Browsing by Author "Suleiman, Z.A"

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    Comparative study of Haemodynamic Effects of Intravenous Ketamine-Fentanyl and Propofol-Fentanyl for Laryngeal Mask Airway Insertions in children undergoing Herniotomy under General Anaesthesia in a Nigerian Tertiary Hospital
    (National Postgraduate Medical College of Nigeria., 2022) Okeyemi, A; Suleiman, Z.A; Oyedepo, O.O; Bolaji, B.O.; Adegboye, M.B; Ige, O.A.
    Background: Insertion of laryngeal mask airway (LMA) with propofol in children may cause hypotension, laryngospasm and apnoea. Ketamine and fentanyl have been combined separately with propofol to prevent depression of cardiovascular system during LMA insertion, especially in paediatric patients. Ketamine-fentanyl and propofol-fentanyl combinations have analgesic effect, prevent coughing and apnoea and regarded as agents of choice for LMA insertions. However, the cardiovascular effects of the two admixtures for LMA insertions have not been fully assessed in children. We compared the haemodynamic effects of ketamine-fentanyl and propofol-fentanyl combinations for LMA insertion in paediatric patients who underwent herniotomy in our facility. Patients and Methods: This comparative study was conducted on 80 children aged 1–15 years, ASA physical Statuses I and II, who had herniotomy under general anaesthesia. The patients were randomised into two groups (A and B) of 40 patients each and LMA was inserted following administrations of the two different drug combinations. Patients in Group A received pre-mixed ketamine 2 mg/kg and fentanyl 2 μg/kg while the patients in Group B received pre-mixed propofol 2.5 mg/ kg and fentanyl 2 μg/kg. The blood pressure and incidence of apnoea were determined in the two groups during and after the LMA insertion. Results: The haemodynamic states of the patients were not comparable statistically as the heart rate, systolic, diastolic and mean arterial blood pressure were significantly higher and stable in the ketamine-fentanyl group than the propofol-fentanyl group (P < 0.05). The incidence of apnoea was significantly lower in the ketamine-fentanyl group compared with propofol-fentanyl group (P = 0.045), but post-anaesthesia discharge scores were similar, with no significant difference in both groups (P = 0.241). Conclusion: The use of ketamine-fentanyl combination for LMA insertion in paediatric patients was associated with better haemodynamic changes and lower incidence of apnoea when compared with propofol-fentanyl combination.
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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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    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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    Knowledge and Attitudes of Pregnant women towards Anaesthetic Techniques for Caesarean Delivery in a North Central Teaching Hospital
    (Published by College of Health Sciences, University of Ilorin., 2016) Adegboye, Majeed B; Suleiman, Z.A; Adeniran, A.S
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    KNOWLEDGE AND ATTITUDES OF PREGNANT WOMEN TOWARDS ANAESTHETIC TECHNIQUES FOR CAESAREAN DELIVERY INA NORTH CENTRAL TEACHING HOSPITAL
    (College of Health Sciences, University of Ilorin, 2016-10) Adegboye, M.B; Suleiman, Z.A; Adeniran, Abiodun
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    Knowledge, awareness and practice of infection control by health care workers in the intensive care units of a tertiary hospital in Nigeria.
    (College of Health Sciences, Makerere University, Uganda, 2018) Adegboye, M.B; Suleiman, Z.A; Ahmed, B.A; Olufemi, G.H.
    Background: Hospital-acquired infections (HAIs), one of the leading causes of, morbidity and mortality, are common in developing countries. Methicillin-resistant staphylococcus aureus (MRSA), commonest cause of HAIs, has been isolated from the hands of more than half of health care workers. Practice of hand hygiene may help in the control of nosocomial infections. We evaluated the practice of infection control among health care workers in the intensive care unit (ICU) of our hospital. Materials and methods: This is a descriptive cross-sectional study. Information on knowledge, awareness and practice of infection control in the ICU were obtained from health care workers with the aid of a structured questionnaire. Results: Sixty nine out of the 80 (86%) respondents had good knowledge that a hand is the most common vehicle of transmission of infection. However, 53.8% and 32.5% of the respondents had knowledge of movement of hand hygiene and practiced six steps of the hand washing technique respectively. Though, physicians accounted for 68 (85%) of the respondents, only 28% of them practiced the six steps of the hand washing technique with resident doctors constituting a large proportion of hand washing technique defaulters. Only 13.9% of non-physician and 7.5% of physician respondents had ever attended a training program on infection control respectively Conclusion: Knowledge and awareness of infection control among the health care workers in our ICU is good but the practice is poor. Training workshop on infection control should be organized for all ICU health care workers to reduce noso-comial infections
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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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    Survey of Current Practice of Labour Analgesia among Obstetricians in Nigeria: Implications for pain-free Labour Initiative
    (by College of Medicine and Allied Health Sciences, University of Sierra Leone., 2016-12) Raji, H.O; Suleiman, Z.A; Ijaiya, M; Abdul, I.F; Saka, M.J; Adebara, I; Adegboye, M.B
    Labour pain has been described as the worst possible pain known to mankind. It is more excruciating than cancer pain, phantom pain or toothache. Failure to relieve pain of any cause has been regarded as a violation of fundamental human rights. This study aimed to evaluate the current obstetrics analgesia practice among physicians in Nigeria, identify constraints to the practice and recommend solutions to improve the provision of such service to parturients. This descriptive cross-sectional questionnaire-based study on the availability and practice of intra-partum analgesia services was conducted among practitioners at the Departments of Obstetrics and Gynecology of 3 tertiary health institutions located in 3 of the 6 geopolitical zones of Nigeria. Of the 120 questionnaires distributed to the participants, 81 (67.5%) of the respondents returned completed questionnaires. The age range of the respondents was 25-44 years with a mean age of 30.8 and a male to female ratio (M: F) of 1.7: 1. Majority of the respondents, 76 (93.8%) believed that intra-partum analgesia was important, epidural analgesia was the most known method of intra-partum analgesia by 86.4% of the participants and epidural analgesia was the most preferred, 61.7% of respondents. Majority of respondents, 66 (81.5%), did not have an institutional policy or protocol on intra-partum analgesia. Doctors working in the same centre responded differently to the questions in the distributed questionnaires; and this is suggestive of lack of departmental harmonisation of clinical practice in the form of Standard Operating Protocol on intrapartum analgesia. Although there is a high level of knowledge of intrapartum analgesia among physicians, inconsistencies in its practice exist within and between tertiary hospitals in Nigeria. Notable absence of institutional policies on intra-partum analgesia at the practice facilities of the respondents was also observed.