Department of Anaesthesia

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

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Browsing Department of Anaesthesia by Subject "Complications"

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  • Item
    Open Access
    How frequent is homologous blood transfusion during pediatric adenoidectomy and tonsillectomy?
    (Woltlers Kluwer, 2016-10) Adekola, O. O; Akanmu, N. O; Bamigboye, B. A; Akinola, M. D; Adedolapo, H. L; Dada, O. I. O; Somefun, A. O
    Background: Blood is routinely grouped and cross matched for elective adenoidectomy and, or, tonsillectomy at our institution. This practice has led to unnecessary delay and cancellation of surgery. Materials and Methods: This was a prospective study conducted in children aged one and half to nine years scheduled for adenoidectomy and, or, tonsillectomy from January, 2012 to April 2013. We investigated the need for routine preoperative grouping and cross matching of blood, and the immediate complications following adenotonsillectomy. Data collected included the number of blood cross matched and transfused, pre- and postoperative haemoglobin, estimated blood loss, duration of delay in commencing surgery due to lack of blood and the immediate complications following adenoidectomy and tonsillectomy. Results: A total of 129 patients were studied, adenotonsillectomy was performed in 88.37%, adenoidectomy in 7.75%, and tonsillectomy in 3.88%. The median estimated blood loss was 100 IQR (60-100 ml), 145 pints of blood were requested in all, one pint in 77.93% and two pints in 22.07%. The Cross-match to Transfusion Ratio, Transfusion Index and Blood ordering quotient were zero (0) respectively. The median duration of delay before surgery commenced on account of lack of blood was 84 IQR (27.5-119.5) mls. Primary haemorrhage was observed in 4 (3.1%), accidental extubation in 13 (10.07%), hypoxia 5 (3.88%) and cardiac arrest in one patient (0.78%). Conclusion: The cross-match to transfusion ratio, transfusion index and blood ordering quotient were zero, which suggest that cross-matched blood is unlikely to be required, and there was low blood usage. Therefore, the routine practice of preoperative grouping and cross matching of blood seems unnecessary adenoidectomy and, or, tonsillectomy. It is recommended that group and save should be encouraged because of shortage of blood in our country.
  • 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.