Background: The present observational study was carried out to evaluate the incidence and severity of PDPH in the obstetrics and non-obstetrics patients. Material & Methods: This was a observational Prospective study carried out at Department of Anaesthesia, Dr. Rajendra Prasad Medical College, Tanda conducted on consecutive patients ASA I and II, aged 20-60 years, obstetric/ non obstetric patients scheduled for surgery under subarachnoid block, over a period of 18 months including data collection, data organization, presentation, analysis and interpretation. After recruitment, the patients were divided into two groups comprising of obstetric and non-obstetric group. Results: The total patients included were 302, being 115 in obstetric group and 187 in non-obstetric group. Mean age of patients in group obstetric and non-obstetric group was 30.66±6.27 years and 52.88±12.72 years respectively (P=0.045). The patients were comparable with regards to body mass index in two groups. With regards to gender distribution in the non-obstetric group, 76 were female patients while 111 were male [P Value=0.001]. In our study, out of 302 patients only 17 patients had post dural puncture headache, the total incidence being 5.6%. There were eight (7%) patients in obstetric and nine (4.8%) patients in non-obstetric group, however the difference was not statistically significant (P=0.597). Majority of the patients had mild PDPH (47.05%) followed by moderate (41.17%), and only one patient had severe (11.76%) PDPH. Conclusion: Therefore, we concluded that in the present study with the use of 26G quincke spinal needle, obstetric population had higher incidence of PDPH in comparison to non-obstetric population.

Background: The present observational study was carried out to evaluate the method of Management, Complications and Patient satisfaction among obstetrics and non-obstetrics patients having Post Dural Puncture Headache (PDPH) after undergoing surgeries under subarachnoid block in a Tertiary Care Hospital. Material & Methods: This was a observational Prospective study carried out at Department of Anaesthesia, Dr. Rajendra Prasad Medical College, Tanda conducted on consecutive patients ASA I and II, aged 20-60 years, obstetric/ non obstetric patients scheduled for surgery under subarachnoid block, over a period of 18 months including data collection, data organization, presentation, analysis and interpretation. After recruitment, the patients were divided into two groups comprising of obstetric and non-obstetric group. Results: The total patients included were 302, being 115 in obstetric group and 187 in non-obstetric group. In our study, out of 302 patients only 17 patients had post dural puncture headache, the total incidence being 5.6%.There were eight (7%) patients in obstetric and nine (4.8%) patients in non-obstetric group. All patients with PDPH had resolution of their symptoms by conservative management (hydration, bed rest, acetaminophen and NSAIDS), the PDPH resolved in 2 (25%) of the parturients within the 1st day of its commencement, 5 (62.5%) parturients and 4 patients [44.4%] in non obstetric group had relief 2nd day after commencement of the headache. Whereas, one parturient [12.5%] and 4 patients [44.4%] in non-obstetric group got relief on the 3rd day. One patient in non obstetric group (11.1%) had relief on the fourth day. 29% of the patient responded to the fluid and bed rest, whereas 35.2% patients required acetaminophen tablet as well, however 35.2% patients required the non steroidal anti-inflammatory drugs as well. No patient in either group required epidural blood patch. In obstetrics and non-obstetrics population, incidence of nausea and vomiting was in 8.7% and 7.5% patients respectively. Other complications like backache, vertigo were 2.61% and 2.7% patients in obstetric and non-obstetric population respectively. In obstetrics and non-obstetrics population, patient satisfaction was comparable (P=0.0778). Conclusion: All patients with PDPH had resolution of their symptoms by conservative management (hydration, bed rest, acetaminophen and NSAIDS) within 3-4 days while incidence of nausea and vomiting and other complications like backache, vertigo were very less.

Background: The present study was done for comparative evaluation of change in intra cuff pressure using Ambu Auragain in Trendelenburg and Reverse Trendelenburg Position in patients undergoing Laparoscopic Surgery. Material & Methods: This was a prospective cohort study conducted on 46 patients in Department of Anaesthesia to determine intra cuff-pressure in laparoscopic surgeries in Trendelenburg and Reverse Trendelenburg position with the use of Ambu AuraGain. Group A included 16 patients with Trendelenburg position and Group B included 30 patients with Reverse Trendelenburg position. Results: The mean age of patients in Group A was 44.44±11.11years whereas the mean age of patients in Group B was 45.50±11.78years (p>0.05). Group A comprised of 2 (12.5%) males and 14 (87.5%) females whereas Group B comprised of 12 (40%) males and 18 (60%) females (p>0.05). The mean BMI of patients in Group A was found to be 22.28±1.58kg/m2 and mean BMI of patients in Group B was 22.57±2.54kg/m2 (p>0.05). Group A comprised of 11 (68.8%) patients with ASA status I and 5 (31.2%) patients with ASA status II. On the other hand, Group B had 15 cases each with ASA status I and II (p>0.05). The average duration of surgeries in Group A was 80-90 minutes whereas the average duration of surgeries in Group B was 70-80 minutes.The baseline Cuff Pressures were comparable in Group A and Group B. The comparison between mean cuff pressure of two groups was found to be statistically significant at all recorded time intervals except after SGA placement, and before CO2 insufflation (p>0.05). Cuff pressure was higher in Group A than Group B. Only 2 patients in Group A and no patient in Group B required intervention by release of air with the help of cuff manometer. This was not found to be statistically significant (p>0.05). Conclusion: We found in this study that Trendelenburg or Head down position increases intra cuff pressure peak airway pressure as compared to Reverse Trendelenburg position. So it is recommended to monitor intra cuff pressure of SGA frequently in laparoscopic surgeries.

Background: The present study was undertaken to evaluate the effect of Vedic chants on Sensory blockade level, number of epidural activations and dose of drug required for labor analgesia in Laboring Parturients with Ambulatory Epidural Labor Analgesia. Material & Methods: A total of 38 patients with full term live cephalic singleton pregnancy in active labor with cervical dilatation 0-4 cm with a request for ambulatory labor analgesia admitted in department of Obstetrics and Gynaecology at Dr. RPGMC Kangra at Tanda were participated in this study. We randomized the patients in two groups A and B. Both groups received epidural labor analgesia with 0.1% ropivacaine and 1.5ug/ml of fentanyl. Patients in group A were made to listen Vedic chants (Gayatri mantra) in 4 sessions of 30 min each with 15mins break in between the sessions. In group B, patients received only ambulatory epidural labor analgesia without any Vedic chants listening. These two groups were observed for the various parameters till the delivery of the baby. Results: The two groups were comparable in terms of age, height, weight, BMI, occupation, parity, POG, mean cervical dilatation and contractions per 5minutes at the time of administration of labor analgesia and were statistically non-significant (p >0.05). Mean number of epidural activations of the patients in group A was comparable to that in group B (11.9±1.8 vs. 11.4±2.3; p = 0.544). Mean dose (in ml) of ropivacaine and fentanyl of the patients in group A was comparable to that in group B (35.6±5.5 vs. 34.4±6.8; p = 0.544). In Group A, 4 (25%), 9 (56%), 1 (6%) and 2 (13%) had sensory blockade level at T4, T6, T8 and T10 respectively. In Group B, 4 (18%), 12 (55%), 4 (18%) and 2 (9%) had sensory blockade level at T4, T6, T8 and T10 respectively. Conclusion: In our study, Mean number of epidural activations of the patients, Mean dose of ropivacaine and fentanyl and sensory blockade level were comparable in both groups.