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Biomedical subjects

S Fyneface-Ogan

Publications and source records attributed to S Fyneface-Ogan.

6 recordsLinked to original sources

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↗

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↗

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↗

A monoblock resection for malignant phaeochromocytoma.

BACKGROUND: Phaeochromocytoma is a rare surgically treatable cause of hypertension. The aim of this paper is to present a case of phaeochromocytoma treated in Port Harcourt. METHOD: The case record of a patent with phaeochromocytoma and a review of the relevant literature. RESULT: A 40 year-old man presented with episodic malignant hypertension resistant to several anti-hypertensive drugs. A 24-hour urinary Vanillyl Mandelic Acid estimation was high at 68 mmol. An ultrasound scan revealed a huge right suprarenal mass. Preoperative medication was given to reduce the blood pressure and prevent perioperative arrhythmias. Under general anaesthesia with propofol, the tumour was explored. It appeared to invade the kidney and there were multiple hepatic secondaries. It was resected in block with the kidney. Intra- and postoperatively he had episodes of hypertension which were successfully controlled with a combination of intravenous chlorpromazine 50 mg, tramadol 100 mg and lorazepam 4 mg. Histopathology examination showed that the suprarenal mass and hepatic lesions were identical showing malignant phaeochromocytoma. The post-operative period was satisfactory. Cytotoxic drugs were not given because they were not available. On review 8 weeks later, the patient remained well. CONCLUSION: Meticulous anaesthetic and surgical skills are essential in the resection of a phaeochromocytoma.

Adrenal Gland Neoplasms↗

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↗