Analgesic effect of continuous adductor canal block versus continuous femoral nerve block for knee arthroscopic surgery: a randomized trial

Abstract Background and objectives Anterior cruciate ligament reconstruction (ACLR) is one of the most frequently performed orthopedic procedures. The ability to perform ACLR on an outpatient basis is largely dependent on an effective analgesic regimen. The aim of the study was to compare the analgesic effect between continuous adductor canal block (cACB) and femoral nerve block (cFNB) during arthroscopy guided ACLR. Method In this prospective, randomized, controlled clinical trial, 60 ASA I/II patients for arthroscopic ACLR were recruited. Patients in Group I received cACB and those in Group II cFNB. A bolus dose of 20 cc 0.5% levobupivacaine followed by 0.125% 5 mL.h-1 was started for 24 hours. Rescue analgesia in the form of paracetamol 1 g intravenous (IV) was given. Parameters assessed were time of first rescue analgesia, total analgesic requirement in 24 hours, and painless range of motion of the knee (15 degrees of flexion to further painless flexion). Results The time-to-first postoperative analgesic request (hours) was earlier in Group II (14.40 ± 4.32) than Group I (16.90 ± 3.37) and this difference was statistically significant (p< 0.05). The cumulative 24-h analgesic consumption (paracetamol in g) was 0.70 ± 0.47 in Group I and 1.70 ± 0.65 in Group II (p< 0.001). The painless range of motion (degree) was 55.67 ± 10.40 in Group I and 40.00 ± 11.37 in Group II (p< 0.001). Conclusion The findings of this study suggest that continuous adductor canal block provides superior analgesia in patients undergoing arthroscopic ACLR when compared to continuous femoral nerve block.

Nurse’s knowledge regarding importance of human milk and milk banking

Background: Breast milk is the complete nutrition for the babies during first 6 months of life. It is very important to feed the baby with breast milk during that crucial period of growth. Unavailability of breast milk can put the baby in life threatening conditions. In order to resolve the problem and to improve the mortality rate of neonates, nurses should have up to date information regarding the breast milk and its storage. Aim of this study was to assess the knowledge of nurses regarding importance of human milk and milk banking.Methods: Quantitative, descriptive research approach was used to assess the knowledge of 150 purposively selected nurses working in obstetric, gynae and pediatric wards in selected hospitals of Punjab by using socio-demographic sheet and self-structured questionnaire. Both descriptive and inferential statistical methods were used for the analysis of data.Results: Study findings revealed that majority of nurses 66% have adequate knowledge regarding importance of human milk and milk banking. Knowledge of nurses regarding importance of human milk and milk banking is significantly associated with working department.Conclusions: Study concluded that knowledge of nurses regarding importance of human milk and milk banking is satisfactory. But for the further improvement in knowledge of nurse’s in-service programs should be provided to them after regular intervals of time. So that they perform their work efficiently.

Peak Expiratory Flow (PEF) in Relation to Selected Anthropometric Parameters in Healthy Adult Males of Kumaun Region of India: A Comparative Study.

Background: PEF is a reasonably good measure of ventilatory function. It varies with various anthropometric parameters, geographical location of the subjects as well as various disease processes. Objective: To assess the relationship between PEF and certain selected anthropometric parameters and to devise prediction equation based upon these parameters. Materials and Methods: Three hundred healthy male adults in the age group of 18-60 years have been assessed for PEF using Wright Peak Flow Meter. Results: In the age group ≤ 40 years, PEF was on the average greater than in the age group > 40 years. Prediction equations were derived for PEF dependent on age and height in <40 age group and age and weight in >40 years age group. Conclusion: PEF appears to decline with advancing age, and to increase with height in younger subjects and weight in older subjects.

Effects of Age and Body Mass Index on Peak Expiratory Flow Rate in Indian Population.

Peak expiratory flow rate (PEFR) is a measure of ventilatory capacity measured by peak flow meter. It is regarded as a basic physiological parameter for the diagnosis, follow up and treatment of patients with respiratory illnesses such as asthma, chronic bronchitis, and emphysema. This study establishes the relationship of PEFR with age and BMI in healthy adult males (N=300) of Kumaon region of Uttarakhand. Overall, the mean PEFR is 478.37±68.14. The age is significantly affecting the PEFR unlike BMI. Age as an independent predictor predicts the 72.3% variability (R2 is 72.3%)in PEFR while BMI > 23 as an independent predictor predicts only 1.4% variability (R2 is 0.014) .PEFR declines with advancing age due to degenerative changes in musculoskeletal system leading to decrease in respiratory muscle strength. PEFR shows some decline with high BMI in elderly age group.