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- Volume 11, Issue 3, 2005
Southern African Journal of Anaesthesia and Analgesia - Volume 11, Issue 3, 2005
Volume 11, Issue 3, 2005
Author R.A. DyerSource: Southern African Journal of Anaesthesia and Analgesia 11 (2005)More Less
Extracted from text ... GUEST EDITORIAL Southern African Journal of Anaesthesia & Analgesia - August 2005 81 Guest editorial This edition of SAJAA contains several highly specialised contributions. The importance of safety in the workplace is emphasised by Milner, in a review of the important field of prevention of needlestick injuries. Of particular concern are the measures which should be implemented in order to prevent contaminated injuries. The sophistication of the interaction between anaesthesia and the pathophysiology of end-stage obstructive lung disease, is outlined by James et al in a review on anaesthesia for lung volume reduction surgery. This review emphasises the need for ..
A comparison of EEG spectral entropy with conventional quantitative EEG at varying depths of sevoflurane anaesthesia : research articleSource: Southern African Journal of Anaesthesia and Analgesia 11, pp 89 –93 (2005)More Less
<I>Background and Aim:</I> Recently an electroencephalographic (EEG) spectral entropy module (M-ENTROPY) for an anaesthetic monitor has become commercially available. We compared its performance as an indicator of the state of anaesthesia with that of an older conventional quantitative EEG (QEEG) module (M-EEG) by the same manufacturer (Datex-Ohmeda Division, Instrumentarium Corp., Helsinki, Finland). <br><I>Methods:</I> There were 40 ASA class I or II subjects, aged between 16-60 years, who underwent elective abdominal surgery. EEG data were collected from the printouts of the respective modules. The data presented here were related to four levels of anaesthesia: Pre-anaesthetic wakefulness (state A), 2% sevoflurane endtidal (ET) concentration after completion of surgery (state B), low ET sevoflurane concentrations (~ 0.5%) just prior to regaining responsiveness (state C), and post-anaesthetic responsiveness (state D). <br><I>Results:</I> In terms of the prediction probability (Pk statistic), response entropy (RE) and state entropy (SE) produced higher values (0.95-1.0) than the best performing QEEG variable, frontal amplitude (0.86-0.95). Only RE scores did not overlap between states A and B or between B and D. The misclassification of subjects between states C and D was far lower for RE (28%) than for any of the conventional QEEG measures (>90%). <br><I>Conclusion:</I> In on-line monitoring spectral entropy is superior in distinguishing states of anaesthesia and is also easier to use than conventional QEEG. It is speculated that the artefact rejection strategies accorded spectral entropy might significantly benefit conventional QEEG analysis.
Author A. BosenbergSource: Southern African Journal of Anaesthesia and Analgesia 11, pp 94 –96 (2005)More Less
Extracted from text ... SYNDROMIC VIGNETTES IN ANAESTHESIA Southern African Journal of Anaesthesia & Analgesia - August 2005 94 Anaesthesia and Sirenomelia (Mermaid Syndrome) fied, but the liver and spleen were normally situated. X-ray of the lower limbs showed a normal looking pelvis, femurs, tibiae and fibulae, and abnormal feet. Full blood count, urea and electrolytes were normal. Neither the paediatric surgeon nor anaesthesiologist had prior experience of this clinical problem and on a Sunday, access to a reference library was not possible. A colostomy, and if possible a stoma for urinary drainage, was planned. Anaesthesia was induced with halothane and intubation achieved ..
Author A. MilnerSource: Southern African Journal of Anaesthesia and Analgesia 11, pp 97 –101 (2005)More Less
Healthcare workers (HCWs) are at risk for needlestick injuries (NSIs), and in the modern context infections acquired in this manner may have lifethreatening sequelae. <br>HCWs often do not report NSIs and this may explain the apathetic attitude that some authorities have adopted, regarding safer "needleless" systems in operating theatres. <br>Completely "needleless" theatre environments can cause a dramatic escalation in costs. However, cheaper options such as drugs in plastic ampoules, blunt drawing-up needles, and three-way stopcocks for administration of drugs, although preventing injury to the HCW, are less effective in preventing contaminated injuries. The combination of the more expensive Engineered Sharps Injury Prevention Devices (ESIPDs)<sup>*</sup>, Needleless Intermittent Intravenous-access Systems (NIIS) <sup>*</sup>, and accessible at-hand sharps disposal bins, should also be available, since these decrease the incidence of percutaneous transmission of infection. It is the responsibility of each anaesthetist to insist that these items are always readily available. <br><sup>*</sup> ESIPDs : intravenous catheters with introducer needles with built-in safeguarded mechanisms. <br><sup>*</sup> NIIS : An example would be needle free fluid administration sets.
Source: Southern African Journal of Anaesthesia and Analgesia 11, pp 103 –106 (2005)More Less
Extracted from text ... REVIEW Southern African Journal of Anaesthesia & Analgesia - August 2005 103 Anaesthesia for Lung Volume Reduction Surgery natural history of the disease or reduce mortality. Bronchodilators improve lung function, exercise capacity, and quality of life in patients with COPD, but are of limited benefit to patients without reversible airway disease. As the medical management of these patients appears to offer only limited benefits, various attempts have been made to improve the quality of life and possibly to reduce mortality through a variety of surgical techniques over the past 90 years including pneumoperitoneum formation, phrenic nerve paralysis, thoracoplasty, denervation of ..
Source: Southern African Journal of Anaesthesia and Analgesia 11, pp 109 –110 (2005)More Less
Extracted from text ... CASE REPORT Southern African Journal of Anaesthesia & Analgesia - August 2005 109 Epidural abscess: diagnosis and management within 2 hours, an emergency laminectomy and drainage of abscess was performed. Gentamycin 80 mg IV 8 hourly was added, and also used to rinse the wound postoperatively via inserted drains. Five days later the patient, much improved and without any neurological defect, resumed surgical therapy for his suppurating foot. Staphylococcus aureus was cultured as the pathological organism. Discussion Delayed diagnosis of an epidural abscess may cause the death of a patient. Important clinical manifestations include a high fever, back pain ..
Source: Southern African Journal of Anaesthesia and Analgesia 11 (2005)More Less
Extracted from text ... SAJAA CPD ANSWER FORM - AUGUST 2005 Subscribe to the SAJAA CPD programme and earn 16 CPD points per year CPD reference number A008/085/03/2005 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 ..