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The patients' understanding on the status and role of anaesthesiologists

Budiman M, Izaham A, Abdul Manap N, Zainudin K, Kamaruzaman E, Masdar A, et al.

Clin Ter, 2015 Nov-Dec;166(6):227-35.
PMID: 26794808 DOI: 10.7417/CT.2015.1892

OBJECTIVES: To evaluate patients' understanding on the status and role of anaesthesiologists.
MATERIALS AND METHODS: This was a prospective, questionnaire-based cross-sectional study. The interview had three segments which questioned on (i) patients' knowledge of the qualification, training and role of anaesthesiologists, (ii) attitude of patients towards anaesthesia and anaesthesiologists and (iii) the demographic data of patients.
RESULTS: Of 384 patients interviewed, 59.4% had prior anaesthesia experience. Most patients (95.6%) knew that anaesthesiologists were medical doctors, but only 27.1% knew the duration of training required to attain this specialist qualification. Patients' awareness of the various anaesthetic responsibilities was 12.2% in managing labour pain, 25.5% in intensive care units, 49.2% in chronic pain and 99.5% in postoperative pain management. During surgery, 73.7% of patients knew that anaesthesiologists were monitoring their vital signs, but only 42.2% thought anaesthesiologists also treated medical problems intraoperatively. Most patients (95.1%) would like to meet their anaesthesiologists prior to the operation and 97.7% want them to inform all possible anaesthesia complications.
CONCLUSIONS: Our patients' understanding and awareness of the status and roles of anaesthesiologists are still limited and variable. This can be further improved with patient interaction and public education.
KEYWORDS: Anaesthesiologist; Attitudes; Patient’s knowledge; Patient’s perception; Survey
Occupational radiation exposure to anesthetists from fluoroscopic projections during orthopedic operative procedures

Abas AA, Rahman RA, Yahya N, Kamaruzaman E, Zainuddin K, Manap NA

Clin Ter, 2014;165(4):e253-7.
PMID: 25203339 DOI: 10.7417/CT.2014.1739

The role of anesthetists during orthopedic fluoroscopic procedures exposes them to radiation. We conducted a prospective, descriptive study to estimate the radiation exposure to anesthetists during procedures over a six-month period in the orthopedic trauma operating theatres which had the most fluoroscopic usage.
Fulltext [Comparing insertion characteristics on nasogastric tube placement by using GlideScope™ visualization vs. MacIntosh laryngoscope assistance in anaesthetized and intubated patients]

Wan Ibadullah WH, Yahya N, Ghazali SS, Kamaruzaman E, Yong LC, Dan A, et al.

Rev Bras Anestesiol, 2016 Jul-Aug;66(4):363-8.
PMID: 27157205 DOI: 10.1016/j.bjan.2016.04.007

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.
KEYWORDS: Complications; Complicações; Direct laryngoscope; Laringoscopia direta; Nasogastric tube; Sonda nasogástrica; Videolaringoscópio; Videolaryngoscope
Fulltext Comparing insertion characteristics on nasogastric tube placement by using GlideScope™ visualization vs. MacIntosh laryngoscope assistance in anaesthetized and intubated patients

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.
Fulltext Unusual Presentation of Myasthenia Crisis Following Thymectomy and Thyroidectomy

Mohamed Daud A, Mat Baki M, Azman M, Kamaruzaman E, Mohamed AS

Indian J Otolaryngol Head Neck Surg, 2019 Oct;71(Suppl 1):118-120.
PMID: 31741945 DOI: 10.1007/s12070-017-1146-x

Respiratory distress after thyroidectomy and thymectomy can be challenging. We encountered a 70-year-old lady with a long-standing goiter with concomitant thymoma. She underwent the surgery and developed respiratory distress upon extubation with loss of laryngeal sensation causing severe aspiration. She was diagnosed myasthenia gravis and symptoms resolved with MG treatments.
The comparison between propofol and dexmedetomidine infusion on perioperative anxiety during regional anesthesia

Lim YP, Yahya N, Izaham A, Kamaruzaman E, Zainuddin MZ, Wan Mat WR, et al.

Turk J Med Sci, 2018 Dec 12;48(6):1219-1227.
PMID: 30541250 DOI: 10.3906/sag-1802-126

Background/aim: Regional anesthesia for surgery is associated with increased anxiety for patients. This study aimed to compare the
effect of propofol and dexmedetomidine infusion on perioperative anxiety during regional anesthesia.
Materials and methods: Eighty-four patients were randomly divided into two groups receiving either study drug infusion. Anxiety
score, level of sedation using the Bispectral Index and Observer’s Assessment of Alertness and Sedation, hemodynamic stability, and
overall patient’s feedback on anxiolysis were assessed.
Results: Both groups showed a significant drop in mean anxiety score at 10 and 30 min after starting surgery. Difference in median
anxiety scores showed a significant reduction in anxiety score at the end of the surgery in the dexmedetomidine group compared to the
propofol group. Dexmedetomidine and propofol showed a significant drop in mean arterial pressure in the first 30 min and first 10 min
respectively. Both drugs demonstrated a significant drop in heart rate in the first 20 min from baseline after starting the drug infusion.
Patients in the dexmedetomidine group (76.20%) expressed statistically excellent feedback on anxiolysis compared to patients in the
propofol group (45.20%).
Conclusion: Dexmedetomidine infusion was found to significantly reduce anxiety levels at the end of surgery compared to propofol
during regional anesthesia.