Background: Parturient undergoing repeat caesarean section (CS) under spinal anaesthesia usually experience anxiety due to unpleasant operative environment. Music therapy has been found to have positive psychological impact to relieve anxiety, improve patient satisfaction and provide stable haemodyanamics.Methods: Sixty patients without any co morbidity having history of previous CS, scheduled for another caesarean under spinal anaesthesia were included in the study. Patients were divided into two groups of 30 each. Group(M) patients were subjected to hearing music of their choice with the help of headphones after administration of spinal anaesthesia till the end of surgery. Group(N) patients were not made to listen to any music but headphones were applied. Haemodyanamic parameters including mean arterial pressure (MAP) and heart rate (HR), visual analogue score for anxiety (VASA) after administering spinal block and at the end of surgery, patient satisfaction score (PSS) and comparison of anxiety with previous CS were observed and recorded.Results: Both MAP and HR in Group M started falling after 10 minutes of spinal anaesthesia as compared to Group N and difference was significant (P <0.005), VASA 2 (2.2±1.8) in Group M was significantly lower than VASA 1 (5.4±1.7). PSS was also in favour of music group (Group M) and difference was highly significant as compared to group N (p=0.018). Patient’s anxiety as compared to anxiety with previous CS was lesser in Group M as compared to Group N(p=0.009).Conclusions: Music is a non-invasive tool to relieve anxiety during intraoperative period along with higher patient satisfaction and stable haemodyanamics.
Schizophrenics, patients with affective disorder and normal controls were tested on a verbal dichotic listening task at three time periods, 0-2, 4-6 and 14-16 weeks. Schizophrenics had non-significant ear difference during the acute state of illness (0-2 weeks) and the normal right-ear advantage emerged when acuteness subsided (14-16 weeks).
Rapid sequence induction (RSI) is a common technique used in clinical anaesthesia to prevent pulmonary aspiration of gastric contents. Sellick introduced this in 1961. However, scientific validation to show the advantage of this technique in preventing aspiration is limited in literature. Numerous researches have shown that cricoid pressure (CP) application might have no benefit in preventing aspiration. Additionally this could lead to problems in securing the airway. Proper teaching and regular training sessions of this technique are mandatory in routine anaesthesia practice.
Modern medicine involves highly specific and sophisticated techniques and equipments. However, human errors as well as equipment failure may lead to fatal accidents an increase in the cost of health care. Using checklist as tool for surgical safety involves safe anaesthesia, maintenance of open airway, correct surgical site, infection control and efficient communications and team work. Although no checklist is universal or guarantees absolute safety, an effective checklist has a patient centered approach and keeps patient safety and comfort a priority.
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