Frequency of Post Dural Puncture Headache with Quincke 25g and Quincke 27g Spinal Needle after Spinal Anaesthesia

2021 ◽  
Vol 15 (11) ◽  
pp. 3116-3118
Author(s):  
Gulsher . ◽  
Riffat Zahid ◽  
Syed Mehmood Ali ◽  
Muhammad Naveed Shahzad ◽  
Amer Latif ◽  
...  

Objective: To compare the frequency of post dural puncture headache with Quincke 25G and Quincke 27G of spinal needles for spinal anesthesia. Design of the Study: It’s a Randomized control trial. Study Settings: This study was carried out Department of anesthesiology and Intensive Care Unit, Shaikh Zayed Hospital Lahore from 29-08-2020 to 01-03-2021. Material and Methods: In this prospective study 100 patients were enrolled who were decided to undergo spinal anesthesia. Two groups were made by randomization. In patients of group I, anesthesia was administered by using 25G quincke needle while 27G quincke needle was used for patients in group II. Evaluation of patients was with regard to development of postoperative PDPH within 3-days. Groups were compared by using Chi-square test and a P-value<0.05 was taken statistically significant. Results of the Study: PDHD was seen in 14 (28%) patients in group I and in 4 (8%) patients in group II. Statistically, the difference between the two groups was significant (p<0.05).. Conclusion: Due to less frequency of PDPH with 27G needle, it should be given preference for applying spinal anesthesia over 25G needle. Keywords: Spinal anesthesia, post dural puncture headache; quincle needle.

2021 ◽  
Vol 15 (6) ◽  
pp. 1221-1222
Author(s):  
M. S. Mehmood ◽  
T. Iqbal ◽  
R. Farooqi ◽  
Z. Y. Bhatti ◽  
F. Liaquat

Aim: Frequency of post dural puncture headache with Quincke 25G and 27G needles for spinal anesthesia Design of study: Control randomized study Setting: Anesthesiology/ deptt. / ICU, Shaikh Zayed Hospital Lahore Duration: 29-08-2013 to 01-03-2014 for 6 months Methodology: This was a prospective study of 100 patients undergoing surgery under spinal anesthesia. The subjects were divided in two groups. In group I, the anesthesia was applied with 25G quincke needle and in group II, the anesthesia was applied with 27G quincke needle. The patients were evaluated for post dural puncture headache till 72 hours postoperatively. Chi-square test was applied. P <0.05 was taken as significant. Results: PDPH was seen in 14 (28%) subjects in group I and in 4 (8%) subjects in group II. Conclusion: 27G needle should be preferred over 25G needle for application of spinal anesthesia due to decreased PDPH Keywords: Post dural puncture headache; spinal anesthesia; quincke needle


2017 ◽  
Vol 4 (2) ◽  
pp. 14-20
Author(s):  
Niroj Hirachan

Introductions: Spinal anesthesia is a safe and acceptable technique for patients undergoing caesarean section because it provides both excellent analgesia and muscle relaxation. Post Dural Puncture Headache (PDPH) is frequently reported complication after spinal anesthesia. This study evaluates the incidence of PDPH following early mobilization and recumbency after caesarean section. Methods: This prospective, randomized comparative interventional study included 100 parturients women of age 18 to 45 years, ASA I and II, randomly divided into two groups – Ambulatory ‘A’ and Recumbent ‘R’. At the end of caesarean section, patients were advised to either lie in recumbent position for 24 hours or mobilize as soon as they become ambulatory after spinal aneshthesia. Occurrence of headache were recorded at 24 hours, 72 hours and 7th day. Software SPSS 16, chi-square test was used for proportions like incidence and severity of PDPH; p<0.05 was taken as significant. Results: The incidence of PDPH was statistically not different (p = 0.361) in Group R 8% (4 patients) and in Group A 6% (3 patients). In both the groups, the severity of headache was mild to moderate with only mild headaches in the Group A (p = 0.549). Conclusions: Early ambulation following spinal anesthesia for caesarean section did not increase the incidence of PDPH in parturients.  


1979 ◽  
Vol 9 (3) ◽  
pp. 373-378
Author(s):  
C J Helphingstine ◽  
D J Hentges ◽  
B J Campbell ◽  
J Butt ◽  
J T Barrett

Heat-extracted antigens from seven species of Bacteroides were used in passive hemagglutination and counterimmunoelectrophoretic tests. Sera from 87 normal persons (group I) and 15 patients with ulcerative colitis (group II) were of low and equal reactivity in passive hemagglutination tests; all positive tests were eliminated by 2-mercaptoethanol reduction of the sera. When these same sera were tested by counterimmunoelectrophoresis with six of the Bacteroides antigens, no significant difference in the percentage of positive reactions was noted. However, using the chi-square test, the seventh antigen, prepared from Bacteroides vulgatus, successfully distinguished the two populations at the 0.025 level. Counterimmunoelectrophoretic tests with the B. vulgatus antigen also provided a means to separate the patients in group II with active disease from those in remission at a P value of 0.01. All the sera from 12 patients with defined Crohn's disease activity indexes reacted with the B. vulgatus antigen in counterimmunoelectrophoretic tests. Reduction and alkylation of patient sera with 2-mercaptoethanol and iodoacetamide removed detectable antibody in 78% of the samples, which suggested a dominant role of immunoglobulin M in the response to Bacteroides antigens.


Author(s):  
Dr. Seema Yadav ◽  
Dr. Rajendra Verma

Background: Different crystalloids commonly used in preloading are Ringer lactate, normal saline and colloids that are used in preloading are gelatin, dextran, hetastarch, pentastarch, tetrastarch. This study was aimed to compare the efficacy of both as preloading infusion to prevent hypotension, requirement of vasopressors and requirement of total fluid given during surgery to maintain stable hemodynamics Methods: This randomized control trials was conducted in the Department of Anaesthesia , R.V.R.S. Medical College, Bhilwara.  60 patients between 18- 40 years of age, belonging to American society of anaesthesia grade I or II going for elective caesarian section under spinal anesthesia were screened for the study eligibility criteria Results: In group (I), in 20 females, efficacy was achieved while in 10 females efficacy could not be achieved because of drop in BP. In group (II), in 22 females, efficacy was achieved while in 8 females, efficacy could not be achieved. The difference between both groups was statistically insignificant but there were more females in group II in which efficacy was achieved. (p-value=>0.05) Conclusion: According to this randomized trial we did not find any significant difference between both groups for prevention of hypotension. Keywords: Anesthesia, coload, hypotension, preload, spinal


Author(s):  
Vedavathi Hanumaiah ◽  
Harini Manjunath

Background: Healthcare workers gain adequate knowledge related to medications used in treating illness from their work experiences which influences self medication practices.Methods: The present study was conducted in N=150 healthcare workers, divided into 2 groups with group I (nursing staff) and group II (paramedical staff) with 75 participants in each group. Data related to self medication was obtained from a pretested validated semi structured questionnaire either in Kannada or English. The responses were compared between each group with chi square test. P value ≤0.05 was considered significant. All statistical analysis was conducted with SPSS 16.Results: The mean age (mean±SD) of the participants in group I and group II is 31.79±8.309 and 34.15 (±8.168) respectively with p =0.081. The prevalence of self medication was 100% in both the groups. Both the groups knowledge related to the definition of self medication was similar (group I 63 (84.0%) and group II 62 (82.7%) p = 0.900). Group I believes that self medication is entirely safe compared to group II which was statistically significant (group I 66 (88.7%) and group II 46 (61.3%) p=0.029). Most common drugs used for self medication was NSAIDS (non steroidal anti-inflammatory drugs) in both the groups being 75 (100%). Antibiotics was used by 26 (2.66%) in group I and 14 (18.66%) in group II.Conclusions: Self medication practice is highly prevalent in the healthcare workers, who also influence the other populations to practice self medication. Practicing responsible self medication is more appreciable.


2021 ◽  
Vol 15 (6) ◽  
pp. 1227-1229
Author(s):  
R. Farooqi ◽  
T. Iqbal ◽  
M. S. Mehmood ◽  
Z. Y. Bhatti ◽  
F. Liaquat

Aim: To Compare frequency of sore throat in early post operative period among patients undergoing general anaesthesia and endotracheal intubation for abdominal surgeries who are given dexamethasone and normal saline. Study Design: Randomized controlled study Setting: Department of Anesthesia/ ICU, Sheikh Zayed Hospital, Lahore Duration of study: Six months i.e. 25-09-2009 to 25-03-2010. Methodology: 120 patients undergoing elective general surgery on abdomen were selected. They were divided into two groups. Group I received dexamethasone 8mg (2ml) I/V pre-operatively and group II received 2ml normal saline I/V pre-operatively. Chi square test was used. Visual analogue (VAS) scale was used for recording sore throat. The VAS score ≤4 was considered as no sore throat and VAS scores>4 were considered as the sore throat. Results: Frequency of post-operative sore throat after the first 24 hours following GA and endotracheal intubation was lower in group (I) as compared to the control group (II). Eleven (20%) patients with dexamethasone had post-operative sore throat compared to thirty one (56.3%) patients in control group. (p<0.01). Conclusion: Pre-operative use of dexamethasone was associated with decreased incidence of post-operative sore throat. Keywords: Visual analogue scale (VAS), Post-operative sore throat, general anesthesia


2020 ◽  
Vol 8 (4) ◽  
pp. 193-199
Author(s):  
Pujan Balla ◽  
Anil Shrestha ◽  
Ninadini Shrestha ◽  
Navindra Bista ◽  
Moda Nath Marhatta

Background: Spinal anesthesia is the preferred technique of anesthesia employed for caesarean sections. However, it is very often complicated by hypotension. Different drugs and techniques have been used to prevent the hypotension induced by spinal anesthesia. In this study, the effect of ondansetron on the prevention of hypotension after spinal anesthesia was evaluated. Objectives: To determine the effect of prophylactic ondansetron on prevention of spinal induced hypotension in elective caesarean section. Methodology: Eighty-six parturients planned for elective caesarean deliveries were randomized into two groups of 43 each. Group O received Ondansetron 4 mg (4 ml) and Group S received Normal Saline (4 ml) intravenously 10 minutes prior to spinal anesthesia. Blood pressure, heart rate, phenylephrine requirements, occurrence of nausea and vomiting and APGAR scores of neonates were compared between the groups. Hemodynamic data was analyzed using Student’s t-test for intergroup comparison and ANOVA was used for intragroup comparison. Categorical data was analyzed using Pearson Chi-Square test. For all determinants, p-value <0.05 was considered significant. Results: Occurrence of hypotension in Group O (20.9 %) was significantly lower than in Group S (72.1%) (p < 0.05). The mean arterial pressure was significantly higher in Group O at 2, 6, 8, 12 and 14 minutes (p < 0.05). The use of phenylephrine (37.21 mcg vs. 146.51 mcg, p < 0.05) and occurrence of nausea (11.6%, vs. 41.9% p < 0.002) was significantly lower in ondansetron group. Conclusion: Ondansetron is effective in preventing spinal induced hypotension in elective caesarean sections.


2021 ◽  
Vol 15 (9) ◽  
pp. 2948-2951
Author(s):  
Mehwish Syed ◽  
Afrah Aman ◽  
Saeeda Safi ◽  
Rabia Nawaz ◽  
Asia Habib ◽  
...  

Objective: The aim of this study is to compare the effectiveness of intrauterine balloon tamponade and B lynch suture for management of severe postpartum hemorrhage. Study Design: Randomized Control trial Place and Duration: The study was conducted at Gynae & Obs department of Qazi Hussain Ahmad Medical Complex, Nowshera KPK for six months duration from January to 2021 to June 2021. Methods: There were one hundred and twenty patients with ages 20-45 years were presented in this study. All women had severe postpartum hemorrhage were included in this study. Demographically detailed of enrolled cases age, body mass index, gestational age and parity were recorded after taking informed written consent. Patients were equally divided into 2-groups I and II. Group I had 60 patients and received Lynch suture while in group II 60 patients received intrauterine balloon tamponade. Post-operative success rate among both groups were assessed and compared in terms of bleeding control within 10-15 minutes. SPSS 24.0 version was used to analyze the complete data. Results: In group I mean age was 29.09±2.53 years with mean BMI 25.11±7.64 kg/m2 while in group II mean age was 29.02±3.62 years with mean BMI 24.87±6.32 kg/m2. Mean gestational age in group I was 37.87±3.29 weeks and in group II mean gestational age was 38.19±6.41 weeks. Mean parity in group I was 4.03±1.19 and in group II it was 4.01±0.87. Frequency of success rate in group I was significantly higher among 54 (90%) cases as compared to group II 39 (65%) with p value < 0.05. We found that patients of group I was significantly satisfied than that of patients who received intrauterine balloon tamponade. Conclusion: In this research we concluded that lynch suture for the management of severe postpartum hemorrhage among females had higher effectiveness in terms of bleeding control within 15 minutes and with higher satisfaction among patients as compared to those females who received intrauterine balloon tamponade. Keywords: Postpartum hemorrhage, Lynch Suture, intrauterine balloon tamponade, Success Rate


2011 ◽  
Vol 52 (1/3) ◽  
pp. 45-47
Author(s):  
Carolina Dos Santos Guimarães ◽  
Gerhilde Callou Sampaio ◽  
Élvia Barros de Almeida ◽  
Luciano Barreto Silva ◽  
Ana Paula Mourato ◽  
...  

Introduction: The present study sought to assess the effect of apical foramen cleaning in the repair of periapical lesions detected by radiography. Methods: The sample comprised 980 teeth collected from 25 February 1997 to 15 March 2005 which had been subjected to endodontic treatment and exhibited radiographically visible periapical lesions. The sample was then divided into two groups: Group I, 402 root canal treatments in which cleaning of the apical foramen had not been performed, and Group II, composed of the remaining 578 root canal treatments where the procedure had been performed. After one year, the teeth were clinically and radiographically evaluated. Results: In Group I, 360 canals (89.55%) had no evidence of periapical lesions, versus 521 (90.13%) in Group II. Partial presence of these lesions was observed in 23 canals (5.72%) in Group I versus 27 (4.67%) in Group II. No changes in images were observed in 19 (4.72%) canals in Group I and 30 in Group II. Pearson’s chi-square test showed no statistically significant difference between the Groups I and II (p = 0.732). Conclusions: These findings suggest that foramen cleaning is not a determinant of periapical lesion repair.


2013 ◽  
Vol 20 (03) ◽  
pp. 409-415
Author(s):  
ASHFAQ AHMED ◽  
MOHAMMAD ASLAM

Objectives: To compare the efficacy of low-dose prophylactic use of ketamine with ketamine plus midazolam for theprevention of shivering caused by spinal anesthesia, during lower segment cesarean section. Main Outcome Measures: Heamodynamicmonitoring, avoidance of lactic acidosis/ increased carbon dioxide production and patient satisfaction. Design: Prospective RandomizedControlled trial. Place: Department of Anesthesia and ICU PNS Shifa Karachi. Duration of study: March 2010 to June 2010. Patients andMethods: 100 ASA-I & II consecutive patients who reported for LSCS in PNS Shifa Hospital were studied. In this double-blind study,patients were randomly allocated to receive ketamine alone (Group I, n= 50), and ketamine plus midazolam (Group II, n = 50). Afterstandardized Spinal anesthesia, a shivering was recorded at 5 min intervals for 15 minutes. Results: Shivering was observed in 9/50(18%) patients of group I (Ketamine only) as compared to only 2/50 (4%) patients in Group II (ketamine + midazolam) (p=0.025) whichis statically significant. The two groups were comparable regarding distribution of age (p=0.37), BMI (p=0.27) and duration of surgery.Results were analyzed by using chi square test. Conclusions: The efficacy of i.v. ketamine plus midazolam is better as compared to lowdosei.v. ketamine alone in preventing shivering in lower segment Cesarean Section patients, during spinal anesthesia.


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