scholarly journals Comparison of two different techniques of uterine closure in caesarean section: Continuous single layer technique versus Babu and Magon technique

2018 ◽  
Vol 7 (6) ◽  
pp. 2197
Author(s):  
S. Vinayachandran ◽  
Vedhapriya Sudhakar
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Single Layer ◽  
Adverse Outcomes ◽  
Caesarean Scar ◽  
Duration Of Surgery ◽  
Layer Technique ◽  
Observational Prospective Cohort Study ◽  
Group A ◽  
Group B

Background: To compare size of the caesarean scar and residual myometrial thickness (RMT) between continuous single non-interlocking and Babu and Magon technique for uterine closure following primary elective caesarean section (CS).Methods: An observational prospective cohort study was conducted at 6 weeks and 4 months postpartum following primary elective CS. Group A included 25 patients who underwent continuous single layer technique and Group B included 25 patients who underwent Babu and Magon technique for uterine closure. Baseline demographic profile, obstetric score, details of the CS and associated complications were studied. Two-dimensional Transvaginal ultrasonography (TVS) measurements of the length, width and depth of the caesarean scar and RMT were compared.Results: Mean age of study population was 29.6 years. Malpresentation (44%) was the most common indication for CS. Mean Bishops score at the time of CS was <4. The duration of surgery (-2.8 min, 37.96 ±5.660min) and estimated amount of blood loss (-51.6 ml, mean 671.20 ±136.208ml) was less in Group A compared to Group B (40.76 ±4.68min, 722.80±132.083ml respectively). The caesarean scar measurements were similar in both groups at both visits. The mean RMT in Group B at 6 weeks and 4 months postpartum (8.05mm±2.06 and 7.10mm±2.04 respectively) was statistically higher than Group A (6.23mm ± 1.76 and 5.36mm ± 1.70 respectively), p=0.002.Conclusions: We conclude that Babu and Magon technique for uterine closure in caesarean section could result in better healing of the scar and probably reduce the adverse outcomes in subsequent pregnancies.

scholarly journals TO DETERMINE EFFICACY OF GRANISETRON VERSUS PLACEBO FOR REDUCING SHIVERING IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION UNDER SPINAL ANAESTHESIA

2021 ◽  
Vol 71 (2) ◽  
pp. 530-34
Author(s):  
Sana Abbas ◽  
Bilal Yasin ◽  
Basit Mehmood Khan ◽  
Umer Hayat ◽  
Beenish Abbas ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Elective Caesarean Section ◽  
Patient Comfort ◽  
Military Hospital ◽  
P Value ◽  
Intravenous Bolus ◽  
Lower Segment ◽  
Group A ◽  
Group B

Objective: To determine the efficacy of granisetron versus placebo (saline) for reducing shivering in patients undergoing lower segment caeserian section under spinal anaesthesia. Study Design: Comparative cross - sectional study. Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital Rawalpindi, from Apr to Sep 2019. Methodology: Total 178 patients undergoing lower segment ceaserian section under spinal anaesthesia with age ranges from 18-40 years of American Society of Anaesthesiologists status I & II with full term pregnancy scheduled for elective caesarean section under spinal anaesthesia. Group A (n=92) received an intravenous bolus of 1 mg granisetron in a 10ml syringe and Group B (n=86) received intravenous bolus of normal saline in a 10ml syringe, drugs were administered immediately before spinal anaesthesia by anaesthetist as coded syringes. Heart rate, blood pressure, core body temperature and shivering scores were measured at 0 minutes, 30 minutes and 60 minutes, average surgery time recorded to be 60 minutes. Results: None of the patients in group A (drug group) exhibited appreciable post spinal shivering whereas 25 (29%) in group B (placebo) had clinically significant shivering necessitated administration of other established pharmacological agents to abort shivering in order to ensure patient comfort and satisfaction with statistically significant p-value of <0.05. Conclusion: Prophylactic injection granisetron was efficacious against post spinal shivering, moreover provides worth while relief of nausea and vomiting which is dilemma with most of the drugs employed for control of post spinal shivering.

scholarly journals Elective versus emergency caesarean section: differences in maternal outcome

2019 ◽  
Vol 8 (8) ◽  
pp. 3207
Author(s):  
Anshu Sharma ◽  
Rajiv Acharya ◽  
Yashika Pehal ◽  
Bhawna Sharma
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Fetal Distress ◽  
Emergency Caesarean Section ◽  
Maternal Outcome ◽  
Common Indication ◽  
Emergency Caesarean ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Caesarean section is a life-saving surgical procedure when certain complications arise during pregnancy or labour. The use of CS worldwide has increased worldwide unprecedented levels although the gap between higher- and lower-resource settings remains. The present study evaluates the difference in maternal outcome in elective versus emergency caesarean sections in our institute.Methods: The study included first 65 cases of emergency caesarean section (group A) and during the study period, first 65 elective caesarean section (group B) if they fulfilled the inclusion criteria. Various intra operative and postoperative events were recorded which included intra operative complications, postpartum haemorrhage and transfusion indices.Results: The most common indication of caesarean section in group A was fetal distress (27.7%). In group B most caesarean sections were classified under 5 followed by class 6, the most common indication being previous caesarean section (27.6%). It was observed that pre-operative mean haemoglobin in group A was 10.6 g/dl and in group B was 11.2g/dl. A drop of 1.36 g/dl in group A and 1.10 g/dl in group B was observed in the post-op period. Cross match / transfusion ratio 1.5 in group A and  2 in group B, transfusion probability ratio was 60 % in group A and  66.7%  in group B and transfusion index was 1 in group A and  group B. There was significantly higher contraception acceptance in group B compared to group A.Conclusions: Elective caesarean section has more favourable maternal outcome as compared to emergency caesarean section as the former is done under controlled and planned circumstances.  However, there should be stringent audit to scrutinise indication of caesarean section, outcome of caesarean and blood transfusion practices.

scholarly journals Comparison of Ondansetron and Granisetron for prevention of PONV following elective LUCS

2009 ◽  
Vol 20 (2) ◽  
pp. 61-65 ◽  
Author(s):  
Md Raihan Uddin ◽  
Lutful Aziz ◽  
SN Samad Choudhury
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Postoperative Period ◽  
Elective Caesarean Section ◽  
Study Groups ◽  
Early Postoperative Period ◽  
Control Group ◽  
Group A ◽  
Group B ◽  
Oral Ondansetron

The aim of the study was to compare the antiemetic effects of oral ondansetron (8mg) and granisectron (2mg) for prevention of PONV following elective caesarean section. Ninety parturients scheduled for elective caesarean section under spinal anaesthesia were randomly allocated into three groups. Group A (n=30) were received vitamin tab, group B (n=30) parturients were received oral ondansectron (8mg) & group C (n=30) parturients were received oral granisetron (2mg). Anesthetic procedure was common to all groups. Emetic episodes in early postoperative period (1st 24 hrs.) were recorded and compared in different study groups. Emetic episodes were observed in six parturients (20%) in group A (control), 3 parturients in group B (3%) and 3 parturients in group C (3%). So to conclude, minimal emetic episodes were observed in early postoperative period in parturients who had received ondensetron or granisetron than the control group. Keywords: LUCS, PONV, Ondansetron, and Granisetron. Journal of BSA, Vol. 20, No. 2, July 2007 p.61-65

scholarly journals Small intestine anastomosis by full thickness, single layer and interrupted suture technique: results of a comparative study

2019 ◽  
Vol 6 (3) ◽  
pp. 675
Author(s):  
Shobhit K. Nemma ◽  
Sarbjeet Singh ◽  
Amritpal Singh Rana ◽  
Rohit Kapoor ◽  
Puneet Bansal
Keyword(s):  
Small Intestine ◽  
Double Layer ◽  
Single Layer ◽  
Stoma Closure ◽  
Full Thickness ◽  
Layer Technique ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Background: Since the dawn of surgery intestinal anastomosis has remained a controversial topic in respect to suture material, anastomotic technique, distance between stitches and borders. Technique of anastomosis is an important determinant in process of anastomosis healing. Despite a large amount of work done on anastomosis techniques, a clear superiority of one technique over another has not been established.Methods: Patients of ileostomy reporting to surgery department for stoma closure were used for study. 80 patients of ileostomy reporting for stoma closure were used as material for the study and randomized in two groups. In single layer group, using 3-0 silk suture, we performed small intestine anastomosis applying single layer of interrupted sutures taking full thickness bite. In double layer group, anastomosis was performed anastomosis by applying first layer of full thickness sutures and second layer of seromuscular sutures. The results were compared in terms of operative time, post operative complications, mortality, hospital stay and cost of the suture material.Results: The mean age of the patients was 33.55 yr in group A (single layer) and 35.85 yr in group B (double layer). Total 7 patients developed anastomotic leak. 5 (12.5%) patients were with double layer anastomosis and 2 (5%) patients were in single layer group. The difference in anastomosis leak in two groups was statistically insignificant (p = 0.232). The mean duration of whole procedure in group A (single layer) was 52.5min and 71.5min in group B (double layer). The difference in mean duration of the procedure was found to statistically significant (P = 0.00).Conclusions: We concluded the single layer technique to be a safe, efficient and more cost effective as compared to double layer technique.

scholarly journals Management of Postcaesarean Delivery Analgesia-Diclofenac Suppository, Paracetamol Infusion and a Combination

2021 ◽  
Author(s):  
Mandem Sadana Reddy ◽  
Munikrishna Munisamaiah
Keyword(s):  
Patient Satisfaction ◽  
Side Effects ◽  
Caesarean Section ◽  
Satisfaction Score ◽  
Early Recovery ◽  
Patient Satisfaction Score ◽  
Duration Of Surgery ◽  
Group A ◽  
Individual Use ◽  
Group B

Introduction: One of the most important aspect of postoperative care is pain management which plays an important role in early recovery and improves patient’s general condition. Paracetamol and diclofenac have an excellent safety profile when compared to opioids. Aim: To assess and compare the analgesic efficacy and safety of individual use of Intravenous (IV) paracetamol, diclofenac suppository and in combination. Materials and Methods: This hospital-based cross-sectional study was conducted from October 2018 to June 2020 at Department of Obstetrics and Gynaecology. A total of 90 women who underwent caesarean section were recruited for the study and were randomly allocated (lottery method) into three groups with 30 participants in each group. The patients underwent Lower Segment Caesarean Section (LSCS) under spinal anaesthesia with the same technique and medicine, (Bupivacaine 0.5%) without receiving any sedation. Group A patients received diclofenac suppository 50 mg every eight hourly, Group B received paracetamol infusion 1000 mg every eight hourly and Group C received 50 mg diclofenac suppository and 500 mg IV paracetamol every eight hourly. Pain severity (Visual Analogue Scale (VAS) score), Heart Rate (HR), Blood Pressure (BP) and side-effects were evaluated at 2,4,6,8,12 and 24 hours postoperatively. Patient satisfaction score was evaluated 24 hours after caesarean section. Results: Age range of participants was 19 to 28 years. Mean duration of surgery (minutes) in each group were- Group A-56.5±7.49, Group B-58.27±8.06 and Group C-56.97±6.78, respectively. There was a significant reduction of pain in patients receiving paracetamol and diclofenac suppository combination group. The satisfaction score was categorised as excellent by 80% patients in Group C. In Group A 30% and in Group B 16.6% categorised as excellent patient satisfaction score. The adverse effects such as nausea and epigastric discomfort was higher (7.7%) with diclofenac suppository group followed by Paracetamol (2.2% side-effects) and minimal with combination (1%). Conclusion: Paracetamol infusion is as effective as diclofenac suppository in reducing postoperative pain following caesarean section. Diclofenac suppository and IV paracetamol combination provides more effective postoperative analgesia compared with individual usage of IV paracetamol or diclofenac suppository in patients following caesarean section. The combined use of paracetamol and diclofenac suppository has fewer side-effects compared with individual use of either IV paracetamol or diclofenac suppository.

scholarly journals Effect of Hydrocortisone on Reducing severity of Post Dural Puncture Headache after Spinal Anesthesia for Elective Caesarean Section

2018 ◽  
Vol 23 (4) ◽  
pp. 468-472
Author(s):  
Shumaila Ashfaq ◽  
Liaqat Ali ◽  
Muhammad Ashraf Zia ◽  
Rizwan Ahmad Khan ◽  
Mehtash Butt
Keyword(s):  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Conventional Treatment ◽  
Dural Puncture ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Post Dural Puncture Headache ◽  
Group A ◽  
Group B

Spinal anesthesia is frequently used in pregnant female undergoing caesarean section due to its safety than general anaesthesia. Post dural puncture headache (PDPH) is commonly occurring problem associated with spinal anaesthesia and causes a considerable morbidity. PDPH depends on several factor and various methods have been used to reduce and treat the pain of PDPH. We evaluated effects of hydrocortisone on the treatment of PDPH in obstetrical patient. To compare mean decrease in Visual Analogue Scalepain score in patients who developed PDPH after elective caesarean section under spinal anaesthesia who were given conventional treatment versus conventional treatment plus hydrocortisone. Double blind randomized control trial. Study conducted in department of anaesthesia and obstetrics of Allama Iqbal Medical College, Jinnah hospital (tertiary care) conducted from13th June 2014 to 13th December 2014. Sample size was calculated 60 (30 each) cases using 95% confidence interval, 80% power of test. Patients who developed PDPH after spinal anaesthesia for elective caesarean section were divided into 2 group; Group A (Conventional Treatment) and Group B, (Conventional Treatment plus Hydrocortisone 100mg 8 hourly for 48 hours). Details were recorded regarding age; mean pretreatment and post treatment VAS after 6 hours. Mean decrease in pain VAS score was 3.30 + 1.2 in group A while 7.17+ 1.3 in group B. (P value 0.001). Intravenous hydrocortisone is more effective in reducing post dural puncture headache pain severity after spinal anaesthesia for elective caesarean section when given along with conventional treatment as compared to conventional treatment alone.

scholarly journals VAGINAL BREECH DELIVERY

2015 ◽  
Vol 22 (08) ◽  
pp. 1024-1028
Author(s):  
Samina Naz
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Perinatal Death ◽  
Elective Caesarean Section ◽  
Breech Presentation ◽  
Neurological Dysfunction ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Group A ◽  
Group B

Objective: To determine the obstetric and perinatal outcome of pregnancieswith singleton breech presentation, and to scrutinize the causes of increasing incidence ofcesarean section in breech presentation. Design: Analytical Observational study. Place andduration: Department of obstetrics and gynecology Fatima hospital Baqai university campusfrom Jan 2010 to Oct 2011. Patients & Methods: This study includes 135 patients with singletonbreech presentation ≥ 34 weeks of gestation, were analyzed in detail with help of designedperforma. Patients were categorized in three groups. Groups a, who had elective C-section,group b. who underwent emergency caesarean section or had C-section after failed trial ofvaginal delivery and group c. who had vaginal breech delivery. Elective caesarean section wasdone in those cases that had some other indications for carrying out this procedure apart frombreech presentation. Trial of vaginal breech delivery was planned for all multiparous womenexcept those falling in group A. All antepartum fetal demise, twin pregnancies and placentaprevia of major degree were excluded. Results: Of 135 women, 7(5%) underwent prelabourcesarean, and 128(95%), had trial of vaginal delivery, of whom 117(91.5%) delivered vaginally.Significantly more infants weighing> 3.5kg were selected for prelabour and intrapartumcesarean than vaginal delivery. Two neonates had Apgar score< 7 at 5 minutes but both werenormal neurologically. There were no nonanomalous perinatal death and no case of significanttrauma or neurological dysfunction. Two infants died due to lethal anomalies. Conclusion:Trial of vaginal breech delivery in well counselled patients, still taken as an appropriate optionwithout compromising prenatal and maternal outcome. It also decreases the rate of cesareansection.

scholarly journals Comparison of Ondansetron And Ondansetron Plus Alprazolum for Prevention of Nausea and Vomiting Following Elective Caesarean Section

2009 ◽  
Vol 21 (1) ◽  
pp. 43-49
Author(s):  
Md Rafiqul Hasan Khan ◽  
SN Samad Choudhury
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Caesarean Section ◽  
Postoperative Period ◽  
Postoperative Nausea ◽  
Elective Caesarean Section ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Group A ◽  
Group B

Pregnancy & operation both causes anxiety. Excessive anxiety & noncompliance with fasting can increase gastric volume & predispose patients to postoperative nausea & vomiting. Prevention rather than treatment of postoperative nausea and vomiting should be the anesthetist's aim. It was a prospective double blind comparative study of 60 parturient scheduled for elective caesarean section under subarachnoid block to see the effect of anxiolytic drug on per & PONV in LUCS. We have carried out comparative study with alprazolum as anxiolytic agent & compared the action of Ondansetron with Ondansetron +alprazolum. Parturient at term or elective caesarean section included in the study were ASA grade I & II. A total of 60 cards, 30 in each group were prepared by another person who was blind for the study. Every parturient was allowed to draw one card and grouped accordingly. Group A: Inj. Ondansetron (8mg), Group B: Oral alprazolum (0.25mg) +inj. ondansetron (8mg). After 20 minutes of prehydration under all aseptic precaution lumber puncture was performed with 25 gauge Quincke's needle in the L3-L4 or L4-L5 space in sitting position and 0.5% Hyperbaric Bupivacaine 2.5 ml (12.5 mg.) was injected within 10-12 sec. Immediately after administration of spinal anaesthesia fetal heart rate was noted for any changes in pulse rate, blood pressure, rate of respiration, discomfort and occurrence of side effects: shivering, nausea, vomiting was recorded every 2 minute for first 10 minutes, then at 10 minutes interval for remainder of the operation. Per operative monitoring such as ECG, continuous SpO2, non invasive arterial blood pressure was recorded each two minutes interval from time of intrathecal injection up to 10 minutes and then at 10 minutes interval until the end of operation. In the recovery room postoperative analgesia was provided with injection ketorolac tromethamine 30 mg IM on complaining pain and repeated in all patients if necessary. Presence of nausea and vomiting patients were interviewed at one hourly over the first 3 hours then at 3 hourly up to 24 hours postoperative period. Rescue antiemetic of prochlorparazine 10 mg I/M was given if vomiting occurs once, nausea for 10 minutes or at the patient request. Rest other parameters as for example; heart rate, BP, respiration and SpO2 were also recorded at same interval. Patients were carefully observed for any adverse effects like headache, flushing, drowsiness or any other symptoms. In the present study incidence of nausea and vomiting in group-A was one and in group-B was zero. Regarding hemodynamic changes (Pulse, Blood pressure) SpO2, respiratory changes, during operation and 24 hours post operative period in some occasions significant changes were observed (P<0.05) but in other occasions no significant changes occur. No other adverse effect like headache, constipation and flushing during operation and 24 hours postoperative period were observed in this study. In this study we have found that Ondansetron reduces peroperative and postoperative nausea and vomiting. But addition of Alprazolum (an anxiolytic) to Ondansetron, the chance of nausea and vomiting was less.   Journal of BSA, Vol. 21, No. 1, January 2008 43-49

scholarly journals Comparative study of diclofenac suppository with tramadol suppository in addition to acetaminophen for post caesarian analgesia

2020 ◽  
Vol 9 (4) ◽  
pp. 1372
Author(s):  
Reetu Hooda ◽  
Prachi Pathak ◽  
Rahul Chavhan
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
P Value ◽  
Breastfeeding Initiation ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Vas Score ◽  
Rectal Suppository ◽  
Group A ◽  
Group B

Background: Pain after emergency and elective caesarean section may adversely affect patient’s recovery and breastfeeding initiation. The aim of present study was to compare the analgesic efficacy of diclofenac suppository-intravenous acetaminophen (APAP) combination, tramadol suppository-intravenous APAP combination and intravenous APAP alone for postoperative pain relief after caesarean section.Methods: We designed a randomized double-blind control study. Three hundred parturient scheduled for caesarean section were randomized to receive diclofenac rectal suppository (100 mg), tramadol rectal suppository (100 mg) or glycerin rectal suppository in Group A, B and C respectively (100 parturient in each group). All the women routinely received 1000 mg acetaminophen intravenously. Assessment of pain was done using a visual analogue scale (VAS) at 0, 1, 6, 12, 18 and 24 hours. injection Pentazocine 0.3 mg/kg IV was given as rescue analgesia when VAS score > 30.Results: The mean VAS score was significantly higher in Group C as compared to Group A and Group B (p value < 0.001). This suggests better efficacy of multimodal treatment as compared to monotherapy. Group A as compared to Group B showed better efficacy in term of VAS score at 12 and 18 hours (p = 0.05, p = 0.02 respectively).Conclusions: We found that when controlling for socio-demographic characteristics, combination of either diclofenac or tramadol suppository with acetaminophen has significantly better results when compared with monotherapy of acetaminophen alone in post-operative analgesia after caesarean section. However, the combination of diclofenac suppository has proved to be superior in comparison to tramadol suppository.

scholarly journals Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Microsurgical Decompression ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

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