Archana Rani

Abstract

Introduction: The number of tobacco users in our country is frightening and hence forth every possible intervention shall be used to try controlling the demon of tobacco. Every visit to hospital either as outdoor or admission shall be treated as an opportunity for tobacco cessation. In our study, we have tried to assess the utility and effectiveness of counselling at the time of pre anaesthesia check-up in patients undergoing elective surgeries as a tool for tobacco cessation. Materials and Methods: Two groups were made on the basis of whether intervention given in form of counselling at time of routine PAC for patients undergoing elective surgery. Both groups were assessed for various demographical characteristics, including nicotine dependence, quitting history. Group 1 was given a session of interactive counselling regarding ill effects of tobacco usage and provided access a helpline number of institutional tobacco cessation clinic. Six months after intervention and surgery, both groups were questioned about their smoking status and statistical methods were used to calculate the difference of outcomes, namely tobacco cessation and decrease in tobacco usage. Result and Discussion: The current study brought forth the fact that smokers or SLT users who are motivated or volunteers to take participation in cessation programme are more likely to successfully abstain from smoking. Age, Gender and educational status are major determinants in outcome of any tobacco cessation programme. The timing of counselling also plays a vital role in success of any counselling session. Hence forth, it is highly advisable to use this golden opportunity for counselling and advising the patient to abstain from using tobacco in any form. Keywords: Smoking, SLT, PAC.

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Abstract

Introduction: Successful insertion of Laryngeal Mask Airway (LMA) ProSeal without any unwanted effects, such as coughing and gagging, requires adequate depth anaesthesia and suppression of the upper airway reflexes. Our prime aim was to study Bispectral Index (BIS) guided conditions for LMA ProSeal insertion comparing Propofol versus Sevoflurane with or without Fentanyl citrate. Materials and Methods: A randomised prospective study was done on 120 unpremedicated ASA grade 1 or 2 patients which were divided into four equal groups as group P – Propofol intravenous induction, group PF - Propofol intravenous induction with Fentanyl, group S – Sevoflurane gas induction in 60% nitrous oxide and 40% oxygen and group SF -Sevoflurane gas induction in 60% nitrous oxide and 40% oxygen with Fentanyl. The parameters studied were induction time, insertion time, insertion conditions for LMA ProSeal like jaw opening, ease of insertion, coughing, gagging, laryngospasm- airway obstruction and patients movements on a three point scale using six variables. Result: Excellent and satisfactory conditions were in 100% patients in group SF, 90% patients in group PF and 66.7% in group P and S. Conclusions: Overall, group PF is better than SF in having shorter induction time and better hemodynamic stability but insertion conditions were better with group SF as compared to group PF though statistically insignificant. Keywords: ProSeal LMA, Propofol, Sevoflurane.

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