STANDARD OPERATING PROCEDURES

SHIRO DHARA

INTRODUCTION

Shirodhara is the procedure in which liquid medicaments like thaila/ksheera/kashaya is poured in a continuous stream of flow on the forehead in oscillating manner.

MATERIALS REQUIRED
  • Ref General Requirements SOP 
  • Liquid Medicaments like Taila/ Ksheera/ Kashaya -1.5litres
  • Dhara stand-1
  • Dhara patra -1
  • Cotton ear plugs- 2
  • Gauze-1
  • Head band- 1
  • Eye pad -1
  • Soft towel- 2
  • Hot water bath -1
  • Vessels-3

Manpower

  • Therapists -2
  • Physician -1
PREPARATION

Preparation of tray

  • Take a clean tray.
  • Put langotti, towel, eye pad, head band, gauze, cotton ear plugs.

Preparation of patient

  • Check vitals.
  • Jeernahara lakshana assessed.
  • Vegotsarga
PURVA KARMA
  • Patient is asked to sit comfortably over the droni with legs extended.
  • Ear plugs are kept on both ears.
  • Gauze is tied around the head above the eyebrows of the patient.
  • Both the eyes are covered with an eye pad.
  • Patient is asked to lie in supine position.
  • Dhara patra hanged on the dhara stand is fixed 4 angulas above the level of forehead.
PRADHANA KARMA
  • The Taila for Shirodhara is made lukewarm using a hot water bath.
  • Temperature of the medicine is checked by pouring it over the dorsum of hand.
  • Ensure the knob of dharapatra is closed.
  • The lukewarm taila is poured into the dhara patra.
  • The knob is slowly opened to get a continuous stream of flow.
  • The dharapatra is oscillated in a to and fro motion covering the whole forehead.
  • The head of the patient is simultaneously massaged at frequent intervals.
  • Uniform temperature is maintained throughout the procedure by refilling it with lukewarm oil.
  •  
PASCHAT KARMA
  • The Nozzle is closed and dharapatra is removed
  • Earplugs, Gauze and eye pad are removed and the head is wiped with a towel.
  • Patient is asked to take hot shower after resting for a while .
  • Rasnadi churna is applied over vertex after bath .
  •  
DURATION
  • 45 mints -1 hour.
INDICATIONS
  • Insomnia
  • Headache
  • Anxiety
  • Mental stress
  • Cerebrovascular disorders
  • Psychological disorders
  • Eye diseases of neurological origin
CONTRAINDICATIONS
  • Glaucoma
  • Conjunctivitis
  • Fever
  • Inflammatory conditions of head.
PRECAUTIONS
  • During the procedure eyes are well protected and covered to avoid leakage of medicated liquid into eyes.
  • The height of the dhara patra should not be more than 4 Angula above the level of forehead.
  • Oscillation of the dhara patra should be neither too fast nor too slow.
  • Also the stream of flow should not go beyond the temporal region on both sides.
COMPLICATIONS AND MANAGEMENT
  • If the dhara is done from more height, very fast or very slow, then it may produce murccha, shoola, chardi, raktapitta and jwara.
  • For these dhara doshas, treatments like gandusha, nasya, sunti kashayapana etc can be done.
  • Yusha with black pepper can be administered.
  • On the third day basti should be given.