Introduction: Patient satisfaction is an integral part of the quality of healthcare processes. The survey performed by the ASA Committee on Performance and Outcomes Measurement (CPOM) in 2013 states that the assessment of patient satisfaction is a reality of practice today. Thus, this study aimed to assess patient satisfaction with perioperative anaesthesia services and determine the factors influencing patient satisfaction in our hospital. Methods: We performed the cross-sectional study at our tertiary care institute after getting institutional review board approval. This study included 200 patients who underwent elective or emergency surgeries under anesthesia from April 2019 to June 2019. The long-form questionnaire was prepared based on various references and validated in our department. Results: Out of 200 patients, 76.5% (n = 153) were satisfied with anaesthesia services. Male gender [87.03% (n = 94/108)], younger [86.66% (78/90)] and literate patients [ 88.52% (108 pts/122)] were more satisfied. Better satisfaction was recorded in patients who had regional anaesthesia [85.18% (92/108)] and no complain of post-operative pain [83.58% (112/134)] or postoperative nausea and vomiting (PONV) [87.90% (109/124)]. Patients with intraoperative awareness were less satisfied. Conclusion: In our study group, type of anaesthesia, postoperative pain, PONV, and intraoperative awareness were factors that affected patient satisfaction.
Background: Diabetes mellitus is a multisystem disease caused by an absolute or relative deficiency of insulin secretion or resistance or a combination of both. Anesthesia in them is of special concern because of complex polypharmacy, an inappropriate dose of oral hypoglycemic agents or insulin and errors in converting IV insulin to usual medication. The objective is to compare the various techniques of anesthesia for surgical management of diabetic foot in terms of intraoperative hemodynamic stability, perioperative problems related to anesthesia techniques, postoperative analgesia. Subjects and Methods: Sixty adult diabetic patients of both gender of ASA grade II-III, aged 35years undergoing surgical management of diabetic foot were elected and separated into three groups, Group A: general anesthesia with tracheal intubation, Group B: unilateral spinal anesthesia with injection 0.5% bupivacaine heavy 1.5ml (7.5mg), Group C: popliteal nerve block via lateral approach by injecting 30 ml 0.5% bupivacaine. Parameters like pulse rate, mean arterial blood pressure, respiratory rate and SpO2 were recorded at regular intervals. Postoperative pain, perioperative side effects, complications and problems related to anesthetic techniques were noted. The analysis is done by unpaired t-test and chi-square test. Results: Group C patients were hemodynamic stable than Group A and B. Post-op analgesia was prolonged in Group C. Perioperative side effects were more found in Group A. Conclusion: Popliteal nerve block and unilateral spinal anesthesia provide better hemodynamic stability and postoperative analgesia with negligible side effects as compared to general anesthesia for surgical management of diabetic foot.
The morbidity and mortality of patients are increased when postoperative pulmonary complications occurs. To prevent postoperative pulmonary complications, thorough preoperative cardiopulmonary functional assessment is required.To study was the preoperative 6-minute walk test (6MWT) and to determine the association of 6 minute walk distance with postoperative pulmonary complications (PPC) in patients undergoing elective abdominal surgery under general anaesthesia. The study was done in 60 adult high risk patients who were undergoing planned elective abdominal surgery under general anaesthesia. Patients having acute coronary disease, NYHA IV, unable to walk etc. were excluded. Preoperatively 6MWT was conducted according to the American Thoracic Society guidelines and patients were observed for PPC until they discharged from the hospital or died. Statistical analysis was done using SPSS software A total of 60 patients were recruited into the study. 6MWT was done completely in all cases without any complications. Out of the 60 patients, 32 patients had no PPC (group 1) and 28 patients had PPC (group 2). The 6MWD of group with PPCs was significantly less (344 ± 61.927 m) compared to the group without PPCs (442.28 ± 83.194 m, P value = 0.001). The cut off 6MWD obtained was 390 m, which correlated with longer duration of hospital stay and ICU stay (P = 0.001).A multiple regression analysis showed elderly, smoker and shorter 6-minute walk distance (6MWD) were the independent factors associated with PPC. 6MWT is a reliable predictor of postoperative pulmonary complications with a cutoff 6MWD of 390m in the high risk elderly patients posted for upper abdominal surgery patients.
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