Anaesthesia and Anaesthesiology
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Item Survival Status and Predictors of Mortality in Adults Undergoing Craniotomy For Traumatic Brain Injury: A Multi-Center Retrospective Cohort Study, Addis Ababa, Ethiopia(Addis Ababa University, 2025-07) Sisay Dedefo; Senait Awoke; Wubayehu AmareBACKGROUND: Traumatic brain injury (TBI) accounts for a significant number of morbidities and mortalities globally, especially in low resource settings. Craniotomy is performed to reduce intracranial pressure and treat complications. however, survival outcomes and their predictors remain poorly defined, especially in low-resource setting. OBJECTIVE: This Study aimed to assess the Survival status and predictors of mortality on patient age greater than 18 years who underwent Craniotomy for Indication of Traumatic brain injury at Tikur Anbessa Specialized Hospital and ALERT hospital from 2019-2023 GC Ethiopia, Addis Ababa. METHODS: A five years A retrospective cohort study was conducted with 121 TBI patients who underwent craniotomy. Data was gathered through medical record review and analysed using Kaplan–Meier survival analysis (survival analysis) and Cox proportional hazards models (Cox model). The log-rank test was used to compare survival distributions among subgroups of patients. Results: The overall mortality rate was 22% with its 95% CI: 14.6% to 29.4%), with a time of 6 months. The most deaths (19 deaths) occurred during the first observation interval, with a hazard ratio of 0.17 at that interval. Advanced age (AHR = 6.20; 95% CI: 2.37-16.19; p = 0.001); severe TBI (AHR= 6.06; 95% CI: 1.94-18.96; p = 0.002); intra-operative hypotension (AHR= 8.47; 95% CI: 2.81-25.55; p=0.001); and post-operative mechanical ventilation (AHR = 4.71; 95% CI: 1.35-16.36; p = 0.015) were independent predictors of mortality. Conclusion: The study showed a significant mortality burden amongst post-craniotomy TBI patients due to both non-modifiable risk factors (age, severity of injury) and modifiable risk factors (hypotension, ventilation). These findings emphasize the need for prompt surgical management, more precise intra-operative monitoring, and effective postoperative management. Therefore, all stakeholders (policymakers, health care service providers, and researchers) need to work together to improve publicly funded trauma care systems to foster improved survivorship resource.Item Effectiveness of Carbetocin Versus Oxytocin Forheamodynamic Satbility After Spinal Anesthesia in C/S Deliveries: A Multicenter Cohort Study in Addis Ababa, Ethiopia(Addis Ababa University, 2025-06-23) Sosina Yimenu; Adugna Aregawi; Zeweter AshebirBackground: Because of its safety margin, spinal anesthetic block is the most commonly used anesthesia procedure for cesarean delivery and during cesarean delivery, uterotonic drugs are routinely recommended after the delivery of the baby to prevent postpartum hemorrhage. Investigations assessing the contractile properties of oxytocin and carbetocin reported comparable adverse reactions for the two agents. Analyzing the hemodynamic side effects of these medicines appears essential and urgent considering their role as prophylactic medication and a rising percentage of high-risk parturient. Objective: To compare effectiveness of carbetocin versus oxytocin for hemodynamic stability after spinal anesthesia in C/S delivery in a private and tertiary public hospital, a prospective cohort study, Addis Ababa Ethiopia, from February 1- April 30/2025. Method: A multi-center cohort study had been conducted among 66 parturients who undergone elective cesarean section under spinal anesthesia. The Collected data was statistically analyzed with SPSS version 26. Demographic and clinical data was computed with independent sample t test and categorical data was measured using chi square test and for qualitative variables fisher’s exact test is employed, when applying the condition for chi square test were not fulfilled. Additionally, non-parametric variables were computed using Mann Whitney U test. A P value of< 0.05 was deemed statistically significant. Result: There was statistically significant difference in terms of hemodynamic parameters1minute after administration of the study medication the decrease in BP was (p- value 0f 0.02inSBP, 0.27 in DBP and 0.003 in MAP). Incidence of hypotension occurred in 12(36.4%) parturients in oxytocin group and 11(33.3%) parturients in a carbetocin group with p- valueof0.796 which is not statistically significant. There was no significant difference in terms of Vasopressor requirement, amount of blood loss and requirement for additional uterotonic agent among the groups with a p- value of 0.301, 0.285 and 0.286 respectively. Conclusion and recommendation: The change hemodynamic profile was better maintained in the carbetocin group. In the availability of both medications, we recommend to preferably use carbetocin than oxytocin, because of higher incidence of chest pain with the use of oxytocin and better hemodynamic profile in the carbetocin.Item Incidence and Associated Factors of Perioperative Respiratory Adverse Events Among Pediatric Patients who Underwent Surgery Under General Anesthesia at Tikur Anbesa Specialized Hospital in Addis Ababa, Ethiopia 2024/25(Addis Ababa University, 2025-04-05) Selam Tigabu; Blen Ayele; Tseganesh BerhanuBackground: Perioperative respiratory adverse events (PRAEs) are the most frequent complications in pediatrics which frequently result in morbidity and mortality. They are accountable for 75% of perioperative critical incidents and 33% of cardiac arrests. Objective: To assess the incidence and associated factors of perioperative respiratory adverse events who underwent surgery under general anesthesia among pediatric patients at Tikur anbesa specialized hospital, Adiss Ababa, Ethiopia. Methods: An institution based cross sectional study was conducted among 176 pediatric patients aged 0 to 12 years who underwent elective and emergency surgery over three month period. Systemic random sampling was used to select patients. Data was collected through structured questionnaires and medical record reviews. Analysis was done by using SPSS 25. Logistic regression was used to identify associated factors and a p-value < 0.05 at 95% confidence intervals was considered as statistical significance. Result: The overall incidence of perioperative respiratory adverse events was 20% (n=36). ASA class 2 and 3 (AOR=8.7, 95%CI=2.74, 27.84) and (AOR=4.9, 95%CI=1.23, 19.77) respectively, upper respiratory tract infection (AOR=7.6, 95%CI=2.14, 27.16). and duration of surgery more than 1 hr (AOR=4.4, 95%CI=1.45, 13.28). were independent predictors for perioperative respiratory adverse events. Conclusion: A significant level 20% of the study participants had preoperative respiratory adverse event. Factors that were associated with were history of Upper respiratory tract infection, increasing American society of anesthesiologist physical status and long duration of surgical procedure.Item Assessment of Patient Satisfaction with Preoperative Anesthetic Evaluation and Associated Factors at Tash, Addis Abeba, Ethiopia(Addis Ababa University, 2025-05) Regassa Samrawit; Ayele BlenPatient satisfaction with reoperative anesthesia care is a key indicator of healthcare quality, influencing both patient experience and outcomes. In Ethiopia, limited evidence exists on the level of patient satisfaction with preoperative anesthetic evaluation, especially at Tikur Anbessa Specialized Hospital (TASH).Item Incidence and Factors Associated with Postoperative Vomiting in Pediatric Elective Surgical Patients at Minilik II Comprehensive Referral Hospital and Tikur Ambessa Specialized Hospital, Addis Ababa, Ethiopia, 2024/2025 G.C(Addis Ababa University, 2025-04-23) Amha Abenzer; Shamil AmriaPostoperative vomiting (POV) is one of the most common complications observed in pediatric anesthesia. The incidence in pediatrics is estimated to be between 33% and 82%. Children have twice the risk of experiencing postoperative vomiting compared to adults. Risk factors for postoperative vomiting can be divided into three categories: those related to the surgery, anesthesia, or patientItem Predictors of Survival Time to Discharge Following Cardio-Pulmonary Resuscitation among Neonates Admitted in NICU at Gandhi Memorial and Tikur Anbessa Specialized Hospital, Ethiopia: A Prospective Cohort Study(Addis Ababa University, 2025-02-15) Admasu Abraraw; Mintesnot HelenCardiopulmonary resuscitation (CPR) is a set of life-saving procedures that increase survival chances. An integrated series of coordinated actions symbolized by the links in the Chain of Survival are necessary for successful resuscitation after cardiac arrest. Cardiopulmonary arrest requiring CPR with chest compressions occurs in 0.25% to 1% of NICU admissions.Item Magnitude of Admission, outcomes and Associated Factors of Neurosurgical Patients at Tikur Anbessa Hospital Surgical Intensive Care Unit, Addis Ababa A Retrospective Observational Study From January 01, 2024 - January 01, 2025.(Addis Ababa University, 2025-04-13) Gebriel Absera; Shamil AmriaNeurosurgical care is resource demanding which require advanced technology in terms of managing and monitoring of patients. Tikur Anbessa Specialized Hospital is the leading territory referral center in Ethiopia providing advanced care for critically ill patients. Neurosurgical patients constitute majority of the patients admitted at the surgical intensive care unit at these hospital patients usually admitted are for postoperative follow up after a neurosurgical procedure or for management of their underlying neurological illnessItem Incidence of Adverse Event and Associated Factor During Intrahospital Transport of Critically Ill Patient in ICU at TASH, Dec 2024-Feb 2025G.C,Prospective Observational Study(Addis Ababa University, 2025-05-10) Getu Addisu; Alferid FetiyaIntra-hospital transport of critically ill patients is a vital component of intensive care unit (ICU) operations, necessary for various diagnostic, therapeutic, or procedural interventions. Despite its critical role, this process can introduce significant risks, including adverse events such as changes in vital signs, procedural complications, or deterioration in patient’s conditionItem Adherence of Health Care Workers to Hand Hygiene at Intensive Care Unit Tikur Anbesa Specialized Hospital, Addis Ababa, 2024/25, Observational Study(Addis Ababa University, 2025-04-15) Mullu Adissu; Ayele BlenHand hygiene (HH) is recognized as the single most effective strategy for preventing health care–associated infections. In developing countries, data on hand hygiene compliance is available only for few health-care facilities. This study aimed to assess hand hygiene adherence of health-care workers working at ICU of TASH, Addis Ababa, EthiopiaItem A prospective, Randomized, Single Blind Study on the Efficacy of Varying Doses of Dexamethasone in Preventing Postoperative Nausea and Vomiting in Adult Elective Surgery Patients at Tikur Anbessa Specialized Hospital (2024-2025)(Addis Ababa University, 2025-06-10) Naba Amanuel; Alfered FetiyaPostoperative nausea and vomiting (PONV) is a common and distressing complication following surgery. Dexamethasone is widely used as a prophylactic antiemetic, though the optimal dose remains unclear. This study aimed to assess the efficacy of two doses of dexamethasone (4 mg vs. 8 mg) in preventing PONV among adult elective surgical patientsItem Incidence 0f Major Intraoperative Adverse Events and Associated Factors Ammong Patients Undergoing Surgery At Tikur Anbesa Specialized Hospital,Addis Ababa ,Ethiopia,2025(Addis Ababa University, 2025-06-10) Libmogn, Ayalew; Jiregna, GetachewSurgery is a critical condition associated with potential complications. Adverse intraoperative events (AIEs) can significantly impact patient outcomes and increase healthcare costs. While several studies have explored AIEs in different settings, data from developing countries like Ethiopia remains limited. Understanding the incidence and associated factors of AIEs in such settings is crucial for improving patient safety and quality of care.Item Preoperative Anxiety and its Hemodynamic Effect among Elective Surgical Patient at Tikur Anbessa Specialized Hospital In 2024/2025 G.C(Addis Ababa University, 2024-06-23) Hordofa Ayantu; Kedir NuraPreoperative anxiety is a common but often under recognized condition. Despite its prevalence ,it is frequently neglected which can negatively affect hemodynamic stability during perioperative period. Understanding its prevalence and physiological consequences is essential for improving perioperative careItem Magnitude and Reasons of Elective Surgery Cancellation among Patients at Tikur Anbessa Sepecialised Hospital, Addis Ababa, Ethiopia, 2024/25; A Cross-Sectional Study(Addis Ababa University, 2025-04-15) Motbaynor Bekalu; Kedir NuraElective surgeries are vital for timely treatment and improved patient quality of life. Cancellation of these surgeries leads to increased costs, delayed treatment, and patient anxiety. Limited data exists on this issue in Ethiopia, particularly at Tikur Anbessa Specialized Hospital, a major referral center. Understanding the magnitude and reasons for cancellations is crucial for improving service deliveryItem Incidence and Associated Factors for Perioperative Respiratory Adverse Events in Elective Pediatric Surgical Patients with Recent Upper Respiratory Tract Infections in Selected Public Hospitals, Addis Ababa , 2025: A Prospective Cohort Study(Addis Ababa University, 2025-06-23) Tefera, Bekalu; Seifu AshenafiPediatric surgery patients frequently have perioperative respiratory adverse events (PRAEs), which are responsible for one-third of cardiac arrests and three-quarters of perioperative critical occurrences. Thus, upper respiratory tract infections (URIs) are the most frequent cause of PRAE and are the main reason for postponing surgical intervention in pediatric patient’s .Currently, there is no consensus on the best period to postpone surgery in children with recent upper respiratory tract infections.Item Effectiveness of Prophylactic Adminstration of Intravenous Paracetamol for Prevention of Post Spinal Anesthesia Shivering Among Parturients Undergoing Cesarian Section at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2024/2025, Prospective Cohort Study(Addis Ababa University, 2025-06-10) Gezahegn Mussie; Abrar MeronSpinal anesthesia is known to be a contributing factor to shivering, leading to undesirable complications that have adverse physiological effects. Recent studies suggest that paracetamol may be a promising prophylactic measure. Nevertheless, there is paucity of information on its effect in preventing post-spinal anesthesia shivering in low-income countries like Ethiopia including the study settingItem Predictors of Mortality among Patients Admitted to Surgical and Medical Intensive Care Units at Tikur Anebessa Specialized Hospital, Addis Ababa, Ethiopia(Addis Ababa University, 2025-05-15) Rekik Walle; Nura KedirIntensive care units (ICUs) play a vital role in managing critically ill patients, yet mortality rates within these settings remain a pressing concern worldwide. Various factors,including demographic characteristics, underlying health conditions, and interventions received, influence patient outcomes in ICUs. In Ethiopia, particularly in high-demand facilities like Tikur Anbessa Specialized Hospital, data on ICU mortality and its predictors are scarce. Understanding the predictors of mortality in surgical and medical ICUs is essential for enhancing patient care and resource allocationItem Incidence, Predictors, and Etiologies of Fever in Critically Ill Patients Admitted to the Surgical Intensive Care Unit (Sicu) at Tikur Anbesa Specialized Hospital in Addis Ababa, Ethiopia : A Retrospective Observationall Study(Addis Ababa University, 2025-04-15) Dawit Eyeberu; Nura KedirFever is frequently observed in critically ill patients, particularly in SICU and can be indicative of underlying infections or other serious conditions. Understanding the incidence, predictors, and etiologies of fever is important for appropriate management and improved patient results. There is limited understanding of the prevalence and contributing factors of ICU fever in Ethiopia, particularly at Tikur Anbessa Specialized Hospital.Item Effectiveness of Iv Fentanyl Alone Vs Combined With Paracetamol in Attenuating Hemodynamic Response to Laryngoscopic Intubation and Post Operative Pain in Laparoscopic Cholecystectomy Patients at Governmental Hospitals, Addis Ababa, Ethiopia, 2025.(Addis Ababa University, 2025-06-15) Demisu Dejene; Eyayalem MeleseLaryngoscopy and endotracheal intubation can cause significant increases in heart rate and blood pressure, posing risks for patients with cardiovascular disease. Similarly, inadequate postoperative pain control, such as after laparoscopic cholecystectomy, can lead to serious complications. Minimizing these effects is essential for safe anesthesia and better patient outcomes. Therefore, evaluating iv fentanyl alone vs its combination with paracetamol is essential to enhance anesthesia care and patient outcome in resource limited settingsItem Incidence and Associated Factors of Intraoperative Arrhythmia in Adult Surgical Patients at Tikur Anbesa Specialized Hospital, 2025(Addis Ababa University, 2025-04-05) Eyerus Yaregal; Nura KedirIntraoperative arrhythmia are frequent, with nearly 11% of patients experiencing abnormal heart rates or rhythms during general anesthesia. While most are transient and clinically insignificant, some may signal underlying pathology or result from procedure specific or medication specific aetiologies, leading to hemodynamic instability. This research will enhance perioperative assessments and enable tailored interventions to prevent arrhythmia related complications, ultimately improving perioperative care and patient outcomesItem Comparing Hemodynamic Response to Laryngeal Mask Airway Insertion Versus Endotracheal Tube Intubation in Surgical Patients A Prospective cohort Study, Addis Ababa Ethiopia(Addis Ababa University, 2025-06) Eyerusalem Sisay; Biruk TesfayeEffective airway management is essential in anesthesia, with endotracheal intubation (ETI) widely regarded as the standard technique. However, ETI is associated with significant hemodynamic responses due to sympathetic stimulation during laryngoscopy, which may pose risks, particularly in patients with cardiovascular compromise. Laryngeal mask airways (LMAs) offer a less invasive alternative and are increasingly used in clinical practice. Despite their growing adoption, limited evidence exists comparing the hemodynamic effects of LMA insertion versus ETI in surgical patients