ABSTRACT
Background: Patients of acute abdomen present anaesthetic problems like fluid and electrolyte loss, intraoperative vomiting, regurgitation and aspiration, postoperative sickness, electrolyte imbalance, prolonged total parenteral alimentation etc. This study focused on intraoperative and postoperative complications with reference to anaesthetic management.Methods: Around 300 patients, suffering from acute abdomen, operated during routine or emergency were randomly distributed in three groups, Group I General anaesthesia with narcotic analgesics and relaxants; Group II General anaesthesia with inhalational agents; Group III Spinal subarachnoid analgesia. No modification of pre and post-operative hospital care and treatment was done.Results: There was a preponderance of younger age group patients (15 to 34years), more often in male patients. The mean duration in Group I was highest. Intraoperative Hypotension was the commonest (86 patients) followed by regurgitation and aspiration. Post-operative pyrexia was the commonest complication (120 patients) followed by postoperative nausea. ASA Grade III had a mortality of 22 patients (11.6%), ASA Grade IV having mortality of 46 patients (60.52%). About 221 patients had long duration of operations and the mortality was 28.95% as compared to 79 patients operated for short duration having mortality of 13.92%.Conclusions: Outcome and the survival of the patients depend on the surgical disease, duration of surgery, preoperative ASA grading, degree of dehydration, and the anaesthetic technique.
ABSTRACT
Background: Objective of present study to determine that administration of Intravenous Lignocaine prior to propofol is as effective as topically on the posterior oropharynx for LMA insertion.Methods: 60 patients of age group 16-45years of both sexes, ASA Grade I and II undergoing elective surgeries. Group 1: (n=30) Patients receiving Lignocaine 1.5 mg/kg IV over 30 seconds. Group 2: (n=30) Patients receiving lignocaine aerosol 40 mg topically. Conditions of LMA insertion, gagging laryngospasm ,coughing noted at time of insertion, ECG, NIBP, SPO2 and ETCO2 were recorded according to scheduled times.Results: In Conditions of insertion, difference between groups reached significance, p<0.05. In groups at first min, rise in heart rate, fall in DSP, SBP and MAP was significant. At two and three minutes post LMA insertion these parameters change slightly but statistically not significant.Conclusions: Topical Lignocaine 10% aerosol prior to propofol induction provides excellent conditions for LMA insertion without the use of neuromuscular blockages.
ABSTRACT
Background: To study the changes in haemogram and coagulation profile in patients undergoing autologous and homologous blood transfusion and suitability of the technique of autologous blood transfusion in routine blood bank management.Methods: Patients who were waiting to undergo elective surgical procedures were randomly distributed in two groups, Group A: Autologous blood transfusion, with or without haemodilution: wherein pre-operative period a predicted volume of blood was collected and Group B: Homologous blood transfusion: where required blood was arranged from Blood Bank. The cardiovascular status, the haemogram and the coagulation profile were recorded at various stages.Results: Out of 240 patients registered only 43 could fulfil the basic requirements only 25 could be motivated in each group. In Group A cases were of age group 51-60 years while it was 41-50 years in Group B. Male:Female ratio was 2:1. 47 Units were retransfused to Group A patients, Group B cases received 45 blood transfusions. In Group A patients 8% cases showed mild hypotention and 1% showed mild hypersensitivity to Haemacel. In Group B, 40% cases showed transfusion reactions. Fall in Hb was lesser in Group A (2.4) on first and (1.7) on second postoperative day compared to Group B (3.3) on first and (2.7) on second postoperative day. The haematocrit levels declined more sharply after operation in Group B (7) rather than Group A (10.4).Conclusions: Advantage of avoiding transfusion reactions, major changes in blood parameters, entry of infections proves Autologous blood transfusion to be the safest, cost effective and easy form of transfusion therapy