Displaying publications 1 - 20 of 57 in total

Abstract:
Sort:
  1. Pre-emptive intraperitoneal local anaesthesia: an effective method in immediate post-operative pain management and metabolic stress response in laparoscopic appendicectomy, a randomized, double-blinded, placebo-controlled study
    Thanapal MR, Tata MD, Tan AJ, Subramaniam T, Tong JM, Palayan K, et al.
    ANZ J Surg, 2014 Jan-Feb;84(1-2):47-51.
    PMID: 23057502 DOI: 10.1111/j.1445-2197.2012.06210.x
    Although laparoscopic surgeries are associated with reduced surgical stress response and shortened post-operative recovery, intense pain and high analgesia requirements in the immediate post-operative period are often the chief complaints.
    Matched MeSH terms: Anesthesia, Local/methods*
  2. A reappraisal of thyroid surgery under local anaesthesia: back to the future?
    Hisham AN, Aina EN
    ANZ J Surg, 2002 Apr;72(4):287-9.
    PMID: 11982518 DOI: 10.1046/j.1445-2197.2002.02372.x
    BACKGROUND: Thyroid surgery is usually performed under general anaesthesia. However, for a selected group of patients, local anaesthesia may be preferable. The aim of this study was to review the authors' experiences with local anaesthesia with regard to the safety and outcome of this approach.
    METHODS: A total of 65 consecutive patients who underwent primary thyroid surgery were accrued prospectively into this study from May to December 1999. A field block with 0.5% bupivacaine and adrenaline in 1:200 000 dilutions was given in all cases. In addition, light sedative and narcotics were given as necessary to achieve patient comfort and cooperation. The pain experienced during surgery was recorded using a visual analogue scoring system on a scale of 1-10.
    RESULTS: Unilateral thyroid resection was performed in 58 patients, isthmectomy in four patients and bilateral thyroid resection in three patients, two of which were in their second trimester of pregnancy diagnosed with papillary thyroid cancer. There were 55 women and 10 men with an average age of 38.2 years (range: 18-67 years). No conversion to general anaesthetic was needed, and the mean operating time was 80 min. The postoperative recovery was quick with this technique and, of interest, 22 (33.9%) patients were discharged within 6 h following the surgery. Overall 62 (95.4%) patients were discharged in the first 24 h and three (4.6%) patients after 24 h. There were no significant postoperative complications encountered except for wound infection in two (3.1%) patients.
    CONCLUSIONS: Thyroid surgery under local anaesthesia can be performed safely in a selected group of patients. It offers an effective alternative approach to general anaesthesia and is associated with low morbidity and high levels of patient satisfaction.
    Matched MeSH terms: Anesthesia, Local/standards*
  3. Letter to: Local anaesthesia for haemorrhoidal rubber band ligation reduces immediate post-operative recovery time and use of opioid analgesia
    Hayati F, Che Ani MF, Syed Abdul Rahim SS, Andee Dzulkarnaen Zakaria, D' Souza UJA
    ANZ J Surg, 2020 06;90(6):1217.
    PMID: 32592306 DOI: 10.1111/ans.15920
    Matched MeSH terms: Anesthesia, Local
  4. The effect of a forced-air warming blanket on patients' end-tidal and transcutaneous carbon dioxide partial pressures during eye surgery under local anaesthesia: a single-blind, randomised controlled trial
    Sukcharanjit S, Tan AS, Loo AV, Chan XL, Wang CY
    Anaesthesia, 2015 Dec;70(12):1390-4.
    PMID: 26348782 DOI: 10.1111/anae.13212
    Surgical drapes used during eye surgery are impermeable to air and hence risk trapping air underneath them. We investigated the effect of a forced-air warming blanket on carbon dioxide accumulation under the drapes in patients undergoing eye surgery under local anaesthesia without sedation. Forty patients of ASA physical status 1 and 2 were randomly assigned to either the forced-air warmer (n = 20) or a control heated overblanket (n = 20). All patients were given 1 l.min(-1) oxygen. We measured transcutaneous and end-tidal carbon dioxide partial pressures, heart rate, arterial pressure, respiratory rate, temperature and oxygen saturation before and after draping, then every 5 min thereafter for 30 min. The mean (SD) transcutaneous carbon dioxide partial pressure in the forced-air warming group stayed constant after draping at 5.7 (0.2) kPa but rose to a maximum of 6.4 (0.4) kPa in the heated overblanket group (p = 0.0001 for the difference at time points 15 min and later). We conclude that forced-air warming reduces carbon dioxide accumulation under the drapes in patients undergoing eye surgery under local anaesthesia.
    Matched MeSH terms: Anesthesia, Local*
  5. Review of anaesthetic management for cataract surgery in transplant recipients
    Chua AW, Chua MJ, Harrisberg BP, Kumar CM
    Anaesth Intensive Care, 2020 Jan;48(1):25-35.
    PMID: 31914784 DOI: 10.1177/0310057X19891737
    Matched MeSH terms: Anesthesia, Local
  6. Inexpensive home-assembled human skull model for training and learning the peribulbar block technique
    Chua AW, Chua MJ, Harrisberg BP, Kumar CM
    Anaesth Intensive Care, 2022 09;50(5):400-402.
    PMID: 36076352 DOI: 10.1177/0310057X211063892
    Matched MeSH terms: Anesthesia, Local/methods
  7. Anaesthetic considerations for the surgical management of ocular hypotony in adults
    Chua AW, Kumar CM, Harrisberg BP, Eke T
    Anaesth Intensive Care, 2023 Mar;51(2):107-113.
    PMID: 36524304 DOI: 10.1177/0310057X221111183
    Ocular hypotony can occur from many causes, including eye trauma, ophthalmic surgery and ophthalmic regional anaesthesia-related complications. Some of these patients require surgical intervention(s) necessitating repeat anaesthesia. While surgical management of these patients is well described in the literature, the anaesthetic management is seldom discussed. The hypotonous eye may also have altered globe anatomy, meaning that the usual ocular proprioceptive feedbacks during regional ophthalmic block may be altered or lost, leading to higher risk of inadvertent globe injury. In an 'open globe' there is a risk of sight-threatening expulsive choroidal haemorrhage as a consequence of ophthalmic block or general anaesthesia. This narrative review describes the physiology of aqueous humour, the risk factors associated with ophthalmic regional anaesthesia-related ocular hypotony, the surgical management, and a special emphasis on anaesthetic management. Traumatic hypotony usually requires urgent surgical repair, whereas iatrogenic hypotony may be less urgent, with many cases scheduled as elective procedures. There is no universal best anaesthetic technique. Topical anaesthesia and regional ophthalmic block, with some technique modifications, are suitable in many mild-to-moderate cases, whilst general anaesthesia may be required for complex and longer procedures, and severely distorted globes.
    Matched MeSH terms: Anesthesia, Local
  8. Retinal artery occlusion after ophthalmic surgery under regional anaesthesia: A narrative review
    Chua AW, Chua MJ, Harrisberg BP, Kumar CM
    Anaesth Intensive Care, 2024 Mar;52(2):82-90.
    PMID: 38041616 DOI: 10.1177/0310057X231215826
    Two recent cases of central retinal artery occlusion under otherwise uncomplicated sub-Tenon's block that resulted in significant visual loss after cataract surgery prompted us to undertake a literature review of such cases. We identified 97 cases of retinal artery occlusion after ophthalmic surgery under regional anaesthesia that had no immediate signs of block-related complications. These occurred after various intraocular (87%) and extraocular (13%) operations, across a wide range of ages (19-89 years) on patients with (59%) or without (39%) known risk factors. The anaesthetic techniques included 40 retrobulbar blocks, 36 peribulbar blocks, 19 sub-Tenon's blocks, one topical anaesthetic and one unspecified local anaesthetic. Different strengths of lidocaine, bupivacaine, mepivacaine and ropivacaine, either alone or in various combinations, were used. The details of the anaesthetic techniques were often incomplete in the reports, which made comparison and analysis difficult. Only nine cases had their cause (optic nerve sheath injury) identified, while the mechanism of injury was unclear in the remaining patients. Various mechanisms were postulated; however, the cause was likely to be multifactorial due to patient, surgical and anaesthetic risk factors, especially in those with compromised retinal circulation. As there were no definite risk factors identified, no specific recommendations could be made to avoid this devastating outcome. We have provided rationales for some general considerations, which may reduce this risk, and propose anaesthetic options for ophthalmic surgery on the fellow eye if required, based both on our literature review and our personal experience.
    Matched MeSH terms: Anesthesia, Local/adverse effects
  9. Fulltext Excision of tracheocutaneous fistula under local anaesthesia
    Irfan Mohamad, Yusri Musa, M.
    Archives of Orofacial Sciences, 2009;4(1):29-31.
    MyJurnal
    Tracheocutaneous fistula (TCF) is a known complication of tracheostomy. It can cause problems such as saliva leak, predispose to infection from external skin into respiratory tract and cosmetically not acceptable. Treatment of the underlying infection is paramount important. Persistence of tract after sufficient duration of observation period should be surgically treated. Cases reported in the literature are mainly regarding paediatric TCF and the procedures are usually done under general anesthesia. We describe a case of surgical treatment of an adult TCF which was done under local anaesthesia.
    Matched MeSH terms: Anesthesia, Local
  10. Fulltext The efficacy of 3 irrigating solution in surgical removal of lower wisdom tooth: a pilot study
    Keat, John Hon Chong, Ahmad Dzulfikar Samsudin, Mei, Siang Ma
    Archives of Orofacial Sciences, 2016;11(1):1-6.
    MyJurnal
    Surgical removal of impacted lower wisdom tooth has become increasingly costly to patient while still remains as the most common dental surgical procedure that is performed on outpatient basis. In the present study, a total of 23 patients with impacted lower wisdom tooth were surgically removed under local anaesthesia by using different irrigating solution namely, normal saline, distilled water and chlorhexidine. The samples underwent standard operating procedures and medication. Post operative complications in terms of pain, swelling, infection and delayed wound healing were assessed and compared on Day 1 and Day 7 after surgery. The result of this study showed that there is no significant difference between the three irrigating solution used in surgical removal of impacted lower wisdom tooth in terms of postoperative complication. A bigger scale of research with more samples is recommended to evaluate the most efficacy irrigating solution during surgical removal of impacted lower wisdom tooth.
    Study site: Oral surgery clinic, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Anesthesia, Local
  11. Fulltext Total parathyroidectomy under local anaesthesia for renal hyperparathyroidism
    Cheong YT, Taib NA, Normayah K, Hisham AN
    Asian J Surg, 2009 Jan;32(1):51-4.
    PMID: 19321403 DOI: 10.1016/S1015-9584(09)60009-9
    Renal hyperparathyroidism with attendant osteodystrophy is a frequent and severe morbidity affecting the quality of life of end stage renal failure patients surviving on long-term renal replacement therapy. A small subgroup of these patients with severe cardiorespiratory dysfunction was deemed at very high risk for general anaesthesia (GA). We report on a series of total parathyroidectomy under local anaesthesia (LA) for these patients.
    Matched MeSH terms: Anesthesia, Local*
  12. The effectiveness of sub-Tenon's infiltration of local anaesthesia for cataract surgery
    Verghese I, Sivaraj R, Lai YK
    Aust N Z J Ophthalmol, 1996 May;24(2):117-20.
    PMID: 9199741
    PURPOSE: To determine if adequate anesthesia and akinesia could be obtained using an inferonasal quadrant sub-Tenons anaesthesia for cataract surgery.
    METHODS: The sub-Tenons method of local anaesthesia was used in 50 patients undergoing extracapsular cataract extraction and lens implantation. The technique following was that described by JD Stevens in his study of 50 patients. Posterior sub-Tenons space was approached through a conjunctival incision in the inferonasal quadrant and the anaesthetic solution delivered by an irrigating cannula. The patients were assessed for residual ocular movements just before surgery. Effectiveness of anaesthesia was assessed during surgery using a verbal pain rating score. Scoring was based on the concept of a visual analogue pain score chart.
    RESULTS: Total akinesia was obtained in 20% patients and total anaesthesia in 24% patients. The remainder of the patients had adequate akinesia and anaesthesia to proceed with and complete the surgery.
    CONCLUSION: This method provides satisfactory anaesthesia for cataract surgery.
    Matched MeSH terms: Anesthesia, Local/adverse effects; Anesthesia, Local/methods*
  13. Fulltext Psychometric properties of the faces version of the Malay-modified child dental anxiety scale
    Esa R, Hashim NA, Ayob Y, Yusof ZY
    BMC Oral Health, 2015 Mar 10;15:28.
    PMID: 25886943 DOI: 10.1186/s12903-015-0013-y
    BACKGROUND: To evaluate the psychometric properties of the faces version of the Modified Child Dental Anxiety Scale (MCDASf) Malay version in 5-6 and 9-12 year-old children.
    METHODS: The MCDASf was cross culturally adapted from English into Malay. The Malay version was tested for reliability and validity in 3 studies. In the Study 1, to determine test-retest reliability of MCDASf scale, 166 preschool children aged 5-6 years were asked to rank orders five cartoons faces depicting emotions from 'very happy' to 'very sad' faces on two separate occasions 3 weeks apart. A total of 87 other 5-6 year-old children completed the Malay-MCDASf on two separate occasions 3 weeks apart to determine test-retest reliability for Study 2. In study 3, 239 schoolchildren aged 9-12 years completed the Malay-MCDASf and the Malay-Dental Subscale of the Children Fear Survey Schedule (CFSS-DS) at the same sitting to determine the criterion and construct validity.
    RESULTS: In study 1, Kendall W test showed a high degree of concordance in ranking the cartoon faces picture cards on each of the 2 occasions (time 1, W = 0.955 and time 2, W = 0.954). The Malay-MCDASf demonstrated moderate test-retest reliability (Intraclass correlation coefficient = 0.63, p <0.001) and acceptable internal consistency for all the 6 items (Cronbach's alpha = 0.77) and 8 items (Cronbach's alpha = 0.73). The highest MCDASf scores were observed for the items 'injection in the gum' and 'tooth taken out' for both age groups. The MCDASf significantly correlated with the CFSS-DS (Pearson r = 0.67, p < 0.001).
    CONCLUSIONS: These psychometric findings support for the inclusion of a cartoon faces rating scale to assess child dental anxiety and the Malay-MCDASf is a reliable and valid measure of dental anxiety in 5-12 year-old children.
    Matched MeSH terms: Anesthesia, Local/psychology
  14. Fulltext Nasopharyngeal diffuse large B-cells lymphoma causing acute airway obstruction amid COVID-19 crisis: an anaesthetist's nightmare
    Yeap TB, Teah MK, Quay YJJ, Wong MTF
    BMJ Case Rep, 2021 Jan 28;14(1).
    PMID: 33509897 DOI: 10.1136/bcr-2020-241008
    Acute stridor is often an airway emergency. We present a valuable experience handling an elderly woman who was initially treated as COVID-19 positive during the pandemic in November 2020. She needed an urgent tracheostomy due to nasopharyngeal (NP) diffuse large B-cell lymphoma causing acute airway obstruction. Fortunately, 1 hour later, her NP swab real-time PCR test result returned as SARS-CoV-2 negative. This interesting article depicts the importance of adequate preparations when handling potentially infectious patients with anticipated difficult airway and the perioperative issues associated with it.
    Matched MeSH terms: Anesthesia, Local
  15. Fulltext Filariasis of the axilla in a patient returning from travel abroad: a case report
    Roethlisberger M, Wuerstlein R, Majores M, Müller-Stöver I, Seitz HM, Rhiem K, et al.
    Breast care (Basel, Switzerland), 2012 Dec;7(6):487-9.
    PMID: 24715832 DOI: 10.1159/000345471
    BACKGROUND: The term filariasis comprises a group of parasitic infections caused by helminths belonging to different genera in the superfamily Filaroidea. The human parasites occur mainly in tropical and subtropical regions, but filariae are also found in temperate climates, where they can infect wild and domestic animals. Humans are rarely infected by these zoonotic parasites.

    PATIENTS AND METHODS: A 55-year-old patient presented with a new-onset, subcutaneous, non-tender palpable mass in the right axilla. Ultrasonography showed a 1.3-cm, solid, singular encapsulated node. Sonography of the breast on both sides, axilla and lymphatic drainage on the left side, lymphatic drainage on the right side, and mammography on both sides were without pathological findings. The node was excised under local anesthesia as the patient refused minimal invasive biopsy.

    RESULTS: On histopathological examination, the tail of a parasite of the group of filariae was found. The patient revealed that she had stayed in Africa and Malaysia for professional reasons. 6 months before the time of diagnosis, she had also suffered from a fever and poor general condition after a trip abroad. The patient was referred for further treatment to the Institute for Tropical Medicine at the University of Dusseldorf, where a treatment with ivermectin was conducted on the basis of positive staining with antibodies against filariae.

    CONCLUSION: Our case demonstrates the importance of interdisciplinary collaboration between breast center, pathology, and other specialties such as microbiology and tropical medicine.

    Matched MeSH terms: Anesthesia, Local
  16. Pain control after thoracotomy. An extrapleural tunnel to provide a continuous bupivacaine infusion for intercostal nerve blockade
    Majid AA, Hamzah H
    Chest, 1992 Apr;101(4):981-4.
    PMID: 1555472
    This study was undertaken to determine whether an infusion of local anesthetic (LA) delivered through an extrapleural tunnel could provide satisfactory control of pain in the postthoracotomy period. Twelve patients undergoing thoracotomy were studied. A T-shaped tunnel was created by elevating the parietal pleura at the posteromedial end of the thoracotomy wound. An irrigation catheter was then inserted and an infusion of bupivacaine commenced, initially at 5 mg/kg/24 h and subsequently at 3 mg/kg/24 h. Pain was well controlled in eight patients and satisfactory in four patients. The latter required one dose of opiate analgesia each in the 48-h postoperative period. We conclude that an infusion of bupivacaine into the extrapleural space is an effective means of control of pain after thoracotomy.
    Matched MeSH terms: Anesthesia, Local/methods
  17. Ab-Externo Implantation of XEN Gel Stent for Refractory Steroid-Induced Glaucoma After Lamellar Keratoplasty
    Tan SY, Md Din N, Mohd Khialdin S, Wan Abdul Halim WH, Tang SF
    Cureus, 2021 Feb 12;13(2):e13320.
    PMID: 33738163 DOI: 10.7759/cureus.13320
    The hazy corneal donor-recipient interface after corneal transplant may cause difficulties when implanting the XEN gel stent via ab-interno approach. We aim to describe XEN gel stent implantation via ab-externo approach in refractory steroid-induced glaucoma after corneal lamellar keratoplasty. Under local anaesthesia, the XEN injector needle was inserted 7 mm behind the limbus with the bevel facing up, directly beneath the conjunctiva and advanced to the marked 2.5 mm scleral entry wound. The needle then pierced the sclera until the needle tip was just visible in the anterior chamber (AC). The slider was pushed until the tip of the XEN stent was seen in the AC. The needle was slowly withdrawn while still pushing the slider to complete stent deployment. Subconjunctival Mitomycin C 0.01% (30 µg/0.3 mL) was then injected posterior to the bleb. Three eyes of three patients with steroid-induced glaucoma after lamellar keratoplasty underwent XEN gel stent implantation via ab-externo approach placed at the superotemporal quadrant. Pre-operatively, all patients had uncontrolled IOP between 30-45 mmHg despite maximum medications and selective laser trabeculoplasty. After XEN gel stent implantation, IOP ranged between 10-17 mmHg with one or two topical antiglaucoma at 12 months. Complications include hypotony maculopathy, stent migration and hyphaema, all of which were successfully managed. Corneal graft remained clear at 12 months. XEN gel stent implantation via ab-externo approach is able to achieve good intraocular pressure (IOP) control without compromising cornea graft in patients with steroid-induced glaucoma after lamellar keratoplasty at 12 months.
    Matched MeSH terms: Anesthesia, Local
  18. Fulltext Non-Traumatic Snapping Tendon on the Dorsal Aspect of the Thumb: A Diagnostic Challenge
    Kesu Belani L, Abdullah S, Soh EZF, Abd Jabar F, Nasseri Z
    Cureus, 2021 Apr 11;13(4):e14417.
    PMID: 33987066 DOI: 10.7759/cureus.14417
    A snapping tendon on the dorsal aspect of the thumb is a rare condition as opposed to the common triggering on the volar aspect of the thumb. This condition is known as triggering of the extensor pollicis longus (EPL). A 21-year-old female presented with a clicking or snapping sensation that was felt on the dorsum of her thumb when it is extended. There was no history of trauma. She worked in an ice-cream parlor with repetitive scooping ice-cream motions. Her triggering immediately resolved on releasing the EPL fascia ulnar to Lister's tubercle. Upon wake-up surgery, we could immediately confirm this. We recommend dynamic ultrasound as an investigation and do not recommend MRI. The surgical method of choice is either wake-up surgery or wide-awake local anesthesia no tourniquet (WALANT) surgery.
    Matched MeSH terms: Anesthesia, Local
  19. In vitro and in vivo Evaluation of New Topical Anaesthetic Cream Formulated with Palm Oil Base
    Khodari SNK, Noordin MI, Chan L, Chik Z
    Curr Drug Deliv, 2017;14(5):690-695.
    PMID: 27480118 DOI: 10.2174/1567201813666160801113302
    BACKGROUND: Topical local anaesthetic cream was reported to be useful for pain relief for cutaneous procedures such as minor surgery and venipuncture.

    OBJECTIVE: The aim of this study was to evaluate the effectiveness of new formulation of lidocaine topical anaesthetic using palm oil base, HAMIN® and to determine how fast this new formulation produces adequate numbness compared to the currently used EMLA cream, in the University of Malaya Medical Centre (UMMC) set-up.

    METHOD: The skin permeation test was conducted by using Franz type diffusion cell and pain assessment was carried out in healthy subject by using Verbal Rating Score (VRS) and Visual Analogue Score (VAS) evaluation.

    RESULT: Result of permeation test demonstrated that the cumulative amount of lidocaine released from HAMIN® cream was increased with time and slightly higher than EMLA cream. The clinical study showed that HAMIN® single lidocaine cream can produces numbness through venepuncture procedure and comparable with EMLA cream which is a combination therapy for local anaesthetic (lidocaine and prilocaine).

    CONCLUSION: It can be concluded that HAMIN® Lidocaine cream is suitable for cream preparation especially for topical application and it can be regarded as an achievement in palm oil and medical industries.

    Matched MeSH terms: Anesthesia, Local
  20. Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia
    Woo YL, Badley C, Jackson E, Crawford R
    Cytopathology, 2011 Oct;22(5):334-9.
    PMID: 21073579 DOI: 10.1111/j.1365-2303.2010.00824.x
    This study examines the impact of excision margin status after large loop excision of the transformation zone (LLETZ) under local anaesthetic for high-grade cervical intraepithelial neoplasia (HG-CIN) on the cytological and histological outcomes up to 5 years after treatment.
    Matched MeSH terms: Anesthesia, Local
Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links