scholarly journals Low Dose Hyperbaric Bupivacaine and Dexmedetomidine as an Adjuvant in Spinal Anaesthesia, Caesarean Section: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Ahmed Ashraf Nasr ◽  
Safaa Mohamed Helal ◽  
Wesam Eldin Abdelrahman Soltan
Keyword(s):  
Caesarean Section ◽  
Postoperative Analgesia ◽  
Ordinal Data ◽  
Low Dose ◽  
Enhanced Recovery ◽  
Elective Caesarean Section ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Hyperbaric Bupivacaine

Abstract Background Alpha-2 agonist, e.g. dexmedetomidine, is a non-opioid adjuvant with a substantial role in extending the analgesic duration of the subarachnoid block. Here, we aim to test the efficacy of adding dexmedetomidine to hyperbaric bupivacaine in the caesarean delivery, targeting enhanced postoperative analgesia and more stable hemodynamics. Methods 40 parturient women scheduled for elective caesarean section were enrolled and randomly allocated to two groups. Low Dose – Dexmedetomidine (LD- DEX) group (n = 20) received 7 mg hyperbaric bupivacaine plus 10 µg dexmedetomidine, control group (n = 20) received 12 mg hyperbaric bupivacaine. Continuous normally distributed data were expressed as mean and standard deviation. Ordinal data and continuous data not fitting to the normal distribution curve were presented as medians (range) meanwhile categorical data were reported as percentage of the total number. Regarding the autonomic variables, we did a stratified analysis to compare the mean change of these variables every 3 minutes till 60 minutes through a two-sample t-test (Welch t-test). All statistical analyses were performed using R software version 3.4.4 Results LD- DEX groups showed significant faster and prolonged sensory block (P-value < 0.05), stable maternal hemodynamic maintained by less amount of IV fluids (P-value < 0.01), lower doses of ephedrine (P-value = 0.02), no signs of foetal distress, and low incidence of postoperative maternal shivering. As well, 3 hours cut off pain was more significant in LD- DEX group (P-value < 0.01). Conclusion LD- DEX group provided an optimum intraoperative condition and postoperative analgesia with less maternal side effects and no neonatal risks, encouraging enhanced recovery and less hospital in-stay.

scholarly journals Low Dose Bupivacaine plus Fentanyl in Subarachnoid Block for Caesarean Section

2016 ◽  
Vol 4 (1) ◽  
pp. 24-30
Author(s):  
Nasir Uddin Ahmed ◽  
Masuda Islam Khan ◽  
Aynul Islam Khan ◽  
AKM Akhtaruzzaman
Keyword(s):  
Blood Pressure ◽  
Caesarean Section ◽  
Systolic Blood Pressure ◽  
Postoperative Analgesia ◽  
Low Dose ◽  
Hyperbaric Bupivacaine ◽  
Haemodynamic Stability ◽  
Group A ◽  
Group B ◽  
Mean Time

Background: Spinal anaesthesia induced hypotension, a common problem during caesarean section, is associated with maternal nausea and vomiting and the risk of neonatal acidosis. Low dose local anaesthetic combined with opioids spinal anaesthesia better preserves maternal haemodynamic stability, resulting in equally efficacious anaesthesia.Objectives: To investigate whether this synergistic action could be used to provide effective anaesthesia while preventing hypotension during caesarean operation.Materials and method: This prospective study included 60 pregnant mothers scheduled for caesarean operation who were then divided into two groups (thirty in each). Group-A received a spinal injection of 12.5 mg of standardized 0.5% hyperbaric bupivacaine and group-B received 8 mg of 0.5% hyperbaric bupivacaine with 20 ?gm fentanyl. Hypotension was defined as the systolic blood pressure drops below 90 mm of Hg or a decrease of systolic blood pressure 25% from pre anaesthesia level and hypotension was treated with a bolus of 5 to 10 mg of intravenous ephedrine. The quality of anaesthesia and postoperative analgesia were evaluated.Results: The mean time required to reach peak sensory level was earlier in group-B than group-A and was statistically significant (p<0.05). The decrease in systolic blood pressure in group-A was significantly more than group-B (p<0.05) and vasopressor requirement was also significantly more in group-A compared to group-B (p<0.05). Mean time of two segment regression of sensory analgesia and complete sensory recovery was significantly early in group-B (p<0.05). Duration of motor recovery in group-B was significantly earlier (p<0.05). The duration of effective analgesia was significantly more in group-B (p<0.05).Conclusion: Low dose Bupivacaine with fentanyl provided excellent intraoperative sensory and motor blockade, haemodynamic stability, and effective postoperative analgesia for caesarean delivery.Delta Med Col J. Jan 2016 4(1): 24-30

scholarly journals The Effectiveness of Lavender Aromatherapy Technique on Pain Reduction of Post Caesarean Section Patients in Ajibarang Hospital

2018 ◽  
Vol 13 (3) ◽  
pp. 119
Author(s):  
Siti Haniyah ◽  
Martyarini Budi Setyawati
Keyword(s):  
Experimental Design ◽  
Caesarean Section ◽  
Pain Reduction ◽  
Pain Scale ◽  
Caesarian Section ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Quasi Experimental ◽  
Paired T Test

<p><strong>ABSTRACT</strong><br />The number of caesarean section birth in Indonesia were 22.8% or 921,000 out of 4,039,000 childbirth. The patients become conscious when the anesthetic effect disappears and they will feel pain in the incision area that makes them uncomfortable. One of the methods to reduce pain of Caesarean Section is lavender aromatherapy technique. The purpose of this study was to determine the effectiveness of lavender aromatherapy technique on pain reduction of caesarean section post-operative patients in Ajibarang hospital. This study was conducted by using a quasi-experimental design with pretest-posttest design. The samples were 22 respondents divided into two groups; 11 respondents received lavender aromatherapy treatment and 11 respondents were in the control group. Paired t test was used to describe pain scale differences in the control group and intervention. The results showed that there was a difference in the pain scale between lavender aromatherapy technique group and the control group with p value of 0.000. It can be concluded that lavender aromatherapy technique reduces pain in post-operative caesarian section patients.</p><p><em><strong>ABSTRAK</strong></em><br /><em>Angka kejadian Caesarean section di Indonesia 921.000 dari 4.039.000 persalinan (22,8%) dari seluruh persalinan. Pasien akan mulai bergerak saat efek anastesi telah habis dan setelah itu mereka akan merasakan nyeri pada area pembedahan sehingga menimbulkan ketidaknyamanan. Salah satu metode untuk menangani Nyeri post Sectio C aesarea adalah dengan teknik aroma terapi lavender.Tujuan dari penelitian ini adalah untuk mengetahui efektifitas teknik aroma terapi lavender terhadap nyeri pada pasien post operasi Caesarean section di RSUD Ajibarang Desain penelitian ini adalah quasi eksperiment with pretest-posttest design dengan sampel 22 responden terbagi menjadi 2 kelompok, 11 responden mendapatkan aroma terapi lavender, dan 11 responden sebagai kelompok kontrol. Uji beda dua mean antar kelompok menggunakan uji Paired T test. Terdapat perbedaan skala nyeri antara kelompok aroma terapi lavender dengan kelompok kontrol p value 0,000. Kesimpulan dari penelitian ini adalah: terdapat pengaruh antara teknik Aroma Terapi Lavender terhadap penurunan nyeri Post SC.</em></p>

scholarly journals Subarachnoid clonidine or fentanyl with low dose hyperbaric bupivacaine for elective caesarean section - A comparative study

2012 ◽  
Vol 17 (1) ◽  
pp. 14-17
Author(s):  
Md Manowarul Islam ◽  
Nadeem Parvez Ali ◽  
Rabeya Begum ◽  
AKM Akhtaruzzaman
Keyword(s):  
Caesarean Section ◽  
Total Dose ◽  
Low Dose ◽  
Epigastric Pain ◽  
Elective Caesarean Section ◽  
Local Anaesthetics ◽  
Hyperbaric Bupivacaine ◽  
Subarachnoid Block ◽  
Parametric Data

Background: Preferred technique of anaesthesia for caesarean section is neuraxial block. Hyperbaric bupivacaine in adequate dose for subarachnoid block often causes complications like hypotension, shivering, nausea, vomiting, chest pain and epigastric pain. Objectives: The aim of study is to reduce the complications of subarachnoid block, improve quality of block, quality of anesthesia, prolong duration of post operative analgesia by reducing total dose of local anaesthetics with the use of adjuvant like fentanyl or clonidine. Methods: Ninety parturients of ASA grade I & II for caesarean section under subarachnoid block were randomly allocated equally into three groups: Group B: hyperbaric bupivacaine 0.5% of 2 ml+ 0.25ml normal saline regarded as controlGroup BC: hyperbaric bupivacaine 0.5% of 1.75 ml + 0.5 ml clonidine (75 ?g)Group BF: hyperbaric bupivacaine 0.5% of 1.75 ml + 0.5 ml fentanyl (25 ?g) Parametric data like pulse, blood pressure among the groups were analyzed by ANOVA test & nonparametric data like chest discomfort, epigastric pain, nausea, vomiting were analyzed by chi-square test. Results: The study revealed that subarachnoid clonidine or fentanyl as adjuvant with low dose hyperbaric bupivacaine provide better quality of block, better quality of anaesthesia,more haemodynamical stability and longer duration of post operative analgesia compared to bupivacaine alone.Clonidine is better alternative to fentanyl as adjuvant with bupivacine in subarachnoid block. Conclusion: Addition of clonidine as adjuvant can reduce total dose of bupivacaine in subarachnoid block to ensure better quality of block, better quality of anaesthesia by reducing complications and longer duration of post operative analgesia compared to fentanyl. DOI: http://dx.doi.org/10.3329/jdnmch.v17i1.12185 J. Dhaka National Med. Coll. Hos. 2011; 17 (01): 14-17

scholarly journals Comparative study with or without application of enhanced recovery after surgery protocols in patients undergoing elective cesarean section

2020 ◽  
Vol 10 (1) ◽  
pp. 173
Author(s):  
Pammy Pravina ◽  
Khushbu Tewary
Keyword(s):  
Caesarean Section ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Financial Burden ◽  
Elective Caesarean Section ◽  
Elective Cesarean Section ◽  
Control Group ◽  
Operative Care ◽  
Operative Recovery ◽  
Eras Protocol

Background: Concept of enhanced recovery after surgery (ERAS) has been applied in various surgical branches. Evidence regarding the necessary components of ERAS for obstetric population is limited. Therefore, objective of this study was to test the application of ERAS in patients undergoing elective caesarean section on the post-operative recovery process.Methods: The study was conducted in the Department of Obstetrics and Gynecology, NMCH, Patna from January 2014 to December 2014. A total of 100 patients (n=100) undergoing elective caesarean section were included in the study. Cases were allocated into two groups a) Study group included 60 patients (n=60) and ERAS protocol was followed b) Control group included 40 patients (n=40) and standard post-operative care protocol was followed. Two groups were compared with respect to recovery parameters, post-operative complications and satisfaction rates.Results: More patients in the ERAS group were discharged on post-operative day 4 than the standard postoperative care group (90% vs 12.5%, p<0.0001). More patient in the ERAS group were significantly satisfied with the protocol compared to standard post-operative care (77% vs 70%, p<0.04). Approximately 77 percent of the patients in the ERAS group rated the satisfication score between 8-10 compared to 70 percent of the patients in control group (p<0.04). There was no difference between two groups with respect to recatheterization rate, readmission rate and post-discharge complaints.Conclusions: In this study with application of ERAS protocol, we reported reduced hospital stay which may reduce financial burden of patients and healthcare facilities.

SUPPORTIVE EDUCATIVE SYSTEM DALAM MENINGKATKAN KEMANDIRIAN MERAWAT KAKI PADA PASIEN DIABETES MELLITUS TIPE II

2019 ◽  
Vol 9 (2) ◽  
pp. 63-72
Author(s):  
Nova Nurwinda Sari ◽  
Herlina Herlina
Keyword(s):  
Diabetes Mellitus ◽  
Health Center ◽  
Intervention Group ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Type Ii ◽  
Foot Care ◽  
Control Group Design ◽  
Patients With Diabetes

Diabetes mellitus dapat menyebabkan cukup banyak komplikasi seperti kelainan mata, kelainan ginjal, kelainan pembuluh darah dan kelainan pada kaki. Penderita diabetes mellitus yang mengalami komplikasi kronis perlu diberikan upaya preventif untuk mencegah komplikasi, salah satunya adalah kemampuan perawatan kaki. Penelitian ini dilakukan untuk menguji efektivitas supportive educative system dalam meningkatkan kemandirian perawatan kaki pada pasien dengan diabetes mellitus Tipe II di Puskesmas Permata Sukarame, Bandar Lampung. Penelitian ini menggunakan metode quasy eksperimen dengan desain pretest-posttest with control group dengan total masing-masing kelompok sebanyak 18 responden. Pengumpulan data dilakukan dengan menyebarkan kuesioner kepada responden yang memenuhi kriteria inklusi penelitian. Penelitian ini diuji menggunakan analisis univariat, bivariat dan uji T-test. Hasil penelitian menunjukkan bahwa terdapat perbedaan rata-rata dalam kemandirian perawatan kaki pada kelompok intervensi dan kelompok kontrol dengan p-value 0,000. Pendidikan dan praktik perawatan kaki harus diberikan sejak dini sebagai upaya pencegahan untuk komplikasi.   Kata kunci : Supportive educative system, kemandirian perawatan kaki   SUPPORTIVE EDUCATIVE SYSTEM IN IMPROVING INDEPENDENCE OF FOOT CARE IN PATIENTS WITH DIABETES MELLITUS TYPE II   ABSTRACT Diabetes mellitus can cause quite a lot of complications such as eye disorders, kidney disorders, vascular disorders and abnormalities in the legs. Patients with diabetes mellitus who have chronic complications need to be given a preventive effort to prevent complications, one of which is foot care ability. This research was conducted to examine the effectiveness of supportive educative systems in increasing the independence of foot care in patients with Type II diabetes mellitus in the Permata Sukarame Health Center Bandar Lampung Working Area. This study used a quasi-experimental method with pretest-posttest with control group design with a total of 18 respondents each. Data collection is done by distributing questionnaires to respondents who meet the research inclusion criteria. This study was tested using univariate, bivariate, T-Test analysis. The results showed that the mean differences in the independence of foot care in the intervention group and the control group in the Permata Sukarame Community Health Center work area with a p-value of 0,000. Education and practice of foot care should be given early as a preventative effort for complications.   Keywords: Supportive educative system, independence of foot care

PENGGUNAAN SELAPUT AMNION SEGAR PADA INSISI LUKA OPERASI SEKSIO SESAREA

2019 ◽  
Vol 1 (2) ◽  
pp. 47-55
Author(s):  
Syahredi Syaiful Adnani ◽  
Hafni Bachtiar
Keyword(s):  
Wound Healing ◽  
Caesarean Section ◽  
Amniotic Membrane ◽  
Healing Time ◽  
Cost Of Care ◽  
Control Group ◽  
P Value ◽  
Control Groups ◽  
And Control ◽  
Wound Healing Time

In the last few decades, the incidence of caesarean section is increasing in the world, especially in Indonesia. One of the way to treat tissue scar is through biologic and synthetic dressing where nowadays, amnion has been used as biologic dressing frequently. This study was conducted to determine the effect of the use of fresh amniotic membrane on wound incision Caesarean section compared with Caesarean section incision wound covered using regular gauze bandages and fixated with plaster in RS. Dr. Reksodiwiryo Padang. The design of this study is an experimen-tal study with Post test design with control group design. Sampling was done using a formula consecutive sampling two different test samples obtained an average of 72 people for each group. The analysis used include univariate and bivariate analyzes. The average wound healing time the difference was statistically significant (p value <0.05) in the treatment and control groups. There was highly significant difference in the proportion of local infection on day 3 between the treatment and control groups (p value <0.05). There were very significant differences in the proportion of local allergic reactions at day 3, and 5 between the treatment and control group (p <0.05). There are significant differences in terms of the cost of care per day between treatment and control groups (p <0.05). From this study, the average wound healing time has a very significant difference.Keywords: Fresh Amniotic Membrane, Wound Cesarean Section, Wound Healing

Cesarean section incisional infiltration with lidocaine and Epinephrine versus Lidocaine alone in reducing postoperative pain. A randomized controlled double-blinded clinical trial

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hazem F El-Shahawy ◽  
Sherif F El-Mekkawi ◽  
. Haitham F Mohmmed ◽  
Hend M Afifi
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Breast Feeding ◽  
Local Anesthetic ◽  
Elective Caesarean Section ◽  
Control Group ◽  
Cesarean Section Delivery ◽  
Anesthetic Effect

Abstract Background Cesarean section delivery is becoming more frequent. Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation Aim of the Work to assess the efficacy and safety adding ef Epinephrine to lidocaine 2% in dose-related manner 1:200.000 in prolongation of anesthetic effect of lidocaine as a local anesthetic to reduce post; caesarean section pain after general anesthesia. Patients and Methods A total number of 200 women planned for elective caesarean section at Shams University Maternity Hospital Was recruited, 2 groups were randomized with a study group included 100 women received lidocaine 2% and epinephrine in dose-related manner and a control group included 100 women received lidocaine 2% only. Results women who received lidocaine and epinephrine were more satisfied and hadsignificant more time after caesarean section free of pain in comparison to women who received lidocaine only by 120 minutes. Also. adding Of epinephrine helped in decrease in amount of analgesic consumption after caesarean section. Women who received lidocaine and epinephrine started breast feeding and mobilization earlier than women who received lidocaine only. Epinephrine prolonged the action of lidocaine as a local anesthetic, this prolongation of action of local anesthetic had a significant effect in early mobilization and breast feeding and decrease in cost of analgesics. Nobody in our candidate had a post-operative infection, past operative pyrexia, Allergic reactions tar general anesthesia or complications with local anesthesia. Conclusion Adding of epinephrine to local anesthetics (such as lidocaine 2% in dose-related manner 1:200.0000) prolonged anesthetic effect by more than double of its original anesthetic time, This prolongation on anesthetic effect of local anesthesia by epinephrine helps in eariy mobilization; early breast feeding and less hospital duration stays. No complications (local nor systemic) developed with local infiltration of post-caesarean section incision with lidocaine 2% even aficr adding epinephrine in dose-related manner 1:200.000

Pengaruh Clay Therapy terhadap Kecemasan Anak Usia Prasekolah yang Menjalani Prosedur Invasif di RSUD Al-Ihsan

2019 ◽  
Vol 13 (2) ◽  
pp. 72-86
Author(s):  
Depi Lukitasari
Keyword(s):  
Venous Blood ◽  
Intervention Group ◽  
Invasive Procedure ◽  
T Test ◽  
The Body ◽  
Preschool Age ◽  
Control Group ◽  
P Value ◽  
Invasive Procedures ◽  
Preschool Age Children

Background. During hospitalization large number of invasive procedure recived by patient and preceived as threatening and anxiety experience. One of the invasive procedures that commonly done is the venous blood extraction. The children in preschool age preceived venous blood extraction as something that endanger the integrity of the body and lead to anxiety experience. To reduce the anxiety during the venous blood extraction, a nurse could perform a clay theraphy. The aim of this research is to ascertain the effect of clay therapy toward scoreof anxiety in preschool age children that undergoing venous blood extraction in RSUD Al-Ihsan.Methode. The study was quasi-experiment with nonequivalent control group posttest only. A total of 34 children who recieve venous blood extraction was assigned into 2 group, 17 children in control and 17 children in intevention. The children anxiety level measured using anxiety observation sheet before the procedure complete. Data were analyzed used independent t test for bivariate and logistik regresion for multivariate. Result Findings. The results  show a significat difference in anxiety score between control group and intervention group with p-value 0,001 < α 0.05 which means there is impact of clay therapy to level anxiety in preschool age children undergoing invasive procedure in RSUD Al-Ihsan. Conclusion. This research indicate that clay therapy may be used to reduce anxiety in children that undergoing venous blood extraction.

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