Résumé
To compare the effects of general versus spinal anaesthesia on Apgar score of neonates in elective Caesarean section. Randomized control trial. The Department of Anaesthesia and Intensive care CMH Lahore over duration of six month from 20-02-07 to 19-08-07. A total of 100 pregnant patients undergoing elective Caesarean section were divided into two groups: Group-A [General anaesthesia], Group-B [spinal anaesthesia]. In both the groups the patients were randomly divided using random number table and were blind to the technique of anaesthesia used. Mean Apgar score at one minute in group-A was 6.4 +/- 1.1 and in group-B was 8.4 +/- 1.1. The difference between two groups was statistically significant [p< 0.001]. Mean Apgar score at 5 minute was observed 9.4 +/- 0.7 in group-A and 9.5 +/- 0.6 in group-B. The difference between these two groups was not statistically significant [p=0.202]. Apgar score of neonates whose mothers received spinal anaesthesia was better at 1 minute than neonates whose mothers received general anaesthesia but there was no significant difference in Apgar score after 5 minutes in both techniques
Résumé
To compare the effects of thoracic epidural and thoracic paravertebral block in post thoracotomy pain relief and early ambulation. Randomized control trial [RCT]. Combined Military Hospital Rawalpindi a tertiary care health facility, from Jan 2007 to Dec 2007. Thoracic epidural block was given in group-A while thoracic paravertebral block was given in group-B patients post operatively. Pain scores were assessed at 30 min intervals after the dose of 0.25% Bupivacaine using visual analogue scale [VAS]. There was no significant difference for pain scores in first 24 hours after surgery between paravertebral block [PVB] and thoracic epidural group measured at 30 min interval. But complication like hypotension occurred less with PVB. Paravertebral block is a safe and effective technique and can to be used more widely for unilateral post thoracotomy pain relief
Résumé
To compare median and paramedian technique of spinal anaesthesia in terms of success rate, number of attempts, paresthesia, bloody tap and length of needle. Comparative cross-sectional study. Department of Anaesthesia and Intensive care PNS Shifa Karachi over duration of one year from March 2007 to Feb 2008. This was a comparative cross-sectional study and 100 patients undergoing spinal anaesthesia for lower abdominal and lower limb surgeries were included. Hundred patients were divided into two separate groups. Group I was given spinal anaesthesia with median approach and Group II was given spinal anaesthesia with paramedian approach. In both the groups the patients were divided using non probability convenience sampling and patients were blind to the choice of technique of spinal anaesthesia used, however consent was obtained from every patient to be included in study. The success rate of median approach was found to be 84%, with the first attempt success rate of 48%. Paresthesia was felt by 38% of patients and incidence of bloody tap was 6%. Length of needle required most of the time was between 4-6 cms. The success rate of paramedian approach was found to be 96%, with first attempt success rate of 70%. Paresthesia was felt by 20% of patients and incidence of bloody tap was 12%. Most of the time length of needle required was between 6-8 cms. Paramedian approach is associated with higher success rate with lesser number of attempts and decreased incidence of paresthesia