Department of Anaesthesia

Permanent URI for this community

https://ir.unilag.edu.ng/handle/123456789/3603

Browse

Browsing Department of Anaesthesia by Author "Olatosi, J. O"

Now showing 1 - 2 of 2
  • Item
    Open Access
    Evaluation of the accuracy of the Masimo Pronto compared to laboratory spectrophotometric method of intraoperative haemoglobin measurement
    (African Journals Online, 2019) Oguntuase, O. O; Adekola, O. O; Dada, O. I. O; Olatosi, J. O; Ogunleye, E. O
    Background: Transfusion decisions intra-operatively are generally guided by accurate blood loss estimation and intermittent invasive haemoglobin measurement. We investigated the accuracy of non- invasive intraoperative haemoglobin measurement using the Masimo Pronto (SpHb) as compared to laboratory spectrophotometry (tHb). Methods and Materials This was a cross sectional study of 110 adult patients undergoing surgery with a potential for blood loss of 500 ml and over under general anaesthesia. Haemoglobin level was determined simultaneously post-induction, pre-transfusion and postoperatively using (SpHb) readings from Masimo Pronto® Pulse CO-Oximeter (Rainbow® SET® Technology Masimo Corporation, Irvine, CA) and haemoglobin analyzer with laboratory spectrophotometry (tHb). Results A total of 244 sample pairs were analysed; 110 post-induction, 24 pre-transfusion and 110 post-operatively. There was a significant difference in mean haemoglobin between SpHb and tHb during the study at all time periods, p<0.0001. The overall mean haemoglobin was SpHb 12.02 ±1.86 g/dl, and tHb10.49 ±1.92 g/dl, p<0.0001, bias (1.5 ±1.76 g/dl), and limits of agreement-1.9 to 5.0 g/dl. There was moderate Pearson correlation (0.57) between SpHb and tHb measurements. The mean pre-transfusion haemoglobin was SpHb 10.25 ±1.96 g/dl, and tHb 8.26 ±1.27 g/dl, p<0.0001, bias, 2.0 ±1.89 g/dl and limits of agreement, -1.7 to 5.7 g/dl. Conclusion It is concluded that SpHb overestimated haemoglobin measurement as compared with tHb. Hence the Masimo Pronto was found to be inaccurate as compared with laboratory spectrophotometry in intraoperative haemoglobin measurement. The bias was too large and limits of agreement too wide between SpHb and tHb to make appropriate transfusion decisions.
  • Item
    Open Access
    Regional anesthesia for small incision cataract surgery: Comparison of subtenon and peribulbar block
    (Woltlers Kluwer, 2018-01) Adekola, O. O; Aribaba, O. T; Musa, K; Olatosi, J. O; Rotimi-Samuel, A; Asiyanbi, G. K; Onakoya, A; Akinsola, F. B
    Background and Objective: The recent trend in cataract surgery is the use of regional ophthalmic nerve blocks or topical anesthesia. We determined and compared the effect of peribulbar and subtenon block on pain and patients’ satisfaction, following small incision cataract surgery (SICS). Methods: This was age‑sex‑matched comparative study involving 462 ASA I‑III patients, aged 18 years and above scheduled for SICS. They were assigned to receive either peribulbar block (Group P) or subtenon (Group ST). The pain score and patients’ satisfaction with the anesthetic experiences were recorded by a study‑masked anesthesiologist during surgery and postoperatively at 30 min and 1, 2, 4, and 24 h. Results: The median numeric rating score was significantly lower in the subtenon group than the peribulbar group: During surgery, Group ST 1 (1) versus group P 1.5 (2.25), P < 0.001. At 30 min after surgery, Group ST 0 (1) versus Group P 1 (2.5) versus P < 0.001, and at 1 h after surgery, Group ST 0 (1) versus group P 1 (2), P = 0.002. Ten patients had akinesia in the peribulbar group compared with one in the subtenon group. Chemosis was significantly higher in the subtenon group 10 (3.2%) than in the peribulbar group 0 (0%), P = 0.035. Similarly, a significant difference was not with subconjuctival hemorrhage; subtenon 14 (4.5%) versus peribulbar 2 (1.3%), P = 0.105. Conclusion: The use of subtenon block resulted in lower pain scores and higher patient’s satisfaction than peribulbar block. However, subconjuctival hemorrhage and chemosis were more common with subtenon block.