ABSTRACT
INTRODUCTION: There are no reports on haemodynamic changes on West African patients undergoing fibreoptic bronchoscopy (FOB). The aim of this study was to document these changes in West African patients undergoing awake FOB. MATERIALS AND METHODS: All consenting patients considered for awake FOB had their pulse rates, blood pressures and oxygen saturations documented at various phases of FOB, during procedures and up to 30 minutes after FOB to monitor any changes from pre-procedure levels. The values were analysed using SPSS version 16. RESULTS: One hundred and sixty FOB were performed on 145 patients. In non- sedated patients, the maximum oxygen saturation fall was 6% at the level of the vocal cord while the pulse rate rose as high as 13% at the carina. Bronchial washings exerted the most changes in sedated patients (SPO2 fell by 4.9%, and pulse rate rose by 11.9%). The mean arterial pressure increased occurred during bronchial washing for both groups (18.7% for non-sedated and 15.7% for sedated patients) CONCLUSION: Tachycardia, elevations in blood pressure and hypoxaemia are more pronounced and occur earlier during FOB in non-sedated patients. Traversing the vocal cords and bronchial washing evoke the most cardivascular changes during FOB.
ABSTRACT
BACKGROUND: Ophthalmic surgical procedures are performed under anaesthesia to enhance comfort and cooperation of patient. OBJECTIVE: To review factors influencing the choice of anaesthesia for ophthalmic surgical procedures. DESIGN: Restrospective descriptive study. SETTING: Eye unit of a tertiary hospital. SUBJECTS: All patients who had ophthalmic surgeries in the operating theatre from January 2002 to December 2009. RESULTS: Two hundred and ninety ophthalmic surgeries were carried out during the study period. Age range was 1-95 years and mean of 61.0 ± 1.9; most (55%) were elderly while 4.8% were children. One hundred and fourty seven (50.7%) were males, 143(49.3%) females; male:female of 1.03:1. Local anaesthesia was the more commonly (92.1%) employed while general anaesthesia was used in 23(7.9%) patients. General anaesthesia was used more frequently (71.4%) in children compared to other age groups; the mean age and standard error of means for patients who had general anaesthesia (27.2 /5.4 years) is smaller compared to 63.9/0.93 years for patients who had local anaesthesia (p < 0.0001). Regional anaesthesia was the most frequently used for all types of procedures except for eye wall repairs in which general anaesthesia was used for 71.4% of patients (p < 0.0001). General anaesthesia was indicated in seven (41.2%) of emergency ophthalmic surgical procedures as compared to 16 (5.9%) of elective ophthalmic procedures P < 0.0001. CONCLUSION: General anaesthesia was more commonly employed in children, eye wall repairs and emergency ophthalmic surgical procedures.
Subject(s)
Anesthesia , Eye Diseases/surgery , Ophthalmologic Surgical Procedures , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Child , Child, Preschool , Eye Diseases/etiology , Eye Diseases/pathology , Female , Humans , Infant , Male , Middle Aged , Nigeria , Patient Selection , Retrospective Studies , Young AdultABSTRACT
AIMS AND OBJECTIVES: This study determined the quality of perioperative analgesia and side effect profile of spinal bupivacaine plus pethidine for caesarean section. PATIENTS AND METHODS: Patients were randomised to receive 2.0mL of bupivacaine + pethidine 7.5mg or 2.0mL bupivacaine + saline of equal volume. Spinal anaesthesia was instituted at L2/3, L3/4 or L4/5 using a 25G pencil point spinal needle. Heart rate, blood pressure and oxygen saturation were monitored. Timelines such as time of injection of study medication, skin incision, delivery time, termination of surgery and time to first request for analgesia as well as complications were noted. Demographic characteristics were also recorded. RESULTS: 50 patients were studied in 2 groups and the demographic characteristics were similar. Addition of pethidine resulted in block height greater than T6 and longer duration of analgesia (256.9 ± 112.2 min.) compared with the saline group (160.5 ± 65.0 min; p = 0.0005). Maternal hypotension occurred more in the pethidine group (10/25 vs 2/25; p = 0.01). Peritoneal irritation and inadequate anaesthesia were more frequent in the saline group. Nausea and vomiting and drowsiness were mild and occurred only in the pethidine group. In the Post Anaesthetic Care Unit (PACU), more patients reported pain in the saline group (p = 0.002). CONCLUSION: Bupivacaine with pethidine 7.5mg resulted in better quality of anaesthesia, longer postoperative analgesia with acceptable side effect profile. This will be of value in the management of post-caesarean section pain particularly in the resource poor setting.
