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- Southern African Journal of Anaesthesia and Analgesia
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- Volume 15, Issue 3, 2009
Southern African Journal of Anaesthesia and Analgesia - Volume 15, Issue 3, 2009
Volume 15, Issue 3, 2009
Author A. CoetzeeSource: Southern African Journal of Anaesthesia and Analgesia 15, pp 5 –6 (2009)More Less
During recent years I have become concerned about the level of scientific knowledge of the specialist we are graduating. It may well be that the expectations have been too high, but then I would think that everybody would agree that aiming high rather than low is what we should be doing. Naturally, there will always be the exceptions, but my main concern is about the average level, and it is in this context that it should be viewed.
Author U.V. OkaforSource: Southern African Journal of Anaesthesia and Analgesia 15, pp 9 –10 (2009)More Less
It has been said that the development of surgery has been in tandem with the evolution of anaesthesia. This should hold true all over the world, but in some areas a lack of resources has hindered the growth of both specialities. Most of the work on the economics of anaesthesia in the developing world, especially in Africa, has been by carried out by Western authors. As commendable and factual as they are, little work has been done in the West African sub-region which consists of about sixteen countries, including the most populous nation in Africa, Nigeria.
This review looks at the economics of anaesthetic practice in a major country in the region and how improvisation has helped limit the number of expensive drugs needed for the delivery of safe anaesthesia, whilst maintaining cost effectiveness. The cost of anaesthesia in Nigeria as a percentage of the total hospital cost is higher than that in most parts of the developed world, while the converse is true of total hospital costs in the developed world, which are much higher.
Author L. LasersohnSource: Southern African Journal of Anaesthesia and Analgesia 15, pp 13 –18 (2009)More Less
Gastro-oesophageal relux disease (GORD) is the most common gastrointestinal diagnosis recorded during visits to outpatient clinics. In the United States, it is estimated that 14 to 20% of adults are affected. This figure may, however, correlate to an overestimation of the disease prevalence. The disease having a nebulous definition, is based on self-reported chronic heartburn and it has been shown that only symptoms of moderate intensity occurring at least once a week have a significant impact on quality of life.
Author J.L. PiercySource: Southern African Journal of Anaesthesia and Analgesia 15, pp 21 –26 (2009)More Less
Acute kidney injury is a common finding in the critically ill patient. It carries a mortality of up to 60.3%. This review covers the definition, early detection and management of acute kidney injury. The review explores current controversies in the prescribing of renal replacement therapy and focuses on the prevention and management of contrast induced nephropathy.
Low dose combined spinal and epidural anaesthesia in a parturient with severe mitral stenosis and severe pulmonary arterial hypertension for Caesarean section : case studySource: Southern African Journal of Anaesthesia and Analgesia 15, pp 27 –28 (2009)More Less
We describe the anaesthetic management for an elective Caesarean section, of a parturient with severe mitral stenosis and severe pulmonary hypertension, using low dose of hyperbaric bupivacaine and for spinal block, supplemented with epidural lignocaine to achieve an adequate level. This patient was vulnerable to develop complications such as hypotension and tachycardia, should conventional regional anaesthesia be employed. This case reports highlights the haemodynamic stability using carefully titrated combined spinal-epidural anaesthesia in a patient with severe mitral stenosis.