Raymond Ndikontar; Roddy Stephan Bengono Bengono; Albert Ludovic Amengle; Joel Noutakdie Tochie; Bonaventure Jemea; Junette Metogo Mbengono; Paul Owono Etoundi; Jacqueline Ze Minkande
Abstract
Background: There is scant data on the effectiveness and safety of adjuvant perioperative intravenous (IV) lidocaine in procuring postoperative analgesia and rehabilitation in gynecology surgery in low-resource settings.Objectives: To evaluate the effects of IV lidocaine on postoperative pain and rehabilitation ...
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Background: There is scant data on the effectiveness and safety of adjuvant perioperative intravenous (IV) lidocaine in procuring postoperative analgesia and rehabilitation in gynecology surgery in low-resource settings.Objectives: To evaluate the effects of IV lidocaine on postoperative pain and rehabilitation gynecology surgery.Methods: We carried out a randomized single-blinded controlled trial from April to August 2017 (5 months) at the Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital, Cameroon. The study population was made up of ASA 1 and 2, women admitted for elective gynecological surgery under general anesthesia divided into two groups of 17 patients: those to receive IV lidocaine and those to receive normal saline as placebo both intra-and postoperatively as an adjuvant to standard care. The variables studied included the additional doses of fentanyl, postoperative pain, side effects of lidocaine, time to first bowel sounds, the ease with which patients were mobilized and patient satisfaction.Results: Compared to patients in the placebo group, those in the lidocaine group had fewer mean amounts of fentanyl reinjections (P<0.0001), shorter recovery time (P=0.0044), reported lesser pain in the immediate postoperative period (P=0.012) till the 3rd postoperative hour (P<0.001), had more early postoperative bowel sounds (94.1% vs. 11.8%), rehabilitated earlier (P<0.001) and were more satisfied with pain management (P=0.001). The lone observed side effect of IV lidocaine was tolerable bradycardia in six (35.3%) patients.Conclusion: Adjuvant IV lidocaine can be effectively used in gynecological surgery, with the advantage of better postoperative analgesia, quicker rehabilitation and minimal side effects.
Junette Arlette Metogo Mbengono; Joël Noutakdie Tochie; Ferdinand Ndom Ntock; Yves Bertrand Nzoaungo; Stephane Kona; Glwadys Ngono Ateba; Cassandra Tocko; Aminata Colibaly; Gérard Beyiha; Jacqueline Ze Minkande
Abstract
Background: Septic shock (SS) is a health priority in sub-Saharan Africa. However, there is a dearth of data in this regard. Objective: This study aimed to determine the epidemiology, therapeutic patterns, outcome, and challenges in managing SS in a tertiary intensive care unit (ICU) of sub-Saharan Africa. ...
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Background: Septic shock (SS) is a health priority in sub-Saharan Africa. However, there is a dearth of data in this regard. Objective: This study aimed to determine the epidemiology, therapeutic patterns, outcome, and challenges in managing SS in a tertiary intensive care unit (ICU) of sub-Saharan Africa. Methods: The hospital files of 36 consecutive patients admitted to the ICU of the Douala General Hospital (DGH), Cameroon over the year 2018 were reviewed for SS. SS was diagnosed based on Sepsis-3 definition. Demographic and clinical characteristics, treatment details, and outcomes of patients with SS were reviewed. Data was analyzed using the chi-square or Fisher exact tests and Bonferroni correction. Results: SS accounted for 36 (9.4%) ICU admissions. The majority of patients were males (63.9%). The most common site of infection was the lungs. The mean age, average mean arterial pressure (MAP), and mean sequential organ failure assessment (SOFA) score of patients were 52.9±25.2 years, 52±18 mm Hg, and 9.2 ±2.3, respectively. Noradrenaline was the sole vasopressor used. Therapeutic challenges included the inability to have a specific antibiogram before a mean duration of 7 days. The mortality rate was 39% and associated with age ≤1 year, MAP ≤ 65 mm Hg, Glasgow Coma Score (GCS) ≤8, and mechanical ventilation, which were not attenuated after Bonferroni correction. Conclusion: SS is a frequent cause of ICU admission and is associated with a high mortality rate. SS mortality-related factors can be screened during SS management for more aggressive ICU management geared at preventing death.