scholarly journals Feasibility of local anaesthesia in lateral internal anal sphincterotomy for chronic anal fissure

2018 ◽  
Vol 5 (7) ◽  
pp. 2578
Author(s):  
Bhimanagouda Venkanagouda Goudar ◽  
Eshwar B. Kalburgi ◽  
Yamanur P. Lamani ◽  
Veerabhadra Gowd Y. C.
Keyword(s):  
Hospital Stay ◽  
Local Anaesthesia ◽  
Primary Outcome ◽  
Treatment Options ◽  
Fissure In Ano ◽  
Post Operative Pain ◽  
Group A ◽  
Prospective Comparative Study ◽  
The Common ◽  
Group B

Background: Fissure in Ano is one of the common and most painful anorectal conditions encountered in surgical practice. Inspite of several conservative treatment options, surgical treatment in the form of Lateral Anal Spincterotomy (LAS) remains the gold standard of treatment for Chronic Anal Fissures (CAF).Methods: Prospective comparative study conducted on 90 patients randomly divided into two groups Group A under Local anaesthesia (LA) and Group B under Spinal anaesthesia (SA) respectively. The primary outcome variables studied were postoperative pain, hospital stay, and cost effectiveness.Results: A total of 90 patients randomly divided into 45 patients in each group. There was no statistically difference in the pain at surgery, but post-operative pain was significantly less in LA group at 5th hour, 24 hours after surgery. Hospital stay in LA group is significantly less when compared to SA group (1.92, 3.75 respectively).Conclusions: LAS can be comfortably performed under LA with added advantages.

EARLY OUTCOME OF LASER INTERNAL SPHINCTEROTOMY VERSUSOPEN INTERNAL SPHINCTEROTOMY IN THE TREATMENT OF ANAL FISSURES

2021 ◽  
pp. 55-59
Author(s):  
Rajkumar Verma ◽  
Satyendra Kumar ◽  
Vipin Mishra ◽  
Narendra Kumar
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Pain Score ◽  
Treatment Options ◽  
Lateral Internal Sphincterotomy ◽  
Fissure In Ano ◽  
Early Outcome ◽  
Internal Sphincterotomy ◽  
Group A ◽  
Group B

INTRODUCTION : Fissure-in-Ano is one of the common and most painful anorectal conditions encountered in surgical practice. Inspite of several conservative treatment options, surgical treatment in the form of Lateral Internal Spincterotomy (LIS) remains the gold standard of treatment for anal ssure. However we compare Laser lateral internal sphincterotomy with Open lateral internal Sphincterotomy for better postoperative pain relief and lesser hospital stay. AIM: Early outcome of laser lateral internal Sphincterotomy versus open lateral internal sphincterotomy in the treatment of anal ssures. MATERIALS AND METHODS: The study was conducted on 50 cases of Laser lateral internal sphincterotomy compare with 50 cases of Open lateral internal sphincterotomy in Maharani Laxmi Bai Medical College, Jhansi between January 2020 to July 2021. RESULTS:In our study in Group A 6% were in 16-20 years, 52% in 21-30 years, 20% in 31-40 years, 20% in 41-50 years and 2% 51-60% years and Group B 2% in 16-20 years, 34% in 21-30 years, 32% in 31-40 years, 18% 41-50%, 10% in 51-60 and 4% in >60. Group A mean postoperative VAS pain score in 6 hours 5.12±0,328, 12 hours 4.32±0.768, 24 hours 3.74±0.777, 36 hours 2.76±1.379 and 48 hours 2.3±1.418. In Group B mean postoperative VAS pain score in 6 hours 5.2±0.452, 12 hours 2.7±1.741, 24 hours 1.76±1.451, 36 hours 0.58±0.971 and 48 hours 0.28±0.671. Group A 44% presented with Perianal swelling, 42% Prutis Ani and 40% atus incontinence. In Group B 6% presented with amount of blood loss 6%, 18% Perianal swelling, 6% infection, 18% atus incontinence. The mean postoperative pain score was signicantly less in Group B at 12 to 48 hours. Group A mean hospital stay was 5.02±1.237 days and in Group B 2.02±0.141 days. It was signicantly less in Group B. CONCLUSION: Laser lateral Internal Spincterotomy is better than open Lateral Internal Spincterotomy with respect to less postoperative pain and lesser hospital stay and also less postoperative complications in the treatment of anal ssure.

scholarly journals HEMORRHOIDECTOMY;

2017 ◽  
Vol 24 (09) ◽  
pp. 1316-1321
Author(s):  
Shibber Ahmed ◽  
Ishtiaq Ahmad ◽  
Humayun Amjid ◽  
Aamir Furqan
Keyword(s):  
Hospital Stay ◽  
Severe Pain ◽  
Conventional Technique ◽  
Categorical Variables ◽  
P Value ◽  
Chi Square ◽  
Post Operative Pain ◽  
Group A ◽  
And Gender ◽  
Group B

Objectives: Is to compare outcomes in terms of mean post-operative pain andhospital stay between stapled versus conventional hemorrhoidectomy. Hypothesis: There isa difference in mean post-operative pain and hospital stay between stapled and conventionalhemorrhoidectomy, stapled technique is better than conventional technique. Study Design:Randomized control trial. Setting: Department of General Surgery Bakhtawar Amin MemorialHospital Multan. Period: February 2016 February 2017. Methodology: A total number of 60patients enrolled in the study, both genders. Statistical software SPSS ver.23 was used toanalyze the data. Mean and SD were calculated and presented for numerical variables likeduration of hemorrhoids, age and pain score while frequencies and percentage were calculatedand presented for categorical variables like ender and grade of hemorrhoids. Independent t-testand chi square test were applied to see effect modification. P value ≤0.05 was considered assignificant. Results: Total number of 60 (100%) patients in the study, 32 (53.3%) were maleand 28 (46.7 %) were female. Mean hospital stay in group A was 1.63 ± 0.71 and in groupB means duration of hospital stay was 1.73 ± 0.74. A P value was 0.001. On stratification ofdata it is concluded that in group A 9 patients have no pain 6 have mild and 6 have moderatepain and 5 patients have severe pain, similarly in group B, 3 patients have no pain 2 have mildpain 1 have moderate pain and no patient have severe pain. P value for male patients was2.65. Conclusion: This study confirms that stapled hemorrhoidectomy is associated with lesspostoperative pain with no effect of age and gender on outcome.

scholarly journals A comparative study between onlay and sublay meshplasty in ventral hernias: a randomized controlled trial

2019 ◽  
Vol 6 (4) ◽  
pp. 1264
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Preetham Anguraj ◽  
Jeyakumar Sundaraj ◽  
Manimaran Pethuraj
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Ventral Hernia ◽  
Controlled Study ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Ventral Hernias

Background: Ventral hernias are one of the most common surgical problems of the modern age. About 15-18% of all the surgical procedures performed around the world comprises of hernia repair. This study aims to compare the two common options of mesh placement in open ventral hernia repairs; over the anterior rectus sheath, the ‘Onlay meshplasty’ and in the retrorectus plane, the ‘Sublay meshplasty’.Methods: A prospective controlled study was done between March 2017 to August 2018 on 150 patients with ventral hernia randomizing patients into 2 groups. Group A (Onlay meshplasty) and Group B (Sublay meshplasty). Duration of surgery, post-operative pain, wound infection, duration of hospital stay and recurrences were analysed with 12 months follow up.Results: The mean duration of surgery in group A was 48.49±0.71 minutes and in group B was 72.84±0.72 minutes. Group B experienced significantly lesser pain when compared with group A. The mean asepsis score in group A was 3.60±1.09 and in group B was 0.47±0.30 with a p value of 0.006. Group A had significantly longer hospital stay (9.39 days) than group B (5.71 days). The recurrences in both the groups were statistically insignificant (Group A- 2 patients; Group B- 1 patient).Conclusions: Sublay meshplasty although requires longer time to perform, proves to be a better alternate in terms of post-operative pain, wound infection and hospital stay.

scholarly journals Intraperitoneal analgesia to reduce pain after laparoscopic hysterectomy

2017 ◽  
Vol 6 (8) ◽  
pp. 3235 ◽  
Author(s):  
Amira Mohammed Badawy
Keyword(s):  
Postoperative Pain ◽  
Primary Outcome ◽  
Laparoscopic Hysterectomy ◽  
Visual Analogue Score ◽  
Local Anaesthetics ◽  
Nausea And Vomiting ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Background: Laparoscopic hysterectomy is now an established operation, as it is less invasive and carries much less post-operative pain compared to open hysterectomy. However, post-laparoscopy analgesia is still a challenge. Intraperitoneal (IP) instillation of local anaesthetics has been shown to minimize postoperative pain after laparoscopic surgeries. This study was conducted to evaluate the efficacy of IP instillation of dilute analgesia prior the end of laparoscopic hysterectomy to reduce postoperative pain. The primary outcome was to assess postoperative pain scores. Secondary outcomes included assessment of postoperative analgesic requirements (type, amount, and timing), and frequency of nausea and vomiting.Methods: 20 cases were enrolled for laparoscopic hysterectomy and were divided randomly into two groups, Group A: 10 cases, where IP analgesia (Bupivacaine and Magnesium Sulphate) was instilled -under vision- prior removal of trocars, and Group B: 10 cases, where no IP analgesia was used. After surgery, Visual Analogue Score (VAS) was recorded at 6, 12, 24 hours and 7 days. Postoperative analgesic requirements (type, amount, and timing), and frequency of nausea and vomiting were also recorded.Results: The overall VAS during the first postoperative 24 hours was significantly lower in group A (P = 0.048, 0.049, and 0.003 at 6, 12, and 24 hours after surgery). Time to first of analgesia required (in hours) was longer (6.0±1.41 vs 3.20±1.48, P = 0.004) and total analgesic consumption (in mg) was lower (2.40±0.89 vs 3.30±0.67, P = 0.047) in group A compared to group B. The need for opioids was also significantly less in group A (3 cases vs 8 cases, P = 0.024). in group A, nausea and vomiting were less reported as well (P = 0.040).Conclusions: The instillation of local IP dilute analgesia is an effective and safe method for reducing pain after laparoscopic hysterectomy.

scholarly journals Effect of perioperative alpha1-blocker on non-stented ureteroscopic laser lithotripsy for ureteric stones

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M S Mohammed ◽  
A M Tawfeek ◽  
H S Shaker
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Laser Lithotripsy ◽  
University Hospitals ◽  
Pain Medications ◽  
Post Operative Pain ◽  
Urinary Tract Symptoms ◽  
Group A ◽  
Group B ◽  
Ureteric Dilatation

Abstract Background Nowadays, ureteroscopy is the first line of surgical treatment of ureteric stones and holmium YAG laser is commonly used in stone fragmentation. Guidelines 2018 recommended not fixing ureteric stent in uncomplicated ureteroscopy. Therefore, when we decrease intra-operative dilatation, we may decrease the complicated ureteroscopy. Objective To assess the safety, efficacy and outcome of peri-operative alpha1 blockers on non-stented ureteroscopic laser lithotripsy for ureteric stones. Patients and Methods Our study was conducted at Urology Department, Ain Shams University Hospitals and National Institute of Urology and Nephrology starting from September 2017 to December 2018. Sixty patients with lower ureteric stone included in this study underwent non-stented laser lithotripsy and were divided into two equal groups; group A (tamsulosin) and group B (no tamsulosin). Results Our study revealed that using peri-operative tamsulosin statistically reduced the need for ureteric dilatation, mean operative time, mean hospital stay, post-operative pain, the need for pain medications and post-operative lower urinary tract symptoms. Conclusion Administration of peri-operative tamsulosin seems to significantly decrease the need for intra-operative dilatation, post-operative LUTs, post-operative pain and the need for analgesia and shorten operative time and hospital stay.

scholarly journals A study to evaluate and compare the outcomes of endoscope versus microscope assisted myringoplasty

2021 ◽  
Vol 7 (6) ◽  
pp. 988
Author(s):  
K. Sharath Babu ◽  
R. Shankar
Keyword(s):  
Sinus Tympani ◽  
Graft Take ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Group A ◽  
Prospective Comparative Study ◽  
The Difference ◽  
One Year ◽  
Group B

<p class="abstract"><strong>Background:</strong> In microscope assisted middle ear procedures surgeons can only observe the parts of the tympanic cavity, the hidden areas, such as the facial recess and sinus tympani, would not be visualised which needs to be exposed for performing tympanoplasty. The aim of the study was to compare the outcomes of microscope versus endoscope assisted myringoplasties in terms of duration of the procedure, graft take up, improvement in hearing and incidence of any complications.</p><p class="abstract"><strong>Methods:</strong> A prospective comparative study was conducted for a period of one year. A total of 72 patients with CSOM were randomised into two groups of 36 each. Group A patients (n=36) underwent traditional myringoplasty under a microscope and group B patients (n=36) endoscopic assisted myringoplasty was performed. Post-operatively all the patients were followed up for a period of one year. During the follow-up period patients were assessed for the graft take up, hearing improvement, incidence of complications and recurrence rate between the two groups.</p><p class="abstract"><strong>Results:</strong> Successful graft uptake was observed in 88.8% among patients underwent microscope assisted myringoplasty and it was 94.4% in endoscopic assisted myringoplasty. The mean duration of surgery was 123 mins in microscopic assisted group compared to 92 mins in endoscopic assisted group and the difference was found to be statistically significant. Similarly, the cosmetic results and the post-operative pain were more favorable for endoscopic assisted group than microscopic assisted group and the difference was found to be statistically significant.</p><p class="abstract"><strong>Conclusions:</strong> Enoscopic assisted procedure could be considered as a better alternative for microscopic assisted myringoplasty.</p>

scholarly journals A prospective comparative study of ureterorenoscopy with and without DJ stenting for the management of ureteric stones

2021 ◽  
Vol 8 (12) ◽  
pp. 3606
Author(s):  
Dinesh Prasad ◽  
Yogesh Satani ◽  
Shivam Singh ◽  
Darpen Gajera
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Operative Time ◽  
Ureteral Stones ◽  
Safe Alternative ◽  
Stone Free Rate ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Free Rate

Background: Urolithiasis is the most common urological disease. Surgical treatment of ureteral stones consists of four minimally invasive modalities including ESWL, URS, PCNL, and laparoscopic or robotic-assisted stone surgery. URS and ESWL are the most widely used techniques. However, the use of ureteral stents for the treatment of ureteral stones is still controversial. Herein, we did a comparative study of URS with and without DJ stenting for the management of ureteric stones. Objectives of current study were to compare prevalence of post-operative complications in patients undergoing ureterorenoscopy without ureteral stenting as compared to patients undergoing stenting procedure, to study the frequency of morbidity in patients during post -operative period in both ‘stent’ and ‘no stent’ groups. Stone free-rate, operative time, complications, hospital stay and need for re-treatment in both groups will be determined.Methods: 50 patients with ureteric stones admitted in our hospital-SMIMER fulfilling our inclusion and exclusion criteria were randomly divided in two groups- patients in group A (25) underwent URS without DJ stenting and group B (25) underwent URS with DJ stenting.Results: URS without DJ stenting had less operative time, less postoperative complications like pain, requirement of analgesia, hematuria, UTI, dysuria, fever, less readmission rate and less hospital stay, similar stone free rate compared to URS with DJ stenting but it requires higher surgical endoscopy skills with urological expertise.Conclusions: Thus, after adequate training, URS without DJ stenting can be recommended as a safe alternative procedure than URS with DJ stenting for management of ureteric stones. 

scholarly journals A study to assess the outcomes following tonsillectomy in patients who were administered only prophylactic pre-operative antibiotics vis-à-vis patients who were administered both pre and post-operative antibiotics

2021 ◽  
Vol 7 (2) ◽  
pp. 354
Author(s):  
Shikha Shah ◽  
James Thomas ◽  
Tejal Sonar ◽  
Srinithya Kancherla ◽  
Aastha Bhatnagar
Keyword(s):  
Clavulanic Acid ◽  
Daily Activities ◽  
Antibiotic Resistant ◽  
Post Operative Period ◽  
Operative Surgery ◽  
Post Operative Pain ◽  
Group A ◽  
Resistant Strains ◽  
The Common ◽  
Group B

<p class="abstract"><strong>Background:</strong> Tonsillectomy is one of the common operative surgery performed by an ENT surgeon. With aim to reduce the hospital stay and post-operative complications, the use of antibiotics has become every common.</p><p class="abstract"><strong>Methods:</strong> 40 patients undergoing tonsillectomy were recruited into the study subsequent to obtaining informed consent. The patients were divided in to two groups, group A and group B. Both the groups were given tablet amoxicillin with clavulanic acid orally for 3 days prior to surgery and subsequently were administered injection amoxicillin and clavulanic acid intravenously 1 hour prior to surgery pre operatively. Only group A patients were given injection amoxicillin and clavulanic acid intravenously 12 hourly for 5 days in the post-operative period. The patients from both the groups were assessed on the following criteria: pain, slough in the tonsillar fossa, fever, clot formation and return to normal daily activities.  </p><p class="abstract"><strong>Results:</strong> Both the groups were comparable with regard to demographics, post-operative infections, post-operative pain and time to return to normal daily activities. There was no cognisant difference for all the parameters assessed.</p><p class="abstract"><strong>Conclusions:</strong> Administration of antibiotics in patients undergoing tonsillectomy can be restricted to pre-operative antibiotics only as giving antibiotics post-operatively does not affect the clinical outcome and also prevents indiscriminate use of antibiotics which can lead to mutant antibiotic resistant strains of bacteria which can also have an economic impact.</p><p> </p>

Outcome of Percutaneous Ultrasound Guided Aspiration versus Open Surgical Drainage of Psoas Muscle Abscess

2021 ◽  
Vol 17 (2) ◽  
pp. 180-183
Author(s):  
Shahida Khatoon ◽  
Ayesha Ahmedani ◽  
Sanam Karim Unar ◽  
Riaz Ahmed Memon ◽  
Shahnawaz Khatti ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Psoas Muscle ◽  
University Hospital ◽  
Abscess Cavity ◽  
Surgical Drainage ◽  
Ultrasound Guided ◽  
Post Operative Pain ◽  
Group A ◽  
Group B ◽  
Medical University

Objective: To compare the outcome of percutaneous ultrasound guided aspiration V/S open surgical drainage for psoas muscle abscess. Methodology: This comparative study was conducted in department of general surgery at Liaquat medical university hospital Hyderabad/Jamshoro, from June 2017 to November 2017. Diagnosed Patients of psoas muscle abscess size more than 5cm, between 18 to 60 years of age and either of gender were included. Patients were randomly divided into two groups, A and B by odd and even method, patients in group A abscess was aspirated by percutaneous ultrasound guided aspiration and patients in group B was underwent open surgical drainage, all the data were entered in the pre designed performa and analyzed into SPSS V:16.0 Results: A total of 58 patients of Psoas muscle abscess were selected, the mean age of study subjects of group A was 38.5+10.5 and group B was 36.5+12.7 (p-673). Early post-operative pain relief was assessed among patients of group A as compared to group B. As per outcome resolution of abscess cavity was significantly high among patients of group B (p-0.004), while post-operative Hospital stay was significantly lower in group A (p-0.002). Conclusion: Both techniques has their own benefits like percutaneous aspiration has shorter duration of hospital stay while in complete resolution of abscess cavity was found in open surgical drainage group of patients.

scholarly journals Cost effectiveness of TAPP (trans-abdominal pre-peritoneal inguinal hernia repair) over open inguinal Lichtenstein meshplasty

2018 ◽  
Vol 5 (5) ◽  
pp. 1812
Author(s):  
Manish Kashyap Kashyap ◽  
Pravin Singhade ◽  
Riddhi Bora ◽  
Gaurav Batra ◽  
Ishant Rege ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hospital Stay ◽  
Lichtenstein Repair ◽  
Hernia Surgery ◽  
Cost Of Treatment ◽  
Duration Of Hospital Stay ◽  
Tapp Repair ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Background: Hernia surgery has undergone tremendous refinement in technique of various methods have been advocated by different authors but each has got its own merit. Laparoscopic Trans-abdominal Pre-Peritoneal inguinal meshplasty (TAPP) is a newer technique which results in less post-operative pain, better cosmetic result, improves recovery time. The aim of the study was to compare cost effectiveness and duration of hospital stay that occurs from both laparoscopic TAPP repair and Lichtenstein repair in patients of inguinal hernia.Methods: The present study comprises 25 cases underwent open Lichtenstein mesh repair and 25 cases underwent laparoscopic (TAPP) repair. After surgery all patients were monitored carefully for pain, infection, cost effectiveness and hospital stay.Results: In present study, Group A is having significantly more cost of treatment than Group B in unilateral. The hospital stay was significantly low in group A than Group B.Conclusions: TAPP repair is more expensive compared to Lichtenstein’s meshplasty, TAPP repair is associated with faster recovery as compared to open Lichtenstein meshplasty, hospital stay is lesser in TAPP as compared to open inguinal meshplasty. 

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