Background:
Workplace bullying is an important and serious issue in a healthcare setting because of its potential impact on the welfare of care-providers as well as the consumers.
Aims:
To gauge the extent of bullying among the medical community in India; as a subsidiary objective, to assess the personality trait of the bullying victims.
Settings and Design:
A cross-sectional, anonymous, self-reported questionnaire survey was undertaken among a convenient sample of all the trainee doctors at a Government Medical College in Tamil Nadu, India.
Materials and Methods:
A questionnaire, in English with standard written explanation of bullying was used. Basic information like age, sex, job grade and the specialty in case of Postgraduates (PGs) were also collected.
Statistical Analysis:
The results were subjected to descriptive statistical analysis and Chi-square test for comparison of frequencies.
Results:
A total of 174 doctors (115 PGs and 59 junior doctors), took part in the study with a cent percent response. Nearly half of the surveyed population reported being subjected to bullying. Nearly 54 (53%) of the men and 35 (48%) of women were subjected to bullying. Significant proportions (P <0.0001) of medical personnel and paramedical staff bullied the PGs and junior doctors, respectively. More than 85 (90%) of bullying incidents went unreported. A significant (P <0.0001) percentage of PGs and junior doctors revealed a personality trait towards bully.
Conclusions:
Workplace bullying is common among trainee doctors and usually goes unreported.
Background and objectives: Various intrathecal adjuvants have been clinically tried for the prolongation of intraoperative and postoperative analgesia. This study aims at evaluating the effects of intrathecal nalbuphine and clonidine as adjuvants to isobaric levobupivacaine in subarachnoid block.
Methodology: 60 patients scheduled for elective infra umbilical surgeries were allocated into two groups of thirty each to receive 15 mg of 0.5% isobaric Levobupivacaine with either 1 mg nalbuphine (Group LN) or 30 µg clonidine (Group LC) intrathecally. Characteristics of spinal anesthesia in terms of sensory analgesia and motor blockade were noted. Hemodynamic parameters and adverse effects if any were recorded. Data obtained was compiled and statistically analysed with appropriate tests.
Results: Onset of sensory and motor blocks was faster in group LN (2.43 ± 0.93 and 2.2 ± 0.9 min) compared to group LC (3.26 ± 1.04 and 3.13 ± 1.0 min). However, time to two segment regression (186.8 ± 24.5 vs 146.5 ± 21.4), total duration of effective analgesia (384.1 ± 56.6 vs 292.1 ± 40.9) and total duration of motor block (345.3 ± 41.7 vs 235.6 ± 29.5 min) were significantly prolonged in group LC than in group LN. There was no significant difference in hemodynamic changes and adverse effects between the groups.
Conclusion: The addition of 30 µg clonidine to intrathecal 0.5% isobaric levobupivacaine as adjuvant, is associated with prolonged sensory and motor blockade with better perioperative analgesia compared to 1 mg nalbuphine.
Citation: Shalini A, Kokila N, Manjunatha HG, Supriya L. Comparative study of intrathecal nalbuphine versus clonidine as adjuvants to 0.5% isobaric levobupivacaine for elective infra umbilical surgeries. Anaesth pain & intensive care 2019;23(4)__
Received: 21 August 2019, Reviewed: 13 September, 22 November 2019, Accepted: 26 November 2019
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.