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Biomedical subjects

C E Famewo

Publications and source records attributed to C E Famewo.

At least 19 recordsLinked to original sources
PubMed2001

The Ibadan conjoined twins: a report of omphalopagus twins and a review of cases reported in Nigeria over 60 years.

An omphalopagus set of female conjoined twins, undiagnosed prenatally, who presented as obstructed labour needing operative delivery is reported. Their anatomic characteristics and clinical features, including overwhelming sepsis in twin II which forced early separation, and those which led to their demise are described. Twelve other cases reported in Nigeria over the past 60 years are reviewed with reference to the aetiology and epidemiology of conjoined twinning and the determinants of successful surgical separation.

Fatal Outcome↗
PubMed1986

Pharmacokinetics of meperidine in spinal anaesthesia.

Five male patients undergoing haemorrhoidectomy received intrathecal meperidine 1 mg X kg-1 as the sole anaesthetic agent. Plasma concentration-time profiles were investigated. The peak plasma concentration of meperidine was 175 +/- 78.8 ng X ml-1 (mean +/- SD) and this occurred 90 minutes after intrathecal injection. The plasma concentrations generally were lower than those necessary for systemic analgesic effects. The terminal elimination half life of meperidine (t 1/2 beta) in the plasma was 198 minutes. Intrathecal meperidine produced good surgical anaesthesia in all patients studied. The mean duration of sensory and motor block was 77 +/- 18.8 and 47 +/- 7.4 minutes respectively. Four patients did not require any analgesic supplement during the postoperative period. No patient developed clinically evident respiratory depression or neurological sequelae. The pharmacokinetic data suggests that intrathecal meperidine provides prolonged postoperative analgesia through a regional effect on opioid receptors in the spinal cord.

Adult↗
PubMed1986

Conditions for endotracheal intubation after atracurium and suxamethonium.

Intubating conditions following 2 different dosage levels of atracurium, a new non-depolarising muscle relaxant was compared with suxamethonium. The dosage levels of atracurium were 0.5 mg/kg and 0.7 mg/kg while the dosage of suxamethonium chloride was 1 mg/kg. A total of 60 patients with 20 patients in each of the three groups were studied. Premedication was with oral diazepam 10 mg. Anesthesia was induced with fentanyl 1 microgram/kg and thiopentone 5 mg/kg and intubation performed in all cases by the same operator. Excellent intubation conditions were obtained in all patients within 60 seconds in the suxamethonium group, 90 seconds in the atracurium 0.7 mg/kg group, and 120 seconds in the atracurium 0.5 mg/kg group. No side effects were observed and there was circulatory stability. It is concluded that atracurium in a dose of 0.7 mg/kg allows more rapid intubation than the 0.5 mg/kg dose. It is however not as rapid as suxamethonium which remains the drug of choice when very rapid intubation is crucial.

Adult↗
PubMed1985

Induction of anaesthesia with etomidate in a patient with acute intermittent porphyria.

This is a case report of a 35-year-old female with acute intermittent porphyria who presented for elective vagotomy and pyloroplasty. The diagnosis of porphyria was made two years previously when she developed acute abdominal pain and lower motor neurone paralysis following ingestion of a barbiturate. The urine porphobilinogen test was positive. The patient had no other acute attack of porphyria and had not had a previous anaesthetic. Anaesthesia was induced with etomidate 0.3 mg X kg-1 IV. Muscle relaxation was obtained with pancuronium 6 mg IV and ventilation was mechanically controlled. Intraoperative analgesia was with 66 per cent nitrous oxide in oxygen and intermittent doses of fentanyl. The patient was stable during anaesthesia and surgery. The postoperative period was uneventful and patient did not have an acute attack of porphyria. This experience suggests that etomidate is safe for intravenous induction of anaesthesia in acute intermittent porphyria. However, reports of its use in more patients with this disease will be necessary before a final conclusion can be made.

Acute Disease↗
PubMed1985

Spinal anaesthesia with meperidine as the sole agent.

Twenty male patients of ASA physical status I or II undergoing surgery of the perineal or inguinal areas received intrathecal meperidine in a dose of 1 mg X kg-1 as the sole anaesthetic agent. There was sensory and motor block within ten minutes of intrathecal injection of meperidine and surgery was performed with complete analgesia. The duration of surgery was 39.7 +/- 14 (mean +/- SD) minutes. Prolonged postoperative analgesia was obtained and some patients did not require additional narcotic analgesic during the postoperative period, lasting up to seven days. Side effects included nausea and vomiting (six patients), hypotension (five patients), pruritus (five patients) and urinary retention (two patients). There was no early or late respiratory depression. It is concluded that intrathecal meperidine in a dose of 1 mg X kg-1 is effective as the sole agent for spinal anaesthesia and produces prolonged postoperative analgesia. It offers an advantage for such painful operations as haemorrhoidectomy and anal fissurectomy where its prolonged analgesic effect is desirable. It could also serve as an alternative agent for spinal anaesthesia when a local anaesthetic is not available.

Adult↗
PubMed1985

The choice of anesthesia as a career by undergraduates in a Saudi university.

In order to find out the career preferences of Saudi medical undergraduates as they relate to anesthesiology, questionnaires were distributed and received from 40 pre-clinical students and 26 clinical students immediately after their two-week anesthesia posting. Almost half of the preclinical students made their final choice. None of the students in this group made anesthesiology a first choice, though about 67.5% had heard about anesthesia. Among the students in the clinical group, medicine, surgery and general practice were the most common choices. Only one indicated anesthesiology a first choice. Most of the clinical students indicated that their I.C.U. rotation was the most enjoyable part of their anesthesia posting. The student's suggestions for improvement in their posting included a longer period than the present 2 weeks and more opportunity to acquire the required clinical skills. The authors advise a positive drive to Saudi medical undergraduates to take up the specialty of anesthesiology as a career in order to correct the present shortage.

Adolescent↗
PubMed1983

Management of post-operative pain: current concepts and methods of management.

This paper discusses the aetiology, incidence and severity of post-operative pain including factors that influence post-operative pain. Current concepts and the need for effective control of post-operative pain are discussed. A review of the various methods available for post-operative pain management is presented with special reference to practice in a developing country.

Acupuncture Therapy↗
PubMed1983

The safety of etomidate: a new intravenous anaesthetic induction agent.

Etomidate is a new non-barbiturate intravenous (i.v.) anaesthetic induction agent. This paper attempts to evaluate its overall safety based on studies on its effects on the cardiovascular and respiratory systems, intraocular pressure changes, apgar scores of newborns, plasma potassium changes and times to full recovery of consciousness. During etomidate anaesthesia there was good cardiorespiratory stability, reduced intraocular pressure, high apgar scores of babies delivered by caesarian section, and rapid recovery of consciousness. Unlike thiopentone, etomidate failed to attenuate suxamethonium-induced hyperkalaemia. The two major disadvantages of etomidate are the pain during i.v. injection and the development of myoclonic muscle movements during induction of anaesthesia. It is concluded that etomidate is quite safe from the above-stated points of view and rates very high when compared with other i.v. anaesthetic agents. However, it rates low with regards to the smoothness and pleasantness of induction of anaesthesia.

Adolescent↗
PubMed1983

A study of certain personal details of adult Nigerian patients presenting for elective general surgery under anesthesia.

500 adult Nigerian patients presenting for elective general surgery under anesthesia were studied with regard to age, sex, obesity, smoking and drinking habits and associated medical diseases. The results showed equal sex distribution with 60% of the patients in the 21-40 years age group. About 30% of the patients (predominantly females) were obese. Smoking and drinking habits were relatively low especially in the females. About 25% of the patients have associated medical disorders of which hypertension and anemia were the commonest. Chronic obstructive lung disease and atherosclerotic heart disease were relatively uncommon. Multiple drug therapy was not a problem in this series.

Adult↗
PubMed1982

Post-suxamethonium pains in Nigerian surgical patients.

Contrary to an earlier report by Coxon, scoline pain occurs in African negroes. Its incidence was determined in a prospective study involving a total of 100 Nigerian patients (50 out-patients and 50 in-patients). About 62% of the out-patients developed scoline pain as compared with about 26% among the in-patients. The abolition of muscle fasciculations (by 0.075mg/kg dose of Fazadinium) did not influence the occurrence of scoline pain. Neither the type of induction agent (Althesin or Thiopentone) nor the salt preparation of suxamethonium used (chloride or bromide), affected the incidence of scoline pain.

Fasciculation↗
PubMed1981

Clinical trial of fazadinium bromide (fazadon).

Fifty healthy Nigerian surgical patients were given fazadinium bromide at a dose level of 10 mg . kg-1 while 30 other similar patients received 1.5 mg . kg-1. Anaesthesia was induced with either thiopentone or alfathesin. Tracheal intubation was satisfactorily accomplished after a mean of 55 seconds with the 1 mg . kg-1 dose and a mean of 32 seconds with the 1.5 mg . kg-1 dose. Duration of action of fazadinium 1 mg . kg-1 was a mean of 42 min (range 30 to 50 min) while the mean for 1.5 mg . kg-1 was 55 min (range 45 to 70 min). There was no significant difference between the thiopentone and alfathesin induction groups. Reversibility with neostigmine was excellent. Whereas the 1 mg . kg-1 dose was satisfactory for normal regular intubation, the 1.5 mg . kg-1 dose is recommended for "crash" intubation. The administration of fazadinium was associated with a stable blood pressure and moderate sinus tachycerdia. No other side effects were seen.

Adult↗
PubMed1981

Effect of fazadinium (Fazadon) on muscle fasciculations induced by succinylcholine.

The effects on muscle fasciculations and ease of tracheal intubation of pretreatment with fazadinium before administration of succinylcholine were evaluated in 85 patients. Four dose levels of fazadinium evaluated were 0.05 mg . kg-1, 0.075 mg . kg-1, 0.10 mg . kg-1 and 0.15 mg . kg-1. The 0.05 mg . kg-1 dose did not always prevent succinylcholine-induced muscle fasciculations. The 0.15 mg . kg-1 dose gave poor conditions for tracheal intubation and was therefore discontinued. The 0.075 mg . kg-1 dose seemed optimal. Most patients felt transient pain at the site of the injection during administration of fazadinium, and many had a sensation of drowsiness.

Adult↗
PubMed1981

The influence of fazadinium on the potassium efflux produced by succinylcholine.

Succinylcholine-induced potassium efflux was studied in two groups of healthy adult patients presenting for elective surgery. One group (Group 1) of 12 patients received alfathesin induction followed by succinylcholine. The other group (Group 2) of 12 patients were pre-treated with fazadinium 0.075 mg . kg-1 about three minutes before administration of alfathesin and succinylcholine. Serial blood samples were taken pre-induction, post-induction and after succinylcholine for estimation of plasma potassium. The results show that pre-treatment with fazadinium 0.075 mg . kg-1 was effective in preventing succinylcholine-induced potassium efflux.

Adult↗