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Background and Aims: Transcutaneous Electrical Nerve Stimulation (TENS) is a nonpharmacological method based on gate theory of pain control and provides analgesia noninvasively. Application of TENS requires simple training and can be self administered by patients without any l potential for toxicity. Patients can titrate the dosage on and whenever needed. TENS can be administered by either dermatomal stimulation or by stimulation of acupuncture points for labour analgesia. This study was undertaken to compare the efficacy of TENS administered by dermatomal stimulation with TENS administered by stimulation of acupuncture points.

Materials and Method: The study was conducted on 40 ASA grade 1 parturients with 37 to 42 weeks gestation in active stage without any fetal or maternal complication. Parturients were randomly allocated by computer generated random number table to one of two groups (Group D- TENS by dematomal stimulation, Group A- TENS by acupuncture points stimulation) comprising of 20 parturients each. Each group was monitored for pain scores, progress of labour and maternal and fetal outcome. The quantitative parameters were analysed using the Student-t test and Mann Whitney test. Qualitative parameters were analysed using Chi-square test/Fisher Exact test. A p value of <0.05 was taken as statistically significant.

Results: TENS administered by dermatomal stimulation causes significant decrease in VAS score and rescue analgesic requirement as compared to acupuncture point stimulation. Parturients in Group D also reported significant decrease of back pain and better ambulation as compared to Group A. Maternal and fetal outcome were similar in both groups without any side effects.

Conclusion: Pain relief in labour is better when TENS is administered by dermatomal stimulation as compared to acupuncture point stimulation.

Keywords

Acupuncture Analgesia, Obstetric Analgesia, Transcutaneous Electrical Nerve Stimulation.

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Available from: https://www.tenscare.co.uk/maternity/mamatens

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An Evaluation of Retrograde Light-Guided Laryngoscopic Intubation and its Comparison with Conventional Direct Laryngoscopic Intubation

Abstract Views :433 | PDF Views:171

Authors

Mohd Shakir Naeem ¹, Kirti N. Saxena ¹, Bharti Taneja ¹

Affiliations
1 Department of Anaesthesiology and Critical Care, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi – 110002, Delhi, IN

Source

Northern Journal of ISA, Vol 3, No 1 (2018), Pagination: 15-20

Abstract

Background: Conventional Direct Laryngoscopic (DL) tracheal intubation requires certain amount of skill for its successful outcome. To improve the success of intubation, various alternatives to conventional laryngoscopy have been described in recent years. Retrograde Light-Guided Laryngoscopy (RLGL) is a recently described technique for endotracheal intubation. Methods: A prospective randomized study was conducted in 100 patients, randomly intubated according to a computer generated procedure using either DL or RLGL by a single operator. The primary outcome was the success rate of tracheal intubation. The parameters evaluated were: success rate of tracheal intubation, time to glottic exposure and time to tracheal intubation, Cormack and Lehane grades, haemodynamic parameters and post operative sore-throat and hoarseness of voice. Results: Compared with DL, the overall success rate was greater in the RLGL group (P = 0.004). This was associated with a shorter time to glottic exposure [4.0(±1.09) vs 4.72±(1.16) sec, P = 0.001], shorter intubation time [5.28(±1.34) vs 6.10(±1.22) sec, P < 0.001]. The laryngoscopic grades using RLGL were better than using DL (p = 0.002). The haemodynamic responses were comparable in both the groups. There was decreased incidence of sore-throat (p = 0.083) and hoarseness (0.005) at 24 hrs with RLGL compared to DL. Conclusions: RLGL is an alternative approach for intubation. We conclude that the RLGL is a safe and effective device for achieving endotracheal intubation in normotensive adults with normal airways.

Keywords

Airway, Endotracheal Intubation, Retrograde Light-Guided Laryngoscopy.

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Anaesthetic Management of a Parturient with Clinoid Meningioma for Caesarean Section

Abstract Views :446 | PDF Views:174

Authors

Kirti N. Saxena ¹, Ayushi Mahajan ¹

Affiliations
1 Department of Anaesthesiology, Maulana Azad Medical College and Associated Hospitals, New Delhi – 110002, Delhi, IN

Source

Northern Journal of ISA, Vol 3, No 1 (2018), Pagination: 25-27

Abstract

Certain tumours such as meningiomas manifest during pregnancy due to rapid growth following increased blood volume which results in increasing size of vascular tumours. A 25 years old primi-gravida (weight 60 kg) presented at 34 weeks gestation with the complaints of headache, generalized grand mal seizure, diminished vision and loss of speech for 1 week and was diagnosed with intracranial meningioma. Caesarean section was performed followed by neurosurgery for removal of tumour. Anaesthetic management of these cases could be challenging due to lack of adequate guidelines.

Keywords

Caesarean Section, Meningioma.

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