NEBULIZED MAGNESIUM VERSUS KETAMINE FOR PREVENTION OF POST-OPERATIVE SORE THROAT IN PATIENTS FOR GENERAL ANAESTHESIA.

BACKGROUND: Sore throat is a common post-operative complaint which can cause significant distress and morbidity. We tested and compared the efficacy of nebulized Magnesium and Ketamine on the incidence and severity of sore throat within the first 24 hours after general anaesthesia. OBJECTIVE: To compare the incidence and severity of post-operative sore throat at 2, 4, 8, 12 and 24 hours after extubation following pre-induction administration of nebulized Magnesium and Ketamine. METHODOS: In this randomized controlled trial, 99 adult ASA I and II patients between the ages of 16 - 65 years were administered nebulized Ketamine 50 mg, Magnesium Sulphate 250 mg or saline for ten minutes prior to induction of general anaesthesia and orotracheal intubation. Incidence and severity of post-operative sore throat were assessed at 2, 4, 8, 12 and 24 hours post extubation. RESULTS: The incidence of sore throat at 4, 8, 12 and 24 hours post tracheal extubation were significantly lower in the Magnesium (18.2%, 12.1%, 0, 0; p = 0.009, 0.006, ≤0.0001, 0.003) and Ketamine group (24.2%, 12.1%, 6.1%, 0; p = 0.041, 0.006, 0.001, 0.003) compared with the saline group (48.5%, 42.4%, 39.4%, 24.2%). Patients also had significantly less severe sore throat at 4 and 8 hours post extubation in both Magnesium and Ketamine groups (p = 0.0 11, 0.041). CONCLUSION: Pre-induction nebulization of Ketamine or Magnesium can decrease the incidence and severity of sore throat in the first 24 hours after anaesthesia.

Ultrasound estimation of foetal gestational age by transcerebellar diameter in healthy pregnant nigerian women.

BACKGROUND: Ultrasonography has application in advanced obstetric practice through relatively detailed assessment of foetal anatomy and accurate assessment of gestational age (GA), especially during the first half of pregnancy. Foetal trans-cerebellar diameter (TCD) is an emerging parameter for gestational age determination among Africans. AIM: This study was carried out to establish baseline data for TCD at various corresponding gestational ages in Nigerian women, and evaluate the correlation between these two parameters. MATERIALS AND METHODS: Four hundred and fifty healthy singleton pregnant women, referred for antenatal scans were prospectively studied, following informed consent. Main inclusion criterion was certain last menstrual dates. A SONOACE χ6 ultrasound scanner, with a curvilinear probe and 3.5 MHz transducer, was used to measure the TCD. Data analysis was done and statistical significance set at p ≤ 0.05. RESULTS: TCD of the foetuses studied ranged from 11.9 mm (at 13 weeks) to 59.3mm (at 41 weeks) with a mean value 34.2 ± 14.1mm.There was significant correlation between TCD and menstrual gestational age (r =0.984; p=0.000). TCD has a predictive accuracy of 96.9% with a standard error of ± 10 days. CONCLUSION: A normogram of foetal TCD throughout gestation is established for Nigerian Africans.

PREDICTIVE ACCURACY OF TRANSCEREBELLAR DIAMETER IN COMPARISON WITH OTHER FOETAL BIOMETRIC PARAMETERS FOR GESTATIONAL AGE ESTIMATION AMONG PREGNANT NIGERIAN WOMEN.

OBJECTIVE: To compare the predictive accuracy of foetal trans-cerebellar diameter (TCD) with those of other biometric parameters in the estimation of gestational age (GA). DESIGN: A cross-sectional study. SETTING: The University of Benin Teaching Hospital, Nigeria. SUBJECTS: Four hundred and fifty healthy singleton pregnant women, between 14-42 weeks gestation. MAIN OUTCOME MEASURES: Trans-cerebellar diameter (TCD), biparietal diameter (BPD), femur length (FL), abdominal circumference (AC) values across the gestational age range studied. Correlation and predictive values of TCD compared to those of other biometric parameters. RESULTS: The range of values for TCD was 11.9 - 59.7mm (mean = 34.2 ± 14.1mm). TCD correlated more significantly with menstrual age compared with other biometric parameters (r = 0.984, p = 0.000). TCD had a higher predictive accuracy of 96.9% ± 12 days), BPD (93.8% ± 14.1 days). AC (92.7% ± 15.3 days). CONCLUSION: TCD has a stronger predictive accuracy for gestational age compared to other routinely used foetal biometric parameters among Nigerian Africans.