Middle East Journal of Anesthesiology最新文献

{"title":"A SHARED OPERATIVE FIELD AND THE DISPUTE--IS THERE A WAY OUT?","authors":"M-Irfan Suleman,&nbsp;Anita N AkbarAli,&nbsp;M Saif Siddiqui,&nbsp;William F Alfonso","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Submental intubation is an alternative to tracheostomy in patients requiring surgical access to both oral and nasal cavities. It is relatively safe, simple, and low morbidity procedure and requires only basic surgical equipment to perform. We successfully performed a submental intubation in a young patient with maxillofacial hypoplasia undergoing Le Fort I maxillary advancement without any intra- and post-operative complications.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34066331","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":"RESIDENT IMPLEMENTATION OF THE 2007 ACC/AHA GUIDELINES ON PREOPERATIVE CARDIAC EVALUATION IN NON-CARDIAC SURGERY PATIENTS: IS CLINICAL EXPERIENCE ENOUGH?","authors":"Hassan H Amhaz,&nbsp;Ruth Kuo,&nbsp;Elie J Chidiac,&nbsp;Vinay Pallekonda,&nbsp;Samir F Fuleihan,&nbsp;George McKelvey,&nbsp;Romeo N Kaddoum","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Preoperative evaluation of surgical patients is important, as perioperative complications are associated with increased mortality. Specialties including anesthesiology, internal medicine, cardiology, and surgery are involved in the evaluation and management of these patients. This institutional study investigated the residents' knowledge of the 2007 American College of Cardiology/American Heart Association (ACC/AHA) guidelines on perioperative evaluation of patients undergoing non-cardiac surgery.</p><p><strong>Methods: </strong>This pilot study used a web-based survey questionnaire to assess resident's knowledge of the 2007 ACC/AHA guidelines through individual steps and corresponding branch point(s) in twelve clinical scenarios. Additionally, residents were asked if they were aware of, or if they had received lectures on ACC/AHA guidelines. Staff anesthesiologists with training in cardiac and intensive care medicine validated the scenarios.</p><p><strong>Results: </strong>A total of 104 resident participants were surveyed including 35 anesthesiology residents, 41 internal medicine residents, 20 surgery residents, and 8 cardiology fellows. Awareness of the 2007 ACC/AHA guidelines by specialty was: anesthesiology (85%), internal medicine (97.6%), cardiology (100%), and surgery (70%). Only 54.3% of anesthesiology, 31.7% of internal medicine, 100% of cardiology, and 10% of surgery residents stated they received lectures. The overall mean score achieved on the eleven scenarios was 50.4% for anesthesiology, 47.0% for internal medicine, 55.7% for cardiology, and 42.3% for surgery.</p><p><strong>Conclusions: </strong>Although the majority of residents were aware of the 2007 ACC/AHA guidelines, fewer received lectures and regardless of specialty, implementation of these guidelines was poor. There exists significant room for improvement in the understanding of preoperative assessment of non-cardiac surgery patients.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34237046","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":"AN AUDIT OF THE CURRENT PRACTICES OF AIRWAY MANAGEMENT IN PATIENTS UNDERGOING SURGERY FOR ATLANTO-AXIAL DISLOCATION IN A SINGLE INSTITUTION.","authors":"Shruti Redhu,&nbsp;M Radhakrishnan,&nbsp;G S Umamaheswara Rao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Patients with atlanto axial dislocation (AAD) undergo stabilisation procedures under general anesthesia. Airway management in these patients is difficult as cervical spine movements during laryngoscopy can worsen spinal cord damage. Though multiple airway devices are used to intubate the trachea of these patients, there is no evidence of superiority of one technique over another. This retrospective study was designed to audit the practice of airway management during surgery for AAD over a 5 year period, starting from 2006 till 2011.</p><p><strong>Methods: </strong>Patients' demographics, airway intervention techniques, types of surgical procedures, postoperative neurological and respiratory deterioration were recorded from the case files. Association between the types of airway interventions and the postoperative neurological and respiratory deterioration were analysed.</p><p><strong>Results: </strong>One hundred and six patients underwent surgery for AAD during the study period. Sixty one percent of the patients were intubated with the help of a fiberoptic bronchoscope (FOB) and among them 15% received general anesthesia to facilitate FOB. Eighteen patients developed neurological deterioration and 15 patients developed respiratory weakness requiring ventilation postoperatively. Congenital AAD patients had higher chances for extubation at the end of surgery when intubated using FOB (p = 0.007). Among the AAD patients, female gender had significantly higher incidence of neurological deterioration compared to males.</p><p><strong>Conclusion: </strong>In the current audit, there was no correlation between the perioperative variables and postoperative respiratory and neurological deterioration. Most of the respiratory problems occurred between 2-5 postoperative days stressing the need for extended intensive postoperative monitoring of these patients.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34237494","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":"COMPARATIVE STUDY BETWEEN ULTRASOUND AND NERVE STIMULATOR GUIDED SCIATIC NERVE BLOCK THROUGH THE ANTERIOR APPROACH.","authors":"W. A. Amin, M. A. Seada, M. M. Elkersh, A. Mathai, Sona Medekova, T. Husain","doi":"10.5339/JEMTAC.2020.QHC.10","DOIUrl":"https://doi.org/10.5339/JEMTAC.2020.QHC.10","url":null,"abstract":"INTRODUCTION\u0000The aim of the current study was to compare block of the sciatic nerve through the anterior approach by two methods, namely, the nerve-stimulator guided and ultrasound-guided, with or without nerve stimulation, with regard to the ease of performance, reliability and safety of this approach.\u0000\u0000\u0000PATIENTS AND METHODS\u000036 adult patients were randomly allocated equally into one of 2 main groups: \"Nerve Stimulator-Guided Group (NSG)\" where the nerve was located by nerve stimulator only and \"Ultrasound guided group (USG)\" where the sciatic nerves were blocked by a stimulated needle under guidance of the ultrasound. Assessment of performing each technique, sensory and motor blockades, occurrence of acute systemic toxicity and haematoma formation were compared.\u0000\u0000\u0000RESULTS\u0000Only one-third of the sciatic nerves could be visualized by US. This did not affect the block execution time but caused less number of needle passes in a statistically significant value. Sensory and motor block showed significant differences between the 2 groups. Criteria of acute systemic toxicity and occurrence of hematoma were not reported in both groups.\u0000\u0000\u0000CONCLUSION\u0000Results of the current study showed that the addition of ultrasound to nerve stimulator in the anterior approach to the sciatic nerve block added only little to the ease of performance, reliability and safety. This was because only one-third of the nerves could be seen. More practice, better machines and new blocking techniques may be needed to overcome the problem of anisotropy of the nerve.","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70838913","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":"COMPLICATIONS FOLLOWING DIFFERENT TECHNIQUES OF ONE-LUNG VENTILATION.","authors":"Anis Baraka","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34237043","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":"LEARNING BY SIMULATION.","authors":"Ghaleb Okla,&nbsp;Douglas Eden","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The future appears bright for the use of simulation in medical education. Medical, nursing, and allied healthcare students trained through simulation have opportunities to practice hands on techniques, teamwork, and communication through trial and error in a safe environment before working with live patients. The cost of high-fidelity simulation will continue to make its use prohibitive and challenging for some programs though the use of low-fidelity simulation, standardized patients, and role-playing continues to have measureable qualitative value. Cost center sharing is one way for programs on a tight budget who desire high-fidelity simulation to access this valuable skills-building, outcome-improving medical education adjunct tool.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34066329","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":"ASSESSMENT OF PREOPERATIVE AND POSTOPERATIVE ANXIETY AMONG ELECTIVE MAJOR SURGERY PATIENTS IN A TERTIARY HOSPITAL IN NIGERIA.","authors":"Adesanmi Akinsulore,&nbsp;Afolabi M Owojuyigbe,&nbsp;Aramide F Faponle,&nbsp;Femi O Fatoye","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Anxiety is an unpleasant emotional experience that involves feelings of tension, apprehension, nervousness and high autonomic activity. Few studies have been conducted in Nigeria on anxiety levels among patient undergoing surgical operation. The aim of this study is to assess preoperative and postoperative anxiety level of patients and identify factors that may influence patient's preoperative anxiety level.</p><p><strong>Methods: </strong>Fifty one adult patients scheduled for elective surgery in a tertiary public hospital in Nigeria were assessed a day before and after their surgery using a questionnaire with socio-demographic and clinical details. Anxiety was assessed with the state portion of the State-Trait Anxiety Inventory (STAI) and different factors responsible for their anxiety were selected from a list. Statistical analysis was done using SPSS version 17.</p><p><strong>Result: </strong>Twenty-six patients (51.0%) had significant preoperative anxiety while 8 (15.7%) had significant postoperative anxiety. The patients preoperative mean anxiety score of STAI (42.72 ± 9.84) was statistically significantly higher than their postoperative mean anxiety score (37.73 ± 8.44; p = .001). In 10 items of STAI, there were significant differences between the preoperative and postoperative mean STAI scores. Fear of complications and result of operation were the most common factors responsible for preoperative anxiety while few patients were anxious about nil per mouth, getting stuck with needle and harm from doctor/nurse mistake.</p><p><strong>Conclusion: </strong>The prevalence of preoperative anxiety is high in Nigerian surgical patients. Psychological preparation and provision of correct information that addresses identified factors may help in reducing preoperative anxiety.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34066327","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":"RESIDUAL NEUROMUSCULAR BLOCKADE (RNMB): ROCURONIUM'S DEFASCICULATING DOSE, NEOSTIGMINE- INDUCED WEAKNESS, AND AWARENESS DURING RECOVERY.","authors":"Deepak Gupta","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34066333","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":"ULTRASOUND-GUIDED SCIATIC POLITEAL NERVE BLOCK: A COMPARISON OF SEPARATE TIBIAL AND COMMON PERONEAL NERVE INJECTIONS VERSUS INJECTING PROXIMAL TO THE BIFURCATION.","authors":"Magdy H Eldegwy,&nbsp;Sami M Ibrahim,&nbsp;Samy Hanora,&nbsp;Elsayed Elkarta,&nbsp;Ayman S Elsily","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Block of the sciatic nerve at the popliteal fossa can be performed using the ultrasound machine; it may be proximally or distally to the bifurcation of the sciatic nerve using lateral, medial, or posterior approaches. It is frequently used for surgeries below the knee specially the foot and ankle operations.</p><p><strong>Purpose: </strong>This study compares one and two injections of the sciatic nerve in the popliteal fossa with ultrasound-guided block in foot or ankle surgeries.</p><p><strong>Methods: </strong>Forty patients received ultrasound-guided sciatic nerve block with the nerve stimulator, using the posterior approach. The patients were enrolled into two groups (20 patients each), group 1: received one injection at 2 cm cephalad to the bifurcation of the sciatic nerve, and group 2: received two injections caudate to the sciatic bifurcation; one for tibial nerve and the other for common peroneal nerve. All patients received 20 ml of levobupivacaine 0.5%. The block performance time, block efficacy, success rate, complications and patient's satisfaction were evaluated.</p><p><strong>Results: </strong>Block the tibial and common peroneal nerves separately (two injections) distal to the point of bifurcation of the sciatic nerve has a significantly (P < 0.05) faster time to complete sensory block of tibial and common peroneal nerves compared to a pre-bifurcation sciatic nerve block (one injection). The complete motor block, block time performance, success rate and patient's satisfaction were not significantly different between groups (P > 0.05).</p><p><strong>Conclusion: </strong>The block of tibial and common peroneal nerves separately distal to the sciatic nerve bifurcation is superior to single injection block of sciatic nerve above the bifurcation in the popliteal fossa as regard complete sensory block time.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34134550","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":"COMPARATIVE STUDY BETWEEN ULTRASOUND AND NERVE STIMULATOR GUIDED SCIATIC NERVE BLOCK THROUGH THE ANTERIOR APPROACH.","authors":"Wafik A Amin,&nbsp;M Osama Abou Seada,&nbsp;Mansour M Elkersh,&nbsp;Abraham Mathai,&nbsp;Sona Medekova,&nbsp;Tafazzul Husain","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the current study was to compare block of the sciatic nerve through the anterior approach by two methods, namely, the nerve-stimulator guided and ultrasound-guided, with or without nerve stimulation, with regard to the ease of performance, reliability and safety of this approach.</p><p><strong>Patients and methods: </strong>36 adult patients were randomly allocated equally into one of 2 main groups: \"Nerve Stimulator-Guided Group (NSG)\" where the nerve was located by nerve stimulator only and \"Ultrasound guided group (USG)\" where the sciatic nerves were blocked by a stimulated needle under guidance of the ultrasound. Assessment of performing each technique, sensory and motor blockades, occurrence of acute systemic toxicity and haematoma formation were compared.</p><p><strong>Results: </strong>Only one-third of the sciatic nerves could be visualized by US. This did not affect the block execution time but caused less number of needle passes in a statistically significant value. Sensory and motor block showed significant differences between the 2 groups. Criteria of acute systemic toxicity and occurrence of hematoma were not reported in both groups.</p><p><strong>Conclusion: </strong>Results of the current study showed that the addition of ultrasound to nerve stimulator in the anterior approach to the sciatic nerve block added only little to the ease of performance, reliability and safety. This was because only one-third of the nerves could be seen. More practice, better machines and new blocking techniques may be needed to overcome the problem of anisotropy of the nerve.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34134552","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}