ABSTRACT
Background and Aims: Ultrasound (US)-guided quadratus lumborum (QL) block is an abdominal field block that has high efficacy in providing postoperative analgesia for abdominal surgeries. This study was undertaken to compare the US-guided QL block with ilioinguinal-iliohypogastric (IIIH) nerve block and local wound infiltration in unilateral inguinal surgeries, in terms of analgesia and overall patient satisfaction. Methods: This randomised controlled trial was conducted in two groups of thirty each. After the completion of surgery under spinal anaesthesia, patients in Group QL received 20 ml of inj. ropivacaine 0.5% while patients in Group IL received 10 ml of inj. ropivacaine 0.5% at the ilioinguinal-iliohypogastric nerve site and 10 ml of inj. ropivacaine 0.5% that was locally infiltrated at the surgical site. Duration of analgesia, Visual Analogue Scale (VAS) score, total requirement of analgesic dosage in the first 24 hours, and patient satisfaction score were compared in both the groups. Statistical analysis was performed using unpaired student's t test and Chi-squared test with IBM SPSS Statistics version 21 software. Results: Duration of analgesia was significantly higher in Group QL (544.83 ± 60.22 min) when compared with Group IL (350.67 ± 67.97 min; P < 0.0001). VAS scores and analgesic requirements were also lower in Group QL. The patient satisfaction score was significantly higher in Group QL (3.93 ± 0.91) when compared to Group IL (3.4 ± 1.0; P < 0.05). Conclusion: US-guided QL block significantly prolongs the duration and quality of postoperative analgesia, thereby reducing analgesic consumption and increasing overall patient satisfaction.
ABSTRACT
AIMS AND OBJECTIVES: To evaluate salivary alpha-amylase (sAA) levels for determining stress variations in patients undergoing spinal anesthesia for infra-umbilical surgery. MATERIALS AND METHODS: One hundred and twenty subjects (age 18-65 years) planned for infra-umbilical surgery under spinal anesthesia were included and allocated to Groups A and B ensuring age and sex matching. In both groups, sAA levels (S1 to S4) were assessed sequentially at different times (E1 to E4). S1 and S2 were collected on the evening before surgery (E1) and in the preoperative room on the day of surgery (E2), respectively. Thereafter, in Group A, S3 and S4 were collected before (E3) and 15 min after spinal anesthesia (E4), following which intravenous Midazolam was given. In Group B, intravenous Midazolam was administered first, S3 was collected 5 min later (E3), spinal anesthesia was administered and S4 was collected after15 min (E4). RESULTS: In both groups, sAA levels showed a mild increase from E1 to E2 (not significant). Thereafter from E2 to E3 and E3 to E4, a significant sharp rise in sAA levels in Group A and a significantly acute decline in Group B was noted. Mean sAA levels in Group A were higher as compared to group B (P < 0.005) in E3 and E4. CONCLUSION: Sequential documentation of increase in sAA levels in our study, starting with the baseline levels, presents a comprehensive report of the stress that the patients experience during preoperative period and reinforces the need of anxiolytic before spinal anesthesia.
ABSTRACT
The dynamics of an initially nonspherical liquid droplet falling in air under the action of gravity is investigated via three-dimensional numerical simulations of the Navier-Stokes and continuity equations in the inertial regime. The surface tension is considered to be high enough so that a droplet does not undergo breakup. Vertically symmetric oscillations which decay with time are observed for low inertia. The amplitude of these oscillations increases for high Gallilei numbers and the shape asymmetry in the vertical direction becomes prominent. The reason for this asymmetry has been attributed to the higher aerodynamic inertia. Moreover, even for large inertia, no path deviations or oscillations are observed.
