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- Southern African Journal of Anaesthesia and Analgesia
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- Volume 21, Issue 5, 2015
Southern African Journal of Anaesthesia and Analgesia - Volume 21, Issue 5, 2015
Volume 21, Issue 5, 2015
The South African Society of Anaesthesiologists initiative to support research development : editorialAuthor Bruce BiccardSource: Southern African Journal of Anaesthesia and Analgesia 21 (2015) http://dx.doi.org/10.1080/22201181.2015.1101879More Less
Research requires protected research time, but this time requires money. In this edition of SAJAA, the South African Society of Anaesthesiologists (SASA) is launching a substantial doctoral grant to support the development of tomorrow's leading researchers within the field of anaesthesiology in South Africa. This is an important contribution from SASA as grant funding improves research productivity
Lipid emulsion therapy : non-nutritive uses of lipid emulsions in anaesthesia and intensive care : reviewSource: Southern African Journal of Anaesthesia and Analgesia 21, pp 5 –11 (2015) http://dx.doi.org/10.1080/22201181.2015.1More Less
Lipid emulsions were introduced into clinical practice more than five decades ago as a calorically dense, non-glucose-based energy source for parenteral nutrition. Recently, intravenous lipid emulsions have been used as rescue for systemic local anaesthetic toxicity. However, the non-nutritive, therapeutic roles of lipid emulsions have recently expanded. This review considers these newer uses of lipid emulsions as drug administration vehicles, for treatment of lipophilic drug toxicity, and as modifiers of ischaemia-reperfusion injury in the anaesthetic and critical care environments. The potential adverse effects of lipid emulsion administration are also succinctly addressed.
Ultrasound-guided supraclavicular brachial plexus anaesthesia improves arteriovenous fistula flow characteristics in end-stage renal disease patients : researchAuthor Shyam MeenaaSource: Southern African Journal of Anaesthesia and Analgesia 21, pp 12 –15 (2015) http://dx.doi.org/10.1080.22201181.2015.1075764More Less
Background: Surgical construction of an arteriovenous fistula is preferred for end-stage renal failure patients requiring long-term haemodialysis.
Methods: Patients were randomised into two groups: brachial plexus group (n = 30) or local infiltration group (n = 30). In all patients, a radiocephalic arteriovenous fistula was created by an experienced surgeon using a standard surgical technique. In both groups 20 ml of 0.375% ropivacaine was used. Doppler assessment of vessels was performed at fixed time intervals.
Results: Primary patency rate was 100% in the brachial plexus block group whereas there was 10% fistula failure rate in the local infiltration group (p-value = 0.237). Diameter of the vessels, peak systolic velocity, mean diastolic velocity, and blood flow at 30 minutes, 48 hours, 2 weeks, and 6 weeks after the fistula creation was significantly greater than the preoperative diameter inall patients (p-value < 0.05). Intergroup comparison revealed that vascular parameters were significantly better in the brachial plexus analgesia group versus local infiltration group at all observation points up to and including six weeks post fistula creation (p-value < 0.05).
Conclusion: Brachial plexus anaesthesia significantly dilates the vessel diameter and increases blood flow whereas local infiltration has a negligible effect on vessel diameter and blood flow.
Effect of ondansetron on the analgesic efficacy of tramadol used for post-operative analgesia : a randomised controlled studySource: Southern African Journal of Anaesthesia and Analgesia 21, pp 16 –20 (2015) http://dx.doi.org/10.1080/22201181.2015.1075935More Less
Background: Ondansetron is used to reduce tramadol induced postoperative nausea and vomiting (PONV). Studies on patient-controlled analgesia (PCA) found that ondansetron reduces the analgesic efficacy of tramadol. Drug requirement in PCA and in conventional intravenous analgesia without PCA device may differ. This study evaluated the effect of ondansetron on analgesic efficacy of tramadol for postoperative analgesia without a PCA device.
Methods: A prospective, randomised, placebo-controlled, double-blind parallel group study was conducted on 126 euthyroid patients of ASA I and II, aged between 30 and 65 years undergoing hemithyroidectomy under general anaesthesia. Patients were divided into group O and group C. At the time of closure of strap muscles, patients in group O received tramadol 1.5 mg/kg IV and ondansetron 0.1 mg/kg (diluted to 4 ml) IV and those in group C received tramadol 1.5 mg/kg IV and normal saline 4 ml IV. Duration of analgesia, pain score (VAS), PONV and sedation scores were analysed.
Results: Duration of analgesia was longer in group C compared with group O (164.1 min vs. 76.3 min, p < 0.05). Postoperative VAS score was higher in group O (p < 0.001). Group C showed higher PONV and sedation score.
Conclusion: Ondansetron reduces the duration and quality of analgesia of tramadol administered conventionally without a PCA device.
Author T. KallenbachSource: Southern African Journal of Anaesthesia and Analgesia 21, pp 21 –24 (2015) http://dx.doi.org/10.1080/22201181.2015.1076108More Less
While beta thalassaemia is not a common disorder with an estimated 100 000 severely affected individuals worldwide, improved survival rates and increased global migration means an increased frequency of such patients being seen for various surgeries. The different aspects of this disorder have wide-ranging implications for anaesthesia. Thus, for safe anaesthetic care, the anaesthetist needs to have a good understanding of beta thalassaemia. Presented here is a case report of a 32-year-old gentleman with beta thalassaemia major presenting for elective laparoscopic cholecystectomy and splenectomy, followed by a discussion of the literature.
Source: Southern African Journal of Anaesthesia and Analgesia 21 (2015) http://dx.doi.org/10.1080/22201181.2015.1089668More Less
Thank you Dr Abraham for your response to our research.
The latest data indicate that South Africa has failed to meet many of its Millennium Development Goals 2015 for child mortality and maternal health. Current data show that for every 1 000 live births there are 3.1 maternal deaths, 2 13 neonatal deaths, 28 infantile deaths and 40 deaths under the age of 5 years. 3 Of particular relevance to anaesthesia, the case fatality rate for caesarean section in South Africa is 18.9 deaths per 10 000 caesarean sections, and 14.8 deaths per 100 000 caesarean sections due to anaesthesia. Anaesthesia-related mortality contributes 2.4% of the maternal mortality rate.
Response to the letter, Williams syndrome : was intubation rather than anaesthetic drug choice a cause of cardiac arrest? : letter to the editorSource: Southern African Journal of Anaesthesia and Analgesia 21 (2015) http://dx.doi.org/10.1080/22201181.2015.1102815More Less