Browsing by Author "Gebeyehu Geresu"

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    Compare the Effectiveness of Prophylactic Intravenous Ketamine 0.5mg/kg and Pethidine 0.5mg/kg for Postoperative Shivering in Patients Undergoing Elective Surgery Under General Anesthesia at Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia, from January 01 to April 30, 2018: A Prospective Observational Cohort study
    (Addis Ababa Universty, 2018-06) Gebeyehu Geresu; Girma Betelhem
    may increase patient’s morbidity. Nowadays, it has become a common phenomenon with the increasing number of surgeries. Various pharmacological and non-pharmacological methods had been employed to control postoperative shivering. Warming the patient and other alternativemethods has been employed over several years, but it was more expensive. Objectives: to compare the effectiveness of intravenous ketamine 0.5mg/kg and pethidine 0.5mg/kg for post-operative shivering after general anesthesia at black lion specialized hospital from January 1 to April 30, 2018. Methods and materials: an observational cohort study was conducted at black lion specialized hospital from January 1 to April 30, 2018. The study involved 76 ASA I and II patients aged 18-65 years, undergoing elective surgery under general anesthesia. The patients in the two groups took either ketamine 0.5mg/kg and pethidine 0.5 mg/kg 20 minutes before completion of the surgery. The incidence and severity of post-operative shivering were compared between the two groups every 10 minutes until one hour postoperatively. Categorical data were analyzed with the Chi-Square test and fisher exact test. Parametric data between groups were analyzed using independent samples t-test and non-parametric data were analyzed with Mann-Whitney U test. Ap value of <0.05 was considered as a statistically significant. Results: The incidence of shivering between the ketamine and pethidine groups in PACU were(28.2%) and (35.9%) respectively (p=0.467). Grades of shivering were not significantly different between the two groups (p=0.893). Comparison of HR and MAP at different time intervals intraoperatively was found to be comparable between the groups (p>0.05). The scores of axillary temperature at different time intervals during intraoperative and postoperative period have shown comparable values. Conclusion and Recommendation: This study showed that prophylactic low dose IV ketamine reduced postoperative shivering as effectively as pethidine. The study also showed a clinically better outcome in favor of ketamine. We recommend prophylactic low dose IV ketamine 20 minutes before completion of surgery to prevent postoperative shivering.
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    Incidence and Associated Factors of Postoperative Pulmonary Complications in Patients Underwent Abdominal Surgery in Multiple Public Hospitals, Addis Ababa Ethiopia. Cross-Sectional study
    (Addis Abeba University, 2021-09) Eshetu Ashenafi; Aweke Senait ; Gebeyehu Geresu
    Background: Postoperative pulmonary complication is a general term of affecting the respiratory system that can alter the clinical course of patients. Its incidence in the world is wide (5-60%) and it leads to morbidity, mortality, and long hospital stay. Managing patients who develop postoperative pulmonary complications requires an understanding of respiratory physiology occurring after surgery and anesthesia as well as a knowledge of factors associated with the development of postoperative pulmonary complications. Objectives: To assess the incidence and associated factors of postoperative pulmonary complications among adult surgical patients who underwent abdominal surgery in multiple public hospitals, Addis Ababa, Ethiopia . Methods: Institutional based cross-sectional study design was conducted at Minilik II, Tikur Anbessa, Zewuditu and Yekatit Hospital and selected purposely. A systematic random sampling method was employed. Data collection included Socio-demographic and Perioperative factors employed by using short interview, chart review and medical record. The data was entered and analyzed using SPSS version 26 and logistic regression also employed. A p-value of <0.05 was considered as a cutoff point to test for statistical significance. Result: Among 287 patients who underwent abdominal surgery, 33 % developed postoperative pulmonary complications. Pneumonia (50%) was the most common complications followed by atelectasis (24%). Age ≥64 years (AOR=12.091, 95% CI=3.310-44.169), duration of surgery >3hours (AOR=11.737, 95% CI=3.621-38.039), preoperative oxygen saturation <94% AOR=10.671,95%CI=3.794-30.016), postoperative serum albumin level <3.5 g/dl (p-value<0.001) were significantly associated with postoperative pulmonary complications. Conclusion: The incidence of postoperative pulmonary complications was high (33%).Pneumonia (50%) was the most common. Age ≥65 years, duration of surgery >3 hours, SpO2%< 94%, and serum albumin level <3.5g/dl were strongly associated with postoperative pulmonary complications. Therefore health professionals should be care given for elderly patients, minimize operative time < 3 hours, treat the underlying cause of low SpO2% and correct serum albumin and should be known all possible factors and develop a strategy for the resource-limited area.
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    Magnitude of Patient Satisfaction with Postoperative Pain Management and Associated Factors among Postsurgical Patients at Tikur Anbessa Specialized Hospital, from Feb1-Apr 30, 2021.
    (Addis Abeba University, 2021-06) Buli Bekele; Gebeyehu Geresu ; Abrar Meron
    Background: Assessment of patient satisfaction with postoperative pain management is vital tools for measuring the quality of care in health center. There is a paucity of data regarding to this topic, as it does not previously been studied yet in study area. Objective: This study aimed to assessing magnitude of patient satisfaction with postoperative pain management and its associated factors among elective surgical patients postoperatively at Tikur Anbessa Specialized Hospital, from Feb to Apr, 2021. Method: Institutional based cross-sectional study was conducted among 335 adult patients using systematic random sampling technique. Data were collected through structured questionnaires based on the modified APS-POQ to obtain responses from the patients. Both bi-variable and multivariable logistic regression analysis was done to evaluate the association. P-value less than0.05 considered as statistically significant. Result: The find of this study revealed that 74.5% of patients were satisfied with overall pain management services. Patients with ASA I (AOR = 2.3; 95%CI: (1.06-5.08), received multimodal analgesics (AOR 4.30; 95% CI: (2.02- 9.18), no perceived pain (AOR =6.7; 95% CI: (1.54-29.7), had pain discussion (AOR = 8.9;95% CI: (3.67-21.90) and waiting for analgesia service less than 30 minute (AOR =6.3;95% CI: (1.34-29.58) were more satisfied with their pain management. Conclusion: The study shows that patient satisfaction with postoperative pain management was low in our setup as compared with many studies. Thus, there is need to improve perceived quality of postoperative pain management services at study area.
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    Preemptive Diclofenac for Post Operative Analgesia Patients with Major Gynecologic Abdominal Surgery Under General Anesthesia in Adama Hospital,Ethiopia,2020
    (Addis Abeba University, 2020-12) Mebratu Yohannes; Gebeyehu Geresu; Shiferaw Selamawit
    Introduction Preemptive analgesia has become one of the most promising strategies of pain management. A significant proportion of patients suffer moderate to severe intensity of pain after surgery. If not managed timely this can lead to prolonged hospital stay, return to the hospital after discharge, reduction of the quality of life of the patients, development of chronic pain and organ system complications. Objective: The aim of this study was to assess the effectiveness of preemptive diclofenac(75mg, IM) for postoperative pain management in patients that undergone gynecologic abdominal surgery in Adama hospital. Methods: This prospective cohort study recruits 90 ASA I and II, age>18 patients. Study participants were selected by systematic random sampling technique. Study participants were grouped as group D (who received preemptive diclofenac) and group N (who doesn’t receive preemptive diclofenac). The outcome variables of the study were pain intensity, total analgesia consumption, first analgesia request time and incidence of nausea and vomiting within 24 hrs. Postoperatively. Two samples ƶ-test and Mann Whitney U test was used for analyzing numeric data. Categorical variable between two groups were analyzed using chi-square test. p -value<0.05 is considered statistically significant. Results: Median pain score in the first 24 hrs. post operatively in group D and group Nrespectively was:- 2ndhr:3(2-4) vs 3(2-4) and 24 hr:1(0-2) vs 2(1-3), 4thth hr:2(1-3) vs 3(2-4),8th hr:2(1-3) vs 4(3-5),12 hr:3(2-4) vs 3(2-4) with a p value of 0.007,0.004, 0.001,0.261 and0.796 respectively. Mean first analgesia request time in group D and group N respectively was186.60±35.19 and 174.45±24.88 with a p value of 0.087. Post-operative 24 hr. mean total analgesic consumption in group D and group N respectively was: - diclofenac consumption:146.25±50.81 vs 187.50±50.95 and Tramadol consumption: 153.75±44.41 vs 177.50±50.57 witha p value of 0.0006 and 0.035 respectively. Conclusion and Recommendation: Preemptive intramuscular administration of diclofenacsignificantly decreases postoperative pain score and analgesic consumption in patients with gynecologic abdominal surgery. Based on this we recommend intramuscular administration of 75mg of diclofenac 30 min to 1 hr. before surgery. th
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    The Effect of Lateral Versus Sitting Position During Spinal Anesthesia on Postdural Puncture Headache and Hemodynamic Status among Orthopedic Patients in Black Lion Specialized, Addis Ababa, Ethiopia, 2023/24.
    (Addis Ababa University, 2024-06) Borana Mulatu Milkias; Gebeyehu Geresu ; Kassa Adugna
    Background: Although spinal anesthesia is simple and creates a safe environment for surgeries below umbilicus, it has many associated side effects that affect the quality of health system on patients’ satisfaction. A postdural puncture headache is a common complication of spinal anesthesia. Although orthopedic patients are among patients that take spinal anesthesia repeatedly, studies that explain the association of postdural puncture headache with position during administration of spinal anesthesia are limited. Objectives: The objective of this study was to assess the effect of lateral vs. sitting position during administration of spinal anesthesia on postdural puncture headache and hemodynamic status among elective orthopedic patients. Method: A prospective cohort study was conducted at Tikur Anbessa Specialized hospital, on department of orthopedics and traumatology from January 1 to April 30, 2024. A total of 84 patients aged 20 to 66 with ASA class of I and II were selected by systematic random samplingtechnique. The demographic data, intraoperative hemodynamics and other results were collected and described in tables and figures. An independent samples t-test was used to analyze hemodynamic status and a chi-square test was used to compare postdural puncture headache. A statistical significance was determined when p value <0.05. Result: The result of this study shows that incidence of postdural puncture headache among elective orthopedic patients was 15.5% with 23% postdural puncture headache is from sitting position and 7.3% from lateral position which is statistically significant with p value of .035.Hypotension was significantly high in patients who have taken spinal anesthesia in lateral position. Conclusion and Recommendation: Our study demonstrated that the incidence of PDPH is low when spinal anesthesia is administered in lateral position and also administration of spinal anesthesia in lateral position decreased MAP which was a statistically significant. We recommend anesthesia providers to make administering spinal anesthesia in lateral position to patients with stable baseline blood pressure, part of routine activity in order to decrease an incidence of a debilitating complication of SA called PDPH on this group of surgical patients.