ABSTRACT
To determine the efficacy of single dose perioperative intravenous steroid [dexamethasone] for postoperative pain relief in patients undergoing tonsillectomy. Quasi-experimental study. Combined Military Hospital, Lahore, from November 2009 to June 2010. Sixty patients were divided into two equal groups. A single dose of dexamethasone was given to patients of group A during induction of anaesthesia, whereas no steroid was given to the patients in group B. Postoperative pain scores were assessed at 2, 6 and 12 hours in both groups using visual analogue scale [VAS]. Pain was classified as mild [0-3], moderate [4-7] and severe [8-10] on visual analogue scale. There was no significant difference in pain scores after 2 hours postoperatively. Pain scores of Group A at 6 and 12 hours postoperatively were found to be significantly low than Group B. Single dose perioperative intravenous injection of dexamethasone in tonsillectomy patients reduces postoperative tonsillectomy pain
Subject(s)
Humans , Male , Female , Tonsillectomy , Steroids , Dexamethasone , Injections, Intravenous , Perioperative Period , Perioperative Care , Pain MeasurementABSTRACT
To compare the postoperative pain relief and vomiting and the length of hospital stay in patients undergoing open cholecystectomy under general anaesthesia versus those receiving thoracic epidural anaesthesia. Quasi experimental study. The Combined Military Hospital, Skardu, from February 2009 to July 2010. American Society of Anaesthesiology [ASA] physical status [PS] I and II patients of either gender undergoing un-complicated open cholecystectomy were randomly divided into two groups, group 1 [n=51] received general anaesthesia [GA] and group 2 [n=49] received thoracic epidural anaesthesia [EA]. Patients of both the groups were assessed for postoperative pain, vomiting and length of hospital stay. Chi-square test was applied to compare the two groups and obtain the p-value. P-value of less than 0.05 was considered significant. Thirty six patients of GA group did not require additional analgesics for postoperative pain relief; however, injection Ketorolac had to be administered to 15 patients [29.4%] for pain relief in the postoperative period. Two patients [4.1%] in the EA group required additional analgesic during that period. Eleven patients [21.5%] in the GA group had postoperative vomiting. In the EA group only 1 patient [2%] had postoperative vomiting. Patients in EA group had better postoperative pain relief [p = 0.001] and remained free from vomiting than the GA group [p = 0.003]. Thirty six patients [70.5%] of the GA group and 34 patients [69.4%] in the EA group were discharged within 36 hours postoperatively [p = 0.896]. The use of intra-operative epidural anaesthesia combined with postoperative epidural analgesia was found to be associated with reduction in the postoperative pain and vomiting in patients undergoing open cholecystectomy
ABSTRACT
The purpose of the study was to determine the association between of pre-operative heart rate and post spinal hypotension in women undergoing cesarean section. It was a quasi-experimental study. It was conducted at Anaesthesia Department Combined Military Hospital Lahore and was of one year duration from June 2006 to May 2007. Two hundred patients undergoing caesarean section were included in the study selected on non probability convenience sampling technique. The patients were divided into two groups depending upon their pre operative heart rate. Spinal anesthesia was administered and number of patients developing hypotension was noted. Among 200 patients, who were included in the study, 112 were placed in group A and 88 were placed in group B depending on mean heart rate of 90 beats per minute or less or 91 beats per minute or more respectively. In group A 14 [11.86%] patients developed hypotension where as in group B 28 [31.82%] patients developed hypotension. Pre operative heart rate is significantly associated with post spinal hypotension in obstetric patients undergoing cesarean section
Subject(s)
Humans , Female , Preoperative Period , Anesthesia, Spinal , Hypotension , Obstetrics , Cesarean SectionABSTRACT
To compare haemodynamic changes on Laryngeal Mask Airway [LMA] insertion using tidal volume induction technique with sevoflurane at high concentration versus an intravenous induction with propofol. Randomized Controlled Trial [RCT]. Place and Duration of study: The study was carried out at Department of Anaesthesiology, Intensive Care and Pain Management, Military Hospital Rawalpindi from May 2006 to April 2007. One hundred patients were enrolled after written informed consent. Patients were divided in two groups. Group A received propofol and group B received sevoflurane for induction of general anaesthesia. Heart rate and mean arterial pressure [MAP] were recorded one minute before induction of anaesthesia and three minutes after induction and LMA placement. Independent sample "t-test" was applied to compare means for MAP and mean heart rate in both the groups and p value was inferred to judge the significance. In group A 20 males and 30 females were enrolled for the study while in group B there were 16 males and 34 females. The mean age of the patients in group A was 30.5 +/- 4.8 years while in group B was 28.4 +/- 5.2 years. Mean weight was 60.5 +/- 5.8 and 62.2 +/- 4.7 kilograms respectively in both groups. Twenty two patients were ASA I and 28 were classified as ASA II in group A while 27 were ASA I and 23 were ASA II in group B. In the group A, MAP was recorded to be 90 +/- 5.3 mmHg before induction and 79.9 +/- 7.5 mmHg after LMA placement following propofol induction. Whereas MAP in Group B before induction of anaesthesia and after LMA placement were 90 +/- 4.8 and 84.2 +/- 7.03 mmHg respectively. The fall in MAP was found to be significant in Group A when compared to Group B after induction and insertion of LMA [p value < .005]. In group A, mean HR was recorded to be 79.1 +/- 4.3 before induction and 82.2 +/- 8 per minute after LMA placement following propofol induction. While mean HR in Group B was 78.1 +/- 7.8 before induction and 83.3 +/- 8.0 per minute after LMA placement following sevoflurane induction. Hence, we found no significant difference in terms of change in mean HR between the two groups [p value > 0.4] before and after LMA insertion. Considering more fall in the MAP following propofol induction in group A and as there was no significant change in MAP and heart rate before and after sevoflurane induction, we conclude that sevoflurane provided better haemodynamic stability than propofol for LMA insertion