MyMedR

Modern anaesthesia carries a definite although small risk. The risk from general and regional anaesthesia is reviewed, the causes explored, and preventive strategies discussed. Although anaesthesia may never be 100% safe, a knowledge of the risk and causes enables us to work towards this goal.

Matched MeSH terms: Anesthesia/adverse effects*; Anesthesia/mortality

Multi-model generalised predictive control for intravenous anaesthesia under inter-individual variability

Jing CJ, Syafiie S

J Clin Monit Comput, 2021 10;35(5):1037-1045.

PMID: 32833146 DOI: 10.1007/s10877-020-00581-0

Inter-individual variability possesses a major challenge in the regulation of hypnosis in anesthesia. Understanding the variability towards anesthesia effect is expected to assist the design of controller for anesthesia regulation. However, such studies are still very scarce in the literature. This study aims to analyze the inter-individual variability in propofol pharmacokinetics/pharmacodynamics (PK/PD) model and proposed a suitable controller to tackle the variability. This study employed Sobol' sensitivity analysis to identify significance parameters in propofol PK/PD model that affects the model output Bispectral Index (BIS). Parameters' range is obtained from reported clinical data. Based on the finding, a multi-model generalized predictive controller was proposed to regulate propofol in tackling patient variability. [Formula: see text] (concentration that produces 50% of the maximum effect) was found to have a highly-determining role on the uncertainty of BIS. In addition, the Hill coefficient, [Formula: see text], was found to be significant when there is a drastic input, especially during the induction phase. Both of these parameters only affect the process gain upon model linearization. Therefore, a predictive controller based on switching of model with different process gain is proposed. Simulation result shows that it is able to give a satisfactory performance across a wide population. Both the parameters [Formula: see text] and [Formula: see text], which are unknown before anesthesia procedure, were found to be highly significant in contributing the uncertainty of BIS. Their range of variability must be considered during the design and evaluation of controller. A linear controller may be sufficient to tackle most of the variability since both [Formula: see text] and [Formula: see text] would be translated into process gain upon linearization.

Matched MeSH terms: Anesthesia*; Anesthesia, Intravenous

Puerperal sterilisation: comparison of the use of local anaesthesia and epidural lumbar anaesthesia

Peng WW, Hing NG, Fuvan IS

Med J Malaysia, 1975 Jun;29(4):293-8.

PMID: 1196177

Matched MeSH terms: Anesthesia, Epidural*; Anesthesia, Local*

Caesarean section under local anaesthesia

Ling NN

Med J Malaya, 1972 Mar;26(3):198-200.

PMID: 5031015

Matched MeSH terms: Anesthesia, Local*; Anesthesia, Obstetrical*

CHILDBIRTH UNDER HYPNOSIS

CHONGTONG MUN

Med J Malaysia, 1963 Dec;18:83-6.

PMID: 14117285

Matched MeSH terms: Anesthesia*; Anesthesia, Obstetrical*

Subtotal gastrectomy under local anaesthesia

Bankoff G

Malayan Medical Journal, 1937;12:50-5.

Matched MeSH terms: Anesthesia, Local

3rd Meeting of the Asian Society of Cardiothoracic Anesthesia and 11th ASEAN Congress of Anesthesiologists. 7-11 July 1999. Abstracts

Med J Malaysia, 1999 Jul;54 Suppl A:1-160.

PMID: 11008619

Matched MeSH terms: Anesthesia*; Anesthesiology*

Hypnosis in clinical medicine

Patrick E

Med J Malaysia, 1963 Sep;18:25-9.

PMID: 14064293

Matched MeSH terms: Anesthesia*

Clinical experiences with halothane

MANAVALAN AS

Med J Malaya, 1962 Sep;17:50-2.

PMID: 13932699

Matched MeSH terms: Anesthesia*; Anesthesiology*

Anaesthesia at the Lady Templer Hospital

GARDINER AS

Med J Malaya, 1959 Jun;13:280-91.

PMID: 13826499

Matched MeSH terms: Anesthesia*; Anesthesiology*

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

The association between physical activity and burnout among anaesthesia postgraduate trainees in Malaysia

Jaishree S, Chong KW, Lim TA

Med J Malaysia, 2022 Nov;77(6):655-660.

PMID: 36448381

INTRODUCTION: Burnout is a psychological problem which is becoming more prevalent among medical professionals resulting in various negative outcomes. Physical activity has been found to be an effective method in alleviating burnout. The aim of this study was to determine the association between physical activity and burnout among postgraduate anaesthesia trainees in Malaysia. The study also intended to determine the level of physical activity among trainees, the factors affecting this practice, and the prevalence of burnout among anaesthesia trainees.

MATERIALS AND METHODS: An online self-administered questionnaire was sent out to all postgraduate anaesthesia trainees between August 2020 and January 2021 via email and respondents were recruited on a voluntary basis.

RESULTS: The prevalence of burnout among postgraduate anaesthesia trainees was high (54%). This prevalence was higher among trainees with low a level of physical activity. Half of the trainees (50.8%) engaged in moderate physical activity while only 12% reported a high level of physical activity. The postgraduate study year was found to be a significant factor affecting the practice of physical activity.

CONCLUSION: There is a significant association between physical activity and burnout among postgraduate anaesthesia trainees in Malaysia. Physical activity has the potential to be an essential method of reducing burnout. Hence, measures should be implemented to improve the practice of physical activity among healthcare professionals in order to reduce workplace burnout.

Matched MeSH terms: Anesthesia*

Trends in obstetric anaesthesia and analgesia over a ten year period in the University Malaya Medical Centre, Kuala Lumpur

Chan YK, Ng KP, Chiu CL

Int J Obstet Anesth, 2002 Jul;11(3):176-9.

PMID: 15321544 DOI: 10.1054/ijoa.2002.0954

Available data for obstetric care in the University Malaya Medical Centre, Kuala Lumpur from 1987 to 1999 were reviewed. Despite incomplete data, we were able to determine fairly well the practice of obstetric anaesthesia and analgesia in the unit, and the changes over the years. There was a decline in the use of general anaesthesia for both elective and emergency caesarean sections from 41.3% and 69.4% respectively in 1995 to 21.6% and 26.9% respectively in 1999. By 1999, regional anaesthesia had become the most common method of anaesthesia administered in both elective (14.3% epidural and 63.5% spinal) and emergency (30.2% epidural and 42.6% spinal) caesarean sections. The percentage of patients delivering vaginally who received epidural analgesia appeared to have stabilised at about 8 to 9% in the last few years, with a gradual decline in the total instrumental delivery rate from a high of about 12% to the pre-epidural rate of 7%.

Matched MeSH terms: Anesthesia, Obstetrical*

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