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- Volume 10, Issue 2, 2004
Southern African Journal of Anaesthesia and Analgesia - Volume 10, Issue 2, 2004
Volume 10, Issue 2, 2004
Author Christina LundgrenSource: Southern African Journal of Anaesthesia and Analgesia 10 (2004)More Less
Extracted from text ... EDITORIAL 1 Editorial Epidemiologic series report direct trauma and toxicity as the aetiologies of most neurological complications, and have identified pain during needle placement or injection of local anaesthetic as major risk factors. In 2003 Horlocker et al published a study evaluating the frequency of neurological complications in 4298 thoracic surgical patients undergoing lumbar epidural catheter placement while under general anaesthesia. Epidurals were mainly used for postoperative analgesia with opioids. There were no neurological complications, including spinal haematoma, epidural abscess or catheter site infections, radicular symptoms, or persistent paraesthesias. Six patients developed new neurological symptoms or worsening of ..
Author R.E. HodgsonSource: Southern African Journal of Anaesthesia and Analgesia 10, pp 4 –5 (2004)More Less
Extracted from text ... GUEST EDITORIAL 4 To the Editor right atrial pressure12, which may be prevented by the administration of anticholinergic agents in high-risk parturients (heart rate < 60 prior to spinal, prolonged PR interval, age < 25 years, block above T2).13 The use of preload, ephedrine and phenylephrine for prevention and treatment of post-spinal hypotension was comprehensively covered by Lamacroft. A rare but extremely dangerous situation is the development of hypotension and/or bradycardia associated with a decreased level of consciousness. This is an indication for urgent administration of adrenalin in boluses of 50-200 mcg (0.5- 2ml of a solution of ..
Wrong drug administration errors amongst anaesthetists in a South African teaching hospital : researchAuthor P.C. GordonSource: Southern African Journal of Anaesthesia and Analgesia 10, pp 7 –8 (2004)More Less
A confidential, self-reporting survey was sent out to all 65 anaesthetists (25 specialists and 40 registrars) in the Department of Anaesthesia at the University of Cape Town with the aim of determining the incidence and possible causes of "wrong drug" administrations. The response rate was 95%. 93.5 % of respondents admitted to having administered the wrong drug at some stage of their anaesthetic career. 19/62 (30.6%) have injected the wrong drug or the correct drug into the wrong site on at least three occasions. 56.9 % of incidents involved muscle relaxants with suxamethonium chloride administered instead of fentanyl accounting for nearly a third of cases. 17.6 % of reported incidents were classified as being dangerous, with the potential to cause either severe haemodynamic instability and / or neurological damage or seizures.
Author Adrian BosenbergSource: Southern African Journal of Anaesthesia and Analgesia 10, pp 10 –11 (2004)More Less
Extracted from text ... SYNDROMIC VIGNETTES IN ANAESTHESIA 10 Anaesthesia for prune belly syndrome Synopsis of patient: An 18month old, 12.8kg male presented for laparotomy. He is a known 'prune belly' syndrome and had undescended testes. The purpose of the laparotomy was to locate his testes and perform a bilateral orchidopexy if possible. His mother gave a history that he suffered from recurrent chest infections but his chest was clear on the day of surgery. He had no cardiac abnormalities. His abdominal musculature was deficient and had no tone. It seemed to consist of folds of loose redundant skin (Fig1a and b). ..
Author A.C. BuysSource: Southern African Journal of Anaesthesia and Analgesia 10, pp 13 –17 (2004)More Less
Extracted from text ... REVIEW 13 Spinal surgery: non surgical complications Invasive Procedures (apart from the definitive surgical procedure) Arterial cannulation Central venous cannulation Catheterisation of the bladder Discography: recently a patient initially developed a low CSF pressure headache as a complication of discography, which cleared up rapidly, but was followed after ? 3 days by the development of thrombosis of the superior sagittal sinus. With a dural puncture, an early blood patch should be considered. (this case is obviously anecdotal) Epidural Injections - complications include: Acute retinal necrosis syndrome after epidural corticosteroid injections for back pain. Patients should be advised ..
Source: Southern African Journal of Anaesthesia and Analgesia 10, pp 19 –21 (2004)More Less
Radiation induces a variety of changes in the airway that can potentially lead to difficult intubation. Osteoradionecrosis (ORN) of the mandible, a severe consequence of radiotherapy for head and neck malignancies can cause a reduction of the 'mandibular space' and alteration of the morphometric measurements, viz. thyromental distance, hyomandibular distance, anterior mandibular length and posterior mandibular length, that usually predict difficult intubation. A case of osteoradionecrosis of the mandible presenting for elective surgery under general anaesthesia is presented. The primary intention of this article is to focus awareness amongst anaesthesiologists on the myriad of airway problems to be anticipated in cancer patients who present for surgery after radiotherapy.
VIOXX(R) relieved pain and improved clinical outcomes in patients undergoing total knee replacement surgery, new study showed : product newsSource: Southern African Journal of Anaesthesia and Analgesia 10, pp 23 –24 (2004)More Less
Extracted from text ... PRODUCT NEWS 23 VIOXX(r) Relieved Pain and Improved Clinical Outcomes in Patients Undergoing Total Knee Replacement Surgery, New Study Showed Study Published in JAMA Demonstrated that Patients Receiving VIOXX Before and After Surgery Used Opioids Less Frequently The study was an investigator-initiated research study conducted at Rush-Presbyterian-St. Luke's Medical Center in Chicago, Illinois, and supported by a medical school grant from Merck, Sharpe & Dohme. VIOXX reduced the need for opioids after surgery Immediately following surgery, patients were able to control the level of epidural analgesic medicine that they received. Pain was judged on the visual analog scale (VAS), ..
Combination proves effective for acute postoperative pain - a meta-analysis of single dose oral tramadol administered in combination with acetaminophen (paracetamol) : product newsSource: Southern African Journal of Anaesthesia and Analgesia 10 (2004)More Less
Extracted from text ... 24 Combination proves effective for acute postoperative pain - A meta-analysis of single dose oral tramadol administered in combination with acetaminophen (paracetamol) effect that is greater than either individual component. The combination formulation also had significantly lower NNT (number-needed-to-treat) than the components alone, comparable to ibuprofen (400mg), the gold standard for this pain model. Tramadol alone and acetaminophen (paracetamol) alone had NNT of about 12 and 8, respectively. However, the combination of tramadol and acetaminophen had a much improved NNT of just under 3. Conclusions The meta-analysis demonstrated the analgesic superiority of the combination treatment over its components, without ..
Source: Southern African Journal of Anaesthesia and Analgesia 10 (2004)More Less
Extracted from text ... PRODUCT NEWS 25 Rayzon(r) matches morphine after laparotomy in women placebo. Rescue analgesia was available to the women on request. The analgesic response was assessed using standard efficacy measures at 0 hours, 30 minutes and specified hourly intervals thereafter for up to 12 hours, or until rescue medication was requested. In addition, the general safety was evaluated continuously, and a Global Evaluation of Study Medication was provided by the women at the conclusion of the study. After rigorous statistical analysis of the study results, the authors concluded that RAYZON(r) demonstrated an analgesic effect which was superior to the lower ..
Source: Southern African Journal of Anaesthesia and Analgesia 10 (2004)More Less
Extracted from text ... SAJAA CPD ANSWER FORM - MAY 2004 Subscribe to the SAJAA CPD programme and earn 20 CPD points per year CPD reference number A008/085/03/2004 Continuing Professional Development Point Questionnaire Accredited by the Wits CPD Office Instructions 1. Read the journal to find all the answers 2. Answer the questions and mark the answer form by putting an "X" in the appropriate square. 3. Make a photocopy for your records in case the form is lost in the mail. 4. Tear out page and place the answer form in a envelope, seal it and send to:- In House Publications, SAJAA CPD ..