Browsing by Author "Samuel, Hirbo (Bsc, Msc)"

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    A comparative study on effect of tracheal tube cuffsfilled with air versus alkalinized lidocaine on hemodynamic response changes during extubation and postoperative laryngotrachial morbidities in childrens.
    (Addis Abeba University, 2020-06) Assefa, Biniyam; Samuel, Hirbo (Bsc, Msc); Fentie, Fisha(Bsc, Msc)
    INTRODUCTION: When the lateral pressure exerted by an inflated cuff on tracheal mucosa exceeds capillary perfusion pressure, it can result in tracheal morbidity, loss of mucosal cilia, ulceration, hemorrhage, and tracheal stenosis. Patients may complain of cough, sore throat and hoarseness in the postoperative period. Lidocaine within tracheal tube cuffs seems to exert a localized effect on the trachea after diffusing through the cuff, resulting in improved tolerance to tracheal. Both alkalinized and non-alkalinized lidocaine used to fill tracheal tube cuffs reduces the incidence of postoperative sore throat. OBJECTIVE: was to assess the effectiveness of tracheal tube cuffs filled with air verses alkalinized lidocaine on heamodynamic response changes and laryngotracheal tracheal morbidities during and post extubation in children’s. METHODOLOGY: Institutional based observational prospective cohort study design used to address the study objective. All elective children aged 3-13 years who undergoing operation under general anesthesia with endotracheal intubation greater than one hour at TASH were selected. The outcome variable ware Haemodynamic response changes i.e. (HR,SBP and DBP), was measured in the 5 min before, and 5 min following, tracheal extubation and laryngotracheal morbidities like cough, hoarsens and sore throat, evaluated as dichotomous variables (yes or no). RESULTS: Hemodynamic changes that recorded during the study were the highest systolic and diastolic blood pressure and the heart rate. The results shows the heat rate difference of p value <0.001. Meanwhile the systolic blood pressures 8 hour after extubation between the groups were with p value of 0.003. The incidence of sore throat post operatively measured at 8hr has a significantly lowered in alkalinized lidocaine groups compared to air with p value difference of 0.027.Meanwhile the incidence of postoperative sore throat that is measured at 24 hour shows significant difference among the groups with p value of 0.009. CONCLUSION: Alkalinized lidocaine inflated tracheal tubes have shows improved hemodynamic and larngotracheal morbidities in children’s.
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    Incidence and associated factors of acute postoperative pain in women undergoing cesarean section at Gandi Memorial women and child care hospital, Addis Ababa,Ethiopia,2019/2020.
    (Addis Abeba University, 2020-06) Bimrew, Dagim; Samuel, Hirbo (Bsc, Msc); Daniel, Tenbit(Bsc,Msc)
    Background: Pain is a sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage according to Association of the Study of Pain. Although advances in medical science, poor post-operative pain management exists in developed as well as developing countries including Ethiopia. Several preoperative, intra-operative and postoperative factors are realized to cause enhancement of postoperative pain. Therefore in resource shortage settings to take appropriate plan of treatment and proper use of multimodal analgesia, it is obliged to identify the problem and its factors. Objective: The aim of this study is to assess the incidence and associated factors of post-operative acute pain after cesarean section in the first 24 post-operative hours in Gandhi memorial Hospital, Ethiopia, 2020. Methods: An institutional based prospective follow up study was conducted in parturient undergone cesarean section in Gandhi memorial hospital from December 1-2019 to February 30-2020, data was collected by through interview and reviewing the patients chart after taking consent. Numerical rating scale was used to evaluate incidence of acute postoperative pain. Data was analyzed using SPSS version 20. Logistic regression was applied to point out independent risk factors for post-operative acute pain. Variables with a p-value of < 0.05 were taken as significant association with dependent variables. Result: A two hundred ninety parturient were participated in the study with a response rate of 98%. Moderate –severe acute postoperative pain after cesarean section was 76.2 %( 95% CI: 71%, 81%)in the first 24 hours postoperatively. On multivariable analysis, history of previous cesarean section (AOR: 2.80 95% CI: 1.40, 5.55), preoperative anxiety (AOR: 2.70, 95%CI: 1.45, 5.05), transverse incision type (AOR: 3.35, 95% CI: 1.67, 6.72), incision length (AOR: 2.46, 95% CI: 1.24, 4.85)were identified as associated factors of postoperative moderate-severe acute pain after cesarean section. Conclusion: The study confirmed that moderate-severe acute postoperative pain after cesarean section is enormous in proportion and also undertreated. Previous cesarean section, preoperative anxiety, incision type and incision length were determinants of post operative acute pain after cesarean section. Evaluate and document the pain rating scale, communicate with other integrative departments for a better management and organize a master plan to lessen the pain occurrence problem must be required.