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 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 A comparative study of induction of preterm vaginal delivery at 20 to 28 weeks gestation in previous one lower segment caesarean section by foley catheter and prostaglandin E2 gel

2017 ◽  
Vol 6 (8) ◽  
pp. 3581
Author(s):  
Shruti Agarwal ◽  
Neelam Bharadwaj ◽  
Lata Rajoria ◽  
Indira Lamba
Keyword(s):  
Caesarean Section ◽  
Prostaglandin E2 ◽  
Foley Catheter ◽  
Induction Of Labour ◽  
P Value ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Catheter Group ◽  
Group A ◽  
Group B

Background: The aim of the study to assess the maternal outcome and safety of induced preterm vaginal birth after a previous one lower segment caesarean delivery.Methods: In this study, 100 women who had singleton pregnancies with a previous one term lower segment caesarean section, in whom induction of labour was required in between 20 to 28 wks of gestation, were included. Group A (n= 50) were induced by transcervical foley catheter and group B (n= 50) were induced by prostaglandin E2 gel and then progression of labour was monitored. Both groups were compared in terms of induction delivery interval, efficacy and safety.Results: In our study, all women were delivered vaginally and hysterotomy was not required. The mean induction delivery interval in Foley catheter group (20.180±3.3499 hrs) was significantly shorter (p-value <0.001) than PGE2 gel group B (24.050±3.6537 hrs). There was no case of uterine rupture, puerperal pyrexia, postpartum haemorrhage and uterine hyperstimulation.Conclusions: Women with previous lower segment caesarean section in whom premature induction of labour is required for any reason can be done easily, safely and effectively without maternal morbidity. Induction can be done more effectively by using transcervical foley catheter than intracervical prostaglandin E2 gel. It has shorter induction delivery interval and low complication. Hence, I suggest that every woman with previous one lower segment caesarean section who requires premature induction should go for trial of labour before repeating caesarean section.

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 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 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 OXYTOCIN IV BOLUS VS INFUSION;

2012 ◽  
Vol 19 (03) ◽  
pp. 382-385
Author(s):  
MUHAMMAD ABDULLAH ◽  
RAHEEL - ◽  
TARIQ ABASSI ◽  
Tassaduq Khurshid ◽  
Asim Ghauri
Keyword(s):  
Infusion Pump ◽  
Elective Caesarean Section ◽  
Military Hospital ◽  
Intravenous Bolus ◽  
Hemodynamic Effects ◽  
Haemodynamic Change ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Trial Setting

Introduction: Obstetric texts advocate the use of oxytocin, either intramuscularly or as a dilute infusion, but warn against the useof intravenous bolus oxytocin, fearing significant maternal hemodynamic consequences. Objective: To compare the hemodynamic effects ofoxytocin given intravenous bolus versus infusion form. Study design: Randomized clinical trial. Setting: Study was conducted in mainoperation theatre and OPD of Combined Military Hospital, Rawalpindi. Duration of study: Study was carried out over a period of six monthsfrom 24-03-2009 to 23-09-2009. Subjects and methods: Total 138 patients were included in this study. Patients were divided into two groups(Group-A received oxytocin as bolus of 5 iu given as quickly as possible (approximately over 1 s) and in group-B 5 iu diluted to 20ml normalsaline given over 5 minute using an infusion pump). Each group comprised of 69 patients. Results: Mean age of the patients in group-A was27.3±1.8 and in group-B, 26.9±1.7. Heart rate (beast/min) effect of oxytocin given intravenous bolus vs infusion showed statistically significantdifference from 1 minute to 15 minute (P<0.001). Similarly mean arterial pressure (MAP) rate (beast/min) effect of oxytocin given intravenousbolus vs infusion also showed statistically significant difference from 1 minute to 15 minute (P<0.001). Conclusions: In conclusion, we foundthat at elective Caesarean section, 5 iu of i.v. oxytocin results in less haemodynamic change than 5 iu diluted to 20ml normal saline given over 5min using as an infusion pump.

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 INTRAVENOUS REGIONAL ANESTHESIA (BIERS BLOCK);

2012 ◽  
Vol 19 (05) ◽  
pp. 710-714
Author(s):  
Muhammad ASGHER ◽  
ASIM GHAURI ◽  
MUHAMMAD ABDULLAH ◽  
Tariq Abassi
Keyword(s):  
Regional Anaesthesia ◽  
Military Hospital ◽  
P Value ◽  
Complete Evaluation ◽  
Intravenous Regional Anesthesia ◽  
Number Of Patients ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Intravenous Regional Anaesthesia

Objective: To compare the analgesic effects of combination of 0.5% Lidocaine plus Ketorolac in intravenous regionalanaesthesia technique with those of Lidocaine (0.5%) alone to prevent post operative pain after intravenous regional anaesthesia (Biersblock). Study design: Randomized Control Trial. Place and duration of study: The study was carried out at Department of Anaesthesiology,Intensive Care and pain management, Combined Military hospital, Rawalpindi from July 2008 to February 2009. Patients and Methods: Thestudy was conducted after complete evaluation of risk / benefit ratio to the patients. On the basis of random number method the patients weredivided into two equal groups (group A and group B). The number of patients in each group was 75. Group A was assigned Lidocaine in a dose of200mg 40ml of 0.5% solution and group B was assigned injection Ketorolac 30mg added to Lidocaine in a dose of 200mg 40ml of 0.5% solution.The patients were kept in post anaesthesia care unit for two hours and pain intensity was measured by visual analogue scale(VAS) on 15,30minutes,1hour, 1.5 and at 2 hours after the cuff deflation. The analgesic efficacy recorded on the basis of visual analog scale of two groups, wascompared using student’s t - test. p value of less than 0.05 was considered statistically significant. Results: In group A 33 males and 42 femaleswere enrolled for the study while in group B there were 38 males and 37 females. The mean age of the patients in group A was 34.31 ± 6.03years while in group B was 32.99 ± 6.08 years. Patients were also classified according to ASA classification in which 87 patients were classifiedas ASA – I and 63 patients as ASA – II. Group B which received Ketorolac in addition to Lidocaine for Bier’s block had low visual analogue scoresas compared to group A which received only Lidocaine for Bier’s block. P values obtained after the comparison of the mean VAS of two groupsat 15 minutes, 30 minutes, 1 hour, 1.5 hours and 2 hours were all less than 0.05 (0.002 for 15 minutes, 0.004 for 30 minutes, 0.001 for 1 hour,0.004 for 1.5 hours and 0.001 for 2 hours). Conclusions: Ketorolac improves the postoperative analgesia markedly when used with Lidocainein intravenous regional anaesthesia.

scholarly journals Epigastric pain after intravenous administration of oxytocin in patients undergoing lower segment cesarean section: A quasi experimental study comparing intravenous bolus with infusion technique

2020 ◽  
Vol 24 (1) ◽  
pp. 50-53
Author(s):  
Ali Kashif ◽  
Rizwana Bashir Kiani ◽  
Syed Muhammad Asad Shabbir ◽  
Tariq Mahmood ◽  
Ghulam Sabir ◽  
...  
Keyword(s):  
Experimental Study ◽  
Cesarean Section ◽  
Epigastric Pain ◽  
Intravenous Bolus ◽  
Lower Segment ◽  
Lower Segment Cesarean Section ◽  
Quasi Experimental ◽  
Group A ◽  
Group B ◽  
Infusion Technique

Aim: To compare the frequency of epigastric pain and uterotonic effect of an equivalent dose of oxytocin administered as an intravenous bolus versus intravenous infusion during elective LSCS under spinal anesthesia. Methodology: We recruited 98 parturients undergoing elective LSCS under spinal anesthesia for this prospective quasi experimental study and divided them into two groups. Group-A received 5 IU of oxytocin as bolus intravenous (IV) injection in 5 sec (bolus group, n= 48), and Group-B (infusion group, n= 50) received 5 IU of oxytocin as an infusion over 5 min. Any complaint of epigastric pain by the patients was noted and its frequency was compared between the two groups. The uterine tone was assessed as adequate or inadequate by an obstetrician. The data were entered into SPSS version 22. Patient demographic data were analyzed with independent samples T-test and the study data were analyzed with Chi‑square test and presented as n (%). p < 0.05 was considered statistically significant. Results: Epigastric pain was noted in 25 (52.03%) out of 48 parturients in Group-A and 15 (30%) out of 50 in Group-B (p = 0.026). There was no significant difference in the uterotonic effect of oxytocin between the two groups (p = 0.736). Conclusion:  We conclude that oxytocin infusion is associated with lower frequency of epigastric pain in elective LSCS when compared to intravenous bolus of an equivalent dose of oxytocin, However, the effect on uterine contractions was adequate with both methods. Citation: Kashif A, Kiani RB, Shabbir SMA, Mahmood T, Sabir G, Fatima NE, Khan WA. Epigastric pain after intravenous administration of oxytocin in patients undergoing lower segment cesarean section: A quasi experimental study comparing intravenous bolus with infusion technique. Anaesth pain intensive care 2020;24(1):_ DOI: https://doi.org/10.35975/apic.v2i1. Received – 20 February 2019; Reviewed – 4, 16 March, 25 June, 9 September, 2, 25 November, 10 December 2019, 7 January 2020; Revised – 19 June, 10 August, 29 September, 1 November 2019, 6 January 2020; Accepted – 10 January 2020;

scholarly journals EMLA Cream Prior to Insertion of Elective Epidurals

1995 ◽  
Vol 23 (3) ◽  
pp. 339-341 ◽  
Author(s):  
J. A. Elson ◽  
M. J. Paech
Keyword(s):  
Elective Caesarean Section ◽  
Needle Insertion ◽  
Patient Comfort ◽  
Epidural Needle ◽  
Double Blind Study ◽  
Double Blind ◽  
Emla Cream ◽  
Skin Infiltration ◽  
Group A ◽  
Group B

A randomized double-blind study was conducted in 83 women scheduled for elective caesarean section to determine the efficacy of EMLA and lignocaine infiltration for epidural insertion. The patients were randomly allocated to one of three groups: Group A (EM/LIG) received EMLA and intradermal and subdermal 1% lignocaine infiltration, Group B (EM/SAL) EMLA and saline while Group C (PL/LIG) received placebo cream and 1% lignocaine. Assessments using a 100 mm pain score were performed on skin infiltration and after subsequent insertion of a 16 gauge Tuohy needle into the supraspinous ligament. Skin changes under the applied cream and nursing rating of patients’ response were also noted. Statistical analyses were performed using Kruskal-Wallis and Fisher's Exact Tests. Groups were comparable for age, weight, parity and EMLA application time (interquartile range 105-150 minutes) There were significantly higher pain scores for skin infiltration in Group C (PL/LIG) (P<0.01) and for epidural needle insertion in Group B (EM/SAL) (P<0.05). We concluded that in this patient population, the application of EMLA cream for at least 90 minutes plus 1% lignocaine infiltration optimized patient comfort for epidural insertion.

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