11 research outputs found
Utility of numerical and visual analog scales for evaluating the post-operative pain in rural patients
No full textBackground: Visual analog scales (VAS) and numeric analog scales (NAS) are used to assess post-operative pain, but few studies indicate their usefulness in rural illiterate population in India. Aims: This study was designed to 1) Compare the impact of literacy on the ability to indicate pain rating on VAS and NAS in post-operative rural patients. 2) Assess the level of agreement between the pain scales. Setting and Design: Cross sectional, hospital based study. Methods: Informed consent was obtained from patients prior to undergoing surgical procedures in a teaching hospital. Post surgery, patients who were conscious and coherent, were asked to rate pain on both VAS and NAS. The pain ratings were obtained within 24 hours of surgery and within 5 minutes of each other. Statistical Methods: Percentages, chi square test, regression analysis. Results: A total of 105 patients participated in the study. 43 (41%) of the sample was illiterate. 82 (78.1%) were able to rate pain on VAS while 81 (77.1%) were able to rate pain on NAS. There was no significant association between pain ratings and type of surgery, duration of surgery and nature of anaesthesia. In multivariate analysis, age, sex and literacy had no significant association with the ability to rate pain on VAS (P value 0.652, 0.967, 0.328 respectively). Similarly, no significant association was obtained between age, sex and literacy and ability to rate pain on NAS (P value 0.713, 0.405, 0.875 respectively). Correlation coefficient between the scales was 0.693. Conclusion: VAS and NAS can be used interchangeably in Indian rural population as post-operative pain assessment tools irrespective of literacy status
PERIOPERATIVE ANAPHYLAXIS – OUR EXPERIENCE OF TWO CASES
No full textAnaphylactic reactions during intraoperative period are difficult to diagnose because of the anaesthetized state of the patient. During the perioperative period, any event relating to sudden-onset haemodynamic collapse or increased airway pressures during certain surgical procedures should raise suspicion of anaphylaxis. Though cited as rare in the western world, echinococcus infection is common in India, resulting in an increased ratio of cases, as and when compared to the western world. We report of two cases of perioperative anaphylaxis for hydatid disease surgery during 3 years period. Anaphylaxis is a medical emergency requiring prompt intervention. Although protocols vary in some of the details of management, adrenaline is the mainstay of treatment and early administration saves lives. However, even with prompt appropriate treatment, anaphylaxis can still kill, as our first case reports. From our experience, we suggest use of 100 % oxygen during the intraoperative period and maintaining anaesthesia with intravenous agents so that in case of an untoward catastrophic event, cerebral hypoxia may be delayed Increased reports of successfully managed cases will help in future references and in formulating guidelines of management .
A simple dietary addition of fenugreek seed leads to the reduction in blood glucose levels: A parallel group, randomized single-blind trial
No full textOxygen Conservation Strategies in Hospital- Current Perspectives
No full textThe significance of oxygen has never been more
apparent. The Covid pandemic has swept the globe like never
before, and the need for oxygen in hospitals and intensive care
units has skyrocketed. The oxygen supply cannot be raised
overnight, but the corona virus is quickly spreading, causing a
supply and demand mismatch. Until the availability of oxygen
is increased, judicious use of oxygen is needed, and oxygen
conservation strategies must be strictly followed. Many
societies, such as the Indian Society of Anaesthesia, have
stepped forward in these trying times and published widely
read advisories1
. It is important to follow these notifications in
order to conserve oxygen
Preoperative anxiety among cardiac surgery patients and its impact on major adverse cardiac events and mortality– A randomized, parallel-group study
No full textBackground: Patients undergoing elective cardiac surgery often experience pre-operative anxiety. Preoperative anxiety influences surgical outcome. There are very few studies which have assessed the impact of clonidine and Gabapentin in the treatment of anxiety especially in Indian populations and its implications on major adverse cardiac events (MACE) and 30 days mortality.
Materials and Methods: Adult patients aged 18 to 80 years old who were scheduled to have an elective coronary artery by-pass graft (CABG) were included in the study. Those who satisfied the inclusion criteria were given either Gabapentin (800 mg) or Clonidine (300 mcg) 90-120 minutes before the induction. State trait anxiety inventory (STAI) was used to assess anxiety in baseline and taking just before operating room. The primary endpoint was a reduction in the STAI associated with the study drug, while the secondary endpoint was the incidence of MACE in the perioperative period (30 days), which included composite episodes of non-fatal cardiac arrest, chaotic rhythm, acute myocardial infarction, congestive heart failure, cardiac arrhythmia, angina, and death.
Results: A total of 75 patients were considered for the statistical analysis. The demographic and clinical features of the study participants were similar in both groups. Nearly 75-80% of participants had severe anxiety in the preoperative period while 10-20% had moderate anxiety. While both the drugs showed a reduction in the anxiety levels, the clonidine group fared better (statistically insignificant). The incidence of MACE was similar in both groups.
Conclusion: The preoperative anxiety levels were high among cardiac surgery patients. Both clonidine and gabapentin were equally effective in reducing the levels of preoperative anxiety. Preoperative STAI scores in the range of 32-53 is not associated with MACE and 30-day mortality among cardiac surgery patients
Minoxidil poisoning presenting as acute coronary syndrome: a rare case scenario
No full textWe present a case of severe minoxidil poisoning (3000 mg) with resultant severe hypotension, tachycardia and subendocardial ischemia initially treated crystalloid, dopamine, aspirin, clopidogrel on the lines of acute coronary syndrome with partial haemodynamic improvement. After getting the history of minoxidil poisoning, the patient was treated with bolus doses of norepinephrine, and norepinephrine infusion, resulting in resolution of hypertension, tachycardia and reversal of ischemia. Topical minoxidil is commonly used agent for male pattern baldness. It also has got antihypertensive action when ingested, acute coronary syndrome and compensatory tachycardia with successful management with norepinephrine bolus and infusion
