Browsing by Author "Josiah, C"

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    Anaesthesia for orthopaedic surgeries in two tertiary institutions in North-Central Nigeria.
    (Polish Society of Orthopaedics and Traumatology, 2018) Adegboye, M.B; Kadir, D.M; Josiah, C
    Background: Orthopedic surgeries involve upper and lower extremities as well as spine surgeries and are performed under various anesthetic techniques. Therefore it is important to review the choice of anesthesia for the various orthopedic surgeries in order to evaluate their appropriateness. Method: A retrospective review of theatre records of all orthopedic surgeries performed over a 2 year period (1st July 2016-30th June 2018) involving patients of all ages was carried out in two tertiary institutions. Patient’s demographic data, site of surgery, the anesthetic technique used and duration of the surgery were recorded. Data were analyzed and presented as frequency and means using statistical package for social sciences (SPSS software version 23). Result: A total of 334 patients had orthopedic surgery done over the period under review. The mean age was 39 ± 20.9 years. More than sixty percent of the patients were males (60.8%). Most of the procedures were done as elective surgeries (61.7%). The sites of orthopedic surgical procedures done were upper limb 73 (21.9%), lower limb 243 (72.8%), upper and lower limb 4 (1.2%) and spine surgeries 14 (4.2%). Of the upper limb surgeries, 55 (75.3%) were performed under general anesthesia (GA) and 18 (24.7%) under regional anesthesia (RA). While for the lower limb, most of the surgeries were done under RA 196 (81%). The RA technique used was predominantly spinal 133 (54.7%) and GA cases were only 46 (19%). All the 14 spine surgeries were performed under GA. The upper and lower limb surgeries were done either as RA 2 (50%) or as GA+RA 2 (50%). Conclusion: Most of the upper limb surgeries that could be performed under regional anesthesia were done under GA, this has to improve. It is however commendable that a large proportion of lower limb surgeries were performed under various regional anesthetic techniques. There is a need to perform more spine surgeries under different anesthetic techniques
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    Postoperative analgesia after Caesarean delivery under neuraxial anaesthesia in a tertiary institution north central Nigeria: An observational study
    (College of Health Sciences, Osun State University Nigeria, 2025) Adegboye, M.B; Josiah, C
    Objective: A retrospective study to evaluate the postoperative analgesic regimens utilized after Caesarean section (CS) under neuraxial anaesthesia. Currently, a multimodal opioid-sparing analgesic regimen is the gold standard for post-CS pain management and it includes local/regional techniques combined with scheduled nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. Methods: This study was conducted on parturients who underwent CS under neuraxial anaesthesia from October 2012- March 2022 in a tertiary hospital in Ilorin, Nigeria. Data extracted from 308 case folders included the patient's characteristics, comorbidities, type of neuraxial technique, and postoperative analgesic regimen. Data analysis was done using IBM-SPSS 22. Result: The commonest post -operative analgesic combination was IV Acetaminophen+ IV pentazocine+ IM diclofenac 273 (66.2%). None of the patients received a patient-controlled analgesia (PCA), transversus abdominis plane (TAP) block. Conclusion: Majority of the parturients received acetaminophenopioid/ NSAID combination drugs. No parturient received the current opioidsparing multimodal analgesic regimen post-CS. The hospital requires a post-cs pain management protocol.
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    Retrospective analysis of anaesthesia for hypertensive disorders in pregnancy at University of Ilorin Teaching Hospital, Kwara State
    (Faculty of Medicine, Ahmadu Bello University, Zaria, Nigeria, 2019) Adegboye, M.B; Adegboye, K.A; Oyewopo, C.I; Josiah, C; Kolawole, I.K.
    Background: Hypertensive disorders are one of the most common medical complications of pregnancy. It is a major cause of fetomaternal morbidity and mortality. Objectives: This article compares the clinical outcome of anesthetic techniques for parturients with hypertensive disorder undergoing cesarean section. Methods: We conducted a retrospective review of the medical records of patients with hypertensive disorders in pregnancy, who underwent cesarean section from January 2016 to December 2017. Data collected included demographic profiles, specific hypertensive disorders, anesthetic techniques, and maternal and neonatal outcome. Result: Over the reviewed period, 1294 cesarean sections were done, out of which 95 (7.3%) patients had hypertensive disorders in pregnancy. Preeclampsia was the most common hypertensive disorder (45.3%) and it was more common among the multiparus patients. Eight-two patients (86.3%) underwent subarachnoid block with 0.5% heavy bupivacaine, 10 patients (10.5%) had general anesthesia with relaxant technique using isoflurane as the volatile agent, whereas three patients (3.2%) had epidural block with 0.5% plain bupivacaine. Eighty-six patients (90.5%) were done as emergency whereas nine patients (9.5%) were done as elective. A total of 82 (86.3%) neonates had good APGAR score of >7. There was no significant difference between the anesthetic techniques and neonatal outcome, P= 0.642. The proportion of blood loss was more during emergency surgeries. There was no statistical significant difference between the nature of surgery and estimated blood loss, P= 0.691. Out of the 95 parturient, 12 (12.6%) had hypotension that necessitated use of vasopressor (ephedrine), out of which 11 cases were done as emergency whereas one was done as elective. There was no significant difference between the nature of the surgery and the use of vasopressor, P=0.942. Conclusion: The choice of anesthesia did not have a significant difference on maternal and neonatal outcome following cesarean section in parturient with hypertensive disorders in pregnancy