Browsing by Author "Bolaji, B.O"

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    An evaluation of effectiveness of preemptive ketamine for postoperative analgesia in elective thyroidectomy
    (Association of General and Private Medical Practitioners of Nigeria, 2021) Oni, O.J; Bolaji, B.O; Kolawole, I.K; Ige, O.A; Oyedepo, O.O; Adegboye, M.B
    Background: The use of preincision low‑dose ketamine as a preemptive analgesic modality has been widely suggested. However, findings from previous studies have remained inconclusive. Materials and Methods: Eighty-two patients scheduled to have elective thyroidectomy under general anesthesia were recruited. The patients were randomly allocated into one of two groups, to receive either 0.5 mg/kg of ketamine intravenously or an equal volume of normal saline, 10 min before surgical incision. At the end of surgery, pain scores, time to first request for analgesic and total opioid requirement in 24 h postoperatively were recorded. Results: There was no significant difference in the postoperative pain scores, time to first requirement for analgesic, postoperative opioid consumption and satisfaction with analgesia between the two groups. The median pain scores at recovery, 2, 6, 12, and 24 h postoperatively for the ketamine and saline groups were not significantly different (P values 0.208, 0.185, 0.412, 0.590, and 0.854 respectively). The times to first request for analgesic were 86.00 ± 56.58 min in the ketamine group and 79.90 ± 68.05 min in the saline group (P = 0.357). The 24‑h opioid (morphine) consumptions were 11.00 ± 3.16 mg in the ketamine group and 13.21 ± 5.87 mg in the control group (P = 0.275). Conclusion: This study concluded that the administration of preincision low-dose ketamine (0.5 mg/kg) did not produce a preemptive analgesic effect in patients who had an elective thyroidectomy.
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    Effect of Spinal Anaesthesia on QT interval: Comparative study of severe pre eclamptic and normotensive parturients undergoing caesarean section.
    (Medical and Dental Consultants Association of Nigeria., 2022) Adedapo, O.A.; Bolaji, B.O; Adegboye, M.B.; Kolo, P.M.; Suleiman, Z.A., Adedapo, O.O., Jimoh, O.S.,
    Aim: This study aimed to compare the effect of spinal anesthesia on QT interval in severe pre-eclamptic and normotensive parturients who underwent cesarean section in a Nigerian tertiary hospital. Patients and Methods: Twelve-lead electrocardiogram (ECG) was obtained before, and at intervals after spinal anaesthesia on fifty severe pre‑eclamptic (Group A) and fifty normotensive parturients (Group B) who underwent caesarean section. The effect of spinal anaesthesia on QT interval was compared. Results: The preoperative (baseline) mean QT interval was longer in group A than in group B; 453.10 ± 34.11 ms versus 399 ± 18.79 ms, P < 0.001. The prevalence of prolonged QT interval in the severe pre‑eclamptic group before spinal anesthesia was 80% while in the normotensive group it was 0%, P < 0.001. At 5, 30, 60, and 120 min after the establishment of spinal anesthesia, the mean QT interval in the severe pre-eclamptic group was shortened and maintained within normal limits; 414.74 ± 28.05, 418.28 ± 30.95, 411.18 ± 19.21 and 401.36 ± 17.52 ms with P < 0.001 throughout. In the normotensive group, there was no significant change in the mean QT interval. Conclusions: This study demonstrated that the QT interval was more prolonged among the severe pre‑eclamptic parturients. Spinal anesthesia using 0.5% hyperbaric bupivacaine normalized the QT interval and maintained it within normal limits during the study period.
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    Effect of spinal anaesthesia on QT Interval: Comparative study of severe pre-eclamptic and normotensive parturients undergoing caesarean section.
    (Medical and Dental Consultants Association of Nigeria, 2022) Adedapo, A.M; Bolaji, B.O; Adegboye, M.B; Kolo, P.M; Ogunmmodede, J.A; Suleiman, Z.A; Adedapo, O.O; Jimoh, O.S
    Aim: This study aimed to compare the effect of spinal anesthesia on QT interval in severe pre-eclamptic and normotensive parturients who underwent cesarean section in a Nigerian tertiary hospital. Patients and Methods: Twelve-lead electrocardiogram (ECG) was obtained before, and at intervals after spinal anaesthesia on fifty severe pre‑eclamptic (Group A) and fifty normotensive parturients (Group B) who underwent caesarean section. The effect of spinal anaesthesia on QT interval was compared. Results: The preoperative (baseline) mean QT interval was longer in group A than in group B; 453.10 ± 34.11 ms versus 399 ± 18.79 ms, P < 0.001. The prevalence of prolonged QT interval in the severe pre‑eclamptic group before spinal anesthesia was 80% while in the normotensive group it was 0%, P < 0.001. At 5, 30, 60, and 120 min after the establishment of spinal anesthesia, the mean QT interval in the severe pre-eclamptic group was shortened and maintained within normal limits; 414.74 ± 28.05, 418.28 ± 30.95, 411.18 ± 19.21 and 401.36 ± 17.52 ms with P < 0.001 throughout. In the normotensive group, there was no significant change in the mean QT interval. Conclusions: This study demonstrated that the QT interval was more prolonged among the severe pre‑eclamptic parturients. Spinal anesthesia using 0.5% hyperbaric bupivacaine normalized the QT interval and maintained it within normal limits during the study period
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    Endoscopic Endonasal Trans-Sphenoidal Pituitary Surgery (EETSS): Clinico-Radiological Presentation and Outcome in Ilorin: Our Experience
    (Otorhinolaryngology Society of Nigeria., 2021) Afolabi, O.A,; Yusuf, A.S; Adeleke, N.A; Balogun, J.A; Omokanye, H.K; Adeyeye, A.A; Adegboye, M.B; Adegboye, K.A; Shittu, N.O; Odebode, T.O; Bolaji, B.O; Ologe, F.E; Alabi, B.S
    Objective: To share our experience on the clinical presentation and management of patients with pituitary adenoma using Endoscopic Endo-Nasal Trans-Sphenoidal Surgery (EETSS Materials and Method: A retrospective review of all patients with non-functional pituitary macro-adenoma seen in who underwent EETS approach between May 2012 and April 2018. The clinical presentations of the patients were documented. All Patients had pre and postoperative visual assessment and they had radiologic investigation. Endocrine evaluations were done pre and postoperatively. All patients were operated by a combined team of Ear, Nose and Throat (ENT) surgeons and Neurosurgeons using rigid endoscope 18cm (4mm; 0 and 30 degree). Results: A total of 18 patients; 12 females and 6 males, were operated via EETS. All patients had visual impairments at presentation which improved postoperatively in 14 patients. 6 patients were postmenopausal, 5 had amenorrhea with secondary infertility. There were two postoperative deaths in intensive care unit. The Mean hospital stay was 4.9 days. Histological diagnosis of pituitary adenoma in was made in 17 patients and one patient had malignant mucoepithelial tumour. Conclusion: Pituitary tumour constituted about 10.5% of all intracranial tumors in our centre, visual impairment is the commonest presentation and total tumor resection via the EETS is about 78%. The approach showed improve vision in 2/3rd postoperatively, mean hospital stay was about 4.9days with nasal crust formation being the most observed complication and mortality of 11.1%.
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    First successfully separated set of thoracic-omphalopagus twins in Ilorin, Nigeria
    (Faculty of Clinical Sciences, College of Medicine, University of Lagos., 2023) Abdur-Rahman, L.O; Raji, T.K; Lawal, A.O; Nasir, A.A; Adesiyun, O.A; Abdulkadir, M.B; Sayomi, O; Ayinmode, I; Oyinloye, O.; Bolaji, B.O; Adegboye, K.A; Adegboye, M.B.; Adeoye, P.O; Oyedepo, O.O; Olafimihan, B.M; Olatunbosun, L.O; Shittu, A; Arinpe, S.F; Deborah, A; Rufai, Z
    The birth of babies sharing body part(s) and surviving independently is indeed a scientific marvel. Conjoined twinning is a rare phenomenon with various presentations, having an estimated incidence of 1 per 200,000 live births. The successes recorded by experts in developed countries in the separation of conjoined twins in recent times, especially among those with complex unions are indeed fascinating. The management of conjoined twins presents a great challenge to medical and surgical teams in tropical African countries such as ours where we are faced with challenges of limited resources and facilities, even amidst the presence of well‑trained experts. The incidence of conjoined twins is difficult to report in our practice because of failures that accompanied previous cases that were managed and not reported. This is the first successful separation after two previous failed attempts at our center. We report a case of successful surgical separation of thoraco‑omphalopagus conjoined twins who were undiagnosed prenatally and delivered by emergency cesarean section following prolonged labor by a primiparous woman. Babies were joined from the lower chest and the upper abdomen and they shared a single umbilicus and omphalocele sac. No internal viscus was shared apart from the torso wall. They were cared for from 12 h of live until 127 days of live when they were successfully separated by a team of medical and surgical experts. This is a report of a successful separation of conjoined twins at the University of Ilorin Teaching Hospital in North Central Nigeria. Careful interdisciplinary conduct of expert activities will ensure the survival of rare congenital malformations such as conjoined twinning even in underdeveloped climes
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    Goitre –related factors for predicting difficult intubation in patients scheduled for thyroidectomy in a resource challenged health institution in north central Nigeria.
    (Jimma University, Ethiopia, 2018) Bolaji, B.O; Suleiman, Z.A; Adegboye, M.B; Agodrin, O.S; Olatoke, S.A; Habeeb, O.G; Rahaman, G.A
    BACKGROUND: Airway management problems may arise when intubating patients with goitre scheduled for thyroidectomy. Goitres are not uncommon in sub-Saharan Africa, thyroidectomy being the main treatment. The aim of this study was to determine incidences of difficult intubation (DI), failed intubation (FI)and predictors of DI using a modified intubation difficulty score (IDS). METHODS: One hundred and twenty-five consenting patients with goitre scheduled for thyroidectomy were recruited. Goitrerelated factors (GRF) of duration of illness, diagnosis, neck circumference, tracheal deviation and narrowing and retrosternal extension were recorded as well as Mallampati classification and BMI. At intubation, modified IDS was determined for each patient. Patients with modified IDS ≤ 5 were categorized as easy intubation group (E), and those with modified IDS >5 were categorized as difficult intubation group (D). The GRF of all patients in group D were compared with matched patients in group E. RESULTS: Incidence of DI was 13.6% with 2 (1.6%) cases of failed intubation. Comparing groups D and E, duration of illness was 4.28 ± 3.78 years in group D versus 7.44 ± 7.63 years group E, p = 0.1353. Neck circumference was 41.42 ±5.30 cm in group D versus 37.43±2.68 cm in group E, p = 0.0200. Tracheal deviation, narrowing and retrosternal extension, and surgical diagnosis were not significantly different among both groups. CONCLUSION: Incidence of DI was 13.6% and that of FI was 1.6%. Neck circumference was found to be a predictor of difficult intubation in goitre patients scheduled for thyroidectomy using the modified IDS.
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    Post-operative analgesic and opioid-sparing effect of a single dose pre-operative oral pregabalin in gynaecological surgeries
    (West African College of Surgeons, 2022) Adegboye, K.A; Kolawole, I.K; Bolaji, B.O; Suleiman, Z.A; Adegboye, M.B
    Background: Post-operative pain treatment is a major challenge in our environment. Opioids may cause respiratory depression post-operatively. Therefore, any combination of opioid and non-opioid analgesics that provides quality post-operative pain control and reduces opioid consumption with its attendant side effects will be highly desirable. Objectives: The aim of this article is to evaluate analgesic benefits and opioid-sparing effects of pre-operative oral pregabalin in patients who undergo abdominal gynaecological surgeries. Materials and Methods: A prospective randomized double-blind placebo-controlled study is carried out at University of Ilorin Teaching Hospital, Kwara State, Nigeria. Eighty-two patients scheduled for gynaecological surgeries were randomized into two equal groups. The patients in the control and study groups received a placebo drug and oral pregabalin 150 mg, respectively, 1 h before induction of general anaesthesia. Post-operative pain intensity using a five-point Verbal Rating Scale, time to first request for analgesia, and 24 h post-operative pethidine consumptions were assessed. Mean values were compared using Student’s t-test. Categorical data were compared with the χ2 test. Level of significance was set at 5% (0.05) and power of the study was 80%. Results: Demographic characteristics were comparable between the two groups. The median pain score was 0–2 (no pain–moderate pain) throughout the study. Post-operative static and dynamic pain scores at 1, 4, and 12 h were significantly higher in the placebo group (<0.001). Twenty-four hours post-operatively, there were no significant differences in static and dynamic pain scores between the two groups (P=0.131 and P=0.384, respectively). Time to first analgesic requirement and total pethidine consumed within 24 h post-operative were 47 ± 19 vs. 258 ± 137 min (P=0.001) and 326.19 ± 62.70 vs. 192.86 ± 55.84 mg (P=0.001) in the control and study groups, respectively. The pre-operative use of pregabalin reduced post-operative opioid requirement by 40.9% in the study group. Nausea and vomiting were more common in the placebo group, whereas dizziness, blurring of vision, and sedation were more common in the pregabalin group. Conclusion: A single pre-operative dose of 150 mg oral pregabalin had significantly greater analgesic effects compared with placebo and reduced post-operative opioid requirements in patients undergoing myomectomy or total abdominal hysterectomy. It should be considered an adjuvant in multimodal pain management regimens following gynaecological surgeries
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    The correlation between body mass index on the length from skin to lumbar epidural space in Nigerian adults
    (West African College of Surgeons, 2017) Adegboye, M.B; Bolaji, B.O; Ibrahim, G.H
    Background: One of the factors that determine success of an epidural anaesthetic is correctly locating the epidural space. Being able to predict the skin to lumbar epidural space distance can serve as a guide to performing epidural anaesthesia and in turn increase the success rate. Aim: To determine the correlation between the BMI, gender and age on SLESD of adults scheduled for elective surgical procedure under lumbar epidural anaesthesia. Design of Study: It was a cross sectional descriptive study carried out on consenting patients scheduled for elective surgery under lumbar epidural anaesthesia. Setting: The study was carried out in the main theatre complex and the obstetric theatre of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Methodology: One hundred and twenty patients of ASA I and II physical status between the ages of 18-65 years scheduled for elective surgical procedures under epidural anaesthesia were enrolled into the study. This was a cross sectional descriptive study involving both sexes. Using aseptic technique epidural anaesthesia was established in the sitting position using the midline approach at L3/L4orL4/L5 interspace. The epidural space was identified by loss of resistance to air. The SLESD in centimetres (cm) was rounded up to the nearest 0.25cm. Data were collected and analyzed using Spearman´s correlation to evaluate the relationship between BMI, weight, sex, age, height and the SLESD. Results: The mean SLESD was 4.60±0.83 cm with a range of 3cm-8cm. The SLESD was significantly influenced by BMI and weight with both having positive correlation and P value of 0.001 and 0.004 respectively. We formulated a relationship between skin to lumbar epidural space and body mass index based on linear regression analysis: Depth cm=a+b ×(BMI) where a=3.33 and b=0.05. There was no correlation between SLESD and height, age or sex of the patients. Conclusion: There was positive linear correlation between the body mass index, body weight and the skin to lumbar epidural space distance. Whereas, the age, sex and height had no correlation with the skin to lumbar epidural space distance.