Abstract: Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value
Abstract: Adequate analgesia following caesarean section
decreases morbidity, hastens ambulation, improves patient outcome
and facilitates care of the newborn. Intrathecal magnesium, an
NMDA antagonist, has been shown to prolong analgesia without
significant side effects in healthy parturients. The aim of this study
was to evaluate the onset and duration of sensory and motor block,
hemodynamic effect, postoperative analgesia, and adverse effects of
magnesium or fentanyl given intrathecally with hyperbaric 0.5%
bupivacaine in patients with mild preeclampsia undergoing caesarean
section. Sixty women with mild preeclampsia undergoing elective
caesarean section were included in a prospective, double blind,
controlled trial. Patients were randomly assigned to receive spinal
anesthesia with 2 mL 0.5% hyperbaric bupivacaine with 12.5 μg
fentanyl (group F) or 0.1 ml of 50% magnesium sulphate (50 mg)
(group M) with 0.15ml preservative free distilled water. Onset,
duration and recovery of sensory and motor block, time to maximum
sensory block, duration of spinal anaesthesia and postoperative
analgesic requirements were studied. Statistical comparison was
carried out using the Chi-square or Fisher’s exact tests and
Independent Student’s t-test where appropriate. The onset of both
sensory and motor block was slower in the magnesium group. The
duration of spinal anaesthesia (246 vs. 284) and motor block (186.3
vs. 210) were significantly longer in the magnesium group. Total
analgesic top up requirement was less in group M. Hemodynamic
parameters were similar in both the groups. Intrathecal magnesium
caused minimal side effects. Since Fentanyl and other opioid
congeners are not available throughout the country easily,
magnesium with its easy availability and less side effect profile can
be a cost effective alternative to fentanyl in managing pregnancy
induced hypertension (PIH) patients given along with Bupivacaine
intrathecally in caesarean section.
Abstract: Background and aim: It has not been well studied
whether fentanyl-thiopental (FT) is effective and safe for PSA in
orthopedic procedures in Emergency Department (ED). The aim of
this trial was to evaluate the effectiveness of intravenous FT versus
fentanyl-midazolam (FM) in patients who suffered from shoulder
dislocation or distal radial fracture-dislocation.
Methods: In this randomized double-blinded study, Seventy-six
eligible patients were entered the study and randomly received
intravenous FT or FM. The success rate, onset of action and recovery
time, pain score, physicians’ satisfaction and adverse events were
assessed and recorded by treating emergency physicians. The
statistical analysis was intention to treat.
Results: The success rate after administrating loading dose in FT
group was significantly higher than FM group (71.7% vs. 48.9%,
p=0.04); however, the ultimate unsuccessful rate after 3 doses of
drugs in the FT group was higher than the FM group (3 to 1) but it
did not reach to significant level (p=0.61). Despite near equal onset
of action time in two study group (P=0.464), the recovery period in
patients receiving FT was markedly shorter than FM group
(P