Knowledge About Epidural Analgesia Among Women in Al-Qassim Province of Saudi Arabia.

INTRODUCTION: Epidural analgesia is one of the most effective and fast anesthesia techniques to relieve labor pain. The technique involves inserting a needle in the epidural space that covers the spinal cord, providing a full block of sensation in the lower part of the abdomen and the lower limbs that starts seconds to minutes after the administration, while the effects last for a couple of hours after. This study assessed women's knowledge of epidural analgesia in the Al-Qassim Province of Saudi Arabia. METHODS: The study was conducted through a descriptive cross-sectional survey distributed among citizens of Qassim Province, Kingdom of Saudi Arabia, from October 2022 to February 2023. The respondents were selected randomly via social media advertising, and only women older than 18 were allowed to participate in the survey. RESULTS: Out of 520 responses, 483 met the study criteria. This study found significant associations between awareness levels of epidural analgesia and pregnancy history. Women who had previous histories reported epidural analgesia as the most effective means of pain control (p < 0.001), postpartum back pain as the major complication (p = 0.025), being used by the majority of other women (p = 0.022), and the potential for epidural analgesia to yield complications (p < 0.001). This means that other studies are required to explore more such associations to widen the scope of this field of study. CONCLUSION: This study highlights the mixed awareness levels of epidural analgesia among Saudi women from the Qassim area. The awareness provided by clinics or hospitals is limited, and further research is required to explore the awareness levels of epidural analgesia. Overall, the study highlights the need for a concerted effort by healthcare providers to improve the awareness and uptake of epidural analgesia in the Qassim area and beyond.

Public Awareness and Knowledge About Anesthesiology and the Role of Anesthesiologists in Al-Qassim Province, Saudi Arabia.

Introduction Anesthesiology is a specialty of medicine that focuses on inducing reversible loss of consciousness, amnesia, muscle relaxation, and analgesia. Anesthesiologists play an important and integral role in pain clinics, operating rooms, and intensive care units (ICU). This study assessed public awareness and knowledge about the specialty of anesthesiology and the role of anesthesiologists in Qassim province, Saudi Arabia. Methods An observational, cross-sectional study was conducted in Qassim province from September 2022 to December 2022. A modified electronic questionnaire was distributed through social media platforms. The questionnaire contained items designated as demographics, knowledge, and experience regarding anesthesia and the importance of anesthesiologists. Saudi participants older than 18 years of age were eligible to complete the survey. Results Of the 405 participants, 375 met the inclusion criteria (48.5% women and 51.5% men), and participants with an undergraduate education level (23.5%, p<.05) had a higher prevalence of having undergone surgery previously. Furthermore, it was found that factors, such as knowledge about the complications of regional anesthesia (p<.001) positively influenced anesthesia knowledge. Moreover, in a linear regression model, an understanding of the complications of regional anesthesia was associated with increased anesthesia knowledge (p<.05). However, the sample demonstrated a poor level of anesthesia knowledge, evidenced by the responses to questions assessing the same. Conclusions Consistent with the literature, there was a poor level of anesthesia awareness and knowledge among the adult population living in Saudi Arabia. Further research is needed to establish the link between anesthesia awareness, knowledge about the role of the anesthesiologist, and knowledge about anesthesiology in the region.

Effects of terlipressin infusion during hepatobiliary surgery on systemic and splanchnic haemodynamics, renal function and blood loss: a double-blind, randomized clinical trial.

BACKGROUND: Terlipressin, in general, is a vasopressor which acts via V1 receptors. Its infusion elevates mean blood pressure and can reduce bleeding which has a splanchnic origin. The primary outcome was to assess the impact of intraoperative terlipressin infusion on portal venous pressure during hepatobiliary surgery; the 2ry outcomes included effects upon systemic hemodynamics, estimated blood loss, and postoperative renal functions. METHODS: This prospective randomized study involved 50 patients undergoing hepatobiliary surgery who were randomly and equally allocated into terlipressin group, or a control group. The terlipressin group received an initial bolus dose of (1 mg over 30 min) followed by a continuous infusion of 2 µg/kg/h throughout the procedure and gradually weaned over the first four postoperative hours, whereas the control group received the same volumes of normal saline. The portal venous pressure changes were measured directly through a portal vein angiocatheter. RESULTS: Portal pressure was significantly reduced over time in the terlipressin group only (from 17.88 ± 7.32 to 15.96 ± 6.55 mmHg, p < .001). Mean arterial blood pressure was significantly higher in the terlipressin group. Estimated blood loss was significantly higher in the control group than the terlipressin group (1065.7 ± 202 versus 842 ± 145.5 ml; p = 0.004), and the units of packed RBCs transfused were significantly higher in the control group ((0-2) versus (0-4) p = 0.003). There was no significant difference between groups as regards the incidence of acute kidney injury. CONCLUSION: Intraoperative infusion of terlipressin during hepatobiliary surgery was shown to improve intraoperative portal hemodynamics with subsequent reduction in blood loss. TRIAL REGISTRATION: Clinical trial number and registry URL: Trial registration number: NCT02718599 . Name of registry: ClinicalTrials.gov. URL of registry: https://clinicaltrials.gov/ct2/show/NCT02718599 . Date of registration: March 2016. Date of enrolment of the first participant to the trial: April 2016.

Nonopioid versus opioid based general anesthesia technique for bariatric surgery: A randomized double-blind study.

OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of giving general anesthesia without the use of any opioids either systemic or intraperitoneal in bariatric surgery. METHODS: Prospective randomized controlled trial. Obese patients (body mass index >50 Kg/m(2)) undergoing laparoscopic sleeve gastrectomies were recruited and provided an informed signed consent. Patients were randomized using a computer generated randomization table to receive either opioid or non-opioid based anesthesia. The patient and the investigator scoring patient outcome after surgery were blinded to the anesthetic protocol. Primary outcomes were hemodynamics in the form of "heart rate, systolic, diastolic, and mean arterial blood pressure" on induction and ½ hourly thereafter. Pain monitoring through visual analog scale (VAS) 30 min after recovery, hourly for 2 h and every 4 h for 24 h was also recorded. Pain monitoring through VAS and post-operative nausea and vomiting 30 min after recovery were also recorded and finally patient satisfaction and acute pain nurse satisfaction. RESULTS: There was no difference in background characteristics in both groups. There were no statistically significant differences in different outcomes as heart rate, mean blood pressure, O2 saturation in different timings between groups at any of the determined eight time points but pain score and nurse satisfaction showed a trend to better performance with non-opioid treatment. CONCLUSION: Nonopioid based general anesthesia for Bariatric surgery is as effective as opioid one. There is no need to use opioids for such surgery especially that there was a trend to less pain in non-opioid anesthesia.

Pleomorphic rhabdomyosarcoma with pulmonary tumour embolism.

Pulmonary tumour embolism is a known complication of cancer disease. To date, pleomorphic rhabdomyosarcoma has been described once with this entity. We report a case of pulmonary tumour embolism diagnosed in the operation room after cardiac arrest of a 30-year-old male patient who had surgical amputation of his right upper limb due to recurrent sarcoma, mandating urgent and successful embolectomy.