Biomedical subjects

C N Mato

Publications and source records attributed to C N Mato.

6 recordsLinked to original sources

PubMed2006

Post-dural puncture headache following caesarean section in Nigerian parturients: A comparison of two spinal needles.

OBJECTIVE: The purpose of this study was to evaluate the role of needle diameter of the same tip configuration in the causation of Post Dural Puncture Headache (PDPH). METHODS: This prospective, single blind, randomised study compares the incidence of PDPH from two spinal needles (Becton Dickinson Whitacre sizes 25 G and 26 G needles) in obstetric patients. One hundred women undergoing elective and emergency Caesarean delivery under spinal anaesthesia were recruited. Each of the patients was interviewed using a standard questionnaire and reviewed until the seventh day postoperative. Both intraoperative and postoperative complications that occur were promptly treated. RESULTS: There was no significant difference in the number of attempts at insertion in both groups, although a shorter time was achieved in group25. PDPH occurred in 6.0% of those in group25. CONCLUSION: There was no difference in the insertion characteristics between the two needles.

Adult↗

PubMedDate not supplied

Postpartum perineal pain in primiparous women: a comparison of two local anaesthetic agents.

BACKGROUND: Episiotomy is the commonest obstetric surgical operation performed to increase the introitus to enhance vaginal delivery. This study was to compare the effect of two local anaesthetic agents on postpartum perineal pain and time for demand for oral analgesics. METHODS: A randomized double-blinded controlled clinical trial was conducted in primiparous women who had spontaneous vaginal delivery, comparing 1% plain lidocaine and 0.25% plain bupivacaine infiltration for the repair of selective episiotomy or perineal injury. RESULTS: The two groups were comparable in sociodemographic characteristics. At 2 and 4 hours, women who had perineorraphy under lidocaine had significantly higher pain scores on the Visual Analogue Scale (VAS) than those who had the repair under bupivacaine, (4.0 v. 2.0)and(6.0 v. 3.0)respectively. At the 6h hour, the mean pain score for the bupivacaine group was 4.0 on the VAS while the lidocaine group had already received a dose of oral analgesic (Ibuprofen 400 mg) following severe pain from the repair. There was however no statistically significant difference in the pain score on the VAS between the two groups at the time of request for oral analgesics. The mean time lapse before demand for oral analgesics for the lidocaine group was 2.25 +/- 0.46 hrs (Mean+Standard deviation) while that for the bupivacaine group was 7.13 1.56 hrs (Mean Standard deviation). The P value was P < 0.0000 (Student's t-test) and statistically significant. CONCLUSION: It is concluded that the patients in the bupivacaine group had a prolonged analgesia and needed fewer doses of oral analgesics in the immediate postpartum perineal repair period.

Adult↗

PubMedDate not supplied

Mechanical airway obstruction from the laryngeal mask airway cuff.

BACKGROUND: The laryngeal mask airway (LMA) classic has been found useful in airway management of both routine and emergency unexpected failed intubations. We report a case of mechanical airway obstruction from anterior in folding of the laryngeal mask airway classical cuff. METHOD: The anaesthetic record of a 55-year-old 70 kg female patient fora left sided total hip replacement that had a failed spinal and was augmented with the laryngeal mask airway. RESULT: Near complete airway obstruction developed after the size 4 laryngeal mask airway classic was inserted and the cuff inflated with 30 ml of air. The reduced reservoir volume and the desaturation that ensued as detected by the portable handheld pulse oximeter alerted the anesthesiologist and called for a check which was not corrected by any head and neck manoeuvre. On withdrawal of the laryngeal mask airway, the cuff was noted to have folded unto the fresh gas aperture thereby obstructing ventilation and oxygenation of the patient. CONCLUSION: Monitoring the monitors and quick reassessment of laryngeal cuff placement guaranties the evasion of anaesethetic catastrophes.

Airway Obstruction↗

PubMedDate not supplied

Epidural anaesthesia for caesarean section in a patient with extreme cardiovascular and respiratory disease.

A 24-year old booked primigravida, with rheumatic heart disease in heart failure and lobar pneumonia presented in active labour. She was stabilized and prepared for an emergency Caesarean section that was successfully managed with Epidural Anaesthesia. She was admitted into the intensive care unit where the pneumonia and heart failure were managed by the physicians. The importance of proper follow up and treatment and, the need to perform more epidural techniques to meet the ever increasing challenges to the Anaesthetist are highlighted.

Adult↗

PubMedDate not supplied

Drug errors in anaesthetic practice: case reports.

BACKGROUND: Error is inherent in any complex human endeavour. It is therefore not unusual for these to occur in drug administration. We report three cases of such errors. METHOD: The anaesthetic record of 3 patients who had errors in drug administration and discussion of the relevant literature. RESULT: Through the years in anaesthetic practice at the University of Port Harcourt Teaching Hospital (UPTH), our Pharmacy has always supplied standard ketamine hydrochloride in a dark brown bottle containing 10 mls of the 5% solution. Suxamethonium chloride on the other hand was always supplied in a 2 ml clear glass ampoule. A change in this known packaging without prior notification resulted in near misses, all of which had the potential for serious morbidity. CONCLUSION: A strict adherence to standard procedure is necessary to minimize the risk, since there is no substitute for vigilance if morbidity and mortality is to be prevented.

Adolescent↗

PubMedDate not supplied

Epidural blood patch for post dural puncture headache: a handy ally [corrected].

BACKGROUND: Epidural blood patch is a well-known item in the management protocol of post dural puncture headache though never been practised or reported in our environment. The aim of this report is to document its efficacy and establish a rationale for its use. METHOD: A review of the case record of patients with post dural puncture headache and the relevant literature. RESULT: A case of post dural puncture headache was encountered at a free medical missionary outreach program following spinal anaesthesia for myomectomy. Having exhausted all the available conservative management options, she was offered epidural blood patch. The recovery profile was collected by assessment of her abilities and disabilities before and after the epidural blood patch, with visual analog scale for pain. The clinical condition improved a lot, with remarkable improvement in neck movement and the visual analog scale. CONCLUSION: We conclude that epidural blood patch is a superior therapy for post dural puncture headache and recommend that post-anaesthetic rounds be conducted routinely to identify complications and enable early institution of therapy.

Adult↗