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Search Results: 1 - 10 of 8678 matches for " Elizabeth Ogboli-Nwasor "
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Maternal Mortality and Morbidity Will Not Reduce in Low Resource Countries without the Anaesthetists’ Involvement  [PDF]
Elizabeth Ogboli-Nwasor
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.45037
Abstract:

Background: Maternal and foetal mortality is unacceptably high in most resource-limited countries and the practice of obstetric anaesthesia has an important influence on outcome for both mother and baby. The much needed close co-operation and collaboration between obstetricians and obstetric anaesthetist providers is crucial for the safety and comfort of parturients, particularly in low-resource environments. The current global maternal mortality is approximately 400 per 100,000 deliveries, with a range of 7 - 740 deaths per 100,000, demonstrating the inequality between the rich and poor countries. Many of the deaths could have been prevented by better essential obstetrics services including safe anaesthesia and surgery, provided such services are made available in a timely manner. Conclusion: Maternal mortality in low resource countries has its basis complex social, economic and political factors, underpinned by a lack of resources. Many of these factors are difficult and slow to resolve and are not specific to maternal health. Comprehensive essential obstetric care services at the district hospital level (first referral level) should include all the above plus safe surgery, safe anaesthesia, and blood transfusion. Government, donor agencies and all stakeholders must recognize the crucial role of anaesthesia in providing emergency obstetric care in hospitals. Advocacy by all concerned will help direct the scarce resources to the appropriate areas of need which includes provision of adequate facilities and manpower for safe anaesthesia.

Use of Laryngeal Mask Airway in the Management of a Difficult Airway: A Case Report  [PDF]
Elizabeth Ogboli-Nwasor,Ahmad Tijjani Lawal
Open Journal of Anesthesiology (OJAnes) , 2013, DOI: 10.4236/ojanes.2013.32024
Abstract: Background: Difficulty in management of the airway occurs most frequently in patients who have Mallampati grade III and IV, and other unfavourable airway findings like short neck, restriction in range of motion of the temporoman-dibular joints and inadequate neck flexion and extension. Because of unavailability of fibreoptic bronchoscopes or inexperience in their use, laryngeal mask airway (LMA) has become a common and acceptable airway management option. This is a case report of a postmenopausal woman who had her airway managed with LMA following initial failed intubation necessitating a rescheduling of the operation. Result: The patient had a successful surgery and postoperative recovery was uneventful. Conclusion: The LMA is a useful option in the management of an anticipated or unexpected difficult airway, especially in resource-poor settings where fibreoptic bronchoscopes may not be readily available.
Use of Laryngeal Mask Airway in the Management of a Difficult Airway: A Case Report  [PDF]
Elizabeth Ogboli-Nwasor, Ahmad Tijjani Lawal
Open Journal of Anesthesiology (OJAnes) , 2013, DOI: 10.4236/ojanes.2013.32024
Abstract:
Background: Difficulty in management of the airway occurs most frequently in patients who have Mallampati grade III and IV, and other unfavourable airway findings like short neck, restriction in range of motion of the temporoman-dibular joints and inadequate neck flexion and extension. Because of unavailability of fibreoptic bronchoscopes or inexperience in their use, laryngeal mask airway (LMA) has become a common and acceptable airway management option. This is a case report of a postmenopausal woman who had her airway managed with LMA following initial failed intubation necessitating a rescheduling of the operation. Result: The patient had a successful surgery and postoperative recovery was uneventful. Conclusion: The LMA is a useful option in the management of an anticipated or unexpected difficult airway, especially in resource-poor settings where fibreoptic bronchoscopes may not be readily available.
Anesthesia for Cesarean Delivery in a Low-Resource Setting, an Initial Review  [PDF]
Elizabeth Ogboli-Nwasor, Abdulghaffar Adeniyi Yunus
Open Journal of Anesthesiology (OJAnes) , 2014, DOI: 10.4236/ojanes.2014.49031
Abstract: Background: Bearing in mind the recent advances in obstetric anesthesia, the safety of both mother and child is of paramount importance, especially in a setting where resources are limited. We set out to find the pattern of cases presenting for cesarean delivery and the types of anesthesias provided for the management of these patients. Methods: A retrospective survey was conducted involving all anesthetics provided for cesarean delivery from January 2006 to December 2009 in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Information such as age, indications and anesthetic technique, including drugs used, were extracted from patients’ records. Data were subjected to statistical analysis using Statistical Package for Social Sciences (SPSS) version 17.0. Results: There were a total of 577 anaesthetics conducted for cesarean delivery during the period under review out of 4277 live births, giving a cesarean delivery rate of 13.5%. General anesthesia (GA) was administered on 266 (46%) of these patients, while 279 (48%) cases were done under subarachnoid block(SAB). 16 (3%) patients had combined GA and SAB, while 16 (3%) patients received epidural anesthesia. There were 302 emergency cesarean deliveries out of 577 cases, giving an emergency cesarean delivery rate of 52%. The commonest indication for cesarean delivery was two previous cesarean deliveries. Conclusion: A large percentage of our obstetric cases are being done under general anesthesia. Though majority of the conducted regional anesthesia were spinals (SAB), only a few cases were done under epidural block. Subspecialty training of anesthetists will go a long way to improve the current trends.
Use of oral ketamine for analgesia during reduction/manipulation of fracture/dislocation in the Emergency Room: An initial experience in a low-resource setting  [PDF]
E. Ogboli-Nwasor, K. E. Amaefule, S. S. Audu
Pain Studies and Treatment (PST) , 2014, DOI: 10.4236/pst.2014.21004
Abstract:

Background: The use of ketamine for relief of procedure-related pain is limited in our environment. Ketamine, a phencyclidine derivative commonly used for induction and maintenance of anaesthesia, is administered routinely via the intravenous and intramuscular routes. One of the concerns while using ketamine for analgesia via these two routes is that the drug may produce anaesthesia, rather than analgesia alone. Aims and Objectives: We sought to find out if ketamine given via the oral route could be used to provide analgesia during minor orthopaedic procedures in the emergency room. We also wanted to find out if there were side-effects peculiar to the oral route. Methods: A prospective observational pilot study in consecutive patientswith fractures/dislocation in our Emergency Room was recruited into the study. All patients gave informed consent. Reduction of fractures was done 15 minutes following the administration of ketamine 5 mg/kg orally. The patients were observed during and after the procedure and the findings entered into a proforma. The data obtained were analyzed using simple statistical methods and the results presented in a table. The findings are discussed. Results: There were 9 males and 2 females with an age range of 4 yrs to 48 yrs. Pain levels were assessed using verbal rating scales. Seven patients (64%) had severe pain before administration of ketamine while 2 patients (18%) each had mild and moderate pain respectively. Four patients had Colle’s fracture only and 1 patient had a Colle’s fracture with a supracondylar femoral fracture. Two patients had tibial fractures, one patient had a complete knee dislocation, while 2 others had ulnar/radial fractures. One other patient had humeral and tibial fractures. For up to 15 minutes after the procedures all but one patient were pain-free. Five (5) patients (45.5%) were noticed to have drowsiness, 3 patients (27%) were sedated while 2 patients (18%) had no side-effects at all. Five (5) patients (45.5%) reported excellent analgesia while 6 patients (64%) said the intra and post procedure analgesia was very good. Conclusions: Oral ketamine may be useful in providing analgesia for minor procedures in the emergency room. Ketamine when sweetened with a soda drink appears to be palatable with a rapid onset of action and few side effects. Thus ketamine given orally may be a cheaper and more accessible option for effective pain-relief in the emergency room. There is a need to conduct more studies on a larger number of patients.

Pain relief in labor: a survey of awareness, attitude, and practice of health care providers in Zaria, Nigeria
Ogboli-Nwasor E, Adaji SE, Bature SB, Shittu OS
Journal of Pain Research , 2011, DOI: http://dx.doi.org/10.2147/JPR.S21085
Abstract: in relief in labor: a survey of awareness, attitude, and practice of health care providers in Zaria, Nigeria Original Research (3538) Total Article Views Authors: Ogboli-Nwasor E, Adaji SE, Bature SB, Shittu OS Published Date August 2011 Volume 2011:4 Pages 227 - 232 DOI: http://dx.doi.org/10.2147/JPR.S21085 E Ogboli-Nwasor1, SE Adaji2, SB Bature2, OS Shittu2 1Department of Anesthesia, 2Department of Obstetrics and Gynecology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria Background: The purpose of this study was to assess the attitudes of maternal health care providers to pain relief during labor in Zaria, Nigeria. Methods: This was a multicenter, collaborative, cross-sectional pilot study of provider perspectives concerning pain relief during labor. A structured, self-administered, questionnaire was completed by 95 consenting maternal health care providers at three high-volume facilities in Zaria, an ancient northern Nigerian city. Descriptive statistics was performed on the data. Results: Most respondents (94.8%) agreed that pain relief is needed during labor. Only 2.1% of respondents were undecided about the provision of pain relief during labor and 3.2% were of the opinion that pain relief was not necessary during labor. Most respondents (93.7%) had attended a woman in labor in the 4 weeks preceding the survey. Of these, 56.8% had counseled a parturient in labor. Most of the counseling (42.1%) took place during labor. Less than half of the respondents (48.4%) had administered pain relief in labor in the preceding 4 weeks and systemic opioids was the most commonly form of pain relief. Among the respondents who did not offer pain relief agents in labor, the majority (54.5%) had no reason for not offering it. Unavailability of methods, inability to afford the cost of pain relief, lack of knowledge and skills, as well as lack of essential equipment to provide the procedure were also given by respondents as reasons for not offering pain relief. Conclusion: Even though maternal health care providers in this environment have a positive attitude to pain relief in labor, most women go through labor without the benefit of analgesia. There exists a gap between provider attitudes to pain relief in labor and practice of the same, with many providers having no genuine reason(s) for not offering pain relief to their clients during labor. Providers need to align their practice to their attitudes, and need to be helped to do this through training as well as enhancing their ability to think critically about their practice.
Pattern of postoperative pain management among adult surgical patients in a low-resource setting
Ogboli-Nwasor E, Sule ST, Yusufu LM
Journal of Pain Research , 2012, DOI: http://dx.doi.org/10.2147/JPR.S28198
Abstract: ttern of postoperative pain management among adult surgical patients in a low-resource setting Original Research (2246) Total Article Views Authors: Ogboli-Nwasor E, Sule ST, Yusufu LM Published Date June 2012 Volume 2012:5 Pages 117 - 120 DOI: http://dx.doi.org/10.2147/JPR.S28198 Received: 14 January 2012 Accepted: 29 February 2012 Published: 01 June 2012 Elizabeth Ogboli-Nwasor,1 Sa’adatu T Sule,2 Lazarus MD Yusufu3 1Department of Anaesthesia, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria; 2Department of Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria; 3Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria Objective: Postoperative pain is one of the most common complications of surgery. The pattern of management varies between centers. The current study aimed to study the prescription pattern and the common drugs used in the management of postoperative pain in adult surgical patients at Ahmadu Bello University Teaching Hospital (ABUTH; Zaria, Nigeria). Methods: Following ethical approval, a prospective observational study of consecutive adult patients who had surgery at the ABUTH Zaria was performed from January to December 2005. The data were entered into a proforma and analyzed using the Minitab statistical package. Results: One hundred and thirty-eight patients were included in the study. The age range was 17 to 80 years, with a mean age of 41 years. One hundred and thirty-two (95.7%) of the prescriptions were written solely by the surgeon or surgical resident; passive suggestions were given by the anesthetists for only six patients (4.3%). Intermittent intramuscular injections of opioids/opiates were prescribed for 126 patients (91.3%), while nine patients (6.5%) received intermittent intramuscular injections with non-steroidal anti-inflammatory drugs. Oral paracetamol was prescribed for six patients (4.3%), while three patients (2.1%) received no postoperative analgesic. Moderate pain was recorded in 48 patients (34.8%), and 90 patients (65.2%) had mild pain 8 hours after their operation before subsequent doses of analgesics were given. More females (81 patients [58.7%]), than males (42 patients [29.7%]) suffered moderate to severe pain. The reported side effects were nausea (reported by 32.6% of patients), dry mouth (21.7%), vomiting (13.0%), and urinary retention (6.5%), with 32.6% of patients experiencing no side effects. The three patients who received no analgesics experienced vomiting as a side effect. Despite the high incidence of pain and other side effects, 108 patients (78.2%) still reported that the methods of postoperative pain management were satisfactory. Conclusion: Despite recent advances and the development of more effective techniques for postoperative pain control, a high proportion of patients still experience moderate to severe postoperative pain. Intermittent intramuscular injection of analgesic medication remains the mainstay of postoperativ
Evaluation of knowledge of cancer pain management among medical practitioners in a low-resource setting
Ogboli-Nwasor EO, Makama JG, Yusufu LM
Journal of Pain Research , 2013, DOI: http://dx.doi.org/10.2147/JPR.S38588
Abstract: luation of knowledge of cancer pain management among medical practitioners in a low-resource setting Original Research (850) Total Article Views Authors: Ogboli-Nwasor EO, Makama JG, Yusufu LM Published Date February 2013 Volume 2013:6 Pages 71 - 77 DOI: http://dx.doi.org/10.2147/JPR.S38588 Received: 27 September 2012 Accepted: 06 December 2012 Published: 07 February 2013 EO Ogboli-Nwasor,1 JG Makama,2 LMD Yusufu2 1Department of Anesthesia, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria; 2Department of Surgery, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria Background: Several factors considered to be barriers to cancer pain management have been reported in the past. The knowledge of cancer pain management may be a hindrance to the proper assessment and treatment of pain in cancer patients. Objective: This report presents an evaluation of the knowledge and practice of cancer pain management among medical practitioners in Ahmadu Bello University Teaching Hospital Shika, Zaria. Methods: This report involves medical practitioners at the Ahmadu Bello University Teaching Hospital who are directly involved in the management of cancer patients. Information was obtained using a structured questionnaire, and the data were analyzed using SPSS (version 11.5). Results: The response rate to the questionnaire was 82%, with an age range of 23 to 50 years (mean age, 34.9), and the majority of actual respondents, 55 (67%), were male. Thirty-six (44%) strongly agreed that cancer patients require pain relief. Yet only 40% of the respondents routinely conducted pain assessments among cancer patients, while 51% only treated when patients complained of pain. Concerning the type of analgesic commonly used for cancer patients, 43% used weak opioids, 32% used NSAIDs, and only 20% used strong opioids. Seventy-five respondents (91.5%) had no formal training on pain management. Conclusion: The knowledge of pain management for cancer patients among medical personnel at the Ahmadu Bello University Teaching Hospital appears to be elementary. We recommend that formal training in the form of lectures, seminars, and workshops on cancer pain management should be part of continuing medical education in low-resource settings like the Ahmadu Bello University Teaching Hospital.
Pattern of postoperative pain management among adult surgical patients in a low-resource setting
Ogboli-Nwasor E,Sule ST, Yusufu LM
Journal of Pain Research , 2012,
Abstract: Elizabeth Ogboli-Nwasor,1 Sa’adatu T Sule,2 Lazarus MD Yusufu31Department of Anaesthesia, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria; 2Department of Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria; 3Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, NigeriaObjective: Postoperative pain is one of the most common complications of surgery. The pattern of management varies between centers. The current study aimed to study the prescription pattern and the common drugs used in the management of postoperative pain in adult surgical patients at Ahmadu Bello University Teaching Hospital (ABUTH; Zaria, Nigeria).Methods: Following ethical approval, a prospective observational study of consecutive adult patients who had surgery at the ABUTH Zaria was performed from January to December 2005. The data were entered into a proforma and analyzed using the Minitab statistical package.Results: One hundred and thirty-eight patients were included in the study. The age range was 17 to 80 years, with a mean age of 41 years. One hundred and thirty-two (95.7%) of the prescriptions were written solely by the surgeon or surgical resident; passive suggestions were given by the anesthetists for only six patients (4.3%). Intermittent intramuscular injections of opioids/opiates were prescribed for 126 patients (91.3%), while nine patients (6.5%) received intermittent intramuscular injections with non-steroidal anti-inflammatory drugs. Oral paracetamol was prescribed for six patients (4.3%), while three patients (2.1%) received no postoperative analgesic. Moderate pain was recorded in 48 patients (34.8%), and 90 patients (65.2%) had mild pain 8 hours after their operation before subsequent doses of analgesics were given. More females (81 patients [58.7%]), than males (42 patients [29.7%]) suffered moderate to severe pain. The reported side effects were nausea (reported by 32.6% of patients), dry mouth (21.7%), vomiting (13.0%), and urinary retention (6.5%), with 32.6% of patients experiencing no side effects. The three patients who received no analgesics experienced vomiting as a side effect. Despite the high incidence of pain and other side effects, 108 patients (78.2%) still reported that the methods of postoperative pain management were satisfactory.Conclusion: Despite recent advances and the development of more effective techniques for postoperative pain control, a high proportion of patients still experience moderate to severe postoperative pain. Intermittent intramuscular injection of analgesic medication
Evaluation of knowledge of cancer pain management among medical practitioners in a low-resource setting
Ogboli-Nwasor EO,Makama JG,Yusufu LM
Journal of Pain Research , 2013,
Abstract: EO Ogboli-Nwasor,1 JG Makama,2 LMD Yusufu21Department of Anesthesia, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria; 2Department of Surgery, Ahmadu Bello University Teaching Hospital, Shika, Zaria, NigeriaBackground: Several factors considered to be barriers to cancer pain management have been reported in the past. The knowledge of cancer pain management may be a hindrance to the proper assessment and treatment of pain in cancer patients.Objective: This report presents an evaluation of the knowledge and practice of cancer pain management among medical practitioners in Ahmadu Bello University Teaching Hospital Shika, Zaria.Methods: This report involves medical practitioners at the Ahmadu Bello University Teaching Hospital who are directly involved in the management of cancer patients. Information was obtained using a structured questionnaire, and the data were analyzed using SPSS (version 11.5).Results: The response rate to the questionnaire was 82%, with an age range of 23 to 50 years (mean age, 34.9), and the majority of actual respondents, 55 (67%), were male. Thirty-six (44%) strongly agreed that cancer patients require pain relief. Yet only 40% of the respondents routinely conducted pain assessments among cancer patients, while 51% only treated when patients complained of pain. Concerning the type of analgesic commonly used for cancer patients, 43% used weak opioids, 32% used NSAIDs, and only 20% used strong opioids. Seventy-five respondents (91.5%) had no formal training on pain management.Conclusion: The knowledge of pain management for cancer patients among medical personnel at the Ahmadu Bello University Teaching Hospital appears to be elementary. We recommend that formal training in the form of lectures, seminars, and workshops on cancer pain management should be part of continuing medical education in low-resource settings like the Ahmadu Bello University Teaching Hospital.Keywords: cancer pain, management, evaluation, knowledge, medical practitioners
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