Peri-operative arrhythmias: diagnosis and management

Arrhythmias are common during the perioperative period. These abnormal rhythms can alter the hemodynamics by reducing cardiac output and may contribute to an increase in morbidity and mortality. Early diagnosis and identification of correctable causes is essential for appropriate management of arrhythmias. Some of these arrhythmias are benign requiring no intervention, while others may need urgent therapeutic intervention. This article focuses on the diagnosis and management of arrhythmias in the perioperative setting

Common complaints associated with caesarean section during spinal anaesthesia

To identify common complaints associated with caesarean section under spinal anaesthesia and manage them, in order to decrease the anxiety and distress level of the patients. Cross sectional observational study was conducted at Department of Anaesthesia, Liaquat National Hospital and Medical College from October 2011 to December 2012. Hundred patients aged from 20-36 years underwent elective caesarean section under spinal anaesthesia. Patients received nothing per oral for 6 hours. Metoclopramide and Ranitidine IV were given half hour before surgery Colloid 10ml/kg was given IV before induction of spinal anaesthesia. All patients were placed in sitting position and under aseptic conditions lumbar puncture was done at L3-L4 or L4-L5 interspaces with 25 gauge pencil point needle lo administer local anaesthetic over 20 seconds slowly. Oxygen 4 Iiters/minute as administered via a Hudson mask. All the patients were asked for any complaint during caesarean section under spinal anaesthesia. More than five common complaints were considered and similar complaints which are less than five were not included in the study. Out of 100 patients, 67% patients had no complaints and 33% patients presented common complaints. Visceral pain or abdominal discomfort was 19%, shivering 11%, nausea and vomiting 10%, epigastric pain 6%, backache 5% and headache 5%. Spinal anaesthesia is an excellent technique for caesarean section in majority of patients. Patients have various complaints during spinal anaesthesia which may increase anxiety and distress levels in patients