Browsing by Author "Lakhe, Gajal"
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Publication Postdural Puncture Headache after Spinal Anaesthesia in Parturients Undergoing Cesarean Section in the Department of Anesthesia in a Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Lakhe, Gajal; Shrestha, Pravin; Duwadi, VijayaAbstract Introduction: The post-dural puncture headache is one of the common complications of spinal anaesthesia. It is one of the most frequent claims for malpractice involving obstetrics anaesthesia. Though self-limiting it is troublesome to the patient. The aim of this study was to find out the prevalence of post-dural puncture headache after spinal anaesthesia in parturients undergoing cesarean section in the Department of Anesthesia in a tertiary care centre. Methods: A descriptive cross-sectional study was done among parturients who underwent cesarean section under spinal anaesthesia from 27 June 2022 to 19 January 2023 after receiving ethical approval from the Institutional Review Committee (Reference number: MEMG/480/IRC). The pregnant patients aged 18-45 years of the American Society of Anesthesiologists Physical Status II/IIE who underwent elective or emergency cesarean section under spinal anaesthesia were included. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 385 parturients, the prevalence of post-dural puncture headache was 27 (7.01%) (4.53-9.67, 95% Confidence Interval). A total of 12 (44.44%) cases experienced post-dural puncture headache in the first 24 hours followed by 9 (33.33%) and 6 (22.22%) cases in 48 and 72 hours respectively. Moderate pain was complained of by 3 (11.11%) and 2 (7.41%) cases at 48 and 72 hours post-cesarean section respectively. Conclusions: The prevalence of post-dural puncture headache after spinal anaesthesia in parturients undergoing cesarean section was similar to studies done in similar settings.Publication Postoperative Pain after Laparoscopic Cholecystectomy in a Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Shrestha, Binod Bade; Lakhe, Gajal; Ghimire, PradeepAbstract Introduction: Laparoscopic cholecystectomy, being minimally invasive, is widely accepted in comparison to open cholecystectomy. The major benefits are small incision, less wound pain, rapid recovery, shorter hospital stay and earlier return to activities. Although, trauma and injury are limited in laparoscopic cholecystectomy; it is not a pain free surgery. Hence, we aimed to find the prevalence of pain at wound site after laparoscopic cholecystectomy at various time intervals in post-operative period. Methods: The descriptive cross-sectional study was conducted among 125 patients who belonged to American Society of Anesthesiologists grade I & II patients, with diagnosis of symptomatic gallstone disease from October, 2022 to September, 2023 in a tertiary care hospital after ethical approval was obtained from Institutional Review Board (Reference number: MEMG/483/IRC). Total sampling was done in this study. The post-operative pain at wound site was measured at 12, 24, 36 and 48 hours. Data were analyzed using Statistical Package of Social Sciences 21.0. Results: At 12 hours postoperatively, 2 (1.60%) patients complained of severe pain, 120 (96%) patients reported moderate pain and 3 (2.40%) patients expressed their pain as being mild. Likewise, at 24, 36 and 48 hours postoperatively, none of the patients suffered from severe pain. At 24 hours post-operative, 105 (84%) patients reported moderate pain which gradually declined over 48 hours. At 36 and 48 hours post-operative mild pain was reported by 85 (68%) and 117 (93.60%) patients. The moderate pain was complained by 40 (32%) and 8 (6.40%) patients. Conclusions: The majority of patients suffered from mild to moderate pain after laparoscopic cholecystectomy, the intensity of which decreased over 48 hours.Publication Preoperative Anxiety among Patients Undergoing Elective Surgery in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Lakhe, Gajal; Shrestha, Binod Bade; Subedi, AnilAbstract Introduction: Preoperative anxiety is universal in patients before surgery. It is mostly unaddressed by health professionals due to a lack of time. The objective of this study was to find out the prevalence of preoperative anxiety among patients undergoing elective surgery in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted on 385 surgical patients in the Department of Anaesthesia, from 27 November 2021 to 20 April 2022 in a tertiary care hospital posted for elective surgery. Ethical approval was obtained from the Institutional Review Committee (Reference number: MEMG/481/IRC). A convenience sampling was used. The level of anxiety and need for information was assessed using the Amsterdam Preoperative Anxiety and Information Scale questionnaire in a preoperative holding area. Point estimate and 95% Confidence Interval were calculated. Results: Out of 385 patients posted for elective surgery, preoperative anxiety was present in 88 (22.85%) (18.66-27.04, 95% Confidence Interval) patients. The mean Amsterdam Preoperative Anxiety and Information Scale score for total anxiety and need for information was 13.59±2.47 and 5.91±3.06 respectively. Anxiety was present in 60 (68.18%) females, 45 (51.13%) young patients aged <30 years and 50 (56.81%) patients without prior experience with surgery and anaesthesia. Conclusions: The prevalence of preoperative anxiety among surgical patients was lower than in previous studies done in similar settings. Preoperative anxiety was common in females, young patients and patients without previous experience with anaesthesia and surgery.