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- Volume 12, Issue 2, 2006
Southern African Journal of Anaesthesia and Analgesia - Volume 12, Issue 2, 2006
Volume 12, Issue 2, 2006
Author Christina LundgrenSource: Southern African Journal of Anaesthesia and Analgesia 12 (2006)More Less
Extracted from text ... Southern African Journal of Anaesthesia & Analgesia ? May/June 2006 49 EDITORIAL Traditionally the work-up of vascular patients is based on clinical and operative predictors, and the functional capacity of the patient. The major clinical predictors include unstable coronary syndromes, heart failure, severe valvular disease and significant arrhythmias, whereas stable angina and diabetes are considered intermediate clinical predictors.1 No mention is made even in the minor clinical predictors of HIV and Aids. Yet more and more patients on our vascular slates present with vascular disease related to HIV and Aids. The spectrum of vascular disorders in HIV/Aids is different from ..
Source: Southern African Journal of Anaesthesia and Analgesia 12, pp 55 –56 (2006)More Less
Extracted from text ... Southern African Journal of Anaesthesia & Analgesia ? May/June 2006 55 SYNDROMIC VIGNETTES IN ANAESTHESIA Synopsis of the patient A 3-month old, 2.5kg female ex-premature infant presented with feeding difficulties, failure to thrive and recurrent chest infections, secondary to reflux and aspiration. She was scheduled for a Nissen fundoplication. Her dysmorphic facial features included a broad forehead, microstomia, micrognathia, low set ears and microphthalmia (Fig 1). She had no teeth. Heart sounds were normal and there were scattered rhonchi on auscultation of her chest. Chest X- ray revealed evidence of resolving aspiration pneumonia. Pregnancy was uneventful. There was no significant ..
Source: Southern African Journal of Anaesthesia and Analgesia 12, pp 58 –60 (2006)More Less
<i>Background:</i> Although anaesthetic deaths are uncommon, most anaesthetists are likely to be involved with an anaesthetic catastrophe at some point in their careers. This experience may have significant psychological impact on the staff concerned. Formal incident reporting accompanies anaesthetic deaths, and in addition involved personnel frequently need professional counseling. <br><i>Objective:</i> To determine the impact and attitude of Nigerian anaesthetists towards an intra-operative death. <br><i>Method:</i> A structured-questionnaire survey of 65 Nigerian physician anaesthetists, of all grades, attending a National Anaesthetic Scientific forum, was carried out to collect relevant information using a descriptive study design. Nurse anaesthetists were excluded from the study. Data was analysed using simple mathematical correlates. <br><i>Results:</i> The response rate was 86%. Out of a total mortality of 77, 48 (62%) were unanticipated. Emergency procedures accounted for 61 (79%) of these mortalities. Only 32 (41%) of the critical incidents were formally reported. Forty-eighty (86%) of the respondents were psychologically affected by the intraoperative catastrophes reported. In order of frequency of incidence, lingering memories of the event accounted for 38%, depression 28% and cardiac dysrhythmias 2% amongst others. Most of the 49 (88%) respondents that were psychological affected did not have any form of debriefing. <br><i>Conclusion:</i> Critical incident reporting should be encouraged, whilst anaesthetic departments should have departmental guidelines for managing the aftermath of critical incidents, and ensuring psychological support for their practitioners. Trainees should undergo a training module in psychological debriefing following critical incidents as part of their curriculum. Medical Defence Organizations should be established in developing countries with appropriate government legislation.
Biographical, pain and psychosocial data for a South African sample of chronic pain patients : researchSource: Southern African Journal of Anaesthesia and Analgesia 12, pp 62 –66 (2006)More Less
<i>Objective:</i> To gather biographical and pain data for a sample of South African patients visiting a specialist pain control unit. To investigate the role of various psychosocial variables in this sample's chronic pain experience. <br><i>Subjects and Method:</i> 325 adult outpatients from a chronic pain unit completed a biographical questionnaire, the West Haven-Yale Multidimensional Pain Inventory, as well as various supplementary scales of the Minnesota Multiphasic Personality Inventory-2. Diagnostic data were also gathered for the sample. Descriptive statistics were calculated for the sample and t-tests were used to compare the current sample's mean scores on the measuring instruments with those of American normative samples. <br><i>Results:</i> The South African sample displayed elevated levels of perceived pain-related functional limitations, as well as an increase in the frequency of psychopathology and emotional distress. However, the current sample also reported higher levels of social support and were inclined to be more socially and physically active when compared with individuals in other studies. <br><i>Conclusion:</i> Specific demographic and diagnostic tendencies appear evident in the current sample. Furthermore, South African chronic pain patients seem to exhibit similar, if not perhaps more pronounced, psychosocial profiles to a comparable American sample. Various suggestions for further research are also made.
Source: Southern African Journal of Anaesthesia and Analgesia 12, pp 68 –70 (2006)More Less
A 20- year male, ASA physical status grade I, was operated on for a duodenal fistula. The intra- and postoperative periods were uneventful. 10 days later, the right internal jugular catheter was substituted with a triple lumen catheter in the right subclavian vein. Immediate chest X- ray revealed a right haemothorax. A chest drain was inserted immediately which was removed after the complete expansion of the lung. 24 hours later, the patient's general condition deteriorated, and he was clinically diagnosed to have a right-sided tension pneumothorax. A 'gush of air' after insertion of the chest drain confirmed the presence of a pneumothorax. After a few hours, the patient developed features of pulmonary oedema, and a diagnosis of re-expansion pulmonary oedema was made. The patient's general condition deteriorated rapidly, and he did not survive. The possible causes for his demise, and a review of the literature are both discussed.
Source: Southern African Journal of Anaesthesia and Analgesia 12 (2006)More Less
Extracted from text ... Southern African Journal of Anaesthesia & Analgesia ? May/June 2006 72 LETTER TO EDITOR The routine use of supplemental oxygen in the postanaesthesia care unit (PACU) has traditionally been used to minimize the incidence of hypoxaemia.1 However, with the introduction of pulse oximetry, we sought to find out if routine postoperative administration of oxygen was necessary and which group/s of patients should receive supplemental oxygen in the postanaesthesia care unit if necessary. Sixty-six patients that had various surgical procedures were involved in this observational study. Without altering routine PACU care, oxygen saturations were noted from arrival in to discharge from ..
Source: Southern African Journal of Anaesthesia and Analgesia 12 (2006)More Less
Extracted from text ... SAJAA CPD ANSWER FORM - MAY/JUNE 2006 Subscribe to the SAJAA CPD programme and earn 16 CPD points per year CPD reference number A008/085/03/2006 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 ..