Online ISSN: 2515-8260

Keywords : Postoperative

Comparative Analysis of Consequences of Laparotomy Wound in Emergency and Elective Surgery

Dr. Pankaj Babubhai Patel, Dr. Harshadray Natvarlal Parmar, Dr. Lomesh Ashok kumar Prajapati

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 5222-5226

Laparotomies are frequently carried out in surgical units. After laparotomy, postoperative problems are more common, especially in emergency situations.In surgical language, “the word laparotomy explains exploration of the abdomen and proceed further according to the cause identified”. The effects of the disease are directly impacted by postoperative complications. Materials and methods: This study included all patients who underwent laparotomy, whether it was elective or necessary. Patients' demographic information was recorded in Performa, all complications were compared based on the type of laparotomy, and patients were monitored for 30 days after surgery. Between emergency and elective surgery, postoperative wound problems and numerous factors impacting them are compared. Results and Conclusion: The study found that the incidence of postoperative tissue and wound issues was higher in emergency surgery (25%) than in elective surgery (14%). It primarily depends on individuals with higher ASA scores, anaemia, and higher wound classes who are more susceptible to suffer wound problems.

Comparative assessment of Levobupivacaine Alone versus Levobupivacaine with Ketamine in Subcutaneous Infiltration for Postoperative Analgesia

Dr Rohit Kansal, Dr Ankur Garg, Dr Dinesh Kumar Sardana

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 8927-8933

Introduction: After a lower segment caesarean section, local anaesthetic wound infiltration is used as part of multimodal analgesia to lessen pain and opiate use (LSCS). Ketamine extends the effects of analgesia by blocking additional spinal pain pathways.
Aims: To compare the analgesic effectiveness of ketamine and levobupivacaine when injected into subcutaneous wounds.
Materials and Methods: 50 patients receiving under spinal anaesthetic, a randomisedwas done. Both Group A and Group B parturients received surgical wound infiltration with 0.5% levobupivacaine diluted with normal saline at a dose of 2 mg/kg body weight for Group A, and 0.5% levobupivacaine with ketamine at a dose of 1 mg/kg body weight for Group B. We evaluated postoperative pain scores, first rescue analgesia time (FRA), hemodynamic parameters, and overall opioid analgesic use.
Results: Group B had a 1.5-hour longer pain-free duration and shorter time to FRA, along with lower mean VAS scores. Additionally, Group B participants consumed significantly fewer opioids overall and overall pain levels (P = 0.003). 97% of parturients in Group A and just 50% of those in Group B required rescue analgesia. The patient satisfaction score in Group B was considerably higher (P = 0.009). Between the groups, there was no difference in the frequency of nausea and vomiting (P = 0.5234).
Conclusions: Adding ketamine to levobupivacaine for surgical wound infiltration increases patient satisfaction, prolongs the duration of analgesia, and reduces the need for 24-hour opioid use.


T. Balaji, Anjaneya Varaprasad S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3067-3082

Background: This study aims to compare insertion parameters, ventilatory parameters, hemodynamic parameters and post-removal complications that occur during LMA insertion and I-gel insertion in pediatric patients for surgical procedures under sevoflurane anesthesia. Supraglottic airway devices are increasingly being used in children as they are less invasive than endotracheal intubation and cause less discomfort in the post-operative period.
Materials and Methods: In our study, 60 children ASA grade I & II aged between 1-5years, scheduled for elective short surgical procedures were allotted to two groups LMA and I-gel of 30 patients each randomly. The efficacy of I-gel in children during intubation, its hemodynamic changes and post-operative complications were compared to LMA under sevoflurane anaesthesia.
Results: I-gel insertion was done easily in 93.3% patients while LMA insertion was done easily in 86.67% patients. The changes in hemodynamic parameters i.e., heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were not statistically significant between both the groups (p>0.05). Saturation of haemoglobin is maintained above 97% with both devices which shown no statistical significance. Incidence of postoperative complications like cough, laryngospasm, lip/dental injury were comparable between both the groups with p>0.05. However, there was a substantial difference in the incidence of postoperative sore throat between both the groups, with the LMA group having a greater frequency.
Conclusion: In conclusion, neither LMA nor I-gel induces any substantial changes in the patients' hemodynamic condition, nor does SPO2. The postoperative complications in LMA and I-gel patients are not considerably different. I-gel insertion is substantially easier and faster than LMA insertion.