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- Volume 12, Issue 3, 2006
Southern African Journal of Anaesthesia and Analgesia - Volume 12, Issue 3, 2006
Volumes & issues
Volume 12, Issue 3, 2006
Author A. BeetonSource: Southern African Journal of Anaesthesia and Analgesia 12, pp 87 –93 (2006)More Less
Extracted from text ... Southern African Journal of Anaesthesia & Analgesia ? July/August 2006 87 GUEST EDITORIAL As medicine moves towards less invasive and fast track options, there is a steadily increasing call for the provision of sedation rather than general anaesthesia for diagnostic and therapeutic procedures. This is a result of reduced staffing, funding and inpatient facilities. 12% of in-patient procedures (and 40 -50% of out-patient surgeries) in the USA in 2001 were performed under some form of sedation. Sedation is, however, not a static or easily achieved entity. It lies at a variable distance along the continuum from the awake state to ..
LMA CTrach(TM) - Results of our first experience with the fiberoptic intubating laryngeal mask airway in 80 patients : clinical researchSource: Southern African Journal of Anaesthesia and Analgesia 12, pp 95 –99 (2006)More Less
We report on our initial clinical experience with the new LMA CTrach<sup>(TM)</sup>. The intention was to evaluate its suitability in the routine anaesthetic working environment. <br><i>Method:</i> After inducing general anesthesia and muscle relaxation, the Ctrach<sup>(tm)</sup> was used in elective patients, and its functionality was tested. We attempted to visualize the level of the vocal cords via the fiberoptic, and to subsequently carry out optically controlled endotracheal intubation. <br><i>Results:</i> The CTrach<sup>(TM)</sup> was used in 80 ASA I-III patients, 10 patients of which had been identified with difficult-to-manage airways. Ventilation via the laryngeal mask and thus securing the airway was possible in all patients. Larynx visualization was achieved in 85% of all cases. Intubation suc-ceeded in 95% at an average of 1.34 intubation attempts per patient. Tracheal intubation failed in 4 patients. <br><i>Conclusion:</i> LMA CTrach<sup>(TM)</sup> allows optically controlled intubation in a large number of patients.
Source: Southern African Journal of Anaesthesia and Analgesia 12, pp 101 –104 (2006)More Less
<i>Background:</i> This prospective questionnaire-based study examined the post-operative symptoms encountered by children who underwent day case surgery at a dedicated day case surgery unit. The study evaluated the post-operative symptoms that occurred at home. The parents evaluated the instructions given in the hospital for care at home. <br><i>Methods:</i> All children aged 1 day -14 years, who were operated on over a one year period were prospectively followed up following elective day case surgery. The incidence and duration of symptoms occurring after discharge was evaluated, using a structured questionnaire completed by the parents. The instructions given in hospital for care at home were evaluated by the parents using a different questionnaire. <br><i>Results:</i> A total of 100 children were operated on during the period. Pain (72%), emetic symptoms (16%) and difficulty with walking(7%) were the commonest symptoms occurring on the way home. There were no unplanned re-admissions. Two- thirds of the parents did not know enough about the treatment of the wound and of the overall recovery of the child. <br><i>Conclusions:</i> Post operative symptoms following elective day case surgery are amenable to treatment and prevention with a wider use of available drugs.
Effects of inhaled nitric oxide on oxygenation and haemodynamic performance during one-lung ventilation in pigs : laboratory researchSource: Southern African Journal of Anaesthesia and Analgesia 12, pp 107 –109 (2006)More Less
<i>Objective:</i> To study the effects of 20 ppm inhaled nitric oxide (iNO) on haemodynamics and systemic oxygenation during one-lung ventilation (OLV) in vivo. <br><i>Design:</i> Prospective animal study with a cross-over design. <br><i>Setting:</i> Animal laboratory of a university hospital. <br><i>Subjects:</i> Eight female pigs. <br><i>Outcome measures:</i> The pigs were anaesthetized, tracheally intubated, and mechanically ventilated. Following placement of femoral arterial and pulmonary artery catheters, a left-sided double-lumen tube (DLT) was placed via tracheotomy. After DLT placement, in each animal OLV was performed during intravenous anaesthesia in a cross-over design with and without iNO (20ppm) in 100% oxygen. After haemodynamic stabilization, haemodynamic measurements and blood gas analyses were made, in addition we measured differential lung perfusion with colored microspheres in three animals. <br><i>Results and Conclusions:</i> iNO did not improve oxygenation nor did iNO reduce pulmonary arterial pressure in our animal model. Mixed venous PvO2 and cardiac output were comparable during the study periods.
Source: Southern African Journal of Anaesthesia and Analgesia 12, pp 111 –113 (2006)More Less
Anaesthetic accidents as a cause of morbidity and mortality are beginning to cause great concern in developing countries, where there is still a dearth of reporting of critical incidents. A case of a 55-year-old Nigerian woman who developed signs of cerebral hypoxia following osteotomy under general anaesthesia delivered through a draw-over Portable Anaesthetic Circuit (PAC) unit is reported. She was resuscitated and had intensive care therapy following this critical incident. This case highlights human error, and possibly technical failure as predisposing factors leading to anaesthetic accidents. It also emphasizes the need for anaesthetists to address safety issues more seriously. Reported critical incidents in our operating rooms should be audited, analysed and discussed in departmental quality assurance meetings, in order to indicate the potential causes and management of those incidents that are attributable to anaesthesia. A multi-disciplinary approach to the management of critical incidents is advocated to prevent future occurrences.
Thoroughness of anaesthesiologists' pre- and post-operative patient visits at the Universitas hospital, Bloemfontein : letter to editorSource: Southern African Journal of Anaesthesia and Analgesia 12, pp 117 –119 (2006)More Less
Extracted from text ... Southern African Journal of Anaesthesia & Analgesia ? July/August 2006 115 LETTER TO EDITOR To the editor The anaesthetic procedure may be viewed as the maintenance of normal physiological process plus the administration of additional medication so that surgery is possible.1 Anaesthesiologists' pre-operative visits to patients are multifunctional because it gives the patient the opportunity to meet the anaesthesiologist, and in addition the anaesthetic technique can be explained.2 The anaesthesiologist must ensure that the patient understands the procedure and that the relevant legal documentation is completed. Recording the patient's history, and examining the patient in order to determine whether to ..
Source: Southern African Journal of Anaesthesia and Analgesia 12 (2006)More Less
Extracted from text ... SAJAA CPD ANSWER FORM - JULY/AUGUST 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 ..