Background:Although anesthesiology has grown tremendously and although anesthesiologists play a crucial role in the perioperative management of patients and also outside operating theater (OT) such as critical care, pain clinic, and labor analgesia, they do not get due recognition. We conducted a study to assess the awareness about the role of anesthesia and anesthesiologists among patients scheduled to undergo surgery in a Government Tertiary Care Teaching Women and Children Hospital.Designs:A prospective cross-sectional survey with a sample size of 100 patients.Materials and Methods:Patients scheduled to undergo elective surgery in the age group of 18–65 years with the American Society of Anesthesiologists (ASA) Grades 1 and 2, who are willing to participate and given written informed consent. Patients whose age <18 years and more than 65 years, ASA health status Class 3 and above were excluded.Analysis:Statistical analysis was done by calculating percentages using Chi-square test.Results:Twenty percent of the participants were illiterate and of the educated, none were graduates or postgraduates. Patients with higher level of education had better knowledge of anesthesiology and role of an anesthesiologist with P < 0.05 than those with lesser education. Forty-eight percent of the participants had no idea about anesthesia despite the majority (62%) having previous surgery with no statistically significant difference (P > 0.05) between those with previous surgery and those without previous surgery regarding their knowledge of anesthesiology and anesthesiologist. Ninety percent did not know the complications, types of anesthesia and 44% did not know that anesthesiologist is a doctor.Conclusion:Most of the participants were not aware of the role of anesthesia and anesthesiologists inside and outside OT. Although this could be attributed to their lower level of education, the fraternity of anesthesiologists has to educate patients and surgeons about the role of anesthesia.
Background and Aims:Laryngoscopy and endotracheal intubation are associated with reflex sympathetic stimulation, known as pressor response and can cause major complications. We compared the attenuating effect of time-tested lignocaine versus clonidine on the hemodynamic response to laryngoscopy and intubation in neurosurgical cases.Design:A prospective, randomized, comparative, double-blind study with a sample size of sixty patients.Methods:Sixty patients undergoing elective neurosurgery were randomly allocated into one of the two groups: Group L (n = 30) received lignocaine 1.5 mg/kg intravenous (i.v.) before induction and Group C (n = 30) received clonidine 2 μg/kg i.v. before induction. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at baseline, after drug, after induction and 1, 2, 3,5,10, and 15 min after intubation.Statistical Analysis:Statistical software, namely, SPSS, version 15.0 by SPSS Inc., Chicago, USA was used for the analysis of data with Chi-square test to compare intergroup hemodynamic parameters.Results:Mean HR remained above baseline at all times after intubation in lignocaine group but decreased at 2 min after intubation and remained below baseline at all times in the clonidine group. SBP, DBP, and MAP all increased above baseline at 1 min after intubation in lignocaine group, and decreased below baseline at 2 min after intubation, whereas in the clonidine group they all decreased below baseline after drug administration and remained below baseline at all times. Therefore, clonidine is very effective in attenuating pressor responses and this difference between the groups is statistically very significant with P < 0.001.Conclusion:Clonidine is more effective than lignocaine for attenuating the pressor responses to laryngoscopy and endotracheal intubation in neurosurgical cases.
Background: Anaesthesia is a speciality, playing a crucial role in the perioperative care of patients. Complex surgeries are facilitated due to the anaesthesiologists catering to the ever-advancing surgical field requirements. Although an important speciality, patients are unaware of the speciality of anaesthesia and anaesthesiologist. Patients are subjecting themselves for surgical procedures without having adequate knowledge of anaesthesia and anaesthesiologist. Hence, the survey was designed with the aim to assess the patients’ knowledge about anaesthesia and anaesthesiologist in surgical patients.Methods: A cross sectional study conducted on four hundred surgical inpatients using predesigned questionnaire containing questions related to the knowledge of anaesthesia and anaesthesiologist. The results were expressed as percentages. Chi-square/ Fisher Exact test was used to find the significance of study parameters.Results: Anaesthesiologists were considered as “doctors” by 60.5% of patients; Thirty three percent of the survey population had “no idea” of Anaesthesia. The survey populations’ knowledge about complications was 32.25%. Awareness about separate consent for anaesthesia was 49%. Anaesthesiologists’ work place was not known to 77.5% of survey population. Anaesthesiologists’ role in operation theatre was known only in 59.5% and remaining 40.5% were unaware of Anaesthesiologists’ role. None of the patients preferred to meet the Anaesthesiologists before surgery.Conclusions: Surgical inpatients in tertiary care hospital have a poor understanding of anaesthesia and poor recognition of the role of anaesthesiologist. The knowledge about anaesthesia and anaesthesiologist is not known in general population. Hence, anaesthesiologists must work towards getting recognition for the speciality of anaesthesiology and the anaesthesiologists.
Intracranial space occupying lesion [SOL] during pregnancy presents several challenges to the neurosurgeons, obstetricians and anaesthesiologists in not only establishing the diagnosis, but also in the perioperative management as it requires a careful plan to balance both maternal and foetal well-being. It requires modification of neuroanaesthetic and obstetric practices which often have competing clinical goals to achieve the optimal safety of both mother and foetus. Intracranial tuberculoma should be considered in the differential diagnosis of intracranial SOL in pregnant women with signs and symptoms of raised intracranial pressure with or without neurological deficits, especially when they are from high incidence areas. We report a 28-week pregnant patient with intracranial SOL who underwent craniotomy and excision of the lesion, subsequently diagnosed as cranial tuberculoma.
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