Objective: To determine if drip infusion should be discontinued after full recovery of the patient from anaesthesia after minilaparotomy cholecystectomy in uncomplicated cases.Design: A randomised controlled clinical trial on 60 patients, from the waiting list, of cholelithiasis/cholecystitis operated by minilaparotomy cholecystectomy between November 1995 to March 1996. 30 patients did not receive postoperative IV drip infusion and in 30 patients 12–24 hours of standard drip transfusion was continued according to the current practice.Setting: Single Surgical Unit, SS Hospital, Banaras Hindu University, Varanasi, India.Main outcome measure: Recognition of clinical indication for continuation of. IV drip infusion after full recovery from anaesthesia.
Results: In the cohorts of 30 patients each who were or were not given IV drip infusion after full recovery from anaesthesia following minilaparotomy cholecystectomy the observations on pulse rate, blood pressure, time to first voiding of urine and time to start first oral intake of fluids were identical. However postoperative urinary retention occured in 6 (20%) patients in whom the IV drip infusion was given.
Conclusion: There is no clinical indication to continue IV drip infusion after full recovery from anaesthesia in patients operated for minilaparotomy cholecystectomy.
Introduction
Obstructive sleep apnea can cause fragmented sleep which decreases total sleep time thus decreasing sleep efficiency. Studies have shown improvement in sleep efficiency with the treatment and adherence to therapy for sleep apnea. Due to the CPAP shortage, alternative treatment options for sleep apnea have opted including Transoral awake state neuromuscular stimulation is a novel FDA-approved therapy for mild sleep apnea.
Methods
Transoral awake state neuromuscular stimulation device procured through the regulatory process at VA Minneapolis is offered to veterans with Mild OSA (AHI 5-15) on a home sleep study. A retrospective data analysis was done on the sleep efficiency of veterans who completed the initial 6 weeks of at least 20 minutes of daily followed by maintenance of 2 weeks of twice weekly use. Sleep efficiency was calculated by total sleep time divided by total recording time multiplied by 100.
Results
A total of 112 patients with mild OSA were offered devices as an alternative option for treatment during the period of December 2021 to August 2022. Of these, 22 veterans completed a post-therapy home sleep study. The average age of patients is 53.22 years (ranging from 27-75). The average mean sleep efficiency Pre-therapy was 78.86% (ranging from 62.55% - 95.29%) post-therapy was 82.97% (ranging from 63.52% - 92.23%) A paired t-test was obtained for sleep efficiency which showed a mean difference of 4.11% with a p-value of 0.150 which is statistically non-significant.
Conclusion
Sleep efficiency can be affected by multiple co-morbid conditions among veterans though our study did show a mean difference of 4.11% pre- and post-therapy it was not statistically significant with a p-value of 0.150 that could be related to the small sample size. We proposed that to evaluate sleep efficiency a large sample size is needed with no other co-morbid conditions which can affect sleep efficiency.
Support (if any)
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