Résumé
Background: Intestinal anastomosis is a frequently performedprocedure equally in elective and emergency cases andtherefore, it is authoritative for surgeons and residents to beacquainted with the art of bowel anastomosis. The technique ofanastomosis is dependent upon the site, situation of the boweland the fundamental disease etiology, and the generalcomplaint of the subject. As per a recent Cochrane reviewcomparing the effectiveness of single layer and double layergastrointestinal anastomosisMaterials and Methods: The present prospective, randomizedcomparative study was conducted in the general surgicaldepartment of the Hospital for a period of 2 years. Subjectsrequiring intestinal resection were evaluated for eligibility to theward. All subjects received same antibiotics postoperativelylike Injection Ceftriaxone and Metronidazole including astandard postoperative care. Subjects were followed up for twoweeks after surgery. Any instant or late complications werenoted. All the data thus obtained was arranged in a tabulatedform and analyzed using SPSS software. Probability value ofless than 0.05 was considered as significant.Results: There were total 100 subjects included in the study,out of which 50 were managed by Single layered and 50 byDouble layered technique. The mean age of the subjects was37.53+/-4.22years. The mean duration of nasogastric tube insitu was 1.92±0.80 and 2.35 ± 1.03 days respectively in singleand double layer technique. The return of bowel soundpostoperatively was 2.45±1.13 days in single layer and 3.2 ±1.36 days in double layer technique. There was a significantdifference in both the groups. There was 1 case of anastomoticleak with double layered technique. Abdominal abscess wasseen in 2 cases each.Conclusion: The hospital stay duration, operating time wascomparatively lesser with single layer technique. It was alsocost effective and easy to perform.
Résumé
Caesarean section is the most common surgical procedure performed in India. Although it has been generally agreed that spinal anesthesia (SA) is the preferred anesthetic technique for Cesarean delivery (CD), epidural anesthesia is advised when an epidural catheter is already in place. However, the efficacy of epidural anesthesia has been reported as inferior to that of SA in both elective and emergency situations. Aim of the study: To compare epidural and spinal anesthesia in patients undergoing C-section. Methods: The study was conducted in the Department of Gynecology and Obstetrics and Department of Anaesthesia, Narayan Medical College and Hospital, Jamuhar, Sasaram, Bihar, India. For the study, patients scheduled for caesarian section were included. Patients who had malfunctioning epidural catheter or improper epidural placement or complicated pregnancy were excluded from the study. A total of 30 patients were included. A written informed consent was obtained from all the participants in the study. To include the patients in the study, it was made sure that they had physical status of I-II; full-term, singleton pregnancy. On the day of surgery, patients were advised to fast for at least 8 hours before the surgery. For the anesthesia, patients were randomly grouped into two groups, Group I and Group II. Patients in Group I was anesthetized with epidural anesthesia and patients in Group II were anesthetized with spinal anesthesia. Results: In the present study, a total of 30 patients were selected. Patients were randomly grouped into Group I and Group 2. The mean age in group 1 was 36.32 years and in group 2 was 35.11 years. The mean height in group 1 was 160.21 cm and in group 2 was 159.21 cm. The mean body weight was 71.11 kg in group 1 and was 70.26 kg in group 2. The Apgar scores at 1 min in Group I was 9.22 and in group II was 8.89. The Apgar scores at 5 min in Group I was 9.56 and in group II was 9.32. VAS pain scores on postoperative day 1 in Group 1 was 2.89 and in Group 2 was 3.16. Conclusion: From the present study, this can be concluded that the effect of anesthesia on the newborn in both the groups was similar and had no different effects.
Résumé
Introduction: Post-operative sore throat (POST) andhoarseness of voice are common complaints from patientsreceiving tracheal intubation. Budesonide is used to reduceall these complications and metered dose delivery of drugis considered as simple and less time consuming with highpatient acceptability. The present study was study was plannedto assess the effect of use of preoperative inhaled budesonideto reduce postoperative sorethroat incidence after endotrachealintubation.Material and methods: All the patients scheduled to undergoshort elective laproscopic surgeries, lasting <2hrs undergeneral anaesthesia with endotracheal intubation will beincluded in this study. The patients were selected randomlyinto two equal groups as follows: Group A- 20 patientsreceived 200μg budesonide inhalation suspension, using ametered dose inhaler 10 min before intubation, which wasrepeated 6hrs after extubation. Group B- 20 patients with nosuch interventions was performed before intubation or afterextubation. Post-operative sore throat was assessed at 2,6,12and 24hrs. All the results were categorized and summarized.Results: Incidence of POST was significantly higher amongsubjects of Group B in comparison to subjects of group A atdifferent time intervals.Conclusion: Administration of budesonide significantlyreduced the incidence of postoperative cough hoarseness ofvoice and POST among subjects undergoing laparoscopiccholecystectomy
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Background: Spinal anesthesia for caesarean section isadvantageous due to simplicity of technique, rapidadministration and onset of anesthesia, reduced risk ofsystemic toxicity and increased density of spinal anestheticblock. The present study was conducted to assesscomplication of spinal anesthesia in cesarean section.Materials & Methods: The present study was conducted on104 cesarean sections performed in gynaecology department.Patient’s parameters such as heart rate, systolic bloodpressure, diastolic blood pressure and respiratory rates wereassessed regularly. Intraoperative complications wereassessed and recorded.Results: Age group 18- 22 years had 45 patients, 22-26 yearshad 30 and 26- 30 years had 25 patients. The difference wassignificant (P< 0.05). The most common complication wasshivering seen in 32, anesthetic failure in 27, Post-duralpuncture headache (PDPH) in 20, hypotension in 16,nausea/vomiting in 14, high spinal block in 12, backache in 5and loss of consciousness in 4. The difference was significant(P< 0.05).Conclusion: Authors found that complications of spinalanesthesia are not uncommon phenomenon. Commoncomplication was shivering, anesthetic failure, Post-duralpuncture headache (PDPH), hypotension, nausea/vomiting,high spinal block, backache and loss of consciousness.
Résumé
Background: For middle ear surgery, familiarity with theinterrelationships of the anatomical structures is as essential asknowledge of their individual morphology, as surgery isstrongly influenced by the close spatial relations between thedifferent components. In the present study, we assessed andcompared the efficacy of nalbuphine and dexmedetomidineversus nalbuphine and propofol in middle ear surgeries undermonitored anaesthesia care.Materials & Methods: A total of 40 patients scheduled toundergo MESs were included in the present study and werebroadly divided into two categories as follows: Group 1:Included patients who received injection dexmedetomidinealong with nalbuphine (intravenously), Group 2: Includedpatients who received injection propofol along with nalbuphine(intravenously). Visual analogue score (VAS) was used forassessing the intraoperative and postoperative pain. Recoveryto be assessed using Modified Aldrete scoring system (scoreranging from 0 to 10) in the recovery room every 5 min, tillscore of 10 was achieved. Adverse events were recorded. Bothpatient satisfaction score (PSS) and surgeon satisfaction score(SSS) were recorded on a scale on 1 to 7; with 1 indicatingextremely dissatisfied and 7 indicating extremely satisfied.Results: Significant results were obtained while comparing themean VAS, number of patients with PSS of 5 to 7 and numberof patients with SSS of 5 to 7 in between the two study groups.Non-significant results were obtained while comparing theincidence of complications between the two study groups.Conclusion: In patients undergoing middle ear surgeries,Nalbuphine/ dexmedetomidine appeared to be significantlymore effective combination in comparison to the nalbuphine/propofol combination.