Anesthesiology Commons^™

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 …

Comparison Between Tramadol And Pethidine In Patient Controlled Intravenous Analgesia, Faisal Shamim, Muhammad Qamarul Hoda, Khalid Samad, Salman Sabir

Department of Anaesthesia

Objective: To compare the efficacy and side effects related to Tramadol with Pethidine in patient controlled intravenous analgesia (PCIA) after total abdominal hysterectomies. Methods: A total of 60 patients were randomized to receive either Tramadol or Pethidine by PCIA (30 in each group) after total abdominal hysterectomy. Pain assessments were recorded one hour after starting the PCIA and then at 6, 12, and 24 hours by using visual analogue scale (VAS). Nausea vomiting score and sedation score were also recorded. Good attempts, total attempts and total drug consumption was noted from PCIA pump at the end of the study period. …

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. …

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

Department of Anaesthesia

No abstract provided.

Blood Volume And Hemoglobin Oxygenation Response Following Electrical Stimulation Of Human Cortex, Minah Suh, Sonya Bahar, Ashesh Mehta, Theodore Schwartz

Physics Faculty Works

No abstract provided.

Low Doses Of Memantine Disrupt Memory In Adult Rats, Catherine Creeley, David Wozniak, Joanne Labruyere, George Taylor, John Olney

Psychology Faculty Works

Memantine, a drug recently approved for treatment of Alzheimer’s disease, has been characterized as a unique NMDA antagonist that confers protection against excitotoxic neurodegeneration without the serious side effects that other NMDA antagonists are known to cause. In the present study, we determined what dose of memantine is required to protect the adult rat brain against an NMDA receptor-mediated excitotoxic process and then tested that dose and a range of lower doses to determine whether the drug in this dose range is associated with significant side effects. Consistent with previous research, we found that memantine confers a neuroprotective effect beginning …

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 …

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 …

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.

Lactate Versus Non-Lactate Metabolic Acidosis: A Retrospective Outcome Evaluation Of Critically Ill Patients, Kyle J. Gunnerson, Melissa Saul, Shui He, John A. Kellum

Anesthesiology Publications

Introduction

Acid–base abnormalities are common in the intensive care unit (ICU). Differences in outcome exist between respiratory and metabolic acidosis in similar pH ranges. Some forms of metabolic acidosis (for example, lactate) seem to have worse outcomes than others (for example, chloride). The relative incidence of each type of disorder is unknown. We therefore designed this study to determine the nature and clinical significance of metabolic acidosis in critically ill patients.

Methods

An observational, cohort study of critically ill patients was performed in a tertiary care hospital. Critically ill patients were selected on the clinical suspicion of the presence of …

The Impact Of An Hematocrit Of 20% During Normothermic Cardiopulmonary Bypass For Elective Low Risk Coronary Artery Bypass Graft Surgery On Oxygen Delivery And Clinical Outcome – A Randomized Controlled Study [Isrctn35655335], Christian Von Heymann, Michael Sander, Achim Foer, Anja Heinemann, Bruce Spiess, Jan Braun, Michael Krämer, Joachim Grosse, Pascal Dohmen, Simon Dushe, Jürgen Halle, Wolfgang F. Konertz, Klaus-Dieter Warnecke, Claudia Spies

Anesthesiology Publications

Introduction

Cardiopulmonary bypass (CPB) induces hemodilutional anemia, which frequently requires the transfusion of blood products. The objective of this study was to evaluate oxygen delivery and consumption and clinical outcome in low risk patients who were allocated to an hematocrit (Hct) of 20% versus 25% during normothermic CPB for elective coronary artery bypass graft (CABG) surgery.

Methods

This study was a prospective, randomized and controlled trial. Patients were subjected to normothermic CPB (35 to 36°C) and were observed until discharge from the intensive care unit (ICU). Outcome measures were calculated whole body oxygen delivery, oxygen consumption and clinical outcome. A …

The Corbett Pain Scale: A Multidimensional Pain Scale For Adult Intensive Care Patients, Gina M. Corbett

Theses and Dissertations

There are no reliable tools that evaluate pain in adult critical care patients who cannot communicate as a result of sedation or illness. This was an observational study in which postoperative cardiothoracic intensive care patients were assessed for pain using both the newly devised Corbett Pain Scale (CPS) and the Numerical Pain Scale (NPS). The CPS was evaluated for content validity, criterion validity, construct validity, test re-test reliability and internal consistency. Thirteen male and seven female patients (n=20) were enrolled and underwent a maximum of five pain assessments each. The mean total scores of the CPS (.740, SD+1.03) and the …

Unplanned Prolonged Postanaesthesia Care Unit Length Of Stay And Factors Affecting It, Khalid Samad, Mueenullah Khan, Hameedullah, Fauzia A. Khan, Mohammad Hamid, Fazal Hameed Khan

Department of Anaesthesia

Objective: To identify the factors that prolong the length of stay in the post anaesthesia care unit (PACU).
Methods: This audit was conducted in the PACU of a university hospital. A special form was designed and filled for those patients who stayed unplanned in the PACU for more than two hours. All patients who were admitted to the PACU after surgery were included. Patients undergoing cardiothoracic surgery, those directly shifted to ICU and cases done under local anaesthesia were excluded. Data was collected for 20 months by a designated recovery nurse for all included patients including those admitted …

Perceived Deprivation In Active Duty Military Nurse Anesthetists, Julie Ann Pearson

Theses and Dissertations

Problem: There is a shortage of military certified registered nurse anesthetists (CRNAs). The exodus from military service to civilian careers could be a result of relative deprivation (the discrepancy that one perceives between what one has and what one could or should have). Relative deprivation is a perception of unfairness dependent on feelings (subjective data) as well as facts (objective data). Purpose: The purpose of this study was to measure relative deprivation in active duty military nurse anesthetists, to explore variables which correlate with relative deprivation, and to validate or refute the theory of relative deprivation in active duty military …

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 …