ABSTRACT
Background: Any anaesthetic procedure, either regional or general, has some potential for complications. For this reason, careful preoperative assessment and adequate planning of appropriate anesthetic are the cornerstones in safe pediatric anesthetic practice. But in Bangladesh, we have very limited research-based information regarding the complication of anaesthesia in children. Aim of the Study: The aim of this study was to assess the complications of anesthesia in children. Methods: This was a prospective observational study. The study was conducted in Department of Aneaesthesia, ICU & Pain Medicine, Shaheed Suharawardy Medical College and Hospital, Dhaka, Bangladesh during the period from January 2018 to December 2018. In total 62 children, aged between 1 day and 15 years prepared for anesthesia associated surgery were selected as the study subjects. The incidence of intra-operative as well as post- anesthesia recovery room complications was recorded and analyzed. Data were analyzed and by using MS Excel and SPSS version 23.0 program as per necessity. Results: In this study, in analyzing the complications among the participants we observed that, bronchospam and bradycardia and hypotension were the most common intraoperative complications which were found in 11%, 10% and 8% cases respectively. On the other hand, tachycardia, prolonged unconsciousness and hypoventilation were found as the most common postoperative complications among the participants which were found in 19%, 10% and 8% cases respectively. Besides those complications some cases with restlessness, respiratory arrest, pain, shivering, hypertension, hemorrhage and laryngospasm were found in both the periods. Conclusion: Anesthesia-related morbidity and mortality can be minimized with early identification and prompt management of any complication. In this current study we observed that, preterm infants are major prone to develop respiratory complications because of using anesthesia.

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Background: The aim of this study was to evaluate the practice of pediatric anesthesia in an adult operating theater in sub-Saharan Africa. Patients and Methods: This was an observational, prospective descriptive study that took place over a period of 12 months in the anesthesiology department of the Essos hospital center in Yaounde (Cameroon). Children <15 years old, seen in anesthesia consultation and operated on for scheduled surgery during the above- mentioned period were included in the study. The variables studied were the variables studied were: the characteristics of the study population, the anesthetic and surgical data, as well as the patient's postoperative itinerary. Results: During the study period, 162 patients were included out of a total of 1205 patients operated on during the same period. The median age was 5 years, the sex ratio 1.8. ASA class 1 was the most represented (98.1%). The combination midazolam and atropine was the premedication of choice (87.1%). General anesthesia was the most practiced technique (96.3%). Induction of general anesthesia was inhalation in 69% of cases, sevoflurane was the hypnotic used in this indication. General anesthesia was performed by a senior anesthesiologist in 67.3% of children. The majority of surgical procedures belonged to otolaryngology surgery (57%). The electrocardiogram (ECG), blood pressure, SpO2 and heart rate constituted the main part of the intraoperative monitoring. Conclusion: In low-income countries, pediatric anesthesia is still performed by personnel who are not specialized in pediatric anesthesia. In order to improve the safety of children in the operating room, health policies must encourage training and specialization in this highly delicate area, which will make it possible to reduce perioperative infant morbidity and mortality.

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Background: Pancreatic cancer is a formidable health problem worldwide with increasing incidence. Debilitating pain is very common in patients with pancreatic cancer. The aim of this study is to observe the effectiveness of neurolytic coeliac plexus block for the relief of pain due to carcinoma of pancreas. Methods: This randomized comparative study carried out in the Department of Anaesthasia, Analgesia and Intensive Care Medicine of Bangabandhu Sheikh Mujib Medical University, Dhaka with a period from July 2008 to June 2010 for two (2) years. Result: All patients of carcinoma pancreas >18 years of age with both sexes, who were needed palliation for their end stage carcinoma, were included in this study and were divided into two groups of which group A was taken the CPB and group B was taken the conventional treatment. A total number of 30 patients were enrolled in this study of which 15 were in the group A who were treated with the neurolytic celiac plexus block (NCPB) and 15 were in the group B who were treated with conventional analgesic drugs. Maximum were from the age group of 40 to 60 years (60.0%) in group A followed by more than 60 years (26.6 %). The mean age in the group A and group B patients were 48.73 14.26 years and 51.47 ± 12.35 years respectively (p=0.579). Both in group A and B male is predominant than female which were 12 (80%) cases and 3(20%) cases respectively (p=0.999) in each group. In group A mostly were service holder which was 8(53.3%). In group A, the mean (±SD) pain VAS before treatment is 8.80±0.86 and in group B, it is 8.07 ±1.44. The difference between this two group is not statistically significant (p=0.101). Conclusion: tthe findings of this study permit to conclude that in patients with unresectable pancreatic cancer, neurolytic celiac plexus blockade (NCPB) was associated with improved pain control, and reduced narcotic usage and constipation compared with standard treatment with clinical significance. Along with higher ..........

ABSTRACT
Background: One of the most important safety measures during the surgical procedure is preoperative fasting, which is defined as deprivation of food and liquid intake for the hours preceding anesthesia. The general objective of our study was to describe the means and methods of compensating for preoperative fasting in children under 15 years of age in a hospital that occasionally performs pediatric surgery. Patients and methods: This is an observational, prospective descriptive study that took place over a period of 12 months, in the anesthesiology department of the Essos Hospital Center. All children whose age was <15 years, operated during the above period were included in the study. The variables studied were: the characteristics of the study population, the indication for surgery, preoperative fasting, and the means of compensation for preoperative fasting. Results: During the survey period, 162 patients met our inclusion criteria. The median age was 5 years. The sex ratio was 1.8 in favor of the male gender. General anesthesia was the most practiced technique (96.3%), ENT surgery the most represented specialty (65.4%). The mean duration of the preoperative fast was 5.8 ± 1.9 hours. One third of the study population (31.48%) observed prolonged fasting. Holliday and Segar's rule was the compensation formula regularly used (96%), ringer's lactate solution (93.8%) represented the reference infusion solution. Fasting compensation began on the operating table in all cases. Conclusion: The respect and observance of the preoperative fasting in the pediatric population is a delicate and laborious step. The mastery of the anatomical, physiological and pharmacological particularities of the child constitutes the basis of pediatric anesthesia for a safe practice.

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Admission to the ICU is relatively common in lung transplant recipients. The ICU mortality rate has been reported to be around 37% per admission. The aim of our study was to assess patient characteristics, ICU outcomes and QOL of lung transplant patients who required ICU readmission. ICU data from the first ICU readmission were collected retrospectively. QOL was assessed using SF36v2 tool prospectively. Cardiopulmonary transplant centre Participants: 63 lung transplant recipients who were readmitted to ICU formed the study group. 66 patients selected by computer random number generator software who underwent transplant at the same time but were not readmitted to ICU after transplant formed the control group. The response rate to the questionnaire was 70%. Mean ICU LOS was 4.53 (SD 4.68) days. Mean duration of mechanical ventilation was 3.83 (SD 4.03) days. Overall mortality was 21% in the study group and 9% in the control group (p = 0.08). SF36v2 scores were lower in the study population compared to Australian norms. The mean PCS summary scores for study group and control groups were 42.21 (SD 12.81) and 45.32 (SD 11.28) respectively (p = 0.267) and that for the mean MCS were 45.68 (SD 12.37) and 47.79 (SD 9.25) respectively (p= 0.410). Lung transplant patients requiring ICU readmission had higher overall mortality (p= 0.08). Those patients who survived had good ICU outcomes and similar QOL scores compared to those who did not require ICU readmission.

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Aim of the study: To describe the perioperative care of anemia in emergency abdominal surgery in the National Hospital of Niamey. Patients and methods: This was a prospective and descriptive study that lasted 6months, from June 6th to December 9th, 2020. Were inclueded in the study, all the patients admitted in the department of surgical emergencies who presented acute surgical abdomen associated with anemia. The main studied variables were: age, gender, history, CBC results, American Society of Anesthesiologists score (ASA), indications, etiological diagnosis, incidents and intraoperative accidents, post operative complications, treatment of the anemia, evolution and duration of hospitalization. Statistical analysis of the data was done using SPSS version 25, graphics and data entry were done with Word and Excel 2016 softaware. The average values were calculated for each variable for each patient and examinated by the chi² test for qualitative variables. P value < 0,05 was considered as significant. Results: Our study involved 147 patients out of 581 admissions, i.e a frequency of 25.30%. the average age of the patients was 16.27 years with extremes of 2 and 70 years, the male gender predominated with 64.63% (n=95) and a sex ratio of 1.83. The main preoperative diagnosis was acute peritonitis in 78.91% f cases (n=120) and peritonitis by ileal perforation was the first etiology with 63.94% (n=94). The majority of our patients had moderate preoperative anemia in 73.47% (n=108) and severe anemia in 21.09% (n=31) of cases. The management of anemia was based on blood transfusion which was performed in 10.20% of cases (n=15) preoperatively and 32.65% of cases (n=48) intraoperatively. In the postoperative period, the treatment of anemia was essentially based on oral iron supplementation. Intra operative incidents and accidents were significantly associated with the severity of anemia preoperatively. Parietal suppuration was the main postoperative complication, ie 70.6% ..

ABSTRACT
Introduction: The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) creates a global pandemic and affects more than 200 countries/regions. As of July 30, 2020, the cumulative number of confirmed cases of COVID-19 in the world exceeded 16 million. SARS-CoV-2-infected patients are more likely to be admitted to the hospital and enter the intensive care unit, with high mortality. The most common symptoms of COVID-19 patients are fever and cough. Objective: To assess the magnesium sulfate extended infusion as an adjunctive treatment for covid-19 infected for anaesthesia. Materials and Methods: The prospective study was undertaken Department of Anesthesiology, Medical College for women and Hospital, Uttara, Dhaka, Bangladesh from July to December 2021. Of the 157 anesthesiologists who responded to this survey, 57 (36.0%) reported using magnesium sulfate in anesthesia. All patients received standard therapy for asthma, while the treatment group received an intravenous magnesium sulfate bolus of 50-75 mg/kg (0.2-0.3 mmol/kg) followed by 40 mg/kg/h (0.16 mmol/kg/h) for 4 h. Patients were monitored for cardiorespiratory complications. The treatment group underwent four blood draws to assess pharmacokinetic parameters. Results: Of the 157 anesthesiologists who responded to this survey, 57 (36.0%) reported using magnesium sulfate in anesthesia. The highest participants 50 years above 48(30.5%), 31-40 years 28(17.8%) and 0-10 years 04(2.5%). The frequency of use of adjuvant drugs in anesthesia is described. The number and percentage of clinical effects (n/%) for the use of magnesium sulfate in anesthesia were (in descending order, more than one response per participant allowed): postoperative analgesia (41/71.9%), reduction of anesthetic consumption (59/68.4%), prevention and treatment of preeclampsia and seizures in eclampsia (36/63.1%), prevention and treatment of arrhythmias (29/50.8%), reduction of the dose .......