Saudi patient's knowledge and attitude toward anesthesia and anesthesiologists: a prospective cross-sectional interview questionnaire

Patients' awareness of the duties of anesthesiologists in the operating theatres may sometimes be limited. Many studies around the world proved lack of patient perception of the anesthesiologist's role in surgical practice. One hundred and seventy operative patients were interviewed by anesthesiologists in the pen-operative period in King Khalid University Hospital at Riyadh KSA This paper reports the results of a prospective study on these patient's interviews by filling predetermined questionnaire by the interviewer. The survey was conducted on two sessions namely before anesthesia and surgery, and in the first post operative day. It included three sections exploring the demographical profile of the participant, knowledge about anesthesia procedure, assessment, anesthesiologists personnel, postoperative pain relief and the attitude toward the service given to him. Patients who recognized the anesthesiologists as specialized doctor consisted of 55.3%. But those who recognized anesthesia services during surgical intervention were only 16.5%. This result reflect ignorance of the public of the function of anesthesiologists, showed lack of perception regarding anesthesia procedures during surgery, and the role of the anesthesiologist in monitoring resuscitation and postoperative analgesia. Patients showed inclination to know more about the anesthesia services and choices and ranked the services from very good to excellent. The illiterate section of the studied population showed statistically significant correlation between their information on anesthesiologists and anesthesia, and their degree of education, level of income and habitat. Reasonable percentage of the patients knew that the anesthesiologist is a doctor who administers anesthesia. Services of anesthesiologists were highly appreciated, but their function during the operation and nature of anesthetics administered were poorly known. These results call for the necessity to educate the surgical patient by the anesthesiologists preoperative interview allow more time to establish rapport, by distributing educational material related to anesthesia and use of the media to educate illiterate section of the public on subjects pertaining to anesthesia

Iatrogenic brain foreign body

We describe a case of an adult patient admitted following severe head injury. His condition necessitated the insertion of intracranial pressure monitoring catheter for brain protection management. When the initial crisis was settled, the ICP catheter was gently removed. However after extracting the catheter it was noted that a considerable part of the tip was missing. Plain X-ray of skull confirmed the presence of radio-opaque fragment inside the brain tissue. The patient needed drainage operation within one week of the episode when the catheter fragment was removed with complete recovery. The aim of this paper is to review the literature and to present warning notes on the untoward effects of iatrogenic brain foreign body

Anesthesia for encephalo-trigeminal angiomatosis [Sturge-Weber syndrome]

A case report of rare congenital disease of encephalo-trigeminal angiomatosis [Sturge-Weber Syndrome] [SWS], is presented to alert the anesthesiologist of its potential risk. The case was anesthetized for emergency orthopedic surgery. Anesthesia management is directed towards observing the clinical manifestations of localized superficial skin lesions, extensive systemic involvement, evaluating its associated anomalies and anticipating difficult intubation due to angiomas of the mouth and upper airway and be a ware of concurrent therapy. The authors reviewed the English-language literature and reported findings regarding the SWS pathophysiologic features, interventions, and outcomes, with emphasis on issues relevant to anesthesiologists. This patient tolerated balanced anesthesia well. Anesthesia should be planned to avoid trauma to the hemangiomata, increases in intraocular and intracranial pressure, and be cognizent of current anticonvulsant therapy