Browsing by Author "Oyedepo, Olanrewaju Olubukola"

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    Anaesthesia management for thyroidectomy in a non-euthyroid patient following cardiac failure.
    (Medical and Dental Consultants Association of Nigeria, 2011) Bolaji, Benjamin olusomi; Oyedepo, Olanrewaju Olubukola; Rahman, Ganiyu Adebisi
    We present a 24-year old thyrotoxic student of a tertiary institution who had thyroidectomy in the presence of a persistently elevated thyroxine (T4) and tri-iodothyronine (T3) levels. The patient who did not initially notice that he had an anterior neck swelling was being managed as a case of hypertension at a private hospital. However, his mother’s insistence that he should seek expert management revealed that he had experienced excessive sweating, undue heat intolerance of 3 years duration and easy fatigability of a month’s duration at the time of presentation at our hospital. He had bilateral anterior neck masses on examination. He was subsequently diagnosed as a case of toxic goiter with biochemical evidence of elevated T3 and T4 levels. The patient was commenced on anti-thyroid drugs but he developed cardiac failure after 6 months on medical treatment and was commenced on anti-failure regime. Surgery was postponed several times due to persistently elevated thyroid hormones. A decision to perform thyroidectomy was taken after the patient’s cardiovascular status was optimized in order to prevent further deterioration of his cardiac function. Serial repeat thyroid hormone profiles showed elevated T3 and T4 levels. The patient eventually had subtotal thyroidectomy uneventfully after 9 months of presentation under general anaesthesia. Contingency plans for managing thyroid storm in the perioperative period were ensured. The anaesthetic management is presented and discussed.
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    Comparative evaluation of 0.5% ropivacaine and 0.5% bupivacaine for day case inguinal herniorrhaphy in a Nigerian tertiary hospital.
    (Journal of the Societies of Anaesthetists of West and East Africa., 2010) Bolaji, Benjamin olusomi; Yusuf, IF; Rahman, Ganiyu Alege; Kuranga, Sulyman Alege; Oyedepo, Olanrewaju Olubukola
    BACKGROUND: Day case inguinal herniorrhaphy is a common surgical procedure performed in our environment with lidocaine used for field block. The study was aimed at comparing 0.5% ropivacaine and 0.5% bupivacaine for the field block, determine their effectiveness and safety in our environment. METHODS: In a double-blind randomized study, 52 ASA physical status I-II patients (age ≥ 18yrs) scheduled for field block for day case inguinal herniorrhaphy were assigned to two study groups to receive 0.5% ropivacaine 25ml (n = 26) or 0.5% bupivacaine 25ml (n = 26). Onset of analgesia, adequacy of block, duration of postoperative pain relief and pain score at first requirement of analgesic were recorded. RESULTS: One patient in the bupivacaine group did not complete the study. Patient demographics and surgical times were similar in the two groups. Mean onset time of anaesthesia was shorter in the bupivacaine group than the ropivacaine group (5.37± 0.50 min vs 5.48 ± 0.45 min) although this was not significant (P = 0.44). Adequacy of block was similar in the two groups (P = 0.55). Postoperative pain relief was significantly longer for the ropivacaine group 6.83 ± 0.57hr than for the bupivacaine group 6.32 ± 0.35 hr (P = 0.0004, unpaired t-test). Mean pain score at the first requirement for analgesic was lower in the ropivacaine group 1.38 ± 0.49 than the bupivacaine group (1.56 ± 0.51), but this was not significant (P = 0.22). Few untoward effects of nausea and dizziness were observed in this study. CONCLUSION: Ropivacaine and bupivacaine have comparable onset of actions and adequacy of anaesthesia when used for day case inguinal herniorrhaphy and are safe.
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    Critically ill obstetric admissions into a tertiary hospital’s intensive care unit.
    (Medical Research Society and College of Medicine and Health Sciences, Abia State University, 2015) Fawole, AA; Bolaji, Benjamin Olusomi; Oyedepo, Olanrewaju Olubukola; Adeniran, AS
    BACKGROUND: Intensive Care Unit (ICU) management is a critical care and may be life saving in critically ill obstetric patients, but mortality remains high in low-resource countries. OBJECTIVE: To review obstetric admissions into a tertiary hospital ICU. DESIGN: Retrospective descriptive study. SETTING: The ICU of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. SUBJECTS: Women admitted to the ICU during pregnancy or within 42 days of the end of the pregnancy. MATERIALS AND METHODS: A list of all eligible participants was compiled, the case files were retrieved and relevant data extracted; the results were presented in tables and percentages. RESULTS: Obstetric patients constituted 12.3% of the total ICU admissions and 0.84% of all deliveries with 45.6% mortality; the mean age was 29.2 ± 5.4 years (range 18 – 42 years), mean parity was 2.0 ± 1.5 (range 0-6), 15 (28.8%) had no formal education, 39 (75.0%) were of low social class, 22 (42.3%) had no antenatal care, 41 (78.9%) were admitted for obstetric reason, and post partum haemorrhage was the most common indication for admission (19[36.5%]). In all 44 (84.6%) were admitted post partum, 45 (86.5%) had organ dysfunction at ICU admission, 36 (69.2%) had mechanical ventilation while most common drugs administered were antibiotics. CONCLUSION: Obstetric patients are important intensive care users, but maternal mortality remains high among them in low-resource countries despite the care received.