ABSTRACT Introduction: Inhalational anaesthesia is commonly used in paediatric patients. The study was designed to compare sevoflurane and halothane anaesthesia in the neonate and paediatric patients and to assess the haemodynamic status of both agents during induction, maintenance and recovery of anesthesia. Material and Methods: We studied 60 patients aged between 1 day to 7 years. All routine and emergency surgery were included. Children were randomly selected between two groups receiving halothane and sevoflurane. Induction time, intubating condition and haemodynamic changes were recorded. Results: Induction of anaesthesia was smooth in both groups but induction was smooth in the sevoflurane group. Maintenance of anaesthesia was smooth in both groups but recovery was rapid in the sevoflurane group. There was no unwanted side effect.
ABSTRACT Introduction: The pre anesthetic consultation is the essential element of the continuity of peri and post interventional care. In fact, it gathers all the information concerning the pre, per operative anesthetic period. For any patient whose condition requires anesthesia, the health structures must provide a preanesthesia consultation. General objective: To highlight the importance of a preanesthetic consultation through the profile and prognosis of the patients as well as the operative indications recorded. Patients and method: This was a prospective and descriptive study conducted over a period of six months from January 1 to June 30, 2021 in the anesthesia and intensive care unit of the national hospital of Zinder. Patients consulted by a surgeon, scheduled for surgery and having a preoperative workup were included. Age, sex, history, ASA class, anesthetic technique, operative indication and outcome of the patent were the variables studied. The data analysis was done by Excel. Results: During the study 401 patients were registered with a sex ratio of 3.6%. The mean age was 42 years with extremes from 02 months to 84 years. Medical history represented 08.72% including hypertension (68.57%) and diabetes (11.42%). ASA II class represented 73.81% (n= 296) and ASA I class 26.18% (n= 105). General anesthesia was the chosen technique in 63.34% (n=254) versus 36.5% (n=147) for spinal anesthesia. Hernia and restoration of digestive continuity were the main surgical indications with respectively 17.45% (n=70) and 10.47% (n=42) followed by benign prostatic hypertrophy for 10.47% (n=42). Visceral surgery occupied the first place with 21.19% (n=85) followed by urology with 15.96% (n= 64). The per and post operative evolution was generally favorable, no case of death was recorded. Conclusion: The pre-anaesthetic consultation remains the essential element of the continuity of pre- and post-anaesthetic care. It should be popularized in health structures with high-risk patients.
ABSTRACT Background: Gastric cancer (GC) is one of the leading causes of mortality and morbidity and adds significantly financial burden to patient and their family on healthcare. The incidence of gastric cancer continues to increase in Bangladesh; therefore there is unmet need of promising treatment modalities. Objective: To investigate the survival of patients undergoing gastric cancer surgery with epidural combined with general anesthesia (EGA) and general anesthesia alone (GA). Methods: A retrospectively observation study was carried out at the Dept. of Anesthesia, National Institute of Cancer Research & Hospital (NICRH), Mohakhali, Dhaka, Bangladesh from June 2021 March 2022. 451 patients with gastric cancer who were scheduled for radical resection. Propensity score matching was performed at a 1:1 ratio between GA (n=75) and EGA (n=75) to reduce selection bias. Univariate and multivariate analyses were used to identify factors significantly correlated with recurrence and/or metastasis and prognosis. The 3-year overall survival rates of patients receiving EGA and GA alone were compared. Results: After the propensity scores were matched, there were 75 patients who underwent EGA and 75 patients who underwent GA. For the entire population, reconstruction type, pN stage, and complications were significantly correlated with prognosis based on multivariate analyses. For patients with a recurrence and/or metastasis, lymphadenectomy and pN stage were shown to be independent prognostic factors by multivariate analysis. Conclusions: In summary, patients might benefit from EGA as a result of better analgesic and anti-inflammatory effects, fewer postoperative complications, higher safety, and a lower rate of metastasis and recurrence is conducive to postoperative recovery in patients with gastric cancer.
ABSTRACT Background: Head injuries constitute a real public health problem in Low Income Countries. The aim of this study is to evaluate the management of severe head trauma. Patients and methods: A prospective study was conducted for a period of six months, from 1st February to 31th July 2018 at Niamey National Hospital. Were been Included all patients victims of head injury with Glasgow Coma Scale (GCS) less than 8. The following variables were studied: age, sex, cause of trauma, deadline admission, means of transport used, Glasgow Coma Scale, CT Scan results, management and evolution. Results: Out of 1,918 patients admitted; 243 were head trauma, of which 76 patients had a GCS less than 8 (3.96%). Male predominance was found with a sex ratio of 24.33, young people was the most concerned (mean age:29.88 ± 16.37 years). Predominant age group was 16 to 30 years old, with 43.42% of patients. The circumstances of the trauma were road traffic accidents (86.84%). Transportation was medicalized in 15%. GCS was between 6 to 8 in 74.02% and the admission deadline was less than 6 hours in 77.63%. Respiratory distress was found in 28.95% and circulatory distress in 14.47%. Cranio-cerebral CT scan was performed in 82.89%. Seven patients (9.21%) were intubated and ventilated. Death rate was 53.94%. Conclusion: Head injury concerns a young male patient, the cause was a road traffic accident, this situation could be improved by raising the population's awareness of road safety and greater efficiency in taking in medical charge.
ABSTRACT Significant differences exist between airways of the neonate and the adults. Anaesthetic management of airway may be challenging in neonates and young infants with large neck masses like cystic hygroma because these patients are at risk for sudden complete airway occlusion resulting in hypoventilation and hypoxemia. Cystic hygroma are benign, but can be disfiguring. It is a condition which usually affects children. Treatment is surgical excision under general anaesthesia either one or multistage resections.
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Mst. Tanzina Islam
Nursing Instructor, Naogaon Nursing Institute, Naogaon, Rajshahi, Bangladesh
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