Displaying publications 321 - 340 of 344 in total

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  1. Wan Ibadullah WH, Yahya N, Ghazali SS, Kamaruzaman E, Yong LC, Dan A, et al.
    Braz J Anesthesiol, 2016 Jul-Aug;66(4):363-8.
    PMID: 27343785 DOI: 10.1016/j.bjane.2014.11.013
    BACKGROUND AND OBJECTIVE: This was a prospective, randomized clinical study to compare the success rate of nasogastric tube insertion by using GlideScope™ visualization versus direct MacIntosh laryngoscope assistance in anesthetized and intubated patients.

    METHODS: Ninety-six ASA I or II patients, aged 18-70 years were recruited and randomized into two groups using either technique. The time taken from insertion of the nasogastric tube from the nostril until the calculated length of tube had been inserted was recorded. The success rate of nasogastric tube insertion was evaluated in terms of successful insertion in the first attempt. Complications associated with the insertion techniques were recorded.

    RESULTS: The results showed success rates of 74.5% in the GlideScope™ Group as compared to 58.3% in the MacIntosh Group (p=0.10). For the failed attempts, the nasogastric tube was successfully inserted in all cases using rescue techniques. The duration taken in the first attempt for both techniques was not statistically significant; Group A was 17.2±9.3s as compared to Group B, with a duration of 18.9±13.0s (p=0.57). A total of 33 patients developed complications during insertion of the nasogastric tube, 39.4% in Group A and 60.6% in Group B (p=0.15). The most common complications, which occurred, were coiling, followed by bleeding and kinking.

    CONCLUSION: This study showed that using the GlideScope™ to facilitate nasogastric tube insertion was comparable to the use of the MacIntosh laryngoscope in terms of successful rate of insertion and complications.
    Matched MeSH terms: Anesthesia
  2. Arshat H, Kim KS, Jalil AH
    Malays J Reprod Health, 1985 Jun;3(1):59-63.
    PMID: 12314428
    PIP:
    A total of 552 women in 1983 have undergone laparoscopic sterilization under local anesthesia with sedation in the family planning clinic at Maternity Hospital and the Specialist Center at Batu Complex. A review was made to evaluate the risks, benefits, and safety of outpatient surgery in view of the shortage of anesthetic personnel, operating theaters and costs to patients if general anesthesia were to be used instead. Anesthetic complications (0.9%) were found to be of a very minor nature, not requiring hospitalization. Surgical complication was higher at 3.8%. There was a high rate (21%) of difficulties encountered at operation, 15% for medical officers and trainees but only 6% for specialists. In summary, a very low complication rate was encountered with local anesthetics. The use of local anesthesia with sedation is advocated. This cuts down on costs, hospitalization and recovey time and overcomes the perennial problem of shortage of anesthetic staff and operating theaters. The rate of the surgical complications was related to the surgeon's experience.

    Study site: family planning clinic at Maternity Hospital and the Specialist Center at Batu Comple
    Matched MeSH terms: Anesthesia
  3. Arshat H, Ali J, Noor Laily Abu Bakar
    Malays J Reprod Health, 1984 Jun;2(1):1-13.
    PMID: 12267515
    Matched MeSH terms: Anesthesia
  4. Law GT, Gunn C
    Singapore Med J, 1971 Apr;12(2):110-3.
    PMID: 4945292
    Matched MeSH terms: Anesthesia, Intravenous
  5. Narhari R, Nazaruddin Wan Hassan WM, Mohamad Zaini RH, Che Omar S, Abdullah Nik Mohamad N, Seevaunnamtum P
    Anaesthesiol Intensive Ther, 2020;52(5):377-382.
    PMID: 33327695 DOI: 10.5114/ait.2020.101387
    INTRODUCTION: The choice of endotracheal tube (ETT) is important for successful orotracheal fibreoptic intubation (OFI). The aim of this study was to compare the use of the Parker flex tip (PFT) with the unoflex reinforced (UFR) ETT during OFI.

    MATERIAL AND METHODS: A total of 58 patients who underwent elective surgery under general anaesthesia were randomised to two ETT groups, the PFT group (n = 29) and the UFR group (n = 29), for OFI in simulated difficult intubation patients using a rigid cervical collar. After successful standardised induction and relaxation, OFI and railroading of selected ETT were subsequently performed by a similarly experienced practitioner. Ease of insertion, degree of manipulation, time to successful intubation, post-intubation complications and haemodynamic changes were recorded for both groups.

    RESULTS: he percentage of easy intubation was comparable between both groups with a slightly higher percentage in the UFR group than the PFT group (69.0% vs. 62.0%; P = 0.599). Degree of manipulation was also comparable between the two groups; the percentage of cases in which manipulation was not required was slightly higher in the UFR group than the PFT group (69.0% vs. 62.1%; P = 0.849). Time to successful intubation was also comparable between the groups, although the time was slightly shorter for the UFR group than the PFT group (56.9 s ± 39.7 s vs. 63.9 s ± 36.9 s; P = 0.488). There were also no significant differences in other parameters.

    CONCLUSIONS: The Parker flex tip ETT was comparable to the unoflex reinforced ETT for OFI in simulated difficult airway patients.

    Matched MeSH terms: Anesthesia, General
  6. Liew YT, Yong DJ, Somasundran M, Lum CL
    Indian J Otolaryngol Head Neck Surg, 2015 Mar;67(Suppl 1):129-33.
    PMID: 25621268 DOI: 10.1007/s12070-014-0801-8
    The aim of the study was to examine and analyze the epidemiology and outcome of treatment for paediatric acquired subglottic stenosis treated with endoscopic bougie dilatation and topical mitomycin C. There were 15 patients identified from 2008 until 2013. All of them had acquired subglottic stenosis due to history of intubation. Majority of the patients had grade III stenosis, with the total of seven. Three patients had grade IV; three were grade II and two were grade I. All of the patients with severe stenosis (grade III and IV) needed tracheostomy while only one in mild stenosis group (grade I and II) required it for prolonged ventilation rather than obstruction due to subglottic stenosis. All of them underwent direct laryngoscopy under general anesthesia followed by endoscopic dilatation with bougie and topical mitomycin C 0.4 mg/ml for 5 min. Aim of success in our study was decannulation of tracheostomy or absence of symptoms at exertion. We achieved 6 (60 %) successful decannulation out of 10 patients with tracheostomy (excluded the patient with tracheostomy in grade I stenosis due to prolonged ventilation). As for those without tracheostomy, 3 (75 %) out of 4 patients were asymptomatic even at exertion. Average number of dilatation was 3.1 times, with mean duration of 28 min. No complications were reported in our series. One patient with grade I stenosis passed away due to severe pneumonia unrelated to the stenosis or dilatation, and she did not have any dilatation before she passed away. Multiple related risk factors were identified such as intubation, prematurity, movement of endotracheal tube, respiratory infection, traumatic intubation and gastroesophageal reflux disease. Experience of open surgical method was very limited in our centre in Sabah in East Malaysia. Endoscopic technique plays an important role in treatment of subglottic stenosis with adjunct like mitomycin C possibly booster the successful rate.
    Matched MeSH terms: Anesthesia, General
  7. Wai YZ, Fiona Chew LM, Mohamad AS, Ang CL, Chong YY, Adnan TH, et al.
    Int J Ophthalmol, 2018;11(10):1685-1690.
    PMID: 30364221 DOI: 10.18240/ijo.2018.10.17
    AIM: To report the incidence, risk factors and visual outcomes for postoperative endophthalmitis (POE) based on 7-year data from the Malaysian Ministry of Health Cataract Surgery Registry (MOH CSR).

    METHODS: Data was collected from the web-based MOH CSR. All consecutive cataract surgery patients from 1st June 2008 to 31st December 2014 were identified. Exclusion criteria were traumatic cataract or previous ocular surgery. Demographic data, ocular co-morbidities, intraoperative details and postoperative visual acuity (VA) at final ophthalmological follow-up were noted. All eyes were taken for analysis. Subjects with POE were compared against subjects with no POE for risk factor assessment using multiple logistic regressions.

    RESULTS: A total of 163 503 subjects were screened. The incidence of POE was 0.08% (131/163 503). Demographic POE risk factors included male gender (OR: 2.121, 95%CI: 1.464-3.015) and renal disease (OR: 2.867, 95%CI: 1.503-5.467). POE risk increased with secondary causes of cataract (OR: 3.562, 95%CI: 1.740-7.288), uveitis (OR: 11.663, 95%CI: 4.292-31.693) and diabetic retinopathy (OR: 1.720, 95%CI: 1.078-2.744). Intraoperative factors reducing POE were shorter surgical time (OR: 2.114, 95%CI: 1.473-3.032), topical or intracameral anaesthesia (OR: 1.823, 95%CI: 1.278-2.602), posterior chamber intraocular lens (PCIOL; OR: 4.992, 95%CI: 2.689-9.266) and foldable IOL (OR: 2.276, 95%CI: 1.498-3.457). POE risk increased with posterior capsule rupture (OR: 3.773, 95%CI: 1.915-7.432) and vitreous loss (OR: 3.907, 95%CI: 1.720-8.873). Postoperative VA of 6/12 or better was achieved in 15.27% (20/131) subjects with POE.

    CONCLUSION: This study concurs with other studies regarding POE risk factors. Further strengthening of MOH CSR data collection process will enable deeper analysis and optimization of POE treatment.

    Matched MeSH terms: Anesthesia
  8. Mohamad S, Shuid AN, Mokhtar SA, Abdullah S, Soelaiman IN
    PMID: 22829855 DOI: 10.1155/2012/372878
    This study investigated the effects of α-tocopherol and palm oil tocotrienol supplementations on bone fracture healing in postmenopausal osteoporosis rats. 32 female Sprague-Dawley rats were divided into four groups. The first group was sham operated (SO), while the others were ovariectomised. After 2 months, the right femora were fractured under anesthesia and fixed with K-wire. The SO and ovariectomised-control rats (OVXC) were given olive oil (vehicle), while both the alpha-tocopherol (ATF) and tocotrienol-enriched fraction (TEF) groups were given alpha-tocopherol and tocotrienol-enriched fraction, respectively, at the dose of 60 mg/kg via oral gavages 6 days per week for 8 weeks. The rats were then euthanized and the femora dissected out for bone biomechanical testing to assess their strength. The callous of the TEF group had significantly higher stress parameter than the SO and OVXC groups. Only the SO group showed significantly higher strain parameter compared to the other treatment groups. The load parameter of the OVXC and ATF groups was significantly lower than the SO group. There was no significant difference in the Young's modulus between the groups. In conclusion, tocotrienol is better than α-tocopherol in improving the biomechanical properties of the fracture callous in postmenopausal osteoporosis rat model.
    Matched MeSH terms: Anesthesia
  9. Abdullah B, Othman NA, Daud MK
    Malays J Med Sci, 2008 Apr;15(2):29-32.
    PMID: 22589622
    To determine the outcome of laser-assisted uvulopalatoplasty for the management of patients with snoring in Universiti Sains Malaysia Hospital (HUSM). A retrospective review of patients who underwent LAUP with or without tonsillectomy or adenoidectomy under general anaesthesia between December 2003 to December 2006. Data was obtained from admission and follow-up records in the otorhinolaryngology clinic of USM Hospital (HUSM). A total of nineteen patients underwent procedure for the treatment of snoring. Majority of these patients presented with symptoms of loud snoring and daytime somnolence. The main operations performed were LAUP with or without tonsillectomy or adenoidectomy. The justification for LAUP were overhanging and excessive uvula or soft palate, whereas for adenotonsillectomy were the hypertrophied adenoids and tonsils. On follow-up, most of the patients claimed improvement of snoring within the first 2 months post-operation. However, majority of them defaulted follow-up after that. One patient (AHI preoperatively was mild) was reviewed up to 8 months with no snoring. One patient (AHI was severe preoperatively and normal post operatively) remained in our follow-up was satisfied with the operation. Two patients continued to experience snoring post LAUP despite trial of non-surgical methods. The outcome of LAUP in our patients showed variable results. This showed that patient selection is very important to achieve good result in LAUP. Long-term follow-up is also essential to document the success for LAUP.

    Study site: otorhinolaryngology clinic of USM Hospital (HUSM)
    Matched MeSH terms: Anesthesia, General
  10. Hassan WMNW, Nasir YM, Zaini RHM, Shukeri WFWM
    Malays J Med Sci, 2017 Oct;24(5):73-82.
    PMID: 29386974 MyJurnal DOI: 10.21315/mjms2017.24.5.8
    Background: The choice of anaesthetic techniques is important for the outcome of traumatic brain injury (TBI) emergency surgery. The objective of this study was to compare patient outcomes for target-controlled infusion (TCI) of propofol and sevoflurane anaesthesia.

    Methods: A total of 110 severe TBI patients, aged 18-60, who underwent emergency brain surgery were randomised into Group T (TCI) (n = 55) and Group S (sevoflurane) (n = 55). Anaesthesia was maintained in Group T with propofol target plasma concentration of 3-6 μg/mL and in Group S with minimum alveolar concentration (MAC) of sevoflurane 1.0-1.5. Both groups received TCI remifentanil 2-8 ng/mL for analgesia. After the surgery, patients were managed in the intensive care unit and were followed up until discharge for the outcome parameters.

    Results: Demographic characteristics were comparable in both groups. Differences in Glasgow Outcome Scale (GOS) score at discharge were not significant between Group T and Group S (P = 0.25): the percentages of mortality (GOS 1) [27.3% versus 16.4%], vegetative and severe disability (GOS 2-3) [29.1% versus 41.8%] and good outcome (GOS 4-5) [43.6% versus 41.8%] were comparable in both groups. There were no significant differences in other outcome parameters.

    Conclusion: TCI propofol and sevoflurane anaesthesia were comparable in the outcomes of TBI patients after emergency surgery.

    Matched MeSH terms: Anesthesia
  11. Hasan MS, Chan L
    J Oral Maxillofac Surg, 2014 Oct;72(10):1920.e1-4.
    PMID: 24985961 DOI: 10.1016/j.joms.2014.03.032
    Treating children with cyanotic congenital heart disease poses many challenges to anesthesiologists because of the multiple problems associated with the condition. The anesthetic technique and drugs used perioperatively can affect a patient's physiologic status during surgery. The adherence to certain hemodynamic objectives and the avoidance of factors that could worsen the abnormal cardiopulmonary physiology cannot be overemphasized. In the present case series, we describe the use of a dexmedetomidine-ketamine combination for dental extraction in spontaneously breathing children with cyanotic congenital heart disease. The anesthetic concerns regarding airway management, the pharmacologic effects of drugs, and maintenance of adequate hemodynamic, blood gases, and acid-base status are discussed.
    Matched MeSH terms: Anesthesia, Dental/methods*
  12. 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*
  13. Roshaliza HM, Liu CY, Joanna OSM
    Med J Malaysia, 2011 Jun;66(2):92-4.
    PMID: 22106684
    This prospective study aimed to determine the extent of contamination of fentanyl solutions used for central neuraxial injection by wiping the neck of the ampoules with 70% isopropyl alcohol swabs (Kendall) before breaking open the ampoules and aspiration of fentanyl solutions using a 5 microm Filter Straw (B. Braun). In Group A, fifty fentanyl ampoules were wiped with 70% isopropyl alcohol swab prior to opening and the contents were aspirated immediately using a 21G needle and a 5 microm filter straw for culture. The same steps were repeated on the remaining solutions after two hours. In Group B, all the above steps were repeated but without wiping the ampoules with 70% isopropyl alcohol swabs. None of the samples from the wiped ampoules or aspiration using filter straw grew microorganisms. Six percent of the samples from unwiped group grew microorganisms when fentanyl were aspirated using a 21G needle and the contamination increased to 16% when repeated after two hours. Wiping the outsides of the fentanyl ampoules with 70% isopropyl alcohol swabs before opening or aspirating the contents using a 5 pm filter straw has been shown to be equally effective in avoiding bacterial contamination and should be practiced routinely when performing regional anaesthesia.
    KEY WORDS: Fentanyl solution, Isopropyl alcohol swab, Filter straw, Contamination, Regional anaesthesia, Hospital Kuala Lumpur, Malaysia
    Matched MeSH terms: Anesthesia, Conduction
  14. Shoji Y
    J Oral Sci, 2011 Mar;53(1):125-7.
    PMID: 21467825
    Cluster headache is a neurovascular disorder characterized by attacks of severe and strictly unilateral pain presenting in and around the orbit and temporal area. Attacks occur in series lasting for weeks or months separated by remission periods. An individual attack lasts 15-180 min with a frequency of once every other day to as often as 8 times per day. Ipsilateral radiation of the headache to orofacial regions, including the teeth, is not unusual. The area of involvement may obscure the diagnosis and lead to irreversible and unnecessary dental treatment. A case in which cluster attacks occurred immediately after a dental procedure is described.
    Matched MeSH terms: Anesthesia, Local
  15. 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
  16. Chiu CL, Jaais F, Wang CY
    Br J Anaesth, 1999 May;82(5):757-60.
    PMID: 10536557
    We have compared the effect of rocuronium and succinylcholine on intraocular pressure (IOP) during rapid sequence induction of anaesthesia using propofol and fentanyl, in a randomized double-blind study. We studied 30 adult patients, allocated to one of two groups. Anaesthesia was induced with fentanyl 2 micrograms kg-1 and propofol until loss of verbal response. This was followed by succinylcholine 1.5 mg kg-1 (group S; n = 15) or rocuronium 0.9 mg kg-1 (group R; n = 15). Laryngoscopy was performed 60 s later. IOP, mean arterial pressure (MAP) and heart rate (HR) were measured before induction, immediately before intubation and every minute after intubation for 5 min. A Keeler Pulsair air impulse tonometer was used to measure IOP and the mean of two readings obtained in the right eye at each measurement time was recorded. Intubating conditions were evaluated according to a simple scoring system. IOP in the succinylcholine group was significantly greater than that in the rocuronium group (mean 21.6 (SEM 1.4) mm Hg vs 13.3 (1.4) mm Hg; P < 0.001). Intubating conditions were equally good in both groups. We conclude that with rapid sequence induction of anaesthesia using propofol and fentanyl, rocuronium did not cause as great an increase in IOP as succinylcholine and may be an alternative in open eye injury cases.
    Matched MeSH terms: Anesthesia, Intravenous
  17. Chong SE, Mohammad Zaini RH, Wan Mohd Rubi I, Lim JA
    J Clin Anesth, 2016 Nov;34:612-4.
    PMID: 27687458 DOI: 10.1016/j.jclinane.2016.06.035
    Mask ventilation is one of the most important skills in airway management. Difficulty in mask ventilation can become life threatening if it is associated with difficulty in intubation during general anesthesia. We report a potential impossible ventilation condition which was safely and easily overcome with appropriate innovative modification of an Opsite adhesive film.
    Matched MeSH terms: Anesthesia, General
  18. Hanifah J, Joehaimey J, Yusof MI
    Malays Orthop J, 2017 Jul;11(2):85-88.
    PMID: 29021888 MyJurnal DOI: 10.5704/MOJ.1707.018
    Spinal epidural abscess is a severe, generally pyogenic, infection of the epidural space of spinal cord or cauda equina. The swelling caused by the abscess leads to compression or vascular disruption of neurological structures that requires urgent surgical decompression to avoid significant permanent disability. We share a rare case of Klebsiella pneumoniae spinal epidural abscess secondary to haematogenous spread of previous lung infection that presented late at our centre with cauda equina syndrome that showed good short-term outcome in delayed decompression. A 50-year old female presented with one-week history of persistent low back pain with progressively worsening bilateral lower limb weakness for seven days and urinary retention associated with saddle anesthesia of 2-day duration. Magnetic resonance imaging with contrast of the lumbo-sacral region showed an intramuscular collection of abscess at left gluteus maximus and left multifidus muscle with a L3-L5 posteriorly placed extradural lesion enhancing peripherally on contrast, suggestive of epidural abscess that compressed the cauda equina. The pus was drained using the posterior lumbar approach. Tissue and pus culture revealed Klebsiella pneumoniae, suggestive of bacterial infection. The patient made immediate improvement of muscle power over bilateral lower limbs postoperative followed by ability to control micturition and defecation the 4th post-operative day. A good short-term outcome in delayed decompression of cauda equine syndrome is extremely rare. Aggressive surgical decompression combined with antibiotic therapy led to good short-term outcome in this patient despite delayed decompression of more than 48 hours.
    Matched MeSH terms: Anesthesia
  19. Toh KW, Nadesan K, Sie MY, Vijeyasingam R, Tan PS
    Anesth Analg, 2004 Aug;99(2):350-2, table of contents.
    PMID: 15271703
    Arrhythmogenic right ventricular dysplasia is an inherited disease causing fatty replacement of heart tissue. This disease often presents as T-wave inversion in the anterior leads of the electrocardiogram (ECG) with life-threatening ventricular arrhythmias. In older patients, progressive right and left ventricular failure can develop. This is a case report of postoperative death occurring in a 59-yr-old woman with undiagnosed arrhythmogenic right ventricular dysplasia after hepatic cystectomy. The patient had T-wave inversion in the inferior ECG leads and no history of arrhythmias. During general anesthesia, cardiovascular collapse occurred in the absence of arrhythmias that was unresponsive to resuscitation.
    Matched MeSH terms: Anesthesia
  20. Fahlman A, Bosi EJ, Nyman G
    J. Zoo Wildl. Med., 2006 Dec;37(4):558-61.
    PMID: 17315446
    Medetomidine (0.02-0.06 mg/kg) in combination with zolazepam-tiletamine (0.8-2.3 mg/kg) were evaluated for reversible anesthesia in four species of Southeast Asian primates: Bornean orangutan (Pongo pygmaeus pygmaeus), Bornean gibbon (Hylobates muelleri), long-tailed macaque (Macaca fascicularis), and pig-tailed macaque (Macaca nemestrina). Twenty-three anesthetic procedures of captive-held and free-ranging primates were studied in Sabah, Malaysia. The induction was smooth and rapid. Respiratory and heart rates were stable throughout anesthesia, whereas body temperature and systolic arterial blood pressure decreased significantly. Atipamezole at five times the medetomidine dose effectively reversed anesthesia, with first signs of recovery within 3-27 min.
    Matched MeSH terms: Anesthesia Recovery Period
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