ABSTRACT
Background: Aim of the study was to reduce congestion in PAC clinic, which is the direct indicator of efficiency of the hospital. 1) To study overall waiting time in the PAC clinic. 2) To suggest action to improve the waiting time in PAC. Methods: Prospective, Descriptive study, 40 patients in each group. Group “R” = Patients registered for PAC clinic, who’s all vitals and clinical assessment was done after arrival to PAC clinic as routine practice. Group “Q” = Patients were provided Self-answering Pre-operative in waiting area and whose vital parameters were taken before arrival to PAC clinic by a trained staff. Data was recorded for both the groups. Results: We found in our study that average waiting time that is total time from registration to completion of PAC in OPD clinic was statistically significantly less in QT-1 (Group “Q”) in comparison to RT-1 (Group “R”). We found in our study that average Doctor – Patient time that is time of interaction with Doctor during PAC in OPD clinic was also statistically significantly less in QT-2 (Group “Q”) in comparison to RT-2 (Group “R”). Conclusion: Present study was planned to reduce congestion in OPD for pre-anesthesia checkup for elective surgery or procedure. Patient satisfaction comes automatically as a byproduct with the achievement of the goal of the study. Time is money in the present scenario and thus best utilization of time with efficient outcome is the prerequisite of any good management.
ABSTRACT
Background: Alpha-2 agonists are added to local anesthetic agents to extend the duration of peripheral nerve blocks. Objective: We evaluated the effect of combining dexmedetomidine with levobupivacine with respect to duration of motor and sensory block and duration of analgesia. Material and Methods: Sixty patients of ASA grade I or II aged between 18-60 years, posted for elective upper limb surgeries were enrolled for a prospective, randomized, double-blind study. Patients were divided into two groups, the control group B and the study group BD. In group B (n = 30), 30 ml of 0.325% levobupivacaine + normal saline; and in group BD (n = 30), 30 ml of 0.325%levobupivacaine + 1μg/kg dexmedetomidine were given for ultrasound guided supraclavicular brachial plexus block. Duration of motor and sensory block and time to first rescue analgesia were recorded. Results: Demographic profile and surgical characteristics were similar in both groups. The onset times for sensory and motor blocks were significantly shorter in BD group (p < 0.05), while the duration of sensory and motor blocks and duration of analgesia (DOA) was significantly longer in BD group. Heart rate level and SBP and DBP levels in group BD were significantly lower 15-20 min after block (p< 0.05). Bradycardia was observed in two patients in the group BD. No other adverse effects were observed in either of the groups. Conclusion: Dexmedetomidine added as an adjuvant to levobupivacaine for supraclavicular brachial plexus block significantly shortens the onset time and prolongs the duration of sensory and motor blocks and duration of analgesia.