BACKGROUND Summary-Despite several novel techniques reported in the literature regarding nasogastric tube placement, no technique has emerged as the most efficient method, especially for unconscious patients. A few of them appears to be achieving higher success rate and considered to be better than the rest. Varied complications have been reported in the literature. We searched for relevant medical literature in English using Google Search Engine. The following Medical Subject Headings (MeSH) terms were used:
Summary Suction termination of pregnancy was performed in 276 patients as an out‐patient procedure under general anaesthesia. Ergometrine, oxytocin, or sterile water were given with the induction of anaesthesia. There was no significant difference in blood loss in the three treatment groups, although blood loss in termination of pregnancy performed after eight weeks was increased in all three groups. Nausea, vomiting and abdominal pain occurred significantly more often after ergometrine compared to oxytocin or water.
BACKGROUNDImage of anaesthesia and anaesthesiologist in the eyes of patients is variedly reported in literature and mostly poor in developing countries. We often realised this underestimation of our risky task, inadequate appreciation and recognition of our effort from patients. Hence, we put an endeavour to explore the existing perception among our patients in this rural region regarding our specialty and anaesthesiologist. MATERIALS AND METHODSThis observational, paper-based questionnaire survey was carried out in the pre-anaesthetic checkup (PAC) clinic involving 101 patients scheduled to undergo elective surgery. The survey was carried out using structured interview based on the open-ended questionnaire consisting of 15 MCQ type questions. Data were mostly categorical data such as number of patients (percentage). Statistical comparison has been done between the favourable response (s) and all other responses taken together as unfavourable response (s). RESULTSAbout 44% of patients knew that anaesthesiologists are qualified doctors. Thirty percent had knowledge that anaesthesiologist has to be present after induction for continuation of the anaesthesia and for monitoring the vitals. About 10% patients are aware about the other roles of anaesthesiologists outside operating room. Regarding the risk related with anaesthesia and surgery, majority of patients (58%) were not informed at all. A considerable proportion of patients (90%) opined that pre-anaesthetic checkup is useful. Among the high literacy group, considerably higher proportions of patients have answered the favourable options. CONCLUSIONThe survey concludes that patients' perception about anaesthesia is poor. The patients also have insufficient knowledge about the exact role of an anaesthesiologist inside or outside the operating room. BACKGROUND Anaesthesiology is one of the rapidly evolving disciplines of medical science that has made immense development in the recent past. Advancement in surgery and anaesthesia are going absolutely parallel to each other. Anaesthesiologists are playing a decisive role in patient management. In the last two decades, the role of anaesthesiologist has extended not only inside but also outside traditional operating room (OR) settings. An anaesthesiologist plays a very crucial role in intensive critical care units, trauma centres, pain clinics and as a member of resuscitation team all over the world. 1 KEYWORDS
BACKGROUNDEpidural anaesthesia is now increasingly being used for lower limb surgeries for its certain advantages. Different adjuvants have been used with epidural ropivacaine to prolong the intraoperative and postoperative analgesia. Evidence is growing in favour of dexmedetomidine as an epidural adjuvant. Different doses of dexmedetomidine have been used with epidural ropivacaine with variable success in modifying the block characteristics and adverse event profile.The aim of the present study was to compare the block characteristics between epidural ropivacaine with dexmedetomidine (2 µg/kg) as adjuvant and epidural ropivacaine alone in patients undergoing lower limb surgeries. MATERIALS AND METHODSIn this randomised, double-blinded study, 88 adult patients of either sex, aged between 40-65 years, scheduled for elective lower limb surgery under epidural anaesthesia, were randomly allocated into two groups to receive either 0.75% ropivacaine alone (Group A) or dexmedetomidine (2 µg/kg) as an adjuvant to ropivacaine 0.75% (Group B) in epidural space. Data from 40 patients of each group were finally analysed. The time to achieve T6 sensory block (Primary outcome), time to reach maximum sensory block, time to achieve complete motor block, time to two-segment regression of sensory block and duration of analgesia were noted in all cases. The incidences of adverse events such as nausea, vomiting, hypotension, dry mouth, bradycardia, desaturation, respiratory depression, etc. were also noted. Statistical analysis was performed using independent sample Student's 't' test for normally distributed variables and Pearson Chi-square test for categorical data. The level of significance was set as P < 0.05. RESULTSThe time to achieve sensory block at T6 level in group B (9.45±1.04 minutes) was significantly shorter than group A (13.65±1.12 minutes), P<0.05. The time to achieve maximal sensory block and time to achieve complete motor block were also found shorter in dexmedetomidine group. Sensory block regressed later in dexmedetomidine group compared to control (157.03±7.87 versus 118.47±7.32 minutes, respectively, P <0.05). The time to first rescue epidural top-up was prolonged in dexmedetomidine group compared with ropivacaine alone group (346.12±17.29 versus 327.98±17.60 minutes, respectively). Incidences of adverse events were comparable. CONCLUSIONEpidural dexmedetomidine is a reliable adjuvant with ropivacaine (0.75%) to provide early onset of sensory block and longer duration of analgesia in lower limb surgeries.
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