Search

Your search keyword '"Chokwe TM"' showing total 8 results
Start Over Author "Chokwe TM"
8 results on '"Chokwe TM"'

1. Maternal and neonatal outcomes after caesarean delivery in the African Surgical Outcomes Study: a 7-day prospective observational cohort study

Author

Abadagan, Hippolyte, Abbas, N, Abdelatif, A Ibrahim, Abdoulaye, Traoré, Abd-rouf, A, Abduljalil, A, Abdulrahman, A, Abdurazig, S, Abokris, A, Abozaid, W, Abugassa, SOA, Abuhdema, F, Abujanah, SA, Abusamra, R, Abushnaf, A, Abusnina, SA, Abuzalout, TS, Ackermann, HM, Adamu, YB, Addanfour, A, Adeleke, DM, Adigun, TA, Adisa, AO, Adjignon, Sèhivè Valéry, Adu-Aryee, NA, Afolabi, BB, Agaba, AFX, Agaba, PKA, Aghadi, K, Agilla, H, Ahmed, B, Ahmed, El-Z, Ahmed, Al-J, Ahmed, M, Ahossi, Rene, Aji, SA, Akanyun, S, Akhideno, I, Akhter, M, Akinyemi, OA, Akkari, M, Akodjenou, Joseph, AL Samateh, AL, al Shams, ES, Alagbe-Briggs, OT, Alakkari, EA, Alalem, RB, Alashhab, M, Alatise, OI, Alatresh, A, Alayeb Alayeb, MSI, Albakosh, BA, Albert, F, Alberts, ANJD, Aldarrat, AD, Alfari, A, Alfetore, A, Algbali, M, Algddar, A, Algedar, HA, Alghafoud, IA, Alghazali, A, Alhajj, M, Alhendery Alhendery, A, Alhoty, FFH, Ali, A, Ali, YA, Alioune, Beye Seïdina, Alkassem, MA, Alkchr, MA, Alkesa, TS, Alkilani, A, Alkobty Alkobty, F, Allaye, Thomas, Alleesaib, SBM, Alli, A, Allopi, K, Allorto, NL, Almajbery, A, Almesmary, R, Almisslati, SHA, Almoraid, F, Alobeidi, H, Alomami, MA, Alphonsus, Christella S, Alqawi, OA, Alraheem, AA, Alsabri, SA, Alsayed, A, Alsellabi, B, Al-Serksi, M, Alshareef, MSA, Altagazi, AA, Aluvale, JS, Alwahedi, HW, Alzahra, EA, Alzarouk, MA, Al-Zubaidy, K, Amadou, M, Amadou, Maiga, Amanor-Boadu, Simbo D, Amer, Al-A, Amisi, BT, Amuthenu, MA, Anabah, TWA, Anani, Felix, Anderson, PGR, Andriamampionona, AGB, Andrianina, L, Anele, A, Angelin, R, Anjar, N, Antùnez, O, Antwi-Kusi, Akwasi, Anyanwu, LJC, Aribi, AA, Arowolo, OA, Arrey, O, Ashebir, Daniel Zemenfes, Assefa, SB, Assoum, Guy, Athanse, V, Athombo, JS, Atiku, M, Atito-Narh, E, Atomabe, Anatole, Attia, A, Aungraheeta, M, Aurélia, DMA, Ayandipo, OO, Ayebale, AET, Azzaidey, HMZ, Babajee, NB, Badi, HB, Badianga, EK, Baghni, RB, Bahta, MT, Bai, M, Baitchu, Y, Baloyi, AM, Bamuza, KA, Bamuza, MI, Bangure, L, Bankole, OB, Barongo, ML, Barow, MM, Basenero, Apollo, Bashiya, L, Basson, CH, Bechan, Sudha, Belhaj, S, Ben Mansour, MM, Benali, D, Benamour, ASB, Berhe, A, Bertie, JD, Bester, JJA, Bester, M, Bezuidenhout, JD, Bhagwan, K, Bhagwandass, DR, Bhat, KAP, Bhuiyan, MMZU, Biccard, Bruce M, Bigirimana, F, Bikuelo, CJ, Bilby, BE, Bingidimi, SS, Bischof, KE, Bishop, David G, Bitta, C, Bittaye, M, Biyase, Thuli, Blake, CA, Blignaut, E, Blignaut, F, BN Tanjong, BN, Bogoslovskiy, A, Boloko, PM, Boodhun, SKB, Bori, I, Boufas, F, Brand, M, Brouckaert, Nicholas T, Bruwer, JD, Buccimazza, I, Bula Bula, IM, Bulamba, Fred, Businge, BC, Bwambale, YB, Cacala, SRC, Cadersa, MA, Cairns, Chris, Carlos, F, Casey, ME, Castro, AC, Chabayanzara, ND, Chaibou, MS, Chaibva, TNO, Chakafa, NK, Chalo, C, Changfoot, C, Chari, MC, Chelbi, L, Chibanda, JT, Chifamba, HN, Chikh, N, Chikumba, E, Chimberengwa, P, Chirengwa, J, Chitungo, FM, Chiwanga, MC, Chokoe, MM, Chokwe, TM, Chrirangi, B, Christian, M, Church, B, Cisekedi, JC, Clegg-Lamptey, JN, Cloete, Estie, Coltman, Megan, Conradie, W, Constance, N, Coulibaly, Youssouf, Cronje, L, Da Silva, MA, Daddy, H, Dahim, L, Daliri, D, Dambaki, MS, Dasrath, A, Davids, JG, Davies, Gareth L, De Lange, JT, de Wet, JB, Dedekind, B, Degaulle, MA, Dehal, V, Deka, PD, Delinikaytis, S, Desalu, IS, Dewanou, Hubert, Deye, MB Moussa, Dhege, C, Diale, BSG, Dibwe, DF, Diedericks, BJS, Dippenaar, JM, Dippenaar, L, Diyoyo, MP, Djessouho, Edith, Dlamini, SN, Dodiyi-Manuel, A, Dokolwana, BA, Domoyyeri, DP, Drummond, Leanne W, du Plessis, DE, du Plessis, WM, du Preez, LJ, Dube, K, Dube, NZ, Dullab, KD, Duvenhage, R, Echem, RC, Edaigbini, SA, Egote, AK, Ehouni, A, Ekwen, G, Ekwunife, NC, El Hensheri, M, Elfaghi, IE, Elfagieh, MA, Elfallah, S, Elfiky, Mahmoud, Elgelany, S, Elghallal, AM, Elghandouri, MG, Elghazal, ZS, Elghobashy, AM, Elharati, FT, Elkhogia, Abdulaziz M, Elkhwildi, RM, Ellis, S, Elmadani, L, Elmadany, HB, Elmehdawi, H, Elmgadmi, A, Eloi, H, Elrafifi, D, Elsaadi, G, Elsaity, RB, Elshikhy, A, Eltaguri, M, Elwerfelli, A, Elyasir, IE, Elzoway, AZ, Elzufri, AM, Enendu, EO, Enicker, BC, Enwerem, EO, Esayas, R, Eshtiwi, M, Eshwehdi, AA, Esterhuizen, JL, Esterhuizen, Tonya M, Etuk, EB, Eurayet, O, Eyelade, OR, Fanjandrainy, RF, Fanou, Lionelle, Farina, Z, Fawzy, Maher, Feituri, A, Fernandes, NL, Ford, LM, Forget, Patrice, François, T, Freeman, T, Freeman, YBM, Gacii, VM, Gadi, B, Gagara, M, Gakenia, A, Gallou, PD, Gama, GGN, Gamal, MG, Gandy, YG, Ganesh, A, Gangaly, Diallo, Garcia, M, Gatheru, AP, Gaya, SSD, Gbéhadé, Oswald, Gerbel, G, Ghnain, A, Gigabhoy, R, Giles, DG, Girmaye, GT, Gitau, S, Githae, B, Gitta, Said, Gobin, Veekash, Goga, Riaz, Gomati, AAG, Gonzalez, ME, Gopall, J, Gordon, Christina Salmina, Gorelyk, O, Gova, M, Govender, K, Govender, P, Govender, S, Govindasamy, V, Green-Harris, JTK, Greenwood, MB, Grey-Johnson, SV, Grobbelaar, Mariette, Groenewald, MA, Grünewald, KK, Guegni, Ambroise, Guenane, M, Gueye, S, Guezo, Marius, Gunguwo, T, Gweder, MG, Gwila, M, Habimana, L, Hadecon, Rodrigue, Hadia, E, Hamadi, L, Hammouda, M, Hampton, MI, Hanta, R, Hardcastle, Tim C, Hariniaina, JA, Hariparsad, S, Harissou, AH, Harrichandparsad, R, Hasan, SHA, Hashmi, HB, Hayes, MP, Hdud, A, Hebli, SH, Heerah, HMSN, Hersi, S, Hery, AH, Hewitt-Smith, Adam, Hlako, TC, Hodges, SCH, Hodgson, Richard Eric, Hokoma, M, Holder, H, Holford, EB, Horugavye, E, Houston, C, Hove, M, Hugo, D, Human, CM, Hurri, H, Huwidi, O, Ibrahim, AI, Ibrahim, Traoré, Idowu, OK, Igaga, IE, Igenge, John, Ihezie, O, Ikandi, K, Ike, IAR, Ikuku, JJN, Ilbarasi, MN, Ilunga, IBB, Ilunga, JPM, Imbangu, NAV, Imessaoudene, Z, Imposo, DH, Iraya, AM, Isaacs, M, Isiguzo, M, Issoufou, A, Izquirdo, P, Jaber, A, Jaganath, UV, Jallow, CS, Jamabo, S, Jamal, ZS, Janneh, L, Jannetjies, MJ, Jasim, I, Jaworska, Megan AJ, Jay Narain, S, Jermi, K, Jimoh, R, Jithoo, S, Johnson, M, Joomye, S, Judicael, RM, Judicaël, M, Juwid, A, Jwambi, LP, Kabango, R, Kabangu, JK, Kabatoro, DK, Kabongo, AN, Kabongo, K, Kabongo, LT, Kabongo, MD, Kady, N, Kafu, S, Kaggya, M, Kaholongo, BNK, Kairuki, PCK, Kakololo, SI, Kakudji, K, Kalisa, Amina, Kalisa, R, Kalufwelu, MR, Kalume, S, Kamanda, RJ, Kangili, MK, Kanoun, H, Kapesa, Kapp, P, Karanja, JK, Karar, M, Kariuki, K, Kaseke, K, Kashuupulwa, PNK, Kasongo, KJP, Kassa, SK, Kateregga, GK, Kathrada, MIS, Katompwa, PM, Katsukunya, L, Kavuma, KAM, Khalfallah, Khamajeet, A, Khetrish, SB, Kibandwa, Kibochi, W, Kilembe, AM, Kintu, AK, Kipng'etich, B, Kiprop, B, Kissoon, VMK, Kisten, Theroshnie K, Kiwanuka, JK, Kluyts, Hyla-Louise, Knox, MEK, Koledale, AK, Koller, VL, Kolotsi, MA, Kongolo, M, Konwuoh, ND, Koperski, WJ, Koraz, MYK, Kornilov, AA, Koto, M Zach, Kransingh, Samantha, Krick, D, Kruger, S, Kruse, C, Kuhn, W, Kuhn, WP, Kukembila, AM, Kule, KL, Kumar, M, Kusel, Belinda S, Kusweje, VK, Kuteesa, KJ, Kutor, YY, Labib, MA, Laksari, M, Lanos, F, Lawal, TA, Le Manach, Yannick, Lee, C, Lekoloane, RM, Lelo, SN, Lerutla, B, Lerutla, MT, Levin, AI, Likongo, TB, Limbajee, ML, Linyama, DM, Lionnet, C, Liwani, MM, Loots, E, Lopez, A Garrido, Lubamba, CLC, Lumbala, KF, Lumbamba, AJM, Lumona, John, Lushima, RF, Luthuli, L, Luweesi, HL, Lyimo, TSK, Maakamedi, HM, Mabaso, BM, Mabina, M, Maboya, ME, Macharia, I, Macheka, AM, Machowski, AZ, Madiba, Thandinkosi E, Madsen, ASM, Madzimbamuto, Farai, Madzivhe, LJ, Mafafo, SC, Maghrabi, M, Mahamane, Diango Djibo, Maharaj, A, Maharaj, AD, Mahmud, MR, Mahoko, M, Mahomedy, NA, Mahomva, O, Mahureva, TM, Maila, RK, Maimane, DM, Maimbo, M, Maina, SN, Maiwald, Dela A, Maiyalagan, MD, Majola, N, Makgofa, N, Makhanya, V, Makhaye, WP, Makhlouf, NM, Makhoba, S, Makopa, EK, Makori, O, Makupe, Alex M, Makwela, MA, Malefo, ME, Malongwe, SM, Maluleke, DM, Maluleke, MR, Mamadou, K Touré, Mamaleka, MP, Mampangula, Y, Mamy, RM, Mananjara, MNR, Mandarry, MTM, Mangoo, DM, Manirimbere, C, Manneh, A, Mansour, A, Mansour, I, Manvinder, M, Manyere, DV, Manzini, VT, Manzombi, JK, Mapanda, PM, Marais, LC, Maranga, O, Maritz, JPB, Mariwa, FK, Masela, RS, Mashamba, MM, Mashava, Doreen M, Mashile, MV, Mashoko, E, Masia, OR, Masipa, JN, Masiyambiri, ATM, Matenchi, MW, Mathangani, W, Mathe, RC, Matola, Christopher Y, Matondo, PM, Matos-Puig, R, Matoug, FFH, Matubatuba, JT, Mavesere, HP, Mavhungu, R, Maweni, S, Mawire, CJM, Mawisa, T, Mayeza, S, Mbadi, R, Mbayabu, M, Mbewe, N, Mbombo, WD, Mbuyi, T, Mbuyi, WMS, Mbuyisa, MW, Mbwele, Bernard, Mehyaoui, RM, Menkiti, ID, Mesarieki, LVM, Metali, A, Mewanou, Serge, Mgonja, L, Mgoqo, N, Mhatu, S, Mhlari, TM, Miima, S, Milod, IM, Minani, P, Mitema, F, Mlotshwa, A, Mmasi, JE, Mniki, T, Mofikoya, BO, Mogale, JO, Mohamed, A, Mohamed, S, Mohamed, TS, Mohamed, AM, Mohamed, P, Mohammed, I, Mohammed, FAM, Mohammed, M, Mohammed, NM, Mohlala, MP, Mokretar, R, Molokoane, FM, Mongwe, KN, Montenegro, L, Montwedi, OD, Moodie, QK, Moopanar, M, Morapedi, M, Morulana, TG, Moses, VL, Mossy, P, Mostafa, H, Motilall, SR, Motloutsi, SP, Moussa, Kanté, Moutari, M, Moyo, OM, Mphephu, PE, Mrara, Busi, Msadabwe, C, Mtongwe, VM, Mubeya, FK, Muchiri, K, Mugambi, J, Muguti, GIM, Muhammad, AB, Mukama, IF, Mukenga, MM, Mukinda, FK, Mukuna, PM, Mungherera, ARW, Munlemvo, Dolly M, Munyaradzi, TW, Munyika, AA, Muriithi, JM, Muroonga, MP, Murray, R, Mushangwe, VK, Mushaninga, M, Musiba, VEM, Musowoya, JM, Mutahi, S, Mutasiigwa, MGH, Mutizira, G, Muturi, A, Muzenda, T, Mvwala, KR, Mvwama, NM, Mwale, A, Mwaluka, CN, Mwamba, JD, Mwanga, HAM, Mwangi, CM, Mwansa, S, Mwenda, V, Mwepu, IM, Mwiti, TM, Mzezewa, SZ, Nabela, L, Nabukenya, MTN, Nabulindo, SM, Naicker, K, Naidoo, D, Naidoo, L, Naidoo, LC, Naidoo, N, Naidoo, R, Naidoo, RD, Naidoo, S, Naidoo, TD, Naidu, TK, Najat, NZ, Najm, Y, Nakandungile, F, Nakangombe, P, Namata, CN, Namegabe, ES, Nansook, A, Nansubuga, NP, Nantulu, C, Nascimento, Rodrigue, Naude, GT, Nchimunya, H, Ndaie, MA, Ndarukwa, PN, Ndasi, Henry, Ndayisaba, Gabriel, Ndegwa, D, Ndikumana, R, Ndonga, Andrew KN, Ndung'u, C, Neil, MC, Nel, MS, Neluheni, EV, Nesengani, DS, Nesengani, NT, Netshimboni, LE, Ngalala, AM, Ngari, BM, Ngari, NBM, Ngatia, E, Ngcobo, GK, Ngcobo, TS, Ngorora, D, Ngouane, D, Ngugi, K, Ngumi, Zipporah WW, Nibe, Z, Ninise, E, Niyondiko, JC, Njenga, PW, Njenga, MN, Njoroge, M, Njoroge, S, Njuguna, W, Njuki, PN, Nkesha, T, Nkuebe, TN, Nkuliyingoma, NP, Nkunjana, M, Nkwabi, Ernest, Nkwine, RN, Nnaji, C, Notoane, I, Nsalamba, Shaaban, Ntlhe, LM, Ntoto, C, Ntueba, B, Nyassi, MT, Nyatela-Akinrinmade, Z, Nyawanda, HO, Nyokabi, NN, Nziene, VN, Obadiah, S, Ochieng, OJP, Odia, PK, Oduor, OEO, Ogboli-Nwasor, EO, Ogendo, SWO, Ogunbode, O, Ogundiran, TO, Ogutu, O, Ojewola, RW, Ojujo, M, Ojuka, DO, Okelo, OS, Okiya, S, Okonu, N, Olang, PR, Omigbodun, Akinyinka O, Omoding, S, Omoshoro-Jones, J, Onyango, R, Onyegbule, A, Orjiako, O, Osazuwa, MO, Oscar, Kpatinvo, Osinaike, BB, Osinowo, AO, Othin, OM, Otman, FFH, Otokwala, J, Ouanes, F, Oumar, Ongoïba, Ousseini, AO, Padayachee, S, Pahlana, SM, Pansegrouw, J, Paruk, FP, Patel, MB, Patel-Mujajati, Ushmaben, Patience, AP, Pearse, Rupert M, Pembe, JD, Pengemale, GN, Perez, N, Perez, MF Aguilera, Peter, A Mallier, Phaff, M, Pheeha, RM, Pienaar, BH, Pillay, V, Pilusa, KA, Pochana, MP, Polishchuk, O, Porrill, Owen S, Post, EF, Prosper, A, Pupyshev, M, Rabemazava, A, Rabiou, MS, Rademan, L, Rademeyer, M, Raherison, RAR, Rajah, FR, Rajcoomar, MSR, Rakhda, Z, Rakotoarijaona, AHR, Rakotoarisoa, AHN, Rakotoarison, Sylvia R, Rakotoarison, RR, Rakotoniaina, François, Ramadan, L, Ramananasoa, MLR, Rambau, M, Ramchurn, TPR, Ramilson, HE, Ramjee, Rajesh J, Ramnarain, H, Ramos, R, Rampai, TJ, Ramphal, SR, Ramsamy, T, Ramuntshi, R, Randolph, R, Randriambololona, DMA, Ras, WAP, Rasolondraibe, RAF, Rasolonjatovo, JDLC, Rautenbach, RM, Ray, S, Rayne, Sarah R, Razanakoto, FAR, Reddy, SR, Reed, Anthony R, Rian, JR, Rija, FR, Rink, B, Robelie, AT, Roberts, CA, Rocher, AGL, Rocher, S, Rodseth, Reitze N, Rois, I, Rois, W, Rokhsi, S, Roos, J, Rorke, Nicolette F, Roura, H, Rousseau, FJ, Rousseau, N, Royas, L, Roytowski, D, Rungan, Devan, Rwehumbiza, SSR, Ryabchiy, BB, Ryndine, V, Saaiman, CR, Sabwa, HK, Sadat, S, Saed, SS, Salaheddin, E, Salaou, H, Saleh, M, Salisu-Kabara, HM, Sama, Hamza Doles, Samateh, Ahmadou L, Sam-Awortwi (Jnr), W, Samuel, N, Sanduku, DK, Sani, Chaibou M, Sanyang, LN, Sarah, HN, Sarkin-Pawa, A, Sathiram, R, Saurombe, T, Schutte, H, Sebei, MP, Sedekounou, MD, Segooa, MP, Semenya, EM, Semo, BO, Sendagire, CS, Senoga, SA, Senusi, FS, Serdyn, T, Seshibe, MD, Shah, GB, Shamamba, R, Shambare, CS, Shangase, TN, Shanin, SH, Shefren, IE, Sheshe, AA, Shittu, OB, Shkirban, AS, Sholadoye, T, Shubba, A, Sigcu, N, Sihope, SE, Sikazwe, DS, Sikombe, BS, Simaga Abdoul, K, Simo, WAG, Singata, K, Singh, AS, Singh, S, Singh, Usha, Sinoamadi, V, Sipuka, N, Sithole, NLM, Sitima, S, Skinner, David Lee, Skinner, GC, Smith, OI, Smits, CAG, Sofia, MSI, Sogoba, Gaoussou, Sohoub, A, Sookun, SS, Sosinska, O, Souhe, Rosalie, Souley, G, Souleymane, Thiam, Spicer, JM, Spijkerman, Sandra, Steinhaus, H, Steyn, A, Steyn, G, Steyn, HC, Stoltenkamp, Heidi L, Stroyer, S, Swaleh, A, Swayeb, E, Szpytko, AJ, Taiwo, NA, Tarhuni, A, Tarloff, D, Tchaou, Blaise, Tchegnonsi, Charles, Tchoupa, M, Teeka, MO, Thakoor, B, Theunissen, MM, Thomas, BP, Thomas, MB, Thotharam, A, Tobiko, O, Torborg, AM, Tshisekedi, SM, Tshisola, SK, Tshitangano, R, Tshivhula, F, Tshuma, HT, Tumukunde, Janat, Tun, M, Udo, IA, Uhuebor, DI, Umeh, KU, Usenbo, AO, Uwiteyimbabazi, JdD, Van der Merwe, DJ, van der Merwe, FH, van der Walt, JE, van Dyk, Dominique, Van Dyk, JG, van Niekerk, JJS, van Wyk, S, van Zyl, HA, Veerasamy, B, Venter, PJ, Vermeulen, AJ, Villarreal, R, Visser, J, Visser, L, Voigt, M, von Rahden, Richard P, Wafa, A, Wafula, A, Wambugu, PK, Waryoba, P, Waweru, EN, Weideman, M, Wise, Robert D, Wynne, EE, Yahya, AI, Yahya, AA, Yahya, R, Yakubu, Y, Yanga, JJ, Yangazov, YM, Yousef, O, Yousef, G, Youssouf, Coulibaly, Yunus, AA, Yusuf, AS, Zeiton, AZ, Zentuti, HZ, Zepharine, Henry, Zerihun, AB, Zhou, S, Zidan, A, Zié, Sanogo Zimogo, Zinyemba, CZ, Zo, A, Zomahoun, Lidwine, Zoobei, NZ, Zoumenou, Eugene, Zubia, NZ, Bishop, David, Dyer, Robert A, Maswime, Salome, Tumukunde, Janat T, Madzimbamuto, Farai D, Ndonga, Andrew K N, Ngumi, Zipporah W W, and Mehyaoui, Ryad

Published
2019
Full Text
View/download PDF

2. Comparative Study on the Efficacy of Two Regimens of Single-Shot Spinal Block for Pain Relief in Women Presenting in Established Labour

Author

Tshibuyi, PN, Olang, POR, Ogutu, O, and Chokwe, TM

Abstract

Background: Most women experience moderate to severe pain during labour and delivery, often requiring some form of pharmacologic analgesia. The lack of proper psychological preparation combined with fear and anxiety can greatly enhance the patientfs sensitivity to pain and further add to the discomfort. Skillfully conducted obstetric analgesia, in addition to relieving pain and anxiety, may benefit the mother by increasing self esteem and improving bonding with the baby.Objective: To assess and compare the satisfaction and efficacy of two regimens of single-shot spinal blocks for the relief of labor pain in women who present in active phase of labour.Design: A prospective randomised single-blind observational studySetting: Labour ward of Kenyatta National Hospital, Nairobi.Subjects: All consenting primiparous women presenting in active phase of labor with uncomplicated singleton pregnancy at term (> 37 weeks) and in cephalic presentation, who reported a > 70 mm VAS (Visual Analog Scale) pain score at cervical dilatation . 5 cm at the time of request for labour analgesia.Results: Effective labour analgesia lasting up to 120 minutes was observed in the fentanyl-bupivacaine group but with a high incidence of breakthrough pain. The fentanyl-bupivacaine-morphine group had labour analgesia lasting up to 180 minutes or even more with a lower incidence of breakthrough pain. The one-minute and fiveminute Apgar scores in the morphine group were significantly lower (p = 0.026 and 0.044 respectively) than in the fentanyl group but the difference in neonatal outcome had no clinical significance, and there were no significant differences in adverse effects, sensory levels, and motor power between the two groups.:Conclusion Effective analgesia for about 120 minutes was observed in the fentanylbupivacaine group with high incidence of breakthrough pain while the fentanylbupivacaine-morphine group had labour analgesia prolonged up to more than three hours. The difference in fetal outcome had no clinical significance for the morphine group, and there were no significant differences in adverse effect, sensory levels, and motor power between the two groups. These findings show that intrathecal analgesia is safe and the use of the combination of fentanyl-bupivacaine-morphine gives adequateand safe analgesia during labour and delivery.

Published
2014

3. Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study

Author

Biccard, Bruce M, Madiba, Thandinkosi E, Kluyts, Hyla-Louise, Munlemvo, Dolly M, Madzimbamuto, Farai D, Basenero, Apollo, Gordon, Christina S, Youssouf, Coulibaly, Rakotoarison, Sylvia R, Gobin, Veekash, Samateh, Ahmadou L, Sani, Chaibou M, Omigbodun, Akinyinka O, Amanor-Boadu, Simbo D, Tumukunde, Janat T, Esterhuizen, Tonya M, Manach, Yannick Le, Forget, Patrice, Elkhogia, Abdulaziz M, Mehyaoui, Ryad M, Zoumeno, Eugene, Ndayisaba, Gabriel, Ndasi, Henry, Ndonga, Andrew K N, Ngumi, Zipporah W W, Patel, Ushmah P, Ashebir, Daniel Zemenfes, Antwi-Kusi, Akwasi A K, Mbwele, Bernard, Sama, Hamza Doles, Elfiky, Mahmoud, Fawzy, Maher A, Pearse, Rupert M, Abadagan, Hippolyte, Abbas, N, Abdelatif, A Ibrahim, Abdoulaye, Traoré, Abd-rouf, A, Abduljalil, A, Abdulrahman, A, Abdurazig, S, Abokris, A, Abozaid, W, Abugassa, SOA, Abuhdema, F, Abujanah, SA, Abusamra, R, Abushnaf, A, Abusnina, SA, Abuzalout, TS, Ackermann, HM, Adamu, YB, Addanfour, A, Adeleke, DM, Adigun, TA, Adisa, AO, Adjignon, Sèhivè Valéry, Adu-Aryee, NA, Afolabi, BB, Agaba, AFX, Agaba, PKA, Aghadi, K, Agilla, H, Ahmed, B, Ahmed, El-Z, Ahmed, Al-J, Ahmed, M, Ahossi, Rene, Aji, SA, Akanyun, S, Akhideno, I, Akhter, M, Akinyemi, OA, Akkari, M, Akodjenou, Joseph, AL Samateh, AL, al Shams, ES, Alagbe-Briggs, OT, Alakkari, EA, Alalem, RB, Alashhab, M, Alatise, OI, Alatresh, A, Alayeb Alayeb, MSI, Albakosh, BA, Albert, F, Alberts, ANJD, Aldarrat, AD, Alfari, A, Alfetore, A, Algbali, M, Algddar, A, Algedar, HA, Alghafoud, IA, Alghazali, A, Alhajj, M, Alhendery Alhendery, A, Alhoty, FFH, Ali, A, Ali, YA, Ali, A, Alioune, Beye Seïdina, Alkassem, MA, Alkchr, MA, Alkesa, TS, Alkilani, A, Alkobty Alkobty, F, Allaye, Thomas, Alleesaib, SBM, Alli, A, Allopi, K, Allorto, NL, Almajbery, A, Almesmary, R, Almisslati, SHA, Almoraid, F, Alobeidi, H, Alomami, MA, Alphonsus, Christella S, Alqawi, OA, Alraheem, AA, Alsabri, SA, Alsayed, A, Alsellabi, B, Al-Serksi, M, Alshareef, MSA, Altagazi, AA, Aluvale, JS, Alwahedi, HW, Alzahra, EA, Alzarouk, MA, Al-Zubaidy, K, Amadou, M, Amadou, Maiga, Amanor-Boadu, Simbo D, Amer, Al-A, Amisi, BT, Amuthenu, MA, Anabah, TWA, Anani, Felix, Anderson, PGR, Andriamampionona, AGB, Andrianina, L, Anele, A, Angelin, R, Anjar, N, Antùnez, O, Antwi-Kusi, Akwasi, Anyanwu, LJC, Aribi, AA, Arowolo, OA, Arrey, O, Ashebir, Daniel Zemenfes, Assefa, SB, Assoum, Guy, Athanse, V, Athombo, JS, Atiku, M, Atito-Narh, E, Atomabe, Anatole, Attia, A, Aungraheeta, M, Aurélia, DMA, Ayandipo, OO, Ayebale, AET, Azzaidey, HMZ, Babajee, NB, Badi, HB, Badianga, EK, Baghni, RB, Bahta, MT, Bai, M, Baitchu, Y, Baloyi, AM, Bamuza, KA, Bamuza, MI, Bangure, L, Bankole, OB, Barongo, ML, Barow, MM, Basenero, Apollo, Bashiya, L, Basson, CH, Bechan, Sudha, Belhaj, S, Ben Mansour, MM, Benali, D, Benamour, ASB, Berhe, A, Bertie, JD, Bester, JJA, Bester, M, Bezuidenhout, JD, Bhagwan, K, Bhagwandass, DR, Bhat, KAP, Bhuiyan, MMZU, Biccard, Bruce M, Bigirimana, F, Bikuelo, CJ, Bilby, BE, Bingidimi, SS, Bischof, KE, Bishop, David G, Bitta, C, Bittaye, M, Biyase, Thuli, Blake, CA, Blignaut, E, Blignaut, F, BN Tanjong, BN, Bogoslovskiy, A, Boloko, PM, Boodhun, SKB, Bori, I, Boufas, F, Brand, M, Brouckaert, Nicholas T, Bruwer, JD, Buccimazza, I, Bula Bula, IM, Bulamba, Fred, Businge, BC, Bwambale, YB, Cacala, SRC, Cadersa, MA, Cairns, Chris, Carlos, F, Casey, ME, Castro, AC, Chabayanzara, ND, Chaibou, MS, Chaibva, TNO, Chakafa, NK, Chalo, C, Changfoot, C, Chari, MC, Chelbi, L, Chibanda, JT, Chifamba, HN, Chikh, N, Chikumba, E, Chimberengwa, P, Chirengwa, J, Chitungo, FM, Chiwanga, MC, Chokoe, MM, Chokwe, TM, Chrirangi, B, Christian, M, Church, B, Cisekedi, JC, Clegg-Lamptey, JN, Cloete, Estie, Coltman, Megan, Conradie, W, Constance, N, Coulibaly, Youssouf, Cronje, L, Da Silva, MA, Daddy, H, Dahim, L, Daliri, D, Dambaki, MS, Dasrath, A, Davids, JG, Davies, Gareth L, De Lange, JT, de Wet, JB, Dedekind, B, Degaulle, MA, Dehal, V, Deka, PD, Delinikaytis, S, Desalu, IS, Dewanou, Hubert, Deye, MB Moussa, Dhege, C, Diale, BSG, Dibwe, DF, Diedericks, BJS, Dippenaar, JM, Dippenaar, L, Diyoyo, MP, Djessouho, Edith, Dlamini, SN, Dodiyi-Manuel, A, Dokolwana, BA, Domoyyeri, DP, Drummond, Leanne W, du Plessis, DE, du Plessis, WM, du Preez, LJ, Dube, K, Dube, NZ, Dullab, KD, Duvenhage, R, Echem, RC, Edaigbini, SA, Egote, AK, Ehouni, A, Ekwen, G, Ekwunife, NC, El Hensheri, M, Elfaghi, IE, Elfagieh, MA, Elfallah, S, Elfiky, Mahmoud, Elgelany, S, Elghallal, AM, Elghandouri, MG, Elghazal, ZS, Elghobashy, AM, Elharati, FT, Elkhogia, Abdulaziz M, Elkhwildi, RM, Ellis, S, Elmadani, L, Elmadany, HB, Elmehdawi, H, Elmgadmi, A, Eloi, H, Elrafifi, D, Elsaadi, G, Elsaity, RB, Elshikhy, A, Eltaguri, M, Elwerfelli, A, Elyasir, IE, Elzoway, AZ, Elzufri, AM, Enendu, EO, Enicker, BC, Enwerem, EO, Esayas, R, Eshtiwi, M, Eshwehdi, AA, Esterhuizen, JL, Esterhuizen, Tonya M, Etuk, EB, Eurayet, O, Eyelade, OR, Fanjandrainy, RF, Fanou, Lionelle, Farina, Z, Fawzy, Maher, Feituri, A, Fernandes, NL, Ford, LM, Forget, Patrice, François, T, Freeman, T, Freeman, YBM, Gacii, VM, Gadi, B, Gagara, M, Gakenia, A, Gallou, PD, Gama, GGN, Gamal, MG, Gandy, YG, Ganesh, A, Gangaly, Diallo, Garcia, M, Gatheru, AP, Gaya, SSD, Gbéhadé, Oswald, Gerbel, G, Ghnain, A, Gigabhoy, R, Giles, DG, Girmaye, GT, Gitau, S, Githae, B, Gitta, Said, Gobin, Veekash, Goga, Riaz, Gomati, AAG, Gonzalez, ME, Gopall, J, Gordon, Christina Salmina, Gorelyk, O, Gova, M, Govender, K, Govender, P, Govender, S, Govindasamy, V, Green-Harris, JTK, Greenwood, MB, Grey-Johnson, SV, Grobbelaar, Mariette, Groenewald, MA, Grünewald, KK, Guegni, Ambroise, Guenane, M, Gueye, S, Guezo, Marius, Gunguwo, T, Gweder, MG, Gwila, M, Habimana, L, Hadecon, Rodrigue, Hadia, E, Hamadi, L, Hammouda, M, Hampton, MI, Hanta, R, Hardcastle, Tim C, Hariniaina, JA, Hariparsad, S, Harissou, AH, Harrichandparsad, R, Hasan, SHA, Hashmi, HB, Hayes, MP, Hdud, A, Hebli, SH, Heerah, HMSN, Hersi, S, Hery, AH, Hewitt-Smith, Adam, Hlako, TC, Hodges, SCH, Hodgson, Richard Eric, Hokoma, M, Holder, H, Holford, EB, Horugavye, E, Houston, C, Hove, M, Hugo, D, Human, CM, Hurri, H, Huwidi, O, Ibrahim, AI, Ibrahim, Traoré, Idowu, OK, Igaga, IE, Igenge, John, Ihezie, O, Ikandi, K, Ike, IAR, Ikuku, JJN, Ilbarasi, MN, Ilunga, IBB, Ilunga, JPM, Imbangu, NAV, Imessaoudene, Z, Imposo, DH, Iraya, AM, Isaacs, M, Isiguzo, M, Issoufou, A, Izquirdo, P, Jaber, A, Jaganath, UV, Jallow, CS, Jamabo, S, Jamal, ZS, Janneh, L, Jannetjies, MJ, Jasim, I, Jaworska, Megan AJ, Jay Narain, S, Jermi, K, Jimoh, R, Jithoo, S, Johnson, M, Joomye, S, Judicael, RM, Judicaël, M, Juwid, A, Jwambi, LP, Kabango, R, Kabangu, JK, Kabatoro, DK, Kabongo, AN, Kabongo, K, Kabongo, LT, Kabongo, MD, Kady, N, Kafu, S, Kaggya, M, Kaholongo, BNK, Kairuki, PCK, Kakololo, SI, Kakudji, K, Kalisa, Amina, Kalisa, R, Kalufwelu, MR, Kalume, S, Kamanda, RJ, Kangili, MK, Kanoun, H, Kapesa, Kapp, P, Karanja, JK, Karar, M, Kariuki, K, Kaseke, K, Kashuupulwa, PNK, Kasongo, KJP, Kassa, SK, Kateregga, GK, Kathrada, MIS, Katompwa, PM, Katsukunya, L, Kavuma, KAM, Khalfallah, Khamajeet, A, Khetrish, SB, Kibandwa, Kibochi, W, Kilembe, AM, Kintu, AK, Kipng'etich, B, Kiprop, B, Kissoon, VMK, Kisten, Theroshnie K, Kiwanuka, JK, Kluyts, Hyla-Louise, Knox, MEK, Koledale, AK, Koller, VL, Kolotsi, MA, Kongolo, M, Konwuoh, ND, Koperski, WJ, Koraz, MYK, Kornilov, AA, Koto, M Zach, Kransingh, Samantha, Krick, D, Kruger, S, Kruse, C, Kuhn, W, Kuhn, WP, Kukembila, AM, Kule, KL, Kumar, M, Kusel, Belinda S, Kusweje, VK, Kuteesa, KJ, Kutor, YY, Labib, MA, Laksari, M, Lanos, F, Lawal, TA, Le Manach, Yannick, Lee, C, Lekoloane, RM, Lelo, SN, Lerutla, B, Lerutla, MT, Levin, AI, Likongo, TB, Limbajee, ML, Linyama, DM, Lionnet, C, Liwani, MM, Loots, E, Lopez, A Garrido, Lubamba, CLC, Lumbala, KF, Lumbamba, AJM, Lumona, John, Lushima, RF, Luthuli, L, Luweesi, HL, Lyimo, TSK, Maakamedi, HM, Mabaso, BM, Mabina, M, Maboya, ME, Macharia, I, Macheka, AM, Machowski, AZ, Madiba, Thandinkosi E, Madsen, ASM, Madzimbamuto, Farai, Madzivhe, LJ, Mafafo, SC, Maghrabi, M, Mahamane, Diango Djibo, Maharaj, A, Maharaj, A, Maharaj, AD, Mahmud, MR, Mahoko, M, Mahomedy, NA, Mahomva, O, Mahureva, TM, Maila, RK, Maimane, DM, Maimbo, M, Maina, SN, Maiwald, Dela A, Maiyalagan, MD, Majola, N, Makgofa, N, Makhanya, V, Makhaye, WP, Makhlouf, NM, Makhoba, S, Makopa, EK, Makori, O, Makupe, Alex M, Makwela, MA, Malefo, ME, Malongwe, SM, Maluleke, DM, Maluleke, MR, Mamadou, K Touré, Mamaleka, MP, Mampangula, Y, Mamy, RM, Mananjara, MNR, Mandarry, MTM, Mangoo, DM, Manirimbere, C, Manneh, A, Mansour, A, Mansour, I, Manvinder, M, Manyere, DV, Manzini, VT, Manzombi, JK, Mapanda, PM, Marais, LC, Maranga, O, Maritz, JPB, Mariwa, FK, Masela, RS, Mashamba, MM, Mashava, Doreen M, Mashile, MV, Mashoko, E, Masia, OR, Masipa, JN, Masiyambiri, ATM, Matenchi, MW, Mathangani, W, Mathe, RC, Matola, Christopher Y, Matondo, PM, Matos-Puig, R, Matoug, FFH, Matubatuba, JT, Mavesere, HP, Mavhungu, R, Maweni, S, Mawire, CJM, Mawisa, T, Mayeza, S, Mbadi, R, Mbayabu, M, Mbewe, N, Mbombo, WD, Mbuyi, T, Mbuyi, WMS, Mbuyisa, MW, Mbwele, Bernard, Mehyaoui, RM, Menkiti, ID, Mesarieki, LVM, Metali, A, Mewanou, Serge, Mgonja, L, Mgoqo, N, Mhatu, S, Mhlari, TM, Miima, S, Milod, IM, Minani, P, Mitema, F, Mlotshwa, A, Mmasi, JE, Mniki, T, Mofikoya, BO, Mogale, JO, Mohamed, A, Mohamed, A, Mohamed, A, Mohamed, S, Mohamed, S, Mohamed, TS, Mohamed, A, Mohamed, A, Mohamed, AM, Mohamed, P, Mohammed, I, Mohammed, FAM, Mohammed, M, Mohammed, NM, Mohlala, MP, Mokretar, R, Molokoane, FM, Mongwe, KN, Montenegro, L, Montwedi, OD, Moodie, QK, Moopanar, M, Morapedi, M, Morulana, TG, Moses, VL, Mossy, P, Mostafa, H, Motilall, SR, Motloutsi, SP, Moussa, Kanté, Moutari, M, Moyo, OM, Mphephu, PE, Mrara, Busi, Msadabwe, C, Mtongwe, VM, Mubeya, FK, Muchiri, K, Mugambi, J, Muguti, GIM, Muhammad, AB, Mukama, IF, Mukenga, MM, Mukinda, FK, Mukuna, PM, Mungherera, ARW, Munlemvo, Dolly M, Munyaradzi, TW, Munyika, AA, Muriithi, JM, Muroonga, MP, Murray, R, Mushangwe, VK, Mushaninga, M, Musiba, VEM, Musowoya, JM, Mutahi, S, Mutasiigwa, MGH, Mutizira, G, Muturi, A, Muzenda, T, Mvwala, KR, Mvwama, NM, Mwale, A, Mwaluka, CN, Mwamba, JD, Mwanga, HAM, Mwangi, CM, Mwansa, S, Mwenda, V, Mwepu, IM, Mwiti, TM, Mzezewa, SZ, Nabela, L, Nabukenya, MTN, Nabulindo, SM, Naicker, K, Naidoo, D, Naidoo, L, Naidoo, LC, Naidoo, N, Naidoo, R, Naidoo, RD, Naidoo, S, Naidoo, TD, Naidu, TK, Najat, NZ, Najm, Y, Nakandungile, F, Nakangombe, P, Namata, CN, Namegabe, ES, Nansook, A, Nansubuga, NP, Nantulu, C, Nascimento, Rodrigue, Naude, GT, Nchimunya, H, Ndaie, MA, Ndarukwa, PN, Ndasi, Henry, Ndayisaba, Gabriel, Ndegwa, D, Ndikumana, R, Ndonga, Andrew KN, Ndung'u, C, Neil, MC, Nel, MS, Neluheni, EV, Nesengani, DS, Nesengani, NT, Netshimboni, LE, Ngalala, AM, Ngari, BM, Ngari, NBM, Ngatia, E, Ngcobo, GK, Ngcobo, TS, Ngorora, D, Ngouane, D, Ngugi, K, Ngumi, Zipporah WW, Nibe, Z, Ninise, E, Niyondiko, JC, Njenga, PW, Njenga, MN, Njoroge, M, Njoroge, S, Njuguna, W, Njuki, PN, Nkesha, T, Nkuebe, TN, Nkuliyingoma, NP, Nkunjana, M, Nkwabi, Ernest, Nkwine, RN, Nnaji, C, Notoane, I, Nsalamba, Shaaban, Ntlhe, LM, Ntoto, C, Ntueba, B, Nyassi, MT, Nyatela-Akinrinmade, Z, Nyawanda, HO, Nyokabi, NN, Nziene, VN, Obadiah, S, Ochieng, OJP, Odia, PK, Oduor, OEO, Ogboli-Nwasor, EO, Ogendo, SWO, Ogunbode, O, Ogundiran, TO, Ogutu, O, Ojewola, RW, Ojujo, M, Ojuka, DO, Okelo, OS, Okiya, S, Okonu, N, Olang, PR, Omigbodun, Akinyinka O, Omoding, S, Omoshoro-Jones, J, Onyango, R, Onyegbule, A, Orjiako, O, Osazuwa, MO, Oscar, Kpatinvo, Osinaike, BB, Osinowo, AO, Othin, OM, Otman, FFH, Otokwala, J, Ouanes, F, Oumar, Ongoïba, Ousseini, AO, Padayachee, S, Pahlana, SM, Pansegrouw, J, Paruk, FP, Patel, MB, Patel, Ushmaben, Patience, AP, Pearse, Rupert M, Pembe, JD, Pengemale, GN, Perez, N, Perez, MF Aguilera, Peter, A Mallier, Phaff, M, Pheeha, RM, Pienaar, BH, Pillay, V, Pilusa, KA, Pochana, MP, Polishchuk, O, Porrill, Owen S, Post, EF, Prosper, A, Pupyshev, M, Rabemazava, A, Rabiou, MS, Rademan, L, Rademeyer, M, Raherison, RAR, Rajah, FR, Rajcoomar, MSR, Rakhda, Z, Rakotoarijaona, AHR, Rakotoarisoa, AHN, Rakotoarison, Sylvia R, Rakotoarison, RR, Ramadan, L, Ramananasoa, MLR, Rambau, M, Ramchurn, TPR, Ramilson, HE, Ramjee, Rajesh J, Ramnarain, H, Ramos, R, Rampai, TJ, Ramphal, SR, Ramsamy, T, Ramuntshi, R, Randolph, R, Randriambololona, DMA, Ras, WAP, Rasolondraibe, RAF, Rasolonjatovo, JDLC, Rautenbach, RM, Ray, S, Rayne, Sarah R, Razanakoto, FAR, Reddy, SR, Reed, Anthony R, Rian, JR, Rija, FR, Rink, B, Robelie, AT, Roberts, CA, Rocher, AGL, Rocher, S, Rodseth, Reitze N, Rois, I, Rois, W, Rokhsi, S, Roos, J, Rorke, Nicolette F, Roura, H, Rousseau, FJ, Rousseau, N, Royas, L, Roytowski, D, Rungan, Devan, Rwehumbiza, SSR, Ryabchiy, BB, Ryndine, V, Saaiman, CR, Sabwa, HK, Sadat, S, Saed, SS, Salaheddin, E, Salaou, H, Saleh, M, Salisu-Kabara, HM, Sama, Hamza Doles, Samateh, Ahmadou L, Sam-Awortwi (Jnr), W, Samuel, N, Sanduku, DK, Sani, Chaibou M, Sanyang, LN, Sarah, HN, Sarkin-Pawa, A, Sathiram, R, Saurombe, T, Schutte, H, Sebei, MP, Sedekounou, MD, Segooa, MP, Semenya, EM, Semo, BO, Sendagire, CS, Senoga, SA, Senusi, FS, Serdyn, T, Seshibe, MD, Shah, GB, Shamamba, R, Shambare, CS, Shangase, TN, Shanin, SH, Shefren, IE, Sheshe, AA, Shittu, OB, Shkirban, AS, Sholadoye, T, Shubba, A, Sigcu, N, Sihope, SE, Sikazwe, DS, Sikombe, BS, Simaga Abdoul, K, Simo, WAG, Singata, K, Singh, AS, Singh, S, Singh, Usha, Sinoamadi, V, Sipuka, N, Sithole, NLM, Sitima, S, Skinner, David Lee, Skinner, GC, Smith, OI, Smits, CAG, Sofia, MSI, Sogoba, Gaoussou, Sohoub, A, Sookun, SS, Sosinska, O, Souhe, Rosalie, Souley, G, Souleymane, Thiam, Spicer, JM, Spijkerman, Sandra, Steinhaus, H, Steyn, A, Steyn, G, Steyn, HC, Stoltenkamp, Heidi L, Stroyer, S, Swaleh, A, Swayeb, E, Szpytko, AJ, Taiwo, NA, Tarhuni, A, Tarloff, D, Tchaou, Blaise, Tchegnonsi, Charles, Tchoupa, M, Teeka, MO, Thakoor, B, Theunissen, MM, Thomas, BP, Thomas, MB, Thotharam, A, Tobiko, O, Torborg, AM, Tshisekedi, SM, Tshisola, SK, Tshitangano, R, Tshivhula, F, Tshuma, HT, Tumukunde, Janat, Tun, M, Udo, IA, Uhuebor, DI, Umeh, KU, Usenbo, AO, Uwiteyimbabazi, JdD, Van der Merwe, DJ, van der Merwe, FH, van der Walt, JE, van Dyk, Dominique, Van Dyk, JG, van Niekerk, JJS, van Wyk, S, van Zyl, HA, Veerasamy, B, Venter, PJ, Vermeulen, AJ, Villarreal, R, Visser, J, Visser, L, Voigt, M, von Rahden, Richard P, Wafa, A, Wafula, A, Wambugu, PK, Waryoba, P, Waweru, EN, Weideman, M, Wise, Robert D, Wynne, EE, Yahya, AI, Yahya, AA, Yahya, R, Yakubu, Y, Yanga, JJ, Yangazov, YM, Yousef, O, Yousef, G, Youssouf, Coulibaly, Yunus, AA, Yusuf, AS, Zeiton, AZ, Zentuti, HZ, Zepharine, Henry, Zerihun, AB, Zhou, S, Zidan, A, Zié, Sanogo Zimogo, Zinyemba, CZ, Zo, A, Zomahoun, Lidwine, Zoobei, NZ, Zoumenou, Eugene, and Zubia, NZ

Abstract

There is a need to increase access to surgical treatments in African countries, but perioperative complications represent a major global health-care burden. There are few studies describing surgical outcomes in Africa.

Published
2018
Full Text
View/download PDF

4. Challenges of Anesthetic Monitoring in Low- and Middle-Income Countries: Availability of Equipment in Major Referral Hospitals in Kenya.

Author

Atandi BO, Chokwe TM, and Sulemanji DS

Subjects
Humans, Kenya, Cross-Sectional Studies, Hospitals, Referral and Consultation, Developing Countries, Anesthetics
Abstract

Background: Anesthetic monitoring within standards defined by various professional anesthesia organizations has been shown to reduce perioperative mortality. Given the scarce resources for anesthesia and surgery in low- to middle-income countries, we sought to determine the availability of recommended monitoring devices in major referral hospitals in Kenya., Methods: We purposely selected the 16 major referral hospitals in Kenya. A cross-sectional survey was conducted in 103 operating theaters, 96 postanesthesia care unit (PACU) beds, and 16 areas where procedural sedation was routinely administered. A checklist questionnaire based on the Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidelines of 2015 was used to determine the availability of basic and functional monitoring devices., Results: We determined that only 1 of 16 (6.25%) hospitals had all the monitoring devices recommended by the AAGBI. Automated noninvasive blood pressure (NIBP) monitoring and pulse oximetry were present in all operating theaters. Continuous electrocardiography (ECG) was available in 102 of 103 (99%) operating theaters, skin temperature monitoring probes in 73 of 103 (70.9%), and capnography in 49 (47.6%). A nerve stimulator was accessible in 5 of 16 (31.25%) hospitals. There were functional patient monitors in all operating theaters (100%). One of the regional referral hospitals did not have a PACU. We encountered 9 of 96 (9.4%) PACU beds without any monitoring devices. Pulse oximetry was the most common device (84.4%) in the PACU beds equipped with monitoring. In 5 of 16 (31.25%) procedural sedation areas, pulse oximetry was the only monitoring device, whereas there were no devices in 2 of 16 (12.5%) areas. Portable multiparameter devices used for patient transport were present in 5 of 16 (31.25%) hospitals., Conclusions: The availability of recommended monitoring devices in major referral hospitals in Kenya is inadequate. Thus, there are challenges to anesthetic monitoring in these hospitals, and perioperative patient safety is jeopardized. We recommend the universal provision of basic monitoring devices and suggest the use of the data collected in this study to affect policy change and safe anesthesia practice in our country., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 International Anesthesia Research Society.)

Published
2023
Full Text
View/download PDF

5. Paediatric antiretroviral overdose: A case report from a resource-poor area.

Author

Ogoti BA, Otedo AA, and Chokwe TM

Abstract

Introduction: Toxic side effects from antiretroviral overdose in children have not been widely reported. Antiretroviral drugs are widely used as oral medications throughout sub-Saharan Africa., Patient Presentation: We describe the clinical presentation and management of a 3-year-old male in rural Kenya, who accidentally overdosed on abacavir/lamivudine combination pills. The number of pills taken was approximately 250 tablets, that is 15 g of abacavir and 7.5 g of lamivudine. He presented 24 hours later to Homabay County Referral Hospital, with unresponsiveness, inability to feed and absence of playfulness. Physical examination revealed a sick-looking, 'unconscious' child, responding only to voice, with tachycardia, hypertension and moderate dehydration., Management and Outcome: He was managed conservatively with rehydration, namely intravenous 1125 mL of 5% dextrose in 0.9% saline, and the monitoring of his neurologic status, urine output and all vital signs. He regained normal neurological function after 24 hours, and recovered uneventfully, but was lost to follow-up., Conclusion: In an area endemic for HIV and where antiretroviral drug use is commonplace, there is a need for health education to ensure that parents keep drugs out of the reach of children. In the case of a suspected overdose, parents need to be reminded to seek medical attention immediately. Physician awareness of the clinical presentation, management and challenges with an antiretroviral drug overdose is also important., Competing Interests: The authors declare that they have no financial or personal relationships that might have inappropriately influenced them in writing this article., (© 2020. The Authors.)

Published
2020
Full Text
View/download PDF

6. Challenges of Anesthesia in Low- and Middle-Income Countries: A Cross-Sectional Survey of Access to Safe Obstetric Anesthesia in East Africa.

Author

Epiu I, Tindimwebwa JV, Mijumbi C, Chokwe TM, Lugazia E, Ndarugirire F, Twagirumugabe T, and Dubowitz G

Subjects
Adult, Africa, Eastern, Anesthesia, Obstetrical adverse effects, Anesthesia, Obstetrical mortality, Anesthesia, Obstetrical standards, Anesthesiologists economics, Anesthesiologists education, Anesthetics economics, Anesthetics supply & distribution, Checklist, Cross-Sectional Studies, Delivery of Health Care standards, Female, Health Care Surveys, Health Services Needs and Demand economics, Healthcare Disparities economics, Humans, Maternal Mortality, Middle Aged, Needs Assessment economics, Personnel Staffing and Scheduling economics, Practice Guidelines as Topic, Practice Patterns, Physicians' standards, Pregnancy, Respiration, Artificial economics, Risk Assessment, Risk Factors, Ventilators, Mechanical economics, Ventilators, Mechanical supply & distribution, Anesthesia, Obstetrical economics, Delivery of Health Care economics, Developing Countries economics, Health Care Costs, Practice Patterns, Physicians' economics
Abstract

Background: The United Nations 2015 Millennium Development Goals targeted a 75% reduction in maternal mortality. However, in spite of this goal, the number of maternal deaths per 100,000 live births remains unacceptably high across Sub-Saharan Africa. Because many of these deaths could likely be averted with access to safe surgery, including cesarean delivery, we set out to assess the capacity to provide safe anesthetic care for mothers in the main referral hospitals in East Africa., Methods: A cross-sectional survey was conducted at 5 main referral hospitals in East Africa: Uganda, Kenya, Tanzania, Rwanda, and Burundi. Using a questionnaire based on the World Federation of the Societies of Anesthesiologists (WFSA) international guidelines for safe anesthesia, we interviewed anesthetists in these hospitals, key informants from the Ministry of Health and National Anesthesia Society of each country (Supplemental Digital Content, http://links.lww.com/AA/B561)., Results: Using the WFSA checklist as a guide, none of respondents had all the necessary requirements available to provide safe obstetric anesthesia, and only 7% reported adequate anesthesia staffing. Availability of monitors was limited, and those that were available were often nonfunctional. The paucity of local protocols, and lack of intensive care unit services, also contributed significantly to poor maternal outcomes. For a population of 142.9 million in the East African community, there were only 237 anesthesiologists, with a workforce density of 0.08 in Uganda, 0.39 in Kenya, 0.05 in Tanzania, 0.13 in Rwanda, and 0.02 anesthesiologists in Burundi per 100,000 population in each country., Conclusions: We identified significant shortages of both the personnel and equipment needed to provide safe anesthetic care for obstetric surgical cases across East Africa. There is a need to increase the number of physician anesthetists, to improve the training of nonphysician anesthesia providers, and to develop management protocols for obstetric patients requiring anesthesia. This will strengthen health systems and improve surgical outcomes in developing countries. More funding is required for training physician anesthetists if developing countries are to reach the targeted specialist workforce density of the Lancet Commission on Global Surgery of 20 surgical, anesthetic, and obstetric physicians per 100,000 population by 2030.

Published
2017
Full Text
View/download PDF

7. Working towards safer surgery in Africa; a survey of utilization of the WHO safe surgical checklist at the main referral hospitals in East Africa.

Author

Epiu I, Tindimwebwa JV, Mijumbi C, Ndarugirire F, Twagirumugabe T, Lugazia ER, Dubowitz G, and Chokwe TM

Subjects
Adult, Africa, Eastern, Anesthesiology standards, Anesthetists standards, Anesthetists statistics & numerical data, Attitude of Health Personnel, Cross-Sectional Studies, Female, Health Care Surveys, Humans, Male, Middle Aged, Postoperative Complications prevention & control, World Health Organization, Anesthesia standards, Checklist, Health Knowledge, Attitudes, Practice, Surgical Procedures, Operative standards
Abstract

Background: Mortality from anaesthesia and surgery in many countries in Sub-Saharan Africa remain at levels last seen in high-income countries 70 years ago. With many factors contributing to these poor outcomes, the World Health Organization (WHO) launched the "Safe Surgery Saves Lives" campaign in 2007. This program included the design and implementation of the "Surgical Safety Checklist", incorporating ten essential objectives for safe surgery. We set out to determine the knowledge of and attitudes towards the use of the WHO checklist for surgical patients in national referral hospitals in East Africa., Methods: A cross-sectional survey was conducted at the main referral hospitals in Mulago (Uganda), Kenyatta (Kenya), Muhimbili (Tanzania), Centre Hospitalier Universitaire de Kigali (Rwanda) and Centre Hospitalo-Universitaire de Kamenge (Burundi). Using a pre-set questionnaire, we interviewed anaesthetists on their knowledge and attitudes towards use of the WHO surgical checklist., Results: Of the 85 anaesthetists interviewed, only 25 % regularly used the WHO surgical checklist. None of the anaesthetists in Mulago (Uganda) or Centre Hospitalo-Universitaire de Kamenge (Burundi) used the checklist, mainly because it was not available, in contrast with Muhimbili (Tanzania), Kenyatta (Kenya), and Centre Hospitalier Universitaire de Kigali (Rwanda), where 65 %, 19 % and 36 %, respectively, used the checklist., Conclusion: Adherence to aspects of care embedded in the checklist is associated with a reduction in postoperative complications. It is therefore necessary to make the surgical checklist available, to train the surgical team on its importance and to identify local anaesthetists to champion its implementation in East Africa. The Ministries of Health in the participating countries need to issue directives for the implementation of the WHO checklist in all hospitals that conduct surgery in order to improve surgical outcomes.

Published
2016
Full Text
View/download PDF

8. A COMPARATIVE STUDY ON THE EFFICACY OF TWO REGIMENS OF SINGLE- SHOT SPINAL BLOCK FOR PAIN RELIEF IN WOMEN PRESENTING IN ESTABLISHED LABOUR.

Author

Tshibuyl PN, Olang PO, Ogutu O, and Chokwe TM

Subjects
Anxiety physiopathology, Apgar Score, Breakthrough Pain epidemiology, Bupivacaine administration & dosage, Fear physiology, Female, Fentanyl administration & dosage, Humans, Incidence, Injections, Spinal, Labor Pain psychology, Morphine administration & dosage, Pain Measurement, Pregnancy, Analgesia, Obstetrical methods, Analgesics, Opioid administration & dosage, Anesthesia, Spinal methods, Anesthetics, Combined administration & dosage, Anesthetics, Local administration & dosage, Labor Pain drug therapy
Abstract

Background: Most women experience moderate to severe pain during labour and delivery, often requiring some form of pharmacologic analgesia. The lack of proper psychological preparation combined with fear and anxiety can greatly enhance the patient's sensitivity to pain and further add to the discomfort. Skillfully conducted obstetric analgesia, in addition to relieving pain and anxiety, may benefit the mother by increasing self esteem and improving bonding with the baby., Objective: To assess and compare the satisfaction and efficacy of two regimens of single-shot spinal blocks for the relief of labor pain in women who present in active phase of labour., Design: A prospective randomised single-blind observational study, Setting: Labour ward of Kenyatta National Hospital, Nairobi., Subjects: All consenting primiparous women presenting in active phase of labor with uncomplicated singleton pregnancy at term (> 37 weeks) and in cephalic presentation, who reported a > 70 mm VAS (Visual Analog Scale) pain score at cervical dilatation ≥ 5 cm at the time of request for labour analgesia., Results: Effective labour analgesia lasting up to 120 minutes was observed in the fentanyl-bupivacaine group but with high incidence of breakthrough pain. The fentanyl-bupivacaine-morphine group had labour analgesia lasting up to 180 minutes or even more with a lower incidence of breakthrough pain. The one-minute and five- minute Apgar scores in the morphine group were significantly lower (p = 0.026 and 0.044 respectively) than in the fentanyl group but the difference in neonatal outcome had no clinical significance, and there were no significant differences in adverse effects, sensory levels, and motor power between the two groups., Conclusion: Effective analgesia for about 120 minutes was observed in the fentanyl-bupivacaine group with high incidence of breakthrough pain while the fentanyl-bupivacaine-morphine group had labour analgesia prolonged up to more than three hours. The difference in fetal outcome had no clinical significance for the morphine group, and there were no significant difference in adverse effect, sensory levels, and motorpowerbetween the two groups. These findings show that intrathecal analgesia is safe and the use of the combination of fentanyl-bupivacaine-morphine gives adequate and safe analgesia during labour and delivery.

Published
2013

Catalog

Books, media, physical & digital resources
See catalog results