Objective: This research aims to compare the effectiveness of intrathecal bupivacaine combined with dexmedetomidine to bupivacaine alone in patients having caesarian procedures. Methods: This randomized, controlled study was conducted at in operation theatre in Liaquat national hospital, with the agreement of the hospital's institutional review board. There were 272 patients total, and they were split evenly in two groups of 136 using non-probability consecutive sampling technique. Group A: Patients received subarachnoid block (2 ml of 0.5 % hyperbaric bupivacaine and 10 micrograms of normal saline). Group B: Patients received subarachnoid block (2 ml of 0.5 % hyperbaric bupivacaine and 10 micrograms of dexmedetomidine at L3-L4 or L4-L5 inter-vertebral space). Before the induction of anaesthesia, the patient's systolic blood pressure (BP), diastolic blood pressure (BP), mean arterial pressure (MAP), heart rate (HR), and peripheral capillary oxygen saturation (SPO2) will be monitored Results: The mean age of the participants in both study groups were 27.14±5.3 and 25.9±3.65 years. A significant difference in the mean systolic blood pressure of the participants in both groups as observed at 15-, 45- and 60-minutes interval (p=0.000). The mean time interval from blocks to shivering occurrence in the participants in both study groups were 57.08±3.8 and 81.03±2.8minutes. A significant difference (P=0.000) in the mean time interval from blocks to shivering occurrence in the participants in both study groups was observed. 49% participants in the groups experienced shivering while 24% in group B. Conclusion: From our findings, we infer that adding 10µg of dexmedetomidine to strong bupivacaine in SA may reduce the frequency and severity of shivering without causing any serious side effects.
Objective: To compare mean time required to request for first analgesia post-operatively in functional endoscopic sinus surgeries (FESS) by using pre-emptive paracetamol versus intra-operative paracetamol. Study Design: Comparative Observational Study. Sampling Technique: Non probable, consecutive sampling Place & Duartion: This Study was conducted in the Department of Anesthesiology, Sindh employee’s social security hospital landhi Karachi, From June, 2018 to January, 2019. Materials and Methods: In this study 64 patients of both genders included. 36 patients were male and 28 were females. They were aged between 18 and 70 years. This study was conducted from June, 2018 to January, 2019. Patients were distributed into two different groups, Group-1 (pre-emptive paracetamol) and Group-2 (intra-operative paracetamol). 32 patients were included in each group. In Group-1 (pre-emptive paracetamol), patients received 1 Gm. I/V paracetamol, 15 minutes prior to induction of general anesthesia and in Group-2 (intra-operative paracetamol), patients received 1gm. I/V paracetamol just before removal of endotracheal tube. Post-operatively patients were observed in Post-Anesthesia Care Unit (PACU) with standard monitoring. Time for first request for analgesia in minutes was noted. Result: SPSS 16 version used for statistical analysis. Chi squire test applied. Mean age of in pre-emptive paracetamol group (group-1) was 51.53 + 18.90 years and mean age of patients in intra-operative paracetamol group, was 50.43 + 19.10 years (p-value 0.819). Mean weight of patients in pre-emptive paracetamol was 66.65 + 10.74 kg and mean weight of the patients in intra-operative paracetamol was 67.71 + 10.78 kg. (P-value was 0.694). ASA status 1 was found in 36 (56.30%) patients and ASA status II was found in 28 (43.80%) patients. Mean time required for first analgesia in pre-emptive paracetamol group was 192.90 + 8.70 minutes and mean time required for first analgesia in intra-operative paracetamol group was 163.93 + 13.57 minutes and p-value found < 0.001 (significant). Conclusion: Significant variance was observed in the mean time required to request for first analgesia post-operatively in functional endoscopic sinus surgeries (FESS) by using pre-emptive paracetamol versus intra-operative paracetamol. Keywords: pre-emptive versus intraoperative paracetamol, functional endoscopic sinus surgeries, time required to request for first analgesia post-operatively.
Objective: The purpose of this study is to assess the incidence of burnout syndrome among Karachi's anesthesiology residents in teaching hospitals. Methods: This cross-sectional research was undertaken at tertiary care hospitals of Karachi. Ethical committee permission, authorization from institutions, and agreement from residents were all required before data collection from 144 anesthesiology residents could begin. Participants were recruited from both public and private healthcare facilities. The demographic data from a questionnaire was used to determine the prevalence of the burnout syndrome, which is defined by feelings of emotional tiredness, depersonalization, and decreased personal accomplishment. SPSS was used to generate descriptive statistics. Results: The mean working hours of the participants in government and private hospitals were 64.21±12.40 and 90.24±25.01 hours. A significant difference (p=0.000) in the mean working hours of the participants were observed in participants at government and private hospitals. Emotional exhaustion score of the participants in government and private hospitals were 15.72±11.56 and 22.69±11.20. A significant difference (p=0.002) in the mean emotional exhaustion score of the participants were observed in participants at government and private hospitals. Depersonalization score of the participants in government and private hospitals were 8.79±6.71 and 12.82±7.59. A significant difference (p=0.004) in the mean depersonalization score of the participants were observed in participants at government and private hospitals. Reduced personal achievement score of the participants in government and private hospitals were 12.97±11.96 and 19±12.65. A significant difference (p=0.002) in the mean reduced personal achievement score of the participants were observed in participants at government and private hospitals. Conclusion: We observed the variation in burnout of private hospital versus government hospital. Residents working in private hospital work for extensive hours as compared to government hospital residents. There is an extensive need of comprehensive support groups, humane number of working hours, improved de-stressing activities for mental health of resident physicians and enhance their productivity. Keywords: Burnout, emotional exhaustion, depersonalization, Reduced personal achievement
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