Anaesthesia and Anaesthesiology

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Browsing Anaesthesia and Anaesthesiology by Author "Abebe Yonathan"

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    Incidence and Associated Factors of Delayed Extubation in Patients Undergoing Infratentorial Craniotomy; A 5-Year Retrospective Analysis in TASH, Addis Ababa, Ethiopia, 2023.
    (Addis Ababa University, 2024-05) Abebe Nebiyat; Abebe Yonathan
    Background: Infratentorial craniotomy, a neurosurgical procedure involving the removal of lesions or tumors located in the posterior fossa of the brain, presents unique challenges and considerations regarding perioperative management. Among these challenges, delayed extubation, defined as the postponement of planned endotracheal tube removal following the surgical procedure, emerges as a critical concern. Understanding the incidence and factors contributing to delayed extubation is crucial for optimizing perioperative care and improving patient outcomes. Objective: The aim of this study was to investigate the incidence of the delayed extubation and to identify the perioperative associated factors in patients undergoing infratentorial craniotomy. Methods: Retrospective data from patients who underwent infratentorial craniotomy at Tikur Anbessa Specialized Hospital between May 2018 and June 2023 between were analyzed. Patient demographics, clinical variables, and intraoperative factors were collected from medical records.The variables were compared between the delayed extubation and early extubation groups. Results: A total of 112 patients met the inclusion criteria. The incidence of delayed extubation was 83.9%. After multivariate forward logistic regression Independent factors related to delayed extubation were Volume of crystalloid (OR [0.998], 95% CI [0.998 - 0.999], p-value < [0.001]) and duration of surgery (OR [0.091], 95% CI [0.030 - 0.281], p-value < [0.001]) Conclusions;The incidence of delayed extubation after infratentorial craniotomy in adults was 83.9%. Volume of crystalloid and duration of surgery are found as an independent risk factors.
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    Incidence and Severity of Intraoperative, Postoperative Shoulder Tip Pain and Associated Factors in Mothers who Undergo Cesarean Section under Spinal Anesthesia in Tikur anbesa Specialized Hospital in year 2023 – 2024GC.
    (Addis Ababa University, 2024-05) Tamene Fitsum; Abebe Yonathan; Shamil Amria
    Background: Shoulder tip pain is a common complaint among women during and after cesarean section delivery. In certain cases, it can be severe, debilitating and lasts for several days. It can cause severe movement restrictions in the upper limb region. STP also seems to be associated with increased hospitalization time and costs; it negatively affects the patient’sphysical and mental health. Pain makes breastfeeding and caring for newborns even more difficult. There is nothing studied about STP incidence, severity and associated factors in Africa and Ethiopia found published or documented, the aim of this study is to generate data, to create awareness to address adequate pain management and to wipe the way for further studies. Objectives: To determine the incidence and severity of intraoperative, postoperative shoulder tip pain and associated factors during and after cesarean delivery. Method and materials: institutional based, Prospective, Cross-sectional study was conducted.The single population proportion formula was used to calculate the sample size. A total of 165 study participants were involved. Sequential non-random sampling was used to select study participants. The data was collected by the standard questioner during the intra op period and within 24hr post op period. The collected data were entered, cleaned, and analyzed by SPSS version 27.0 statistical software. Descriptive results were presented by tables and figures. Bi-variate analysis was employed to select independent variables and multivariate regression used to measure the association between independent and dependent variate. On bi-variate analysis,those variables with a value less than 0.25 were entered on multi-variate analysis. Finally,variables with a p-value < 0.05 were declared as independent predictor of the outcome variables.The model fitness test was checked by Hosmer and Lemeshow's goodness-of-fit test. Result: Out 165 participants 44.2% experienced shoulder Tip pain either intraoperative or post operative, 14.5% experienced intraoperative and 38.8% experienced post operative Shoulder tippain. Right side STP found dominant and moderate to sever type of pain scale found. Bleeding is found to be as sole associated factor with a p value of < 0.01 with adjusted odd ratio and 95%CI of 4.427(2.162-9.064). Conclusion: STP is a less noticed and understood problem with high incidence rate, requires attention and interventions. Further RCT and Multidisciplinary studies recommended.
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    Incidence of Adverse Effects and Associated Factors After Intrathecal Administration of Morphine in Elective Surgeries in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2024,GC.
    (Addis Ababa University, 2024-05) Niftalem Firaol; Abebe Yonathan ; Shamil Amria
    Background:One of the most efficient analgesic techniques in various surgical operations is the intraspinal injection of opioids (1,2). Intrathecal morphine can enhance and prolong intraoperative and postoperative analgesia when used alone or in conjunction with a local anesthetic. However, awide range of clinically significant adverse effects have been documented. This covers symptoms including nausea, vomiting, pruritus, urine retention, or respiratory depression(1,3). Objectives:Determining the incidence of adverse effects and associated factors after intrathecal administration of morphine in elective surgeries. Methods:A cross-sectional analytic study was conducted on patients who underwent elective surgery with spinal anesthesia combined with morphine at Tikur Anbessa Specialized Hospital. The data was collected within 24 hours after the administration of intrathecal morphine. The study used the binary and logistic regression models to assess the association between morphine-related adverse effects and potential independent factors. Result:Among 273 study participants who received spinal anesthesia combined with intrathecal morphine, 78(28.6%) and 42(15%) had nausea and vomiting respectively. And 63(23.1%) of the participants reported having pruritus, 11(4%) reported urinary retention and respiratory depression was reported as shortness of breath 10(3.7%) and cyanosis/respiratory rate less than 10 (2.7%) in the study. Conclusion and Recomendation:A study was conducted to determine the adverse effects of intrathecal morphine and associated factors in elective patients. The findings revealed that a considerable proportion of participants experienced nausea, vomiting, pruritus, urinary retention, and respiratory depression. Vigilant monitoring and tailored interventions are needed to mitigate the risk of adverse effects. Further research is warranted to optimize patient outcomes.
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    Readmission of Patients to Surgical Intensive Care Unit, Incidence, Associated Factors and Outcome at Tikur Ambessa Specialized Hospital From September 2023 to February 2024
    (Addis Ababa University, 2024-05) Aman Osman; Abebe Yonathan ; Shamil Amria
    Background:Globally, the survival of critically sick patients has improved significantly as a result of theremarkable strides made in critical care treatment. However, the lack of and high cost of intensive care facilities is a major concern, particularly in developing nations. ICU readmission occurs when a patient deteriorates during the same hospitalization and needs to return to the ICU for treatment. Although studies mostly done in developed countries show the association of ICU readmission with poor prognosis and increased cost, the knowledge of ICU readmission epidemiology, causes and outcome is uncertain in our country. Objective: To determine the incidence, associated factors and outcomes of readmission to surgical ICU at TASH from September 2023 to February 2024. Methodology; Institutional based prospective cross sectional study was conducted from September 1, 2023 – February 29, 2024. Data collected from patient chart will be filled into prepared checklist. Data was checked for completeness and then imported to SPSS version 27 software for analysis. Descriptive analysis was done for continuous variables. Bivariate logistic regression was done for each predictor variable and outcome variable. Multiple logistic regressions were done and a statistical significance p value less than 0.05 were taken as a determinant factor. Results:A total of 155 patients that were transferred from ICU to ward were included in ourstudy,among this 12(6.5%) required readmission. The mechanical ventilator need on admission (AOR=7.057(CI 1.668-29.850) and oxygen requirement during transfer to ward ( AOR =4.1(CI 1.004-17.093) were main factors associated with readmission. Only 41.7% of readmitted patients wererecovered while 58.3% died. Conclusion:In this study of surgical ICU patients, mechanical ventilation requirement on ICU admission and oxygen requirement during transfer to ward was found to be a major risk for readmission. The readmitted patient had poor outcome with a mortality of 58.3%. Further study is required to identify interventions that may improve outcome.