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1. Evaluation of patient satisfaction with provided spinal anesthesia for Cesarean delivery: A survey in Leskovac General Hospital, Serbia

Author

Pejčić Nada, Mitić Radomir, Gavrilović Slobodan, Jović Marija, Krušić Slavica, Pujić Borislava, Velicković Ivan, and Sadana Neeti

Subjects
spinal anesthesia, cesarean delivery, patient satisfaction, quality improvement, Medicine
Abstract

Introduction/Objective. Тo ensure that all patients receive the best possible anesthetic care, it is essential to continuously evaluate our practices and strive for improvement. The objective of this study was to internally assess the anesthesia services provided during the peripartum period. Methods. The Anesthesiology Department of Leskovac General Hospital, Serbia (LGH) aimed to evaluate patient satisfaction with spinal anesthesia (SA) for Cesarean delivery (CD) using a questionnaire consisting of four open-ended questions. Following Institutional Review Board approval, an institutional-based survey was conducted from August 2021 to July 2022. During the study period, 624 (40.6%) of the total 1535 deliveries in LGH were CDs, with 311 (49.8%) of them performed under SA. Of the patients who underwent CD under SA, 87 agreed to anonymously complete the questionnaire. Results. Although patients had sufficient space to provide detailed responses, the majority of participants opted for brief answers, often limited to “yes” or “no”. Of the surveyed participants, 78% were informed about SA for CD before delivery, and 96.6% expressed satisfaction with the information provided during the preoperative anesthesiologist’s visit. Additionally, the majority of participants (94.3%) reported satisfaction with the postoperative analgesia they received. Conclusion. Our patients expressed high levels of satisfaction with the preoperative anesthesiologist’s visit and the SA provided for CD. However, there is a need to improve antenatal education for expectant mothers in the field of anesthesia. Conducting a new and more detailed survey would be necessary to further explore the influence of patient education and socio-economic status on patient satisfaction.

Published
2023
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2. Quadratus lumborum block in pediatric patients - a case series

Author

Pejčić Nada, Mitić Radomir, Nikolić Ivana, Sadana Neeti, and Veličković Ivan

Subjects
qlb, interfascial plane block, pediatrics, Medicine
Abstract

Introduction. The quadratus lumborum block (QLB) was the first interfascial plane block introduced to the Leskovac General Hospital thanks to the Kybele Inc. international teaching program in April 2017. Outlines of cases. During the period from April 2017 to December 2019, 22 pediatric patients underwent various surgical procedures and had the QLB type 1 block as a part of a multimodal perioperative pain management plan. Unilateral QLB was provided for unilateral inguinal hernia repair, orchidopexy, testicular torsion repair, and open appendectomy. Bilateral QLB was provided for laparoscopic appendectomy and cholecystectomy. Decreased use of fentanyl and sevoflurane was noticed in the cases when QLB was performed preoperatively. All the patients had well controlled pain. Conclusion. QLB is a simple and safe technique. Clear sonographic landmarks allow it to be easily performed. QLB has great potential to improve and facilitate postoperative pain management.

Published
2021
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14. Introduction

Author

Sadana, Ajit, primary, Sadana, Neeti, additional, and Sadana, Richa, additional

Published
2018
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18. Interfascial Plane Blocks in Obstetric and Gynecologic Surgery

Author

Pejčić, Nada, Mitić, Radomir, Sadana, Neeti, Veličković, Ivan, Pejčić, Nada, Mitić, Radomir, Sadana, Neeti, and Veličković, Ivan

Abstract

Introduction: Interfascial plane blocks (IPB) are truncal blocks with local anesthetic injected into space between two muscle layers. IPBs are easy to learn, simple to perform, provide satisfactory analgesia up to 24 hours, having a minimal risk of complications. Methods: We present a retrospective analysis of the patients who had IPB as a part of postoperative pain management plan following either CD or hysterectomy in Leskovac General Hospital, Serbia during the period April 2017 – February 2022. Results: We had 131 patients who had IPB perioperatively. Bilateral QLB type 1 was performed in 53 patients after CD and in 68 patients after hysterectomy. Bilateral ESPB T10-11 was done following one CD case and in 9 patients before hysterectomy. Patients had both acetaminophen and nonsteroidal anti-inflammatory drug for postoperative pain control. Decreased usage of fentanyl and sevoflurane was noticed in the cases where IPB was performed preoperatively. Almost all patients had well-controlled pain, and were very satisfied with pain score of 0-4/10 at numeric rating scale during 24 hours after surgery, with no opioid use. There were no complications regarding block performance. Conclusion: QLB and ESPB have great potential to improve and facilitate postoperative pain management in obstetric and gynecologic surgery., Uvod: Interfascijalniblokovi (Interfascial plane block, IPB) su blokovi trupa koji se izvode ubrizgavanjem lokalnog anestetika u prostor između dva sloja mišića. Laki su za učenje, jednostavni za izvođenje, omogućuju analgeziju u trajanju do 24 sata. Metode: Ovo je retrospektivna analiza pacijentica koje su perioperativno dobile IPB, a bile podvrgnute carskom rezu ili histerektomiji u Općoj bolnici Leskovac (Srbija) tijekom perioda travnja 2017 – veljače 2022. Rezultati: IPB perioperativno dobila je ukupno 131 pacijentica. Bilateralni kvadratus lumborum blok (quadratus lumborum blok, QLB) izveden je kod 53 pacijentice nakon carskogreza, i kod 68 pacijentica nakon histerektomije. Bilateralni erektor spine blok (erector spinae plane block, ESPB) T10-11 izveden je kod jedne pacijentice nakon carskog reza i kod 9 pacijentica neposredno prije histerektomije. Za postoperativnu kontrolu bola korišteni su paracetamol i nesteroidni antiupalni lijekovi. Smanjena upotreba fentanila i sevoflurana zabilježena je kod osoba koje su blok dobile preoperativno. Gotovo sve pacijentice su bile zadovoljne ostvarenom kontrolom bola nakon bloka, sa skorom 0-4/10 nanumeričkoj skali bola tijekom prva 24 sata postoperativno. Nije bilo postoperativne upotrebe opioida, niti komplikacija vezanih za izvođenje IPB. Zaključak: QLB i ESPB imaju odličan potencijal da unaprijede i olakšaju postoperativnu terapiju bola u opstetričkoj i ginekološkoj kirurgiji.

Published
2022

20. Interfascijalni blokovi u porodništvu i ginekološkoj kirurgiji

Author

Pejčić, Nada, Mitić, Radomir, Sadana, Neeti, and Veličković, Ivan

Subjects
Quadratus Lumborum Plane Block, QLB, Erector Spinae Plane Block, ESPB, Cesarean delivery, Hysterectomy, Quadratus umborum blok, QLB, Erector spine blok, carski rez, histerektomija
Abstract

Introduction: Interfascial plane blocks (IPB) are truncal blocks with local anesthetic injected into space between two muscle layers. IPBs are easy to learn, simple to perform, provide satisfactory analgesia up to 24 hours, having a minimal risk of complications. Methods: We present a retrospective analysis of the patients who had IPB as a part of postoperative pain management plan following either CD or hysterectomy in Leskovac General Hospital, Serbia during the period April 2017 – February 2022. Results: We had 131 patients who had IPB perioperatively. Bilateral QLB type 1 was performed in 53 patients after CD and in 68 patients after hysterectomy. Bilateral ESPB T10-11 was done following one CD case and in 9 patients before hysterectomy. Patients had both acetaminophen and nonsteroidal anti-inflammatory drug for postoperative pain control. Decreased usage of fentanyl and sevoflurane was noticed in the cases where IPB was performed preoperatively. Almost all patients had well-controlled pain, and were very satisfied with pain score of 0-4/10 at numeric rating scale during 24 hours after surgery, with no opioid use. There were no complications regarding block performance. Conclusion: QLB and ESPB have great potential to improve and facilitate postoperative pain management in obstetric and gynecologic surgery., Uvod: Interfascijalniblokovi (Interfascial plane block, IPB) su blokovi trupa koji se izvode ubrizgavanjem lokalnog anestetika u prostor između dva sloja mišića. Laki su za učenje, jednostavni za izvođenje, omogućuju analgeziju u trajanju do 24 sata. Metode: Ovo je retrospektivna analiza pacijentica koje su perioperativno dobile IPB, a bile podvrgnute carskom rezu ili histerektomiji u Općoj bolnici Leskovac (Srbija) tijekom perioda travnja 2017 – veljače 2022. Rezultati: IPB perioperativno dobila je ukupno 131 pacijentica. Bilateralni kvadratus lumborum blok (quadratus lumborum blok, QLB) izveden je kod 53 pacijentice nakon carskogreza, i kod 68 pacijentica nakon histerektomije. Bilateralni erektor spine blok (erector spinae plane block, ESPB) T10-11 izveden je kod jedne pacijentice nakon carskog reza i kod 9 pacijentica neposredno prije histerektomije. Za postoperativnu kontrolu bola korišteni su paracetamol i nesteroidni antiupalni lijekovi. Smanjena upotreba fentanila i sevoflurana zabilježena je kod osoba koje su blok dobile preoperativno. Gotovo sve pacijentice su bile zadovoljne ostvarenom kontrolom bola nakon bloka, sa skorom 0-4/10 nanumeričkoj skali bola tijekom prva 24 sata postoperativno. Nije bilo postoperativne upotrebe opioida, niti komplikacija vezanih za izvođenje IPB. Zaključak: QLB i ESPB imaju odličan potencijal da unaprijede i olakšaju postoperativnu terapiju bola u opstetričkoj i ginekološkoj kirurgiji.

Published
2022

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