ABSTRACT
Background and Aims: Laparoscopic cholecystectomy (LC) is a widely accepted surgical procedure associated with postoperative pain. This study was done to compare peripheral nerve stimulator (PNS)-guided serratus anterior plane block (SAP) and transversus abdominis plane (TAP) block for postoperative analgesia for patients undergoing LC. Methods: Following approval from the ethical committee, 70 patients for LC were randomly assigned to Group S: SAP block and Group T: TAP block. The blocks were performed under PNS guidance, and 20 ml of 0.375% ropivacaine was administered. The severity of pain was measured using a visual analogue scale (VAS). The study's primary objective was the evaluation of the postoperative VAS score. The time of the first dose of rescue analgesia and total tramadol consumption for 24 h postoperatively were secondary objectives. All the statistical calculation was done using statistical analyses for Social Sciences for Windows version 23.0 (IBM Corp, NY, USA). Results: Lower VAS score was seen in patients of TAP block at rest as well as movement at 6 h (P = 0.001), 12 h (P = 0.001) and 18 h (P = 0.001) postoperatively compared with SAP. The TAP group showed a significantly increased time of first rescue analgesic compared to the SAP group (7.97 ± 0.51 vs. 5.89 ± 1.45, P = 0.001). Tramadol usage was significantly higher in the SAP group than in the TAP group (128.9 ± 36.22 vs. 72.43 ± 44.80, P = 0.001). Conclusion: TAP block guided by the PNS improves postoperative pain with less tramadol consumption and during the postoperative period without significant complications.
ABSTRACT
Introduction: With a global pandemic like coronavirus disease 2019 (COVID-19) spreading across borders, creating an extensive fear amongst all groups alike due to the increased morbidity and mortality, there is uncertainty in all patients affected. The government policy of quarantine of pregnant and postnatal women with COVID-19 in hospitals leads to ironic isolation and loneliness, mounting anxiety and fear of unknown outcomes. This study was undertaken to assess maternal anxiety in relation to COVID-19 and to observe factors influencing anxiety, drawing on anxiety scoring scales and a comparison of the levels of anxiety between antenatal and postnatal mothers. Methods: This cross-sectional descriptive study was conducted on 123 perinatal women with COVID-19 and their levels of anxiety were assessed on the basis of a pre-formed questionnaire, using the Coronavirus Anxiety Scale (CAS) and Generalized Anxiety Disorder-7 Questionnaire (GAD-7). The levels of anxiety between antenatal and postnatal mothers were compared based on these 2 scoring systems, using IBM.SPSS statistics software Version23.0. Results: Although both groups were having high scores of anxiety, antenatal women were found to possess statistically significant higher level of anxiety, compared to postnatal women, as determined by CAS. Conclusion: Better assessment on antenatal and postnatal women will lead to need-based counselling from healthcare workers during their hospital stay and better use of resources for the identification of the vulnerable group and their management.
ABSTRACT
BACKGROUND AND AIM: Intra/post-operative shivering is frequently observed in parturients posted for elective cesarean delivery (C/D) under spinal anaesthesia. Several studies have advocated the anti-shivering effect of 5-HT3 antagonists, although none has revealed convincing results. The study aims to evaluate the prophylactic effect of a single intravenous dose of ramosetron (0.3 mg), compared with a placebo (N - normal saline), for the prevention of post-spinal shivering (PSS) during elective C/D. METHOD: The study comprised 80 parturients of the American Society of Anaesthesiologists (ASA) physical status I/II, posted for elective C/D under spinal anaesthesia who were randomly divided into 2 equal groups; Group N: 0.9% normal saline (4 ml) immediately before induction of spinal anaesthesia and Group R: ramosetron (0.3 mg) intravenously diluted to 4 ml volume. Shivering at any time on a (0-4) scale and total dose of tramadol required for its treatment was recorded. The study also includes the recording of haemodynamic parameters and the incidence of early onset nausea and vomiting. RESULTS: Statistically significant data was obtained while comparing incidence of shivering and maximum shivering at any time (P = 0.001). A lower incidence of early onset nausea and decreased total dose of tramadol was also observed in the ramosetron group. CONCLUSION: Ramosetron (0.3 mg) is advocated to be an effective drug in preventing post-spinal shivering among parturients posted for elective C/D. Moreover, its role in preventing maternal nausea together with better haemodynamic parameters further supported the advantageous role of ramosetron in our group of patients.
