Today, intensive care units (ICUs) of most hospitals in developed countries have become separate departments staffed by career intensive care physicians or intensivists from various fields of medicine. In Nigeria, however, ICUs are still part of the anaesthesia department and critical care constitutes a significant part of the workload and responsibilities of anesthetists. This study was carried out to ascertain the types of disease conditions that were brought into the ICU for management at the Benue State University Teaching Hospital (BSUTH), interventions undertaken as well as the outcome of such admissions. A total of 125 patients were evaluated. The age bracket between 21 and 30 years recorded the highest figure of 28 accounting for 22.4% of the study population. This was followed by the age bracket between 31 and 40 years with 24 representing 19.2%. The study population was made up of 81 males and 44 females making up 64.8% and 35.2%, respectively. The most frequent conditions occasioning ICU admissions are post laparotomy (24.8%), head injury (18.4%), and burns (11.2%). A total of 289 interventions in various combinations were carried out on these patients. Of these, monitoring of the patients was undertaken 106 times, representing 36.7%. Oxygen therapy followed closely with 102 (35.3%). The lowest number of days spent by patients in the ICU in this study, was 1, while the longest was 35 with a mean of 5.97 days ± 7.76 days. Majority of the patients, 68, were discharged from the ICU to the wards making up 54.4% of the study population. This was closely followed by those that died, 50, accounting for 40.0% of the study population. This study has established that in our ICU, the most common indications for admission were post-laparotomy, head injury and burns. Also, it has been observed that most of the patients underwent haemodynamic monitoring and oxygen therapy. Finally, while most patients admitted were discharged to the wards, a good number also died in the ICU.
HighlightsImpacted penetrating injuries in airways of children create management challenges.Unavailability of ideal working tools worsens situations in resource-poor settings.Practitioners should think outside box and improvise what is available to save lives.Parents and caregivers should be responsive and keep sharp objects away from children.
Background: Urological surgery entails operating on the urinary system. Like every other surgery, they require anesthesia for the elimination of surgical pain. The organ to be operated as well as surgical approach determines the choice of anaesthesia used. This may be in the form of regional (including neuroaxial anesthesia) or general or even local anesthesia. This study was conducted to ascertain the anesthetic techniques employed for urological surgeries in the Benue State University Hospital (BSUTH), Makurdi, Nigeria.
Methodology: This was a three-year retrospective study carried out in BSUTH, Makurdi, Nigeria. A total of 125 case files of eligible patients were retrieved from the records department following approval of an application. Relevant information was extracted from the patients’ folders and transferred into a prepared proforma. The data collected were analyzed using SPSS version 25 using simple statistics.
Results: The age group with the highest number is that between 61 and 70 years, recording 40 (32.0%). The mean age was 54.0±20.4 Males were a clear majority with 119 cases accounting for 95.2% while only 6 cases (4.8%) involved females. The male to female ratio was 19.8:1. Most of the patients belonged to ASA II which recorded 70 (56.0%). Of the total of 125 diagnoses made, cancer of the prostate (CaP) was the highest with 63 (50.4%). The most common surgical procedure was prostate biopsy which was undertaken 58 times accounting for 46.4% of the procedures. Caudal block was employed most with 59 (47.2%). This was followed by Local infiltration with 30 (24.0%). Eighty-eight patients had surgery on day case basis while 37 patients underwent surgery as in-patients representing 70.4% and 29.6% of the study group respectively.
Conclusion: Urological procedures are mostly infra-umbilical and are thus quite amenable to either regional or local anesthesia. This study has shown that caudal epidural block is the anesthetic technique of choice in urological surgery in this centre. Local anesthesia and sub-arachnoid block are next in that order. GA is not often employed. LA and regional techniques involve fewer disturbances to the respiratory system, and these were the anaesthetic methods mostly employed as established in this study.
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