ABSTRACT
Objective: To compare the technique of paramedian with midline approach of subarachnoid block in terms of number of attempts and frequency of success rate in elderly patients undergoing elective lower body surgeries
Study Design: Randomized controlled trial
Place and Duration of Study: This study was carried out at Anaesthesia department of Combined Military Hospital Lahore. Six months from Jan 2014 to Jun 2014
Material and Methods: One hundred and seventy elderly patients were scheduled for lower body surgery, using spinal anaesthesia. They were randomized to either Midline approach [n=85] or Paramedian approach [n=85] by lottery method. The outcome measures number of attempts and success rate were noted in both groups and analyzed using SPSS version 18
Results: The successful block in first attempt was 95.3 percent in Paramedian group and 58.8 percent in Midline group. Mean number of attempts in paramedian group was 1.24 +/- 0.52 as compared to 1.95 +/- 0.97 in midline group. A p-value <0.05 was taken significant
Conclusion: The Paramedian technique was found associated with higher success rate, lesser possibility of repeated number of attempts in elderly patients as compared to Midline approach
ABSTRACT
Objective: Objective of study is to compare peri-operative complications between exteriorization and intra-abdominal repair of uterus after cesarean delivery
Study Design: Randomized controlled trial
Place and Duration of Study: Obstetrics and Gynecology Department of Pakistan Ordinance Factory Hospital, Wah Cantt, from 1[st] April 2010 to 30[th] September 2010
Material and Methods: Patients planned for 1st cesarean section under spinal anesthesia were randomly allocated by lottery method to exteriorized [A] or in situ uterine repair [B] group. Patients with history of uterine surgeries and cesarean section were excluded from study. Variables analyzed were operation time, peri-operative hemoglobin [Hb] fall, nausea and vomiting during the cesarean delivery
Results: The study analyzed 170 patients and divided them in 2 groups, having no significant difference with respect to maternal demographics, procedure statistics and indication of cesarean section. Significant difference was observed in operation time being 32.78 min in exteriorized group and 36.38 min in situ uterine repair group [p-value 0.0001]. Hb% fall was 0.85 g/dl and 0.92 g/dl respectively in both groups [p-value 0.62] Nausea and vomiting was 23.5% in group A and 11.8% in group B [p-value 0.02, 0.04 respectively]
Conclusion: Peri-operative complications like operative time and Hb fall are less in uterine repair after temporary exteriorization as compared to intra-abdominal repair of uterus after cesarean delivery. Nausea and vomiting were increased in exteriorized group but proper regional anesthetic technique and achieving adequate analgesia can reduce patient discomfort