Avinash Prakash

Abstract

Introduction and Aim: Nitrous oxide (N2O) is one of the oldest inhalational anaesthetic agents used in modern anaesthesia practice, N2O has been on and off the list of drugs in the anaesthesiologist’s armamentarium. It is believed that diffused N2O will accumulate in the third spaces causing its expansion and pressures build up. However, much is not known about how much it diffuses. The aim of present study is to analyze the extent of N2O in peritoneal cavity following creation of pneumoperitoneum for laparoscopic surgeries as well as relationship to the duration of pneumoperitoneum. Materials and Methods: Twenty two ASA I & II patients of both sexes aged between 18 to 65 years who underwent elective laparoscopic cholecystectomy were included with consent. N2O and O2 were administered at a fixed proportion of 60:40. Volatile anaesthetic agent Sevoflurance was administered and adjusted to achieve a MACage of 1.1 to 1.2. Results: Entire 22 (50% female) patients with mean + standard deviation (SD) age and weight of 40.18 + 8.96 years and 63.05 + 6.09 kilogram fulfilled inclusion criteria and data were analyzed. No N2O or anaesthetic agent was detected in the aspirated sample at the end of surgery. Conclusion: Amount of N2O accumulated in CO2 pneumoperitoneum used for laparoscopic surgeries are insignificant to nil for 3hour procedures. Keywords: Nitrous oxide, Pneumoperitoneum.

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Abstract

Introduction and Aim: Anaesthesia as speciality has evolved very much but the services are yet very much under recognized. This may be partly because of low knowledge of anaesthesia and anaesthesiologists. School education level of patients may also affect this. This study was conducted to assess the patient’s knowledge and perception about the role of anaesthesiologists, anaesthesia and their relationship with different educational level of patients and previous anaesthesia exposure Materials and Methods: The present cross sectional study was conducted with 150 participants aged > 15 years of either sex posted for elective surgery. A questionnaire was used as data collection tool. Data of entire cohort as well as in different subgroups based on education level and previous exposure were calculated and compared using INSTAT software and p < 0.05 was considered significant. Results: All the participants (56.67% female; mean age 39.36 + 12.63 years) completed the questionnaire. Their knowledge and awareness of anaesthesia and anaesthesiologists was very poor. Even patients with previous anaesthesia exposure were having poor knowledge (3 to 41 % in different aspects). No difference in knowledge and awareness was noted with different educational level (p > 0.05). Previously exposed patients had significantly more knowledge regarding ‘who makes you unconscious’, ‘types of anaesthesia’ and routes of ‘general anaesthesia administration’ but it failed to show difference in other aspects. Conclusion: Knowledge about anaesthesia and anaesthesiologists are still very poor. School education has no positive impact and previous anaesthesia exposure increases the knowledge in limited aspects. Keywords: Anesthesia and analgesia, Anesthetist, Awareness of education of patients, Risks involved, Recognition.

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