Background: Difficulty in management of the airway occurs most frequently in patients who have Mallampati grade III and IV, and other unfavourable airway findings like short neck, restriction in range of motion of the...Background: Difficulty in management of the airway occurs most frequently in patients who have Mallampati grade III and IV, and other unfavourable airway findings like short neck, restriction in range of motion of the temporoman-dibular joints and inadequate neck flexion and extension. Because of unavailability of fibreoptic bronchoscopes or inexperience in their use, laryngeal mask airway (LMA) has become a common and acceptable airway management option. This is a case report of a postmenopausal woman who had her airway managed with LMA following initial failed intubation necessitating a rescheduling of the operation. Result: The patient had a successful surgery and postoperative recovery was uneventful. Conclusion: The LMA is a useful option in the management of an anticipated or unexpected difficult airway, especially in resource-poor settings where fibreoptic bronchoscopes may not be readily available.展开更多
Background: Bearing in mind the recent advances in obstetric anesthesia, the safety of both mother and child is of paramount importance, especially in a setting where resources are limited. We set out to find the patt...Background: Bearing in mind the recent advances in obstetric anesthesia, the safety of both mother and child is of paramount importance, especially in a setting where resources are limited. We set out to find the pattern of cases presenting for cesarean delivery and the types of anesthesias provided for the management of these patients. Methods: A retrospective survey was conducted involving all anesthetics provided for cesarean delivery from January 2006 to December 2009 in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Information such as age, indications and anesthetic technique, including drugs used, were extracted from patients’ records. Data were subjected to statistical analysis using Statistical Package for Social Sciences (SPSS) version 17.0. Results: There were a total of 577 anaesthetics conducted for cesarean delivery during the period under review out of 4277 live births, giving a cesarean delivery rate of 13.5%. General anesthesia (GA) was administered on 266 (46%) of these patients, while 279 (48%) cases were done under subarachnoid block(SAB). 16 (3%) patients had combined GA and SAB, while 16 (3%) patients received epidural anesthesia. There were 302 emergency cesarean deliveries out of 577 cases, giving an emergency cesarean delivery rate of 52%. The commonest indication for cesarean delivery was two previous cesarean deliveries. Conclusion: A large percentage of our obstetric cases are being done under general anesthesia. Though majority of the conducted regional anesthesia were spinals (SAB), only a few cases were done under epidural block. Subspecialty training of anesthetists will go a long way to improve the current trends.展开更多
Background: Maternal and foetal mortality is unacceptably high in most resource-limited countries?and the practice of obstetric anaesthesia has an important influence on outcome for both mother and baby. The much need...Background: Maternal and foetal mortality is unacceptably high in most resource-limited countries?and the practice of obstetric anaesthesia has an important influence on outcome for both mother and baby. The much needed close co-operation and collaboration between obstetricians and obstetric anaesthetist providers is crucial for the safety and comfort of parturients, particularly in low-resource environments. The current global maternal mortality is approximately 400 per 100,000 deliveries, with a range of 7 - 740 deaths per 100,000, demonstrating the inequality between the rich and poor countries. Many of the deaths could have been prevented by better essential obstetrics services including safe anaesthesia and surgery, provided such services are made available in?a timely manner. Conclusion: Maternal mortality in low resource countries has its basis complex?social, economic and political factors, underpinned by a lack of resources. Many of these factors are difficult and slow to resolve and are not specific to maternal health. Comprehensive essential?obstetric care services at the district hospital level (first referral level) should include all the above?plus safe surgery, safe anaesthesia, and blood transfusion. Government, donor agencies and all stakeholders must recognize the crucial role of anaesthesia in providing emergency obstetric care in hospitals. Advocacy by all concerned will help direct the scarce resources to the appropriate areas of need which includes provision of adequate facilities and manpower for safe anaesthesia.展开更多
文摘Background: Difficulty in management of the airway occurs most frequently in patients who have Mallampati grade III and IV, and other unfavourable airway findings like short neck, restriction in range of motion of the temporoman-dibular joints and inadequate neck flexion and extension. Because of unavailability of fibreoptic bronchoscopes or inexperience in their use, laryngeal mask airway (LMA) has become a common and acceptable airway management option. This is a case report of a postmenopausal woman who had her airway managed with LMA following initial failed intubation necessitating a rescheduling of the operation. Result: The patient had a successful surgery and postoperative recovery was uneventful. Conclusion: The LMA is a useful option in the management of an anticipated or unexpected difficult airway, especially in resource-poor settings where fibreoptic bronchoscopes may not be readily available.
文摘Background: Bearing in mind the recent advances in obstetric anesthesia, the safety of both mother and child is of paramount importance, especially in a setting where resources are limited. We set out to find the pattern of cases presenting for cesarean delivery and the types of anesthesias provided for the management of these patients. Methods: A retrospective survey was conducted involving all anesthetics provided for cesarean delivery from January 2006 to December 2009 in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Information such as age, indications and anesthetic technique, including drugs used, were extracted from patients’ records. Data were subjected to statistical analysis using Statistical Package for Social Sciences (SPSS) version 17.0. Results: There were a total of 577 anaesthetics conducted for cesarean delivery during the period under review out of 4277 live births, giving a cesarean delivery rate of 13.5%. General anesthesia (GA) was administered on 266 (46%) of these patients, while 279 (48%) cases were done under subarachnoid block(SAB). 16 (3%) patients had combined GA and SAB, while 16 (3%) patients received epidural anesthesia. There were 302 emergency cesarean deliveries out of 577 cases, giving an emergency cesarean delivery rate of 52%. The commonest indication for cesarean delivery was two previous cesarean deliveries. Conclusion: A large percentage of our obstetric cases are being done under general anesthesia. Though majority of the conducted regional anesthesia were spinals (SAB), only a few cases were done under epidural block. Subspecialty training of anesthetists will go a long way to improve the current trends.
文摘Background: Maternal and foetal mortality is unacceptably high in most resource-limited countries?and the practice of obstetric anaesthesia has an important influence on outcome for both mother and baby. The much needed close co-operation and collaboration between obstetricians and obstetric anaesthetist providers is crucial for the safety and comfort of parturients, particularly in low-resource environments. The current global maternal mortality is approximately 400 per 100,000 deliveries, with a range of 7 - 740 deaths per 100,000, demonstrating the inequality between the rich and poor countries. Many of the deaths could have been prevented by better essential obstetrics services including safe anaesthesia and surgery, provided such services are made available in?a timely manner. Conclusion: Maternal mortality in low resource countries has its basis complex?social, economic and political factors, underpinned by a lack of resources. Many of these factors are difficult and slow to resolve and are not specific to maternal health. Comprehensive essential?obstetric care services at the district hospital level (first referral level) should include all the above?plus safe surgery, safe anaesthesia, and blood transfusion. Government, donor agencies and all stakeholders must recognize the crucial role of anaesthesia in providing emergency obstetric care in hospitals. Advocacy by all concerned will help direct the scarce resources to the appropriate areas of need which includes provision of adequate facilities and manpower for safe anaesthesia.
