No abstract

As early as in 1934 the idea and relevance of post anesthesia visits have been implemented, with the recommendation that anesthesiologists should follow up i.e.; visit their patients regularly in the first two days after surgery to obtain information about the patient’s condition. Sparse literature exists regarding the importance of post anaesthesia visits, currently there are no studies done on how post anaesthesia visits are performed and documented. To find a solution for these issues, we had conducted a questionnaire research on the practice of post anesthesia visits among anaesthesiologists.: The aim of this study is to know whether anesthesiologists does regular post operative anaesthesia visits and to know the importance of post anaesthesia visits.A validated; self-reported electronic questionnaire was used to collect the data from a total of 80 anaesthesiologists who willfully participated in the study. The questionnaire generated using Google forms was sent to consultant as well as resident anaesthesiologists including free-lance practitioners through electronic mail.90% of the participants were resident anaesthesiologists and the rest were consultants. 93.8% of the responders reported that post anaesthesia visits are mandatory at their work place. 91.3% of the participants significantly anaesthetize up to 4 cases on an average per day (p<0.001%). Most of the responders (93.8%) had responded that Post Anesthesia Visits is mandatory in their workplace and documentation of post anaesthesia visits are done mostly in the pre anaesthetic evaluation sheets. Post anaesthesia visits for all high-risk cases on daily basics shows a significant p value (p<0.001%). Daily post anaesthesia visits for all cases on the evening on the day of surgery (p<0.047%) for all cases anaesthetize by the responders for a minimum duration of 10 minutes per patient shows the significant p value (p<0.028%). Post anaesthesia visits are done on a daily basis and documented in pre anaesthetic evaluation sheets or daily progress charts helps in detecting adverse effects related to anaesthesia procedure.

Background: Patients with hip fractures will be experiencing excruciating pain, which would prevent the ideal positioning of the patient for the neuraxial blockade. There is growing interest in using regional nerve blocks for pain in the elderly associated with a fractured hip. Pericapsular Nerve Group (PENG) block is gaining popularity as a provider of adequate analgesia in patients suffering from a hip fracture. The present study aimed to assess the effectiveness of PENG block using ropivacaine alone or ropivacaine with dexamethasone in reducing pain scores during patient positioning for the central neuraxial blockade and to compare the duration of postoperative analgesia.Materials and methods: This randomized double-blinded study was conducted on patients posted for hip surgery under spinal anesthesia at a tertiary care referral hospital between January 2021 and May 2022. Twenty-eight patients (14 in each group) were randomly allocated to receive either group A (20 ml of 0.5% ropivacaine for PENG block) or Group B (20ml of 0.5% ropivacaine with 8mg Dexamethasone for PENG block) before patient positioning for subarachnoid block. Intra-operative hemodynamic variables, pain scores on a visual analog scale (VAS), at rest and with movement, before block, at the time of positioning for spinal anesthesia, time for first rescue analgesic request, and the total dosage of rescue analgesia in the first 24 hours after PENG block were measured.Results: Pain scores at rest and with movement at baseline and at the time of positioning for spinal anesthesia were significant within the groups (p< 0.01). The time for the first rescue analgesic requirement was significantly longer in group B (445.0 ±17.4 minutes) than in group A (388.9±19.0 minutes) (p<0.05). The mean average number of doses of rescue analgesia (Tramadol in milligrams) was significantly lower in group B (190 ± 60) than in group A patients (250 ± 70) (p<0.05). Conclusion:The present study documented the effectiveness of PENG for patient positioning during the neuraxial blockade. Further, the addition of dexamethasone as an adjunct to ropivacaine yields a significantly longer duration of postoperative analgesia with a lower postoperative analgesic requirement.