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Background: Local anaesthesia is most commonly used for cataract surgery in adult patients. Different combinations of local anesthetic agents and adjuvants have been used to provide adequate anaesthesia and analgesia. This study assessed the effect of adding 25 µg fentanyl to lidocaine with adrenaline mixture on the onset and duration of anaesthesia in adult patients undergoing cataract surgery under peribulbar anaesthesia. Methods: This was a double blind, randomized controlled study. Adult patients aged 40 years and above with American Society of Anesthesiologists Physical Status Classes 1 and 2 undergoing cataract surgery under peribulbar block (PB) were studied. Sixty‑six patients were randomized into two equal groups. Group A had 25 µg fentanyl (0.5 mL) added to 6 mL of 2% lidocaine with adrenaline while Group B had sterile water 0.5 mL added to 6 mL of 2% lidocaine with adrenaline for PB. Onset and duration of lid akinesia, globe akinesia, globe anaesthesia, Numerical Rating Scale (NRS) pain score, time to analgesia request as well as patient and surgeon satisfaction were assessed. Results: The differences in the onset of lid akinesia, globe akinesia, and globe anaesthesia between the two groups were statistically significant(P ≤ 0.001,respectively).Themeanduration of globe akinesia and globe anaesthesia was longer in GroupA as compared to GroupB (P = 0.008 and P = 0.009, respectively). Statistically significant differences in median NRS scores were found at the 4th, 5th, and 6th h (P = 0.001, respectively). The mean duration to analgesia request was 238.1 ± 65.5 min in Group A compared to 207.2 ± 49.1 min in Group B (P = 0.034). Conclusion: The addition of 25 µg fentanyl to 2% lidocaine plus adrenaline mixture improved the quality of peribulbar anaesthesia and is recommended in Nigerian adults scheduled for cataract surgery under peribulbar anaesthesia to improve their surgical experience. [ABSTRACT FROM AUTHOR]

Objectives: To review the current indications and outcome of pulmonary resections for tuberculosis (TB) at the Cardiothoracic Surgery Unit of the University College Hospital, Ibadan, Nigeria.Subjects and Methods: A retrospective case series review of patients who had lung resections from January 2014 to January 2017 was performed. Data obtained from medical records included demographics, presenting symptoms, indication for surgery, preoperative evaluation and preparation, operative procedure, postoperative complications, and follow-up. The presence of TB in the patients was confirmed by detecting pathological changes suggestive of TB and/or past history of pulmonary TB associated with its anatomical complications such as cavitation and bronchiectasis. Data were analysed using descriptive statistics.Results: Ten patients had pulmonary resections during this study period. The median age was 33.5 years (range: 3-50). The indication for lung resection was massive or persistent haemoptysis, and 2 patients also had aspergilloma. Six patients (60%) had lobectomy, 1 had a bilobectomy, and the remaining 3 had pneumonectomy. Complications included partial wound dehiscence in 2 patients, 1 of whom also had postoperative empyema thoracis. One patient died immediately due to haemorrhage. Follow-up ranged from 6 to 37 months.Conclusion: This study showed that the factors for a good outcome in patients presenting with massive or recurrent haemoptysis from TB complications were initial stabilization and multidisciplinary care. Hence, improved awareness of high-standard care to encourage inclusion of patients with TB complications in the surgical care protocol as part of national control programmes is recommended. [ABSTRACT FROM AUTHOR]

Background: Typhoid perforation ileitis is a serious complication of typhoid fever, a common and unfortunate health problem in a resource-poor country like Nigeria. Following bowel perforation, treatment is usually by simple closure or bowel resection and anastomosis after adequate aggressive fluid resuscitation and electrolyte correction. Postoperatively, some of these patients do require management in Intensive Care Unit (ICU) on account of sepsis or septic shock and to improve survival.Patients and Methods: This is a prospective observational study in which 67 consecutive patients who had exploratory laparotomy for typhoid perforation between August 2009 and October 2012 in the main operating theatre of the University College Hospital, Ibadan, were studied. The attending anaesthetists had the freedom of choosing the appropriate anaesthetic drugs depending on the patients' clinical condition. The reason for admission into the ICU, the types of organ support required and outcomes were recorded.Results: Twenty-five patients (37.3%) out of 67 required critical care. Reasons for admission among others included poor respiratory effort, hypotension, septic shock and delayed recovery from anaesthesia. Twenty-one patients (84%) required mechanical ventilation with a mean duration of 2.14 days (range 1-5 days). Fourteen patients required ionotropic support and the length of ICU stay ranged from 1 to 15 days (mean 4.32 days). Nineteen patients (76%) were successfully managed and discharged to the ward while 24% (6 patients) mortality rate was recorded.Conclusion: This study showed high rate of post-operative ICU admission in patients with typhoid perforation with a high demand for critical care involving mechanical ventilation and ionotropic support. In centres that manage patients presenting with typhoid ileitis and perforation, post-operative critical care should be available. [ABSTRACT FROM AUTHOR]