Browsing by Author "Kadir, D.M"

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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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    Maximum surgical blood ordering schedule for common orthopedic surgical procedures in a tertiary hospital in north central Nigeria
    (Polish Society of Orthopaedics and Traumatology, 2018) Adegboye, M.B; Kadir, D.M
    Background: Blood transfusion is an important part of management of patients undergoing orthopedic surgeries. However frequently perioperative anticipated blood requirements overshoot the actual need resulting in unnecessary cross matching of blood. Therefore, it is important to formulate a maximum surgical blood ordering schedule (MSBOS) for common orthopedic surgeries. Objective: To evaluate our blood utilization in various orthopedic surgeries and to develop a blood ordering schedule for various orthopedic surgeries. Methodology: A 12-month (January-December 2016) retrospective study was carried out on patients undergoing orthopedic procedures. Data collected included number of patients transfused, number of units cross-matched and number of units transfused. The cross matched to transfusion ratio (CTR), transfusion probability and transfusion index were calculated and from the calculated values a MSBOS was proposed. Results: A total of 224 units of blood were cross matched for 105 patients out of which only 97 units of blood was transfused to 55 patients. Nine out of 15 surgical procedures had CTR higher than 2, 4 had a low TI <0.5 and 12 had a blood utilization of <50%. Fracture of the forearm, total knee replacement (unilateral), tibiofibular and ankle fractures all had blood utilization of <30% and thus Type & Screen policy was recommended for these procedures. Conclusion: The overall CTR was high with low percentage blood utilization and resultant significant blood wastage. To prevent unnecessary blood wastage, we suggest the implementation of the recommended MSBOS schedule