STANDARD OPERATING PROCEDURES

NIRUHA BASTI

INTRODUCTION

The procedure in which the medicine is administered through rectal route using basti yantra.

MATERIALS REQUIRED

For procedure:

  • Ref General Requirements SOP
  • Basti putaka – 1
  • Basti Netra – 1
  • Thread – 1
  • Cotton pad – 4
  • Towel – 1
  • Gloves – 2
  • Bowl – 1
  • Vessels – 2
  • Khalwa yantra – 1
  • Hot water bath
  • Steam box – 1

 

Medicines:

 

  • Taila for abhyanga – 150 ml
  • Thalam
  • Saindhava – Q. S.
  • Makshika – Q. S.
  • Taila for niruha basti – Q. S.
  • Kalka dravya – Q. S.
  • Kashaya dravya – Q. S.
  • Avapa dravya – Q. S.

Manpower

  • Therapist -2
  • Physician -1
PREPARATION

Preparation of medicine

Preparation of basti dravya 

  • Ref video of basti preparation
  • Saindhava is taken in a khalwa yantra and made into fine powder using the khaja
  • Measured honey is then added as a thin stream from the sides of vessel slowly and is  triturated uniformly with  Add honey in small divided quantities slowly and simultaneously mix the basti dravya till it become fine paste.
  • Then Measured taila is taken and added to the above mixture as a thin stream line flow. Add taila in small divided quantities slowly and simultaneously mix the basti dravya till it becomes a homogenous mixture.
  • On achieving proper consistency, add small quantities of kalka into the dravya simultaneous to trituration with khaja.
  • The cooled and filtered Kashaya is then added to the basti dravya slowly simultaneous with mixing until it becomes a homogenous mixture.
  • Finally add measured avapa dravya slowly in a thin stream and mix well.

Tying of basti putaka

  • Few minutes before the time of administration of basti, the dravya is made warm by placing over hot water bath.
  • Then the basti dravya is filtered through a sieve and is poured into the basti putaka.
  • Sterilized basti netra is taken and a varti made of cotton palced over the basti netra to avoid spillage.
  • Basti netra placed inside the basti putaka so that the netra is in a level just above the level of basti dravya.
  • Now tie the basti putaka using a thread by tightening at the lower part of netra ;the first knot above the first karnika. By the first twist, the level of basti dravya should enter the lower part of netra.
  • The thread should be twined from below upwards, so that it should be tight above the second karnika, after that it should be twined higher and the knot should be butterfly knot.

Preparation of Thalam

  • Prescribed drugs taken and thalam prepared.
  • Refer video and SOP of Thalam

Preparation of tray

  • Take a clean tray.
  • Put prepared basti dravya in a bowl, taila for abhyanga in a bowl, basti netra, basti putaka, thread, thalam, cotton pad, langotti, towel, gloves.

Preparation of patient

  • Check vitals.
  • Jeernahara lakshana assessed.
  • Vegotsarga
  • Make patient wear langotti.
PURVA KARMA
  • Sarvanga abhyanga is done in all seven postures. (Ref SOP and video of abhyanga)
  • Then, bashpa sweda is to be done. (Ref SOP and video of bashpa sweda)
PRADHANA KARMA
  • Patient is asked to lie in left lateral position with right leg flexed and left leg straight.
  • The left hand of the patient is flexed in such a way that head is rested over the left arm in the form of a pillow and right hand placed above the body.
  • The therapist is to wear gloves on both the hands.
  • Then, using the cotton pad dipped in medicated oil firstly the left index finger is lubricated, then netra and finally anal opening which facilitates the easy entry of nozzle into the anal canal.
  • The varti at the tip of the netra is removed.
  • Slowly the left index finger is inserted into the anal opening.
  • Then, using the right hand, the basti netra is gently inserted into the anal canal supported by the left index finger.
  • The basti netra is inserted up to one fourth part from the tip, slowly and straight following the position of the vertebral column.
  • Then, left index finger is slowly removed.
  • Now, with left hand basti netra is held and with right hand basti putaka is pressed with uniform pressure so that the basti dravya goes inside at one stretch.
  • Patient is asked to take deep breath through mouth at the time of administration.
  • The pressing of basti putaka is continued till only small quantity of medicine remains in the putaka.
  • After the administration of basti dravya, gently remove the basti netra.
PASCHAT KARMA
  • The patient is asked to lie in supine position till he feels the urge to defaecate.
  • After evacuation, patient is asked to take hot shower.
  • Rasnadi churna is applied over vertex after bath.
  • Then the patient is asked to take peya.
DURATION
  • 1 hour
INDICATIONS
  • Hemiplegia
  • Paraplegia
  • Parkinson’s disease
  • Arthritis – Osteo arthritis, Rheumatoid arthritis, Gouty arthritis
  • Low back ache
  • Sciatica
  • Myalgia
  • Digestive disorders
  • Neurodegenerative disorders
  • Obesity
CONTRAINDICATIONS
  • Acute Fever
  • Haemorrhoids
  • Fistula
  • Indigestion
  • Bleeding Disorders
  • Diarrhoea
  • Ascites
  • Weak person
  • Pregnancy up to 7 months
PRECAUTIONS
  • Should closely observe the general condition of the patient during the procedure.
  • The therapist should not shake or tremble his hand while pressing the basti putaka.
  • Also, pressing of basti putaka should be neither too fast nor too slow.
  • Pressing should be neither with great force nor with low force.
  • Small quantity of liquid should be allowed to remain in the syringe to prevent the entering of air.

 

COMPLICATIONS AND MANAGEMENT
  • Abdominal pain: fomentation with hot water bag, can give dhanwantharam gulika or hinguvachadi churna.
  • Dehydration: can give ORS, tender coconut water, laja tarpanam, manda.
  • Distension of abdomen: fomentation with hot water bag, can give dhanwantharam gulika or hinguvachadi churna.
  • Proctitis: can apply Satadhoutha ghritha or Murivenna lepam, Avagaha swedam with triphala Kashaya.
  • Vaso vagal shock: Splash cold water on to face, keep legs in a higher level than head.
  • Nausea, vomiting: can give vilwadi lehya, madiphala rasayana, dhanwantaram gulika.
  • Long retention: apply guda varti, introduce netra to guda for stimulation.
  • Headache: apply rasna jambira lepa on forehead.