stay. A comparative study was carried out at in-patients presenting at Surgical Departments of Benazir Bhutto Hospital, Holy Family Hospital and author's clinics. A total of 100 patients were included in the study and the patients were divided randomly in Group A and Group B, having 50 patients in each group, Group A representing open mesh repair group and Group B laparoscopic repair group. Patients of both groups were observed per-operatively for duration of surgery, postoperatively for length of hospital stay and intensity of postoperative pain. There was no statistically significant difference between two groups for duration of surgery [P >0.96]. Pain was calculated at 2 and 24 hour, using visual analogue scale. Less pain was noted in Group B. Difference of pain score was statistically significant at 2h and 24h [P0< .05]. Average duration of postoperative stay in hours was more in Group A [39.6 hrs] as compared to Group B [31.4 hrs] [P < 0.05]. Laparoscopic ventral hernia repair is beneficial due to less post operative pain and short duration of post operative hospital stay but duration of surgery remained same in both the settings
ABSTRACT
To determine advantages and disadvantages of postoperative nasogastric intubation after small bowel anastomosis. Quasi experimental. Surgical Unit-1, Holy Family Hospital, Rawalpindi, from December 2003 to December 2006. A total of 112 patients, undergoing small bowel anastomosis were equally divided in group I and II with and without postoperative nasogastric intubation respectively. Variables compared were number of patients having episodes of vomiting, change in abdominal girth, the time for onset of bowel sounds, time to begin per oral fluids, length of hospitalization and postoperative complications. In group-I, nasogastric tube was removed on an average after 3.1 days. Average postoperative nasogastric output was 357, 154 and 64 ml/day for day 1, 2 and 3 respectively. There was no statistically significant difference between two groups in abdominal girth before and after operation, frequency of vomiting, time taken for onset of bowel sounds and start of oral sips after operation, frequency of wound infection, anastomotic leak and mortality [p>0.05]. Length of postoperative hospital stay and frequency of postoperative respiratory complications were more in group-l as compared to group-II [p<0.05]. Nasogastric decompression does not provide added advantage after small bowel anastomosis
Subject(s)
Humans , Male , Female , Intestine, Small/surgery , Anastomosis, Surgical , Postoperative PeriodABSTRACT
To determine if intraoperative instillation of bupivacaine into gall bladder fossa would decrease early postoperative pain after laparoscopic cholecystectomy, Double-blind, randomized, controlled trial. Surgical Unit-l, Holy Family Hospital, Rawalpindi and Surgical Unit-1, Benazir Bhutto Hospital, Two year study. Fifty patients underwent laparoscopic cholecystectomy group-A. They were compared with a control group of fifty patients who had laparoscopic cholecystectomy but did not receive bupivacaine Group-B. Instillation of 10 ml of 0.5% bupivacaine into gall bladder fossa intra operatively after removal of gall bladder. Visual analogue scale [VAS] pain scores assessed 3 times post operatively, at 1, 6 and 24 hours, using similar peroperative and postoperative analgesics in both groups. Mean VAS pain scores [range 0 [no pain] to 10 [severe pain]] at 1 hour and at 6 hours after surgery were 6.5 and 4.2 respectively, in the bupivacaine group [Group-A] compared with 6.2 and 4.5 respectively, in the control group [Group-B] [p =.085 and 0.078,sd=.919 and.495]. VAS scores at 24 hours postoperatively did not differ between the two groups [2.4 VS 2.5][p=.282,sd=.636]. Instillation of bupivacaine into gall bladder fossa has no effect on post operative pain control in elective laparoscopic cholecystectomy