scholarly journals Comparison between fractionated dose with bolus dose in Spinal Anaesthesia for haemodynamic stability and duration of analgesia in patients undergoing elective Lower Segment Caesarean Section (LSCS)

Mediscope ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. 95-102
Author(s):  
Md Munjur Hossain ◽  
Biplab Biswas ◽  
Pankaj Kumar Mohanta ◽  
Muhammad Masud Hassan ◽  
Plabon Basu ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Bolus Dose ◽  
Elective Caesarean Section ◽  
Lower Segment ◽  
College Hospital ◽  
Lower Segment Caesarean Section ◽  
Haemodynamic Stability ◽  
Spine Deformities ◽  
Group B

Background: Elective or emergency caesarean sections are routinely done under spinal anaesthesia (SA) with bolus dose of local anaesthetic drugs. Objective: To compared fractionated dose with bolus dose in SA for haemodynamic stability and duration of analgesia in patients undergoing elective lower segment caesarean section (LSCS). Methods: The present study was carried out in the Department of Anaesthesiology, Ad-din Akij Medical College Hospital, Khulna from January 2018 to December 2018 on sixty female patients (thirty in each group) of the American Society of Anesthesiologists physical status I–III, age from 18 to 40 years, height from 140 to 180 cm, singleton pregnancies scheduled for elective LSCS under SA. Patients with pre-existing diseases or pregnancy-induced hypertension, cardiovascular or cerebrovascular disease, any contraindication to SA, those weighing <50 kg or >110 kg and those taller than 180 cm or shorter than 140 cm and severely altered mental status, spine deformities or history of laminectomy were excluded from the study. Results: The mean duration of analgesia was statistically significant (p<0.05) between two groups. Mean pulse rate- after 5 min, after 10 min, after 15 min, after 30 min, after 45 min and after 60 min were significantly (p<0.05) higher in group F than group B. Mean arterial pressure- before given study drug, after 0 min, after 5 min, after 10 min, after 15 min, after 30 min, after 45 min and after 60 min were not significantly (p>0.05) between two group. 14 patients (46.7%) in group B and 5 patients (16.7%) in group F required vasopressor. The difference was significant (p<0.05) between two groups. Conclusion: Separation process in which a certain quantity of a mixture dose of SA provides better haemodynamic stability and longer period of analgesia compare to bolus dose in patients undergoing elective caesarean section. Mediscope Vol. 7, No. 2: July 2020, Page 95-102

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.

SPINAL ANAESTHESIA USING TAYLOR’S APPROACH SAVES THE DAY IN OBESE PARTURIENT.

2021 ◽  
pp. 228-228
Author(s):  
Vishal Vashist ◽  
Roohani Mahajan ◽  
Bhanu Gupta
Keyword(s):  
Caesarean Section ◽  
General Anesthesia ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Case History ◽  
Breech Presentation ◽  
Lower Segment ◽  
Subarachnoid Block ◽  
Lower Segment Caesarean Section ◽  
History Of

Subarachnoid block is commonly employed for caesarean deliveries, by virtue of its simplicity in terms of performance, safety for the parturients as compared to general anesthesia. The case history of a 27-yearold female parturiant patient is presented. She was posted for emergency lower segment caesarean section in view of primigravida with breech presentation in labour . She was obese with bodyweight of 102 kg. She had a thick scaly plaque over the back in midline from L1 to L5 area, which is contraindication for administration of spinal anaesthesia via standard median and paramedian approach . Taylor’s approach for administration of the same was tried and proved successful, thus saving the patient from receiving general anaesthesia .

scholarly journals Syncopal Attack! - A Rare Complication after Whitacre Spinal Needle Insertion during Spinal Anaesthesia

2021 ◽  
Vol 10 (24) ◽  
pp. 1845-1847
Author(s):  
Sanjot Ninave ◽  
Aditya Rameshbabu Devalla
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Vasovagal Syncope ◽  
Needle Insertion ◽  
Spinal Needle ◽  
Common Mechanism ◽  
Lower Segment ◽  
Young Females ◽  
Lower Segment Caesarean Section ◽  
Sequence Of Events

Fine gauze spinal needles are known to decrease the incidence of postdural puncture headache (PDPH) in patients undergoing spinal anaesthesia. We present a rare case of syncopal attack in a patient posted for caesarean section. A patient undergoing elective surgery with inadequate anxiolysis can have a rare chance of a syncopal attack. Hence, high level of suspicion and management of a vasovagal attack is vital. The most common mechanism of syncope is reflex mediated, which can be ‘neurally’ or ‘vasovagally’, and it characteristically develops in the sitting or upright position but may occur in supine position also.1,2 It is characterized by a rapid onset, brief duration, and with a spontaneous recovery. Anxious and apprehensive patients prior to any surgical or anaesthetic procedure can lead to a vasovagal syncope, especially in young females.3 Medline search did not reveal any case report regarding the vasovagal syncope just after spinal needle insertion in young females undergoing spinal anaesthesia. Spinal anaesthesia is the most common anaesthesia performed for lower segment caesarean section (LSCS). A case of syncopal attack with sequence of events, during the insertion of a 25 G Whitacre spinal needle, in a parturient posted for emergency lower segment caesarean section, is discussed here.

scholarly journals To Compare the Incidence of Post-Dural Puncture Headache Using 25G Quincke and 25G Whitacre Spinal Needles in Patients Undergoing Lower Segment Caesarean Section

2021 ◽  
Vol 10 (14) ◽  
pp. 1014-1019
Author(s):  
Aditya Rameshbabu Devalla ◽  
Sanjot S. Ninave ◽  
Amol P. Singam
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Lower Segment ◽  
Early Ambulation ◽  
Post Dural Puncture Headache ◽  
Lower Segment Caesarean Section ◽  
Key Words Spinal Anaesthesia ◽  
American Society ◽  
Obstetric Surgery

BACKGROUND Spinal anaesthesia is the first preference of anaesthesia in obstetric surgery. Post dural puncture headache (PDPH) is more common after C-section in young parturients. In the present world which is developing and fast-paced, brisk recovery along with minimal side effects & importantly early ambulation are now the need of the hour. This headache is more worrying to the mother who is required to tend to the newborn baby. This study compared the incidence of PDPH subsequent to subarachnoid blockade for lower segment Caesarean section (LSCS) 25G Whitacre & 25G Quincke needles. We wanted to compare the incidence of PDPH using 25G Quincke and 25G Whitacre spinal needles in patients undergoing LSCS. METHODS Two hundred (ASA II) American Society of Anaesthesiologists 11 females who were pregnant and in the age group of 20 - 50 years, planned to get sub-arachnoid blockade for C-section, were assigned randomly into two equal groups (N = 100 each). Both groups received spinal anaesthesia with 25-gauge Quincke and 25 gauge Whitacre needle. Postoperatively, incidence, site, onset, severity and duration of headache was studied. RESULTS The incidence of post spinal headache was 6 % in the Quincke group. No patients in Whitacre group had PDPH. The number of lumbar punctures required for successful sub arachnoid block was recorded in both the groups. 92 % patients from group Q and 88 % patients from group W required only one puncture. 8 % patients from group Q and 12 % patients from group W required two punctures. CONCLUSIONS It is prudent to conclude that 25G Whitacre spinal needle is a better alternative to 25G Quincke needle for reducing the incidence of post dural puncture headache in patients undergoing lower segment Caesarean section. KEY WORDS Spinal Anaesthesia, Post Dural Puncture Headache, Caesarean Section

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

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