Journal of the Bangladesh Society of Anaesthesiologists最新文献

{"title":"A comparative study on the maternal and foetal outcome between normal and high risk pregnancy patient","authors":"A. Sultana, Beauty Rani Roy, Montosh Kumar Mondal, S. Yeasmeen, S. B. Chowdhury","doi":"10.3329/jbsa.v25i2.61003","DOIUrl":"https://doi.org/10.3329/jbsa.v25i2.61003","url":null,"abstract":"Background Pregnancies and deliveries are potentially at risk. Well supervised antenatal, intranatal and postnatal care can reduce this risk to a minimal acceptable level. \u0000Objective To find out perinatal outcome of high-risk pregnant patients in comparison with the normal pregnant women and to evaluate the utility of numerical scoring system in identifying high-risk pregnancy. \u0000Methods 200 patients were selected from the admitted patients in the obstetric ward of Bangabandhu Sheikh Mujib Medical University, Dhaka. Study patients were divided into three groups: 100 patients (control group) were normal pregnancy (score 0-2), 85 patients were high-risk ( score 3 – 6), and 15 patients were severe-risk (score 7 or more). Both case and control subjects were followed intranatally and postnatally up to the discharge from the above institutions. All types of abnormalities or complications like prolonged ist stage, 2nd stage, APH, PPH and all types of operative and non operative interventions were recorded in order to correlate with perinatal mortality, morbidity and maternal morbidity. Each patient was followed up to discharge from the hospital and abnormalities important for the study were recorded. Neonatal morbidity was defined for surviving newborn by Apgar score <7 at 5 minutes or birth weight < 2.5 kg. \u0000Results In normal pregnancy group, 43% needed to be delivered by caesarean section in comparison to 63 (74.1%) and 14 (93.33%) patients respectively in high-risk and severe-risk group (P <0.001). Maternal complication following normal vaginal delivery was highest (100%) in severe-risk group, followed by highrisk group (36.36%) and normal pregnancy (19.30%). Complications following caesarean section were also highest in severe-risk group (28.47%), followed by normal pregnancy (25.59%) and high-risk pregnancy (20.63%). Neonatal complications in normal pregnancy group was 30.23% in comparison 38.46% in high risk group. 6 (6%) of neonates in the normal pregnancy group had Apgar score < 7 at 5 minutes and in high risk and severe-risk groups, 10 (11.76%) and 7 (43.75%) of the neonates respectively had Apgar score <7 at 5 minutes (P < 0.001). In the severe-risk group, 8 (50%) of the babies had birth weight <2.5kg, which is higher than high and normal pregnancy group, i.e. 25 (28.41%) and 3 (3%), respectively(P<0.001). Higher perinatal deaths also occurred in high-risk and severe risk groups. \u0000Conclusion It can be concluded that the perinatal morbidity, mortality and maternal morbidity are significantly higher in high-risk pregnancies. This group, though represent only 20-30 percent of all pregnant patients, is responsible for 70-80 percent of the perinatal morbidity and mortality. \u0000JBSA 2012; 25(2): 59-65","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72810321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Labetalol-Fentanyl and Fentanyl alone for attenuating pressure responses to intubation and skull pin insertion in neurosurgery: A Comparative study","authors":"Shukha Ranjan Das, Md. Abu Kawsar, Muhammad Mamun Ur Rashid, Hasan Ali Talukder, Subrata Mondal, M. S. Mondol, N. Ara","doi":"10.3329/jbsa.v34i2.67749","DOIUrl":"https://doi.org/10.3329/jbsa.v34i2.67749","url":null,"abstract":"Background: Laryngoscopy and endotracheal intubation are noxious stimuli capable of producing a hugespectrum of stress responses such as tachycardia, hypertension, laryngospasm, bronchospasm, raisedintracranial pressure and intraocular pressure. Simultaneously skull pin insertion during neurosurgicaltechnique aggravates the noxious stimulus causing acute hypertension even in an adequately anaesthetizedpatient. These haemodynamic changes are generally temporary without any sequelae in normotensive patients,but can accelerate the development of complications, e.g., myocardial ischemia, arrhythmia, infarction andcerebral haemorrhagein patients with coronary artery disease, hypertension or cerebrovascular disease.Different pharmacological agents are used in order to prevent haemodynamic responses. Intravenous Fentanylhas showed a promising result, preventing the increase in plasma concentrations of catecholamines anddecreasing the central sympathetic outflow. Another agent labetalol, is an unique oral and parenteralantihypertensive drug that is α1 and nonselective β1 and β2 adrenergic antagonist.\u0000Objectives: To evaluate the effectiveness of Labetalol-fentanyl for attenuating pressure responses tointubation as well as skull pin insertion in patients undergoing neurosurgery under general anesthesia.\u0000Materials & method: This prospective, randomized controlled trial was conducted Department ofAnaesthesia Analgesia and Intensive Care Medicine, Dhaka Medical College Hospital from 18th March 2019to 17thSeptember 2019. Total 60 patients undergone elective neurosurgery and requiring pin insertion wereenrolled for the study and allocated into two groups. Group A: patients given intravenous 0.25 mg/kgLabetalol and fentanyl 2μg/kg combination. Group B patients were given intravenous Fentanyl alone.Following that haemodynamic condition and outcome was assessed at different point of time.\u0000Result: Mean age was found to 45.8±11.5 years. It was observed that almost two third (63.3% & 60.0%)patients had ASA grade I in group A and group B respectively. After induction, mean heart rate wasincreases in both group but more in group B. It was 92.4.7±7.8 beat/min and 97.3±7.4 beat/min in group Aand group B respectively. After pin insertion, mean heart rate was 84.1±5.4 beat/min in group A and98.5±85.4 beat/min in group B. after intubation MAP in group-B was statistically significant high(111.4±15.6 mmHg) as compared to group A (99.8±9.5 mmHg) and was unstable upto5 minute time. Thestatistically significant difference between groups was also observed at time of pin insertion (97.5±9.7 mmHgin group A vs. 110.6±12.9 mmHg in group B), after pin insertion (94.9±10.3 mmHg in group A vs. 111.5±10.4mmHg in group B). Intraoperative HR & MAP were almost normal and and remained stabilized in group-Apatients.\u0000Conclusion:Labetalol-Fentanyl combination was more effective compared to Fentanyl alone in attenuatingthe pressure responses to intubation and skull pin insertion in neurosurgery.","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"157 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74876810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes mellitus emergence in Covid-19 Pandemic","authors":"D. Banik","doi":"10.3329/jbsa.v34i2.67742","DOIUrl":"https://doi.org/10.3329/jbsa.v34i2.67742","url":null,"abstract":"Abstract not aavailable\u0000JBSA 2021; 34 (2) : 1-2","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78979377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of intravenous dexmedetomidine compared to intercostal nerve blocks in patients undergoing simple mastectomy with axillary dissection under general anaesthesia.","authors":"D. Kumar, S. Yeasmeen, Miraj Hossain, Montosh Kumar Mondal, A. F. Hoque, M. Islam, Ashfaqul Islam, Mohammad Mahabubuzzaman","doi":"10.3329/jbsa.v34i2.67748","DOIUrl":"https://doi.org/10.3329/jbsa.v34i2.67748","url":null,"abstract":"Background: General anaesthesia is used for breast cancer surgery. The downside of generalanaesthesia includes inadequate pain control and a high incidence of nausea and vomiting. Generalanaesthesia with intravenous dexmedetomidine or intercostal nerve block reduce the incidence ofpostoperative pain.\u0000Objective: To evaluate the effectiveness of intravenous dexmedetomidine compared to intercostal nerveblocks in patients undergoing simple mastectomy with axillary dissection under general anaesthesia.Methods:It was a single-blinded prospective randomized comparative study. This study was conductedat the Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh MujibMedical University (BSMMU), Dhaka from March 2018 to March 2019. A total of 60 patients sufferingfrom breast cancer admitted in the Department of General Surgery of BSMMU Dhaka and scheduledfor simple mastectomy with axillary dissection, were enrolled in this study. Results: Age ,height andweight were almost identical between two groups. Duration of anaesthesia and surgery were almostsimilar between two groups. The mean heart rate, systolic blood pressure, diastolic blood pressure ,mean arterial pressure did not significantly fluctuate in subsequent baseline follow up and 15 minuteand at 160 minutes parameters were almost similar within two groups.Mean time to achieve adequateAldrete recovery score after extubation was almost similar between two groups. Postoperative sedationlevel was also similar between two groups. Majorty of the surgeon were satisfied about anaesthesiatechnique in both group A and group B. Mean time of rescue analgesic requirement in postoperativeperiod was satistically significant (p<0.05) between two group but it was clinically less significant(groupA= 112 minutes and groupB=141minutes.\u0000Conclusion: Intravenous dexmedetomidine may be an alternative to intercostal nerve blocks inpatients undergoing simple mastectomy with axillary dissection under general anaesthesia as itprovided stable intraoperative haemodynamics, reduced blood loss and analgesic requirement, smoothrecovery, postoperative sedation level and surgeon satisfaction as well as intercostal nerve blocks.\u0000JBSA 2021; 34 (2) : 24-35","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85588559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory Changes under Spinal Anaesthesia for Laparoscopic Gynaecological Procedures- a comparison with General Anaesthesia","authors":"Abdullah Masum, F. Kalam, M. Alam","doi":"10.3329/jbsa.v34i2.67746","DOIUrl":"https://doi.org/10.3329/jbsa.v34i2.67746","url":null,"abstract":"Background: Laparoscopic surgery has become a frequently applied technique for a wide field ofindications. The procedure has become the gold standard for many procedures, with some of the mostcommon being gynecological procedures and appendectomy. Laparoscopic procedures that are widelyused in gynecological surgery are commonly applied under general anesthesia (GA). Now a days spinalanaesthesia (SAB) has become a routine technique for healthy patients. It is currently presumed thatspinal anaesthesia can compromise respiratory muscle function during carbon dioxide (CO2)pneumoperitoneum and causes some respiratory changes.\u0000Objective: This study was designed to compare the respiratory effects of CO2 pneumoperitoneumunder spinal anaesthesia with general anaesthesia for short duration (<1hr) laparoscopicgynaecological procedures.\u0000Methods: A total number of sixty female patients, thirty in each group of ASA grade I & II wereenrolled for the study. Group I patients received lumber SAB with 15 mg heavy bupivacaine and 25mcg fentanyl. Group II patients received standard general anaesthesia with propofol, halothane andfentanyl. Baseline heart rate, blood pressure, respiratory rate, ETCO2 & SPO2 were noted in allpatients. Arterial blood gas analysis was done at time 0, 20 and 40 min after initiation ofpneumoperitoneum. Continuous ECG, pulse oximetry, noninvasive blood pressure, and ETCO2 weremonitored during the procedure. Any per operative and post-operative side effects were recorded andmanaged.\u0000Results: There were no observed changes in the respiratory rate. In group I, ETCO2 increased in astepwise manner over the first 10 min and reached a plateau between 15th and 30th min and declinedafter deflation of pneumoperitoneum. Arterial CO2 tension also increased at 20 min with significantchanges (p=0.000) in arterial to end tidal carbon dioxide tension. ETCO2 and arterial carbon dioxidetension changes were almost similar in both groups.\u0000Conclusion: Arterial and end-tidal CO2 tension changes during lower abdominal laparoscopicsurgery under SAB remain within physiological limits and comparable to the CO2 tension under GA.SAB may be adopted in ASA physical status I and II patients with proper preoperative counseling.Hence it is a safe alternative to GA with minimum respiratory alterations.\u0000JBSA 2021; 34 (2) : 10-15","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80018798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Platelet Rich Plasma and Methylprednisolone on lumbar facet joint hypertrophy: A Quasi-experimental study","authors":"A. F. Haque, Gopal Deb, M. Kamal, Md. Mizanur Rahman, Md Zunaid, Dilip Kumar Bhoumick, D. Banik, Shofina Sultana","doi":"10.3329/jbsa.v34i2.67744","DOIUrl":"https://doi.org/10.3329/jbsa.v34i2.67744","url":null,"abstract":"Background: Low back pain (LBP) is now regarded as the important cause of disability worldwide anda priority for future research on prevention and treatment. Facet joint hypertrophy is an importantpathogenesis of Low back pain. The aim of this study was to assess the effectiveness of Platelet RichPlasma and Methylprednisolone on Facet Joint Hypertrophy in Chronic Low Back Pain (LBP).\u0000Methods: This Quasi-experimental study was carried out on adult patients with chronic low back paindue to lumbar facet joint hypertrophy attended the Pain Medicine Unit, OPD and KOSAKA Pain Clinic,BSMMU, during the period of October 2019 to September 2020. The patients were randomly assignedto one of the two groups; group A (patients treated with PRP); group B (patients treated by withMethylprednisolone). After providing the allocated treatment, all patients undergone follow-upexamination 30 minutes after procedure, end of 1st week, end of 1st month and end of 3rd month forpain improvement by visual analogue scale (VAS) and for disability status by Roland Morris disabilityQuestionnaire (RMDQ)score. Follow up of the patients were carried out while they visited in Pain Clinicat mentioned intervals or over phone. The significance of the difference of the VAS and RMDQ score atthe end of 1st week, end of 1st month & end of 3rd month were tested by using unpaired t- test andchi-square test.\u0000Results: It was observed that mean ± SD of age was 42.31 ± 7.6 years for Group A and 42.29 ± 8.0 yearsfor Group B. Most of the participants in all Group A [14 (70.0%)] & in Group B [15 (75.0%)] were males.Male: Female ratio was about 2.6:1. Imaging findings shows that, Grade II degenerative changes were13(65.0%) patients of group A & 12(60.0%) patients of group B. L3/4 level involvement waspredominant, 15(75.0%) patients in Group A and 15(75.0%) in Group B. The difference was statisticallynon-significant (p>0.05) between groups. Mean VAS score at pretreatment & after 30 minutes ofintervention were not statistically significant between groups. But end of 1st week, end of 1st month andend of 3rd month follow up, VAS score decreased in both groups, but significantly reduced in Group A.In case of disability improvement, RMDQ score more decreases in group A than group B.\u0000Conclusion: Lumbar facet joint injection with platelet rich plasma (PRP) provides better pain reliefand improvement of functional status than Methylprednisolone in chronic low back pain due to lumbarfacet joint hypertrophy.\u0000JBSA 2021; 34 (2) : 3-9","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75241096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergence Delirium in Paediatric Anaesthesia","authors":"A. Maruf, M. Kamal, M. Hassan","doi":"10.3329/jbsa.v34i2.67747","DOIUrl":"https://doi.org/10.3329/jbsa.v34i2.67747","url":null,"abstract":"Emergence delirium(ED) in children is a well-documented clinical phenomenon with incidence rangingfrom 25 to 80%. It is characterized by confusion, mental irritability, disorientation, inconsolable crying,and thrashing. No single factor can identified as the cause of postoperative agitation, which shouldtherefore be considered a syndrome made up of biological, pharmacological, psychological and socialcomponents. Possible causes and risk factors include child’s personality, inhalation anaesthetics,surgery of head and neck, rapid awakening and pain. Many scales have been proposed to evaluate theincidence and severity of ED and a variety of scales are used in clinical practice and for researchpurposes in children. Preventive measures include the co-administration of propofol, midazolam, orfentanyl, but the risks associated with their use must be weighed against the self-limiting nature of ED.Once ED is established, the most common interventions are pharmacological. Treatment options areclam environment in recovery and with agents having sedative and analgesic effect,such as propofol,fentanyl, ketamine andalpha-2 receptor agonists (clonidine and dexmedetomidine). ED may increasethe incidence of new-onset postoperative maladaptive behavior changes such as general anxiety,night-time crying, bed wetting, general anxiety and loss of appetite for up to 14 days after surgery. Astandard diagnostic, preventable and treatable guideline should be required for adverse outcomes in thepaediatric populations.\u0000JBSA 2021; 34 (2) : 16-23","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76274590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of hypertension on the outcomes of Covid-19 infected patients- A retrospective study","authors":"S. Yeasmeen, Montosh Kumar Mondal, A. F. Hoque, Sana Masud, Shofina Sultana, D. Banik","doi":"10.3329/jbsa.v34i2.67750","DOIUrl":"https://doi.org/10.3329/jbsa.v34i2.67750","url":null,"abstract":"Background: Hypertension has been reported as the most prevalent comorbidity in patients with corona virusdisease 2019 (COVID-19) .Since hypertension is exceedingly frequent in the elderly and older people appear tobe at particular risk of being infected with SARS-COV-2 virus and of experiencing severe forms andcomplications of COVID-19.\u0000Objective : This retrospective study aim to compare the outcomes in COVID-19 infected patients with orwithout hypertension.\u0000Method : Atotal 180 hospitalized patients with laboratory confirmed COVID-19 were included. The medicalrecord including clinical feature, history of hypertension were included in this study. This study wasconducted in COVID-19 ICUof Bangabandhu Sheikh Mujib Medical University from August 2020 to January2021.Informationwere obtained frommedical record including clinical features, complication,treatments andclinical outcome were extracted for the analysis.\u0000Results: There were 180 patients selected for this study. 50(27.8%) patients had 51-60 years ,79(43.5%)patients had61-70 years and 27(15%) patients had 71-80 years.This study showed that 71.7% patients washypertensive and 29.3% patients was non-hypertensive. In total 180 patients, mortality rate was 65.1% inhypertensive patientsand mortality rate was41.1% in non-hypertensivepatients.Among them patientscomorbidity was 50% Diabetes mellitus,14% Bronchial asthma,14% patients Ischemic heart disease, 11%Chronic Kidney disease ,6% hypothyroidism and 5% cerebrovascular disease.\u0000Conclusion: This study concluded that hypertension does not affect the outcome of COVID-19. Compared withthe group of survivors and non-surviving COVID-19 patients with hypertension, most of the patients were olderand had more comorbidity.\u0000JBSA 2021; 34 (2) : 44-48","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"166 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76577150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetric and Gynaecologic Patients Requiring Intensive Care: A One Year Retrospective Study in a Tertiary Teaching Hospital in Bangladesh","authors":"N. Begum, Easnem Khanum, M. Kamal, Nelufa Tahera Rahman, Md. Ashraful Islam, Md. Rezaul Haque","doi":"10.3329/jbsa.v34i2.67751","DOIUrl":"https://doi.org/10.3329/jbsa.v34i2.67751","url":null,"abstract":"Background: Care of obstetric patients has always been a challenge for obstetricians and critical carephysicians, because of the consideration of multidimensional pregnancy related diseases as well asfoetal wellbeing.\u0000Objective: The aim of the study was to evaluate the incidence, indications for admission,interventions and consequences of the obstetrics and gynaecologic patients admitted to the ICU.\u0000Methods: A retrospective observational study was conducted in the multidisciplinary ICU of EnamMedical College and Hospital from January, 2020-December, 2020.All the obstetric and gynae patientsadmitted to the ICU were the study population. Data regarding demographic characteristics of thepatients, indications for admission, associated medical disorders, interventions, length of ICU stay,and outcome were collected and analyzed.\u0000Results: During the study period, total 870 patients were admitted to the ICU, among which the dataof 90(10.3%) patients were analyzed. The mean age of the patients was 26.84±6.95years. Total 63% ofthe patients came from rural area. Obstetric cases were 72% and gynaecological cases were 28%.Among the obstetric cases 22% had post-partum Eclampsia, 12% cases had preeclampsia, another 12%had PPH, and 9%cases had APH. Among the gynaecological reasons, 52% cases were ruptured ectopicpregnancy, and 36% cases had post abortion complications. Majority (64.61%) admitted in theirpostpartum period. Inotropes were needed for 36.7%. Transfusion of blood and blood products wererequired for 51.1%. Mechanical ventilation was needed for 31.8%. The majority of the patients 63.3%stayed in the ICU for a period of 1-3 days. Maternal mortality was 12.2% (11). Most common cause formaternal death was MODS 4(36.36%).\u0000Conclusion: Hypertensive disorders account for the most number of admission to ICU followed byobstetric haemorrhage.Early detection and speedy referral to the tertiary center with ICU facilitiesshould be promoted among medical society to reduce the incidence of ICU admissions and maternalmortality.\u0000JBSA 2021; 34 (2) : 49-54","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75303495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Subcutaneous Ring Block of the Penis with Caudal Epidural Block for Post Circumcision Analgesia in Children","authors":"Raihan Uddin, Maooz Khan","doi":"10.3329/jbsa.v34i1.67572","DOIUrl":"https://doi.org/10.3329/jbsa.v34i1.67572","url":null,"abstract":"Background: Pain is an inevitable consequence of circumcision and a number of methods have nowbeen described to ameliorate this. Local anesthetic techniques have been shown to be more effective thansystemic opioids.\u0000Objective: This study compared the subcutaneous ring block of the penis with caudal epidural block forpost circumcision analgesia in children.\u0000Materials and method: This comparative study was done during the period of January 2020 to December2020 in BIRDEM General Hospital, Dhaka, Bangladesh. A randomized, prospective, blind trial wasconducted comparing caudal epidural blockade (caudal block) with subcutaneous ring block of the penis(penile ring block) in forty healthy boys between three to five years of age undergoing elective circumcision.\u0000Results: Subjects receiving caudal block had a longer duration of analgesia (p <0.05), and longer to firstmicturition (p <0.05) but there was no difference in time taken to awaken from anesthesia or spontaneouslywalk unaided. There were no local or systemic complications related to either block and a very lowincidence of vomiting.\u0000Conclusion: It is concluded that both techniques are effective. Caudal block is more reliable and providesa longer duration of analgesia but penile ring block is inherently safer and has a lower incidence ofadverse effects.\u0000JBSA 2021; 34(1): 50-53","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89530521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}