Comparison of the durations and complications of spinal anaesthesia between unilateral spinal anaesthesia and bilateral spinal anaesthesia for unilateral lower limb surgery

Despite the advantages of spinal anaesthesia when compared to general anaesthesia, it is associated with complications such as hypotension, bradycardia, shivering and nausea. Our study is set to compare the durations and complications between unilateral and bilateral spinal anaesthesia in patients undergoing unilateral lower limb surgeries. Method: Sixty four (64) American Society of Anesthesiology (ASA) 1 and 2 patients that were randomly assigned to two groups. Group U which is the unilateral spinal anaesthesia and group B which is the conventional bilateral spinal anaesthesia group to receive 2ml of 0.5% heavy bupivacaine plus 1ml of distilled water and 3ml of 0.5% heavy bupivacaine only respectively. The group U patients who had the procedure in the lateral decubitus position remained in that position for 20 minutes, while those in group B had the spinal injection in sitting position and immediately took the supine position after the injection. Results: The 64 adult patients who were randomly allocated into two groups with 32 patients each successfully had their surgeries done under the chosen technique. The mean duration of spinal anaesthesia was found to be 64±23.29 minutes and 100± 37.08 minutes in the group U and B respectively (p=0.001). There was no statistical differences in the general overall complications when the two groups were compared (p=0.03), however, on individual bases unilateral spinal anaesthesia has less complications compared to bilateral spinal anaesthesia for unilateral lower limb surgeries. Conclusion: The study showed that unilateral spinal anaesthesia with 2 ml of 0.5% bupivacaine had shorter duration of spinal anaesthesia with less complications compared to bilateral spinal anaesthesia for unilateral lower limb surgeries

Obstetric admissions in a general intensive care unit in north-central Nigeria

Context: Maternal mortality remains unacceptably high in many developing countries and many pregnant women in these countries will require critical care during pregnancy and will be managed in general intensive care units.Objective: To determine the indications for admission of obstetric patients into the general intensive care unit of Jos University Teaching Hospital over a 14 years period and the outcome of their management.Study Design: The study is a retrospective descriptive study. All obstetric admissions into the intensive care unit of Jos University Teaching Hospital from January 1994 to December 2007 were reviewed.Results: There were 231 obstetric admissions which was 17.29% of total ICU admissions and 2.05% of all deliveries in the hospital during the period of review. The mean age of the patients was 25±7.1 years. Pregnancy induced hypertension made up 80.52% of the admissions, while haemorrhage was 12.56% and non-obstetric admission was 6.93%. The most common non-obstetric admission was sepsis (43.70%). Of all admissions 90.91% were in the postpartum period and 9.09% during the antepartum period. The medium length of was two days. The mortality rate was 15.15% with significantly higher ratio of deaths in patients with non-obstetric indications for admission and in patients older than 35 years.Conclusion: There is a high rate of ICU admission of obstetric patients in our hospital. This increases the burden of care in the ICU and contributes to poor outcome. Establishment of obstetric high dependency units will reduce the burden on general ICUs

Comparison of Pethidine-Ketorolac Versus Pethidine Alone for Postoperative Pain After Limb Implants

Presented as a poster at Indiana Society of Anesthesiologists Annual Meeting 2020

Effect of paracetamol pre-treatment on Propofol injection pain among surgical patients

Background: Propofol injection pain is often a cause of distress for patients. This study was conducted to find the incidence of Propofol induced pain and the efficacy of Paracetamol (Acetaminophen) in the prevention of Propofol injection pain among surgical patients at a tertiary hospital.Methods: The study was a prospective, double blind randomized clinical trial carried out at the Jos University Teaching Hospital main theatre. Consenting American Society of Anesthesiologists (ASA) physical status I or II patients scheduled to undergo general anaesthesia for elective surgery were allocated into one of two study groups of 35 each. Group I  was the Paracetamol (drugamol® ) group, who received 2mg/kg of intravenous Paracetamol while the control group (group II) received 5ml of 0.9% saline with venous occlusion. The venous occlusion was released 2 minutes after injecting the study drug and one-fourth of the total calculated dose (2.5mg/kg) of  Propofol (Pofol 1% ®Dongkook Pharmaceutical) was delivered through the iv line over a period of five seconds and the patients assessed for pain on a 4-point scale. Results: The two groups were comparable in demographic characteristics and ASA classification. Twenty-one (60.0%) patients in the control group and 1 (2.9%) patient in the Paracetamol group experienced pain on injection of Propofol, p = 0.000. There were no significant haemodynamic variations between the two groups during the study period.Conclusion: Paracetamol when applied with tourniquet significantly attenuated Propofol injection pain in our adult patients with no significant haemodynamic variations.Key words: Paracetamol, Propofol, Injection pai