There were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia.

There were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia.

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Introduction: Anatomical and physiological changes of the respiratory system in obese patients predispose them to rapid oxygen desaturation during apnoea. Adequate pre-oxygenation before anaesthesia induction allows a period of safe apnoea. The efficacy of pre-oxygenation with facemask versus facemask with nasal prong was compared. The time taken for expired end-tidal oxygen (FEO2) to reach 0.8 (T0.8) from commencement of pre-oxygenation (T0), and time to oxygen desaturation to 95% (T95%), following apnea (TA) was studied. Methods: This prospective, randomised study recruited 36 surgical patients of body mass index (BMI) ≥ 30 kg/m2 requiring general anaesthesia with endotracheal intubation. They were randomised to receive pre-oxygenation with oxygen facemask at 12 L/min, or concurrent pre-oxygenation with facemask at 7 L/min and nasal prong at 5 L/min. Oxygen saturation (SpO2) and FEO2 were recorded at T0, T0.8, and at TA following completion of rocuronium administration. Oxygen was then discontinued, and the patient left apnoeic with no ventilation. Intubation was performed 60 seconds after TA, and the patient left apnoeic with the endotracheal tube exposed to room air. Duration from TA until the patient’s SpO2 reached 95% (T95%) was documented. Results: Pre-oxygenation with facemask and nasal prong resulted in a shorter T0.8 compared to facemask alone (48.61 s ± 23.3 versus 77.72 s ± 26.15), p = 0.001. There was no difference in T95% between the groups. Conclusion: Pre-oxygenation with facemask plus nasal prong resulted in a shorter time taken to reach FEO2 0.8, but with comparable time to oxygen desaturation between both groups.

Introduction: Fentanyl-induced cough is common during induction of general anaesthesia. This unpleasant cough may increase the intraocular, intracranial, and intraabdominal pressure. We hypothesised that 30 mg/kg of prophylactic intravenous magnesium sulphate is effective in obtunding 2 μg/kg fentanyl-induced cough.Methods: One hundred and forty patients scheduled for general anaesthesia, aged between 18 to 70 years old with American Society of Anesthesiologists physical status I were randomised into two groups. Group I and Group II patients received 30 mg/kg intravenous magnesium sulphate and normal saline, respectively. The solution studied was infused over 15 minutes followed by a fentanyl bolus 2 μg/kg delivered within 3 seconds. The incidence of cough and severity were documented. Mean arterial pressure and heart rate were recorded every 5 minutes during the infusion.Results: Eight patients (11.4%) had cough in Group II and one (1.4%) in Group I. Compared to Group II, the incidence and severity of cough were significantly lower in Group I (p = 0.003 and p = 0.037), respectively. There was no significant difference regarding the haemodynamic status between the two groups during the infusion of both solutions.Conclusion: During general anaesthesia induction, 30 mg/kg of intravenous magnesium sulphate effectively obtunded fentanyl-induced cough.

Introduction: Many studies have investigated the effects of music on perioperative anxiety and its implication on anaesthetic practice, however there are limited number of studies reported for religious or spiritual intervention in this aspect. We investigated the effects of listening to Islamic praises (Dzikr) and nature-based sounds delivered via headphones as non-pharmacological interventions for perioperative anxiety. Materials and Methods: Sixty-three Muslim patients scheduled for elective lower limb surgery under regional anaesthesia were randomly assigned to listen to Dzikr (Group A), nature-based sounds (Group B) or given headphones without any sounds (Group C). Anxiety levels were assessed using a visual analogue scale for anxiety (VAS-A). Physiological responses (mean arterial pressure, heart rate and respiratory rate) as well as patients’ overall satisfaction level were documented. Results: Patients in Group A demonstrated statistically significant lower VAS-A scores compared to those in Group B and C at 30-minutes after skin incision (p=0.002 and p=0.001 respectively) and at the end of the surgery (p=0.028 and p<0.001 respectively). Patients in Group A recorded significantly higher satisfaction levels compared to those in Groups B (p=0.038) and C (p=0.001). No significant differences were seen for the physiological responses, nor was there any additional anxiolytic requirement among the three groups. Conclusion: Listening to Dzikr among Muslim patients was more effective in reducing perioperative anxiety levels when compared to nature -based sounds, in patients who had undergone lower limb surgery under regional anaesthesia. ><0.001 respectively). Patients in Group A recorded significantly higher satisfaction levels compared to those in Groups B (p=0.038) and C (p=0.001). No significant differences were seen for the physiological responses, nor was there any additional anxiolytic requirement among the three groups. Conclusion: Listening to Dzikr among Muslim patients was more effective in reducing perioperative anxiety levels when compared to nature -based sounds, in patients who had undergone lower limb surgery under regional anaesthesia.

Introduction. ProSeal-Laryngeal Mask Airway™ (P-LMA™) is one of the commonly used laryngeal mask airways. Despite the proper insertion technique, suboptimal positioning and airway morbidity still occurs. This study explored the possibility of the operating table height position affecting successful P-LMA™ placement. Methods. A total of 138 patients aged between 18 and 65 years old with the American Society of Anesthesiologists (ASA) I or II status, who required general anaesthesia and had no contraindication towards the use of P-LMA™, were recruited. They were randomly positioned into three anatomical landmarks, which were umbilicus, lowest rib margin, and xiphoid. P-LMA™ was inserted following muscle paralysis, and the first successful placement was evaluated using positional and performance tests. Duration, ease of P-LMA™ insertion, and airway complications were compared. Results. Demographic and airway features were comparable among all groups. The P-LMA™ placement success rate improved when the table height was positioned at the lowest rib margin ( p = 0.002 ). All three positions were comparable in terms of duration, ease of insertion, and airway morbidities. Conclusion. The lowest rib margin anatomical landmark can be used as a guide in achieving the optimal operating table height for successful P-LMA™ placement.

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