Anesthetic techniques used for cesarean section at the royal medical services hospitals in 2007

To describe the different anesthetic techniques used for cesarean section at the Royal Medical Services Hospitals. We retrospectively reviewed the anesthetic techniques used for Cesarean sections performed between 1[st] of January to the 31[st] of December 2007 at Royal Medical Services Hospitals. Data collection aimed at anesthetic techniques used for scheduled and non-scheduled Cesarean sections. Out of a total of 5,314 Cesarean sections performed in the year 2007 at our institution, 81.6% were performed under general anesthesia, 18.3% under spinal anesthesia, and 0.1% under epidural anesthesia. General anesthesia still predominated in our hospitals, the percentage of general anesthesia performed by different hospitals varied from 41% to 96%. This review of anesthetic techniques used for Cesarean section shows an overuse of general anesthesia and low use of regional anesthesia. There is a need to adjust clinical practice at the Royal Medical Services Hospitals in accordance with recent scientific data

Prevention of hypotension after spinal anesthesia for transurethral resection of the prostate using 6% hetastarch versus lactated ringer's solution

To compare the use of 6% Hetastarch with Lactated ringer's solution for prevention of hypotension after spinal anesthesia for transurethral resection of the prostate. In a randomized double blind study, 60 patients who underwent subarachnoid anesthesia for transurethral surgery were divided into two equal groups: group A were given Lactated ringer's solution and group B were given 6% Hetastarch. One thousand ml of Lactated ringer's solution for group A and 500 ml of 6% Hetastarch for group B was started to be administered intravenously to patients 10 minutes before the administration of the spinal anesthesia. Heart rate, blood pressure and oxygen saturation were recorded prior to, during and after surgery. Also the incidence of nausea and vomiting and the use of ephedrine were recorded. The incidence of hypotension was higher in group A [83%] than in group B [43%]. Systolic blood pressure < 90 mmHg occurred in 25 patients out of 30 who received Lactated ringer's solution compared to 13 patients who received Hetastarch. More patients required ephedrine to treat hypotension in group A than in group B. Nausea or vomiting was lower in group B also. Six percent Hetastarch is superior to Lactated ringer's solution for prevention of hypotension after spinal anesthesia for transurethral resection of the prostate

Local infiltration anesthesia versus spinal anesthesia in pilonidal sinus surgery

To compare local infiltration anesthesia plus sedation with spinal anesthesia for pilonidal sinus surgery, with respect to recovery time, postoperative complications and patient satisfaction. This study was conducted at Prince Hashem Military Hospital, Zarqa. A total of 64 patients were randomized into two groups; local infiltration anesthesia group [n=32] received local anesthesia of 20 ml 0.5% bupivacaine infiltrated around the pilonidal sinus plus 1.5-3 mg intravenous midazolam and spinal anesthesia group [n=32] received 1.5 ml of 0.5% bupivacaine into the subarachnoid space as spinal anesthesia. Perioperative side effects, visual analogue pain scale score for three days, patient satisfaction and hospital stay were recorded and assessed. Patients in the spinal anesthesia group spent more time in the operating theater and recovery room. Two thirds of the patients in the local infiltration anesthesia group [65.6%] left the hospital on the day of surgery, compared to only [34.4%] in the spinal anesthesia group. About 91% were satisfied in-group local infiltration anesthesia in comparison to 75% in the spinal anesthesia group Postoperative complications occurred in five patients of spinal anesthesia group [3 urinary retention and 2 spinal headache]. Sacrococcygeal local infiltration anesthesia for pilonidal sinus resulted in lower complications, shorter hospital stay and more postoperative patient's satisfaction