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Articles 271 - 300 of 314

Full-Text Articles in Anesthesia and Analgesia

Estimation Of Blood Loss During Caesarean Section: An Audit, Fauzia A. Khan, Mueenullah Khan, Asif Ali, Ursula Chohan Dec 2006

Estimation Of Blood Loss During Caesarean Section: An Audit, Fauzia A. Khan, Mueenullah Khan, Asif Ali, Ursula Chohan

Department of Anaesthesia

Objective: To evaluate the blood ordering practice and blood transfusion for Caesarean sections at our institution and to compare the estimated blood loss between anaesthetists and obstetricians.Methods: A review of 126 patients undergoing both elective and emergency Caesarean section was undertaken in 2002. Information collected included the number of blood units cross-matched preoperatively, type of surgery (emergency or elective), type of anaesthesia, parity of the patient, estimated blood loss by both anaesthetists and obstetricians, intraoperative and postoperative transfusion within 48 hours and pre and post operative haemoglobin (Hb) and haemocrit (Hct).Results: A total of 215 units were cross-matched for 126 …

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One Year Experience Of Mri Under General Anaesthesia, Shahla Siddiqui Jul 2006

One Year Experience Of Mri Under General Anaesthesia, Shahla Siddiqui

Department of Anaesthesia

A case series over one year of our experience of using Propofol and Laryngeal mask airway (LMA) in children under 10 years of age undergoing MRI under general anaesthesia is presented. All paediatric patients under the age of ten attending out-patient department were included in the case series starting from January 1st, 2004 till December 31st, 2004. All patients underwent general anaesthesia using Propofol / LMA technique as described in detail in communication below. A total of 78 children were included; the only patient requiring intubation was the youngest: a neonate of 1 day who had a large orbital mass. …

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Viral Hemorrhagic Fever - An Icu Perspective, Asghar Ali, Shahla Siddiqui Jul 2006

Viral Hemorrhagic Fever - An Icu Perspective, Asghar Ali, Shahla Siddiqui

Department of Anaesthesia

No abstract provided.

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Diagnostic Value Of Chest X-Ray And Echocardiography For Cardiac Tamponade In Post Cardiac Surgery Patients, Mohammad Hamid, Mueen Ullah Khan, Allen C. Bashour Mar 2006

Diagnostic Value Of Chest X-Ray And Echocardiography For Cardiac Tamponade In Post Cardiac Surgery Patients, Mohammad Hamid, Mueen Ullah Khan, Allen C. Bashour

Department of Anaesthesia

Objective: To investigate the effectiveness of X-ray and echocardiography (ECHO) as a diagnostic tool for cardiac tamponade in adult cardiac surgery patients.Methods: Thirty five coronary artery bypass and graft surgery patients who developed cardiac tamponade at Cleveland clinic foundation, were included in this study. Their diagnosis was confirmed at the time of re-exploration in the operating room. These patients were followed retrospectively for demographics, X-ray and echocardiography findings. Abnormal and enlarged cardiac silhouette which was different from first postoperative X-ray was used as radiological criteria for tamponade while echocardiographic diagnosis was left to the discretion of cardiologist.Results: Twenty four males …

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Standardization Of Anaesthesia Ready Time And Reasons Of Delay In Induction Of Anaesthesia, Saeed U. Zafar, Fauzia Anees Khan, Mueenullah Khan Mar 2006

Standardization Of Anaesthesia Ready Time And Reasons Of Delay In Induction Of Anaesthesia, Saeed U. Zafar, Fauzia Anees Khan, Mueenullah Khan

Department of Anaesthesia

Objective: Anaesthesia-Ready Time (ART) is the time taken by the anaesthetist to provide sufficient anaesthetic depth for start of surgery. Our aim was to set benchmark timings for ART and compare it with our current practice.Methods: Benchmark ART time of 15 minutes was set for American Society of Anesthesiologists (ASA) class I and II patients, 30 minutes for ASA III and IV patients, 20 minutes for spinal and 30 minutes for epidural anaesthesia. An additional 15 minutes was added for each invasive procedure.Results: Three hundred elective cases were audited. Seventy eight percent of the cases were within benchmark timings. The …

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Laparoscopic Surgery In Children--Anaesthetic Considerations, Aliya Ahmed Feb 2006

Laparoscopic Surgery In Children--Anaesthetic Considerations, Aliya Ahmed

Department of Anaesthesia

Laparoscopic surgery has several advantages over conventional surgery for the patient. An increasing number of diagnostic and surgical procedures are being done laparoscopic not only in adults but also in paediatrics patients. In addition to the routine anaesthetic considerations for any surgical patient, the choice of the anaesthetic technique in patients undergoing laparoscopic procedures should consider the patient's underlying cardio respiratory functions induced by the pneumoperitoneum and carbon dioxide [CO2] insufflations. This article describes the physiological alterations induced by laparoscopic procedures in children and the anaesthetic implications of laparoscopic in the paediatric patient population.

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The Role Of Prophylactic Intra-Aortic Balloon Pump Counterpulsation (Iabp) In Emergency Non-Cardiac Surgery, Khalid Samad, Fauzia Anis Khan Jan 2006

The Role Of Prophylactic Intra-Aortic Balloon Pump Counterpulsation (Iabp) In Emergency Non-Cardiac Surgery, Khalid Samad, Fauzia Anis Khan

Department of Anaesthesia

Patients with recent myocardial infarction (MI), congestive heart failure, severe angina, or uncorrected multivessel coronary artery disease are at increased risk of cardiac complications after urgent major non-cardiac surgery. Although invasive haemodynamic monitoring and preoperative optimization of cardiac status may lead to some reduction in the rate of perioperative cardiac events, the mortality from such events still remains high. The use of an intra-aortic balloon pump (IABP) may play a role in such patients by improving the function of the injured heart. We report our experience with the use of perioperative IABP in a patient with unstable angina and recent …

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Retrospective Review Of The Use Of Swan Ganz Catheters In Our Intensive Care Unit (Icu): A Short Report, Shahla Siddiqui Dec 2005

Retrospective Review Of The Use Of Swan Ganz Catheters In Our Intensive Care Unit (Icu): A Short Report, Shahla Siddiqui

Department of Anaesthesia

The widespread and often 'misuse' of the Swan Ganz (SG) or Pulmonary artery catheter has often been seen in intensive care patients. The objective of this preliminary review was to observe the trends and possibly formulate an association with outcome of the use of SG catheters as well as to determine the frequency of use and possible complications. The chart review of ten patients was carried out for the months of January and February 2004 in a retrospective manner. The incidence of SG catheter insertion was 12% per month on average. Nine out of 10 patients received the SG catheters …

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Prevention Of Deep Vein Thrombosis And Pulmonary Embolism In The Perioperative Period: A Review, Aliya Ahmed Aug 2005

Prevention Of Deep Vein Thrombosis And Pulmonary Embolism In The Perioperative Period: A Review, Aliya Ahmed

Department of Anaesthesia

No abstract provided.

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Perioperative Anaesthetic Management Of A Patient With Relapsed Aplastic Anaemia, Aliya Ahmed, Abdul Monem Jun 2005

Perioperative Anaesthetic Management Of A Patient With Relapsed Aplastic Anaemia, Aliya Ahmed, Abdul Monem

Department of Anaesthesia

Aplastic anaemia occurs due to failure of blood cell production by bone marrow. All blood cell counts are low. Untreated patients may die within one year mainly due to uncontrolled infection due to neutropenia. Anaemia and thrombocytopenia cause troublesome symptoms and necessitate frequent red cell and platelets transfusions. Surgery poses a very high risk for these patients because of the several complications that can occur in the perioperative period. In this paper we report on a patient with relapsed aplastic anaemia who was optimized preoperatively and underwent a total abdominal hysterectomy under general anaesthesia.

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Apache Ii Score As A Predictor Of Length Of Stay And Outcome In Our Icus, Shahla Siddiqui, Saad Ahmed, Roshan Manasia Jun 2005

Apache Ii Score As A Predictor Of Length Of Stay And Outcome In Our Icus, Shahla Siddiqui, Saad Ahmed, Roshan Manasia

Department of Anaesthesia

The APACHE II (acute physiology and chronic health evaluation) is used widely for predicting probability of hospital mortality and length of stay in the ICU. APACHE II forms were available to all ICU residents within 24 hours of admission, and a score was assigned to them. Based on our results the APACHE II score has reliably predicted an outcome of the least amount of length of stay (LOS) in the ICU as well as a 100% probability of being shifted out of the ICU for a score of < 10 (according to international benchmarks). This reliable scoring system can be used for predicting mortality and length of stay and therefore, resource allocation, antibiotic use and ethical decisions regarding counseling families about end of life decisions--all within 24 hours of admissions.

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Unanticipated Hospital Admission After Ambulatory Surgery, Mueenullah Khan, Aliya Ahmed, Laila Abdullah, Azmeena Nizar, Aslam Fareed, Fauzia Anis Khan Jun 2005

Unanticipated Hospital Admission After Ambulatory Surgery, Mueenullah Khan, Aliya Ahmed, Laila Abdullah, Azmeena Nizar, Aslam Fareed, Fauzia Anis Khan

Department of Anaesthesia

The unplanned admission rate is considered to be an important measure of the quality of ambulatory surgical units. The objective of our study was to evaluate the unanticipated hospital admission rate from the Surgical Day Care (SDC) unit of our university affiliated teaching hospital and to analyze the reasons for admission. A review of all unanticipated admissions over a one-year period was done. The admission rate was calculated and the reasons for admission were analysed. The overall admission rate was 4.93%. Most of the admissions were ordered by the surgeons (97%). The main reasons for admission were patient observation indicated …

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Knowledge, Attitude And Practice Of Parturients Regarding Epidural Analgesia For Labour In A University Hospital In Karachi, Mohammed Raheel Minhas, Rehana Kamal, Gauhar Afshan, Hafsa Raheel Feb 2005

Knowledge, Attitude And Practice Of Parturients Regarding Epidural Analgesia For Labour In A University Hospital In Karachi, Mohammed Raheel Minhas, Rehana Kamal, Gauhar Afshan, Hafsa Raheel

Department of Anaesthesia

Objective: To assess the knowledge, sources of knowledge, attitude (fears and misconceptions) regarding Epidural Analgesia (EA) and practices of parturients delivery at Aga Khan University hospital (AKUH).Methods: A hospital based cross sectional study was conducted at the obstetric unit of AKUH, from November to December 2003. A questionnaire was filled through verbal interviews conducted on 448 parturients fulfilling the inclusion criteria.Results: Seventy six percent of the females were aware of epidural analgesia as a labor pain relieving method. However, only 19% availed EA. About 40% had heard about EA from their obstetricians and 64% from friends or relatives. Twenty even …

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Drug Related Critical Incidents, F A. Khan, M Q. Hoda Jan 2005

Drug Related Critical Incidents, F A. Khan, M Q. Hoda

Department of Anaesthesia

Drug related incidents are a common form of reported medical errors. This paper reviews the critical incidents related to drug errors reported from the main operating theatre suite in a teaching hospital in a developing country from January 1997 to December 2002. Each report was evaluated individually by two reviewers using a structured process. During this period, 44 874 anaesthetics were administered; 768 critical incidents were reported, 165 (21%) of which were related to drug errors. Underdosage, side-effect/drug reaction and syringe swap were the most common. A total of 76% were classified as preventable; 56% due to human error and …

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Case Of Inhaled Prostaglandin E1 Used To Improve Hypoxia In Ards, Shahla Siddiqui, Salwa Zubair, F Hameed Khan Dec 2004

Case Of Inhaled Prostaglandin E1 Used To Improve Hypoxia In Ards, Shahla Siddiqui, Salwa Zubair, F Hameed Khan

Department of Anaesthesia

No abstract provided.

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Anaesthesia For Surgical Correction Of Scoliosis With Spinal Cord Monitoring--A Case Series, M Q. Hoda, S U. Zafar Nov 2004

Anaesthesia For Surgical Correction Of Scoliosis With Spinal Cord Monitoring--A Case Series, M Q. Hoda, S U. Zafar

Department of Anaesthesia

Objective: To share our experience of anaesthetic management of scoliosis with intra-operative somatosensory evoked potential monitoring and wake up test.Methods: All the cases of scoliosis surgery scheduled during a period of two years in which SSEP and intra-operative wake-up test was planned were included in the study. The patient in which intra-operative wake-up test was not planned were excluded from this case series.Results: We managed a series of sixteen cases of scoliosis in our hospital. Eleven patients were female and five were male with the age ranging from six to twenty two years. SSEPs were monitored throughout the procedure and …

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Negative Pressure Pulmonary Edema: Case Report, S M. Abbas, M Q. Hoda Jul 2004

Negative Pressure Pulmonary Edema: Case Report, S M. Abbas, M Q. Hoda

Department of Anaesthesia

No abstract provided.

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Effect Of Ketorolac On Postoperative Pain Relief In Dental Extraction Cases--A Comparative Study With Pethidine, S M. Abbas, R S. Kamal, G Afshan Jun 2004

Effect Of Ketorolac On Postoperative Pain Relief In Dental Extraction Cases--A Comparative Study With Pethidine, S M. Abbas, R S. Kamal, G Afshan

Department of Anaesthesia

Objective: To compare the analgesic efficacy and side effects of ketorolac with pethidine in a day care procedure.STUDY Design: Single dose, double blind, case matched study.Methods: Sixty patients were divided into group A and group B, who received either ketorolac 30 mg or Pethidine 0.8 mg/kg ( both IN ) respectively at the time of induction of general anaesthesia. Patients were assessed in recovery room for pain according to visual analogue scale and any side effects. Amount of rescue analgesia required by both groups were also recorded. Odds Ratio and and Chi Square test were used for statistical analysis.Results: Statistical …

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Chemical And Biological Warfare Preparing To Meet The Threat, S Sophie, S U. Haq, M R. Khan Apr 2004

Chemical And Biological Warfare Preparing To Meet The Threat, S Sophie, S U. Haq, M R. Khan

Department of Anaesthesia

No abstract provided.

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Peri-Operative Management Of A Patient With Uncontrolled Polycythemia Vera For Above Knee Amputation, A Ahmed, K A. Shah Jan 2004

Peri-Operative Management Of A Patient With Uncontrolled Polycythemia Vera For Above Knee Amputation, A Ahmed, K A. Shah

Department of Anaesthesia

No abstract provided.

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Midazolam And Thiopentone Co-Induction: Looking For Improvement In Quality Of Anaesthesia, M A. Khan, F A. Khan Nov 2003

Midazolam And Thiopentone Co-Induction: Looking For Improvement In Quality Of Anaesthesia, M A. Khan, F A. Khan

Department of Anaesthesia

Objective: To evaluate improvement in quality of anaesthesia induction using thiopentone and midazolam for co-induction of anaesthesia. An additional end point was taken as loss of response to a tetanic stimulation (50 Hz) delivered for 5 seconds after the loss of verbal contact and eyelash reflex.Methods: Ninety ASA I and II patients, within the age range of 20-60 years were studied. Patients were randomly divided into three equal groups; A, B and group C.Results: Onset of induction and loss of response to a tetanic stimulation was achieved earlier in group B as compared to the other study groups (p < 0.05).CONCLUSION: Co-induction with midazolam 0.02 mg x kg(-1) followed by thiopentone 3 mg x kg(-1) was superior to other two groups. Induction of anaesthesia in this group was found to be smoother and faster, provided better hemodynamic stability, better airway maintenance and with lesser incidence of untoward effects.

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A Comparison Of Morphine And Nalbuphine For Intraoperative And Postoperative Analgesia, F N. Minai, F A. Khan Sep 2003

A Comparison Of Morphine And Nalbuphine For Intraoperative And Postoperative Analgesia, F N. Minai, F A. Khan

Department of Anaesthesia

Introduction: Short acting narcotics are not available in Pakistan and the supply of drugs like morphine and pethidine is short and erratic; therefore there is a need for investigating acceptable alternatives for analgesia, to be used for balanced anaesthesia.Objective: We studied the agonist-antagonist narcotic nalbuphine compared to morphine, for intra and postoperative pain relief in total abdominal hysterectomies.Methods: In a randomised double blind trial, fifty ASA I and II patients in two groups of twenty five each were given equianalgesic doses of morphine and nalbuphine. Hemodynamic stability, intraoperative analgesia, recovery profiles, incidence of side effects and need for postoperative supplements …

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Effect Of Acupressure On Postoperative Nausea And Vomiting In Laparoscopic Cholecystectomy, K Samad, G Afshan, R Kamal Feb 2003

Effect Of Acupressure On Postoperative Nausea And Vomiting In Laparoscopic Cholecystectomy, K Samad, G Afshan, R Kamal

Department of Anaesthesia

Objective: To evaluate the effectiveness of acupressure applied at meridian P6 point for prevention of nausea and vomiting in patients undergoing laparoscopic cholecystectomy.METHODOLOGY: A randomized double blind study was performed in 50 ASA I and II patients scheduled for laparoscopic cholecystectomy. Patients were divided into two groups; control and placebo. In the control group acupressure was applied at P6 point half an hour before surgery while in the placebo group the acupressure band was tied on meridian P6 point but the plastic bead was placed on the dosum of right forearm away from meridian P6 point. Patients were assessed for …

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Comparison Of Fentanyl And Nalbuphine In Total Intravenous Anaesthesia (Tiva), F A. Khan, Hameedullah Oct 2002

Comparison Of Fentanyl And Nalbuphine In Total Intravenous Anaesthesia (Tiva), F A. Khan, Hameedullah

Department of Anaesthesia

Objective: To compare Nalbuphine and fentanyl as total intravenous anaesthesia with propofol infusion in laproscopic cholecystectomy cases.STUDY Design: Double blind randomised.Methods: Changes in haemodynamic variables greater than twenty percent above or below the baseline and recovery profile were observed.Results: Blood pressure remained within 20% of baseline in either group. Nine patients in fentanyl and fifteen in nalbuphine group required an additional bolus of propofol intraoperatively. Heart rate response after tracheal intubation was significantly higher in the nalbuphine group (25%). No difference was observed in the incidence of nausea and vomiting in the recovery room. Twenty-seven percent patients in the nalbuphine …

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Anaesthetic Management For A Patient With Severe Multiple Sclerosis, E I. Khan, N Amjad, A A. Khan Jun 2001

Anaesthetic Management For A Patient With Severe Multiple Sclerosis, E I. Khan, N Amjad, A A. Khan

Department of Anaesthesia

No abstract provided.

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Comparison Of Spontaneous With Controlled Mode Of Ventilation In Tonsillectomy, F A. Khan, G A. Memon Mar 2001

Comparison Of Spontaneous With Controlled Mode Of Ventilation In Tonsillectomy, F A. Khan, G A. Memon

Department of Anaesthesia

Methods: This randomized study compares spontaneous versus controlled ventilation in 60 ASA I and II patients undergoing tonsillectomy as regards haemodynamic stability, recovery characteristics, intra- and immediate postoperative complications and surgical impressions.Results: The patients in the balanced anaesthesia (B) group showed less haemodynamic variability compared to baseline after tracheal intubation, mouth gag application and removal and incision. Two patients had dysrhythmias in the B group compared to six in the spontaneous breathing (S) group. Six patients in the S group had a rise in endtidal carbon dioxide concentration above 7.8 kPa (60 mmHg). Recovery scores were higher in the B …

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A Comparative Study Of Positive Pressure Ventilation Via Laryngeal Mask Airway And Endotracheal Tube, A Idrees, F A. Khan Oct 2000

A Comparative Study Of Positive Pressure Ventilation Via Laryngeal Mask Airway And Endotracheal Tube, A Idrees, F A. Khan

Department of Anaesthesia

Objective: To investigate the use of Laryngeal Mask Airway (LMA) and its comparison with the endotracheal tube for positive pressure ventilation.SETTING: A tertiary care teaching hospital.Methods: Fifty adult ASA I and II patients undergoing peripheral limb surgery were randomly allocated to 2 groups for LMA or endotracheal tube insertion. A standardized anaesthetic technique was used. The groups were then compared regarding haemodynamic changes on insertion as well as removal of LMA and ETT and any complications that occurred were noted.Results: The haemodynamic response to insertion was significantly attenuated (p < 0.05) in LMA group as compared to ETT group. The cardiovascular response to extubation was not significantly different between the groups. A higher incidence of coughing and mild hypoxaemia at extubation was noted in ETT group as compared to LMA group (p < 0.05) and blood was detected in 4 cases after LMA removal.CONCLUSION: It is concluded that the use of LMA during positive pressure ventilation is safe in selected cases. There is an attenuated haemodynamic response to insertion of LMA as compared to endotracheal tube which will be beneficial in certain patients e.g., those with ischaemic heart disease, vascular disease and hypertensives.

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Incidence And Pattern Of Thrombocy To Penia In Cardiac Surgery Patients, S Bashir, S M. Shah, I Babar Jun 2000

Incidence And Pattern Of Thrombocy To Penia In Cardiac Surgery Patients, S Bashir, S M. Shah, I Babar

Department of Anaesthesia

No abstract provided.

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The Accuracy Of Nitrous Oxide Passive Dosimeters As Compared With An Infra-Red Spectrographic Reference Method, Susan Allen May 1999

The Accuracy Of Nitrous Oxide Passive Dosimeters As Compared With An Infra-Red Spectrographic Reference Method, Susan Allen

Community & Environmental Health Theses & Dissertations

Nitrous oxide is a gas often used in dental, surgical and veterinary operations as an anesthetic agent. Employees stationed in proximity of fugitive gas emissions may potentially suffer adverse health effects from chronic exposure to this agent. Passive dosimeters can be worn in the breathing zone of potentially affected personnel during exposure periods, then later analyzed to quantify nitrous oxide exposure. This study sought to establish the accuracy of several commercially available passive monitoring devices for nitrous oxide by comparison against an infra-red spectrophotometric reference method.

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Bronchospasm/Desaturation Under Anaesthesia: Are They Signs Of Pneumothorax?, N A. Zubair, A Zaidi, R S. Kamal Jun 1997

Bronchospasm/Desaturation Under Anaesthesia: Are They Signs Of Pneumothorax?, N A. Zubair, A Zaidi, R S. Kamal

Department of Anaesthesia

No abstract provided.

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