Search

Objective The purpose of this study was to compare two different sizes of an endotracheal tube (ETT), with inner diameters (ID) of 6.5 mm and 7.5 mm, for the frequency of postoperative sore throat in patients undergoing elective breast cancer surgery. Methodology This study was a randomized controlled trial conducted in the Shaukat Khanum Memorial Cancer Hospital and Research Center from December 3, 2016, to February 3, 2017. This study included 110 patients, 55 from each group, who were selected from the elective surgery list fulfilling the inclusion criteria. Group A patients were intubated with 6.5-mm ID ETTs and group B patients with 7.5-mm ID ETTs. All patients were carefully extubated in the operating room when fulfilling extubation criteria. Any concerns of sore throat were recorded 24 hours postoperatively. All relevant data were recorded on a pro forma. Results In this study, the mean age was 46.6 ± 13.2 years (range: 18-65 years). The mean body mass index (BMI) was 29.50 ± 07.12 kg/m2, with a minimum and maximum of 19 kg/m2 and 38 kg/m2, respectively. The mean four-point scale was 2.98 ± 1.3, with a minimum and maximum of 1.0 and 4.0, respectively. Of the 110 patients, 47 patients reported a sore throat at 24 hours after surgery, whereas 63 patients did not report a sore throat. In this study, 14 patients in group A were diagnosed with a postoperative sore throat, whereas 33 patients in group B were diagnosed with a sore throat at 24 hours. A chi-square test was significant, and a poststratification chi-square test was applied to compare sore throat at 24 hours postoperative between the groups with respect to age and BMI. Conclusions ETT sizes produced a significant difference in the frequency of postoperative sore throat in patients undergoing breast surgery. Physicians should consider this impact on clinical practice to optimize patient outcomes. Additional studies with a larger sample size are warranted to further explore this impact.

Lumbar spine surgery can be performed using different anaesthetic techniques such as general endotracheal anaesthesia (GA) or spinal-based regional anaesthesia (RA). Few of the studies have been done to compare the outcomes of spinal anaesthesia versus general anaesthesia for lumbar laminectomies as both having some advantages as well as disadvantages but still it is controversial. The objective of current study is to make a comprehensive review of literature for comparing the outcomes of lumbar laminectomy performed under general anaesthesia versus spinal anaesthesia.Literature search was performed by using PubMed, Google scholar and bibliography of related articles. To compare groups of general anaesthesia versus spinal anaesthesia, the variables focused were mean heart rate (HR), mean arterial pressure (MAP), blood loss during surgery, duration of surgery, post-operative anaesthesia care unit (PACU) time, postoperative narcotic use/pain scale, post-operative urinary retention, and post-operative nausea/vomiting.Data of eleven studies were presented in current article, of these five were randomized controlled trials, three case-controls and four were retrospective cohort studies. 5/8 studies reported that SA group having more hemodynamic stability with postoperative outcomes as compared to GA. Likewise, majority of reviewed studies (7/8) reported better pain control or decreased requirement of analgesics in SA group. Additionally, more than half of the reviewed studies (5/8) reported lower incidence of postoperative nausea and vomiting among patients of SA group..The current study concluded that SA has better outcomes than GA in terms of hemodynamic stability and decrease postoperative adverse effects. So special attention should be paid for SA as an alternative to GA for lumbar laminectomy.

Regional anaesthesia is choice of anaesthesia for orthopaedic surgery due to lower side effects such as nausea, vomiting, postoperative pain and early mobilization. Despite of this, some orthopaedic patients refuse this modality. This study was conducted to interrogate the surgeons about their choice of anaesthesia in order to gain some insights into the concerns of surgeons and to change their minds and choose a safer mode of anaesthesia. The aim of the study was to assess the surgeons' fears and their perception about regional anaesthesia.After institutional approval, thirty surgeons from three different tertiary care hospitals were interviewed. They were asked questions as per the questionnaire to choose choice of anaesthesia for their patients.After regional anaesthesia, 27.6% of respondents were concerned about paralysis and neurological disorders, 34.5% about seeing and hearing whatever is happening in theatre, 17.2% about perioperative pain, 24.1% about backache and 24.1% about delayed discharge. The most important reason to change their mind was the reassurance that the complications are not as frequently as they thought their patient would receive after a block.Due to the lack of information on regional anaesthesia and the risks of general anaesthesia, orthopaedic surgeons' fears and conceptions about regional anaesthesia are distorted. Anaesthesiologists should be aware of the concerns of the surgeons as well as the patients and should be willing to discuss the concerns with them and suggest the safest way to receive anaesthesia with evidence-based data.

Endotracheal intubation is one of the basic prerequisites of general anaesthesia. Recovery of patients is delayed due to the development of post-operative nausea, vomiting, sore throat and shivering. This study was conducted to determine role of dexamethasone for improved recovery of patients.This randomized controlled trial was performed in the Department of Anaesthesia, Ayub Teaching Hospital, Abbottabad from June to November 2018. One hundred and twenty-two consenting patients of both genders, aged between 18-60 years, American Society of Anaesthesiologists (ASA) I and II, scheduled for general surgeries of 60-180 minutes duration under general anaesthesia were included. Patients with long duration surgeries, anticipated difficult airways, nasogastric tube in situ, upper respiratory tract infections, on steroid therapy and critically ill and emergency surgeries were excluded. They were randomly allocated into two groups by lottery method as dexamethasone (group A, n=61) or Placebo (group B, n=61). Postoperative nausea, vomiting, sore throat was observed at 2, 12 and 24 hours, shivering was observed at 2 hours only and patient satisfaction at 24 hours post-operatively.Group A patients had statistically proven better outcomes at 2, 12 and 24 hours for post-operative sore throat, nausea and vomiting, shivering was controlled in 24.5% p-value (0.006). Patient satisfaction was found in 83.6% of group A patients..Thus, dexamethasone is effective drug for prevention of postoperative nausea, vomiting, sore throat and shivering in general surgical procedures thus improving patient satisfaction and their early discharge.