Abdullah M Kaki - Academia.edu (original) (raw)

Papers by Abdullah M Kaki

BJA: British Journal of Anaesthesia, Oct 1, 2003

Background. Tramadol administered epidurally has been demonstrated to decrease postoperative anal... more Background. Tramadol administered epidurally has been demonstrated to decrease postoperative analgesic requirements. However, its effect on postoperative analgesia after intrathecal administration has not yet been studied. In this double-blind, placebo-controlled study, the effect of intrathecal tramadol administration on pain control after transurethral resection of the prostate (TURP) was studied. Methods. Sixty-four patients undergoing TURP were randomized to receive bupivacaine 0.5% 3 ml intrathecally premixed with either tramadol 25 mg or saline 0.5 ml. After operation, morphine 5 mg i.m. every 3 h was administered as needed for analgesia. Postoperative morphine requirements, visual analogue scale for pain at rest (VAS) and sedation scores, times to ®rst analgesic and hospital lengths of stay were recorded by a blinded observer. Results. There were no differences between the groups with regard to postoperative morphine requirements (mean (

Saudi Medical Journal, Feb 1, 2022

Objectives: To estimate the prevalence of postamputation pain among lower-limb amputees and its b... more Objectives: To estimate the prevalence of postamputation pain among lower-limb amputees and its burden on their lives. Methods: A retrospective patients record review of lower limb amputation surgeries was carried out at

To compare anesthesiologist-controlled sedation (ACS) with patient-controlled sedation (PCS), wit... more To compare anesthesiologist-controlled sedation (ACS) with patient-controlled sedation (PCS), with respect to propofol requirements, sedation, and recovery, in patients undergoing extracorporeal shockwave lithotripsy for urinary calculi. Methods: Sixty-four patients were randomized, in this doubleblind study, to receive propofol sedation according to one of two regimens: infusion of 200 µg•kg-1 •min-1 for ten minutes reduced thereafter to 50-150 µg•kg-1 •min-1 titrated by an anesthesiologist, according to patient response (group ACS), or propofol administered by patient-controlled analgesia (bolus dose 300 µg•kg-1 , lockout interval three minutes, no basal infusion), (group PCS). All patients received midazolam 10 µg•kg-1 iv and fentanyl 1 µg•kg-1 iv preoperatively, followed by fentanyl infused at a rate of 0.5 µg•kg-1 •hr-1 throughout the procedure. Sedation and analgesia were assessed using the A-line ARX index and visual analogue scale, respectively. Psychomotor recovery and readiness for recovery room discharge were assessed using the Trieger dot test and postanesthesia discharge score, respectively. Patient satisfaction was assessed on a sevenpoint scale (1-7). Results: In comparison to group PCS, patients in group ACS received more propofol (398 ± 162 mg vs 199 ± 68 mg, P < 0.001), were more sedated (A-line ARX index: 35 ± 16 vs 73 ± 16, P < 0.001), experienced less pain (visual analogue scale: 0 ± 0 vs 3 ± 1, P < 0.001), and were more satisfied (median [Q1, Q3]: 7 [7, 7] vs 6 [6, 7], P < 0.001). In contrast, patients in group PCS had faster psychomotor recovery (Trieger dot test median [Q1, Q3]: 8 [4, 16] vs 16 [12, 26] dots missed, P = 0.002) and achieved postanesthesia discharge score ≥ 9 earlier (median [Q1, Q3]: 40 [35, 60] vs 88 [75, 100] min, P < 0.001) compared with group ACS. Conclusion: In comparison to PCS for patients undergoing extracorporeal shockwave lithotripsy, propofol/fentanyl ACS is associated with increased propofol administration, deeper sedation levels, and greater patient comfort. However, ACS is associated with slower recovery and a longer time to meet discharge criteria, when compared to PCS. Objectif : Comparer la sédation contrôlée par l'anesthésiologiste (SCA) à la sédation contrôlée par le patient (SCP) quant aux demandes de propofol, à la sédation et à la récupération chez des patients devant subir une lithotripsie à ondes de choc électrohydraulique pour urolithiase. Méthode : Soixante-quatre patients, répartis au hasard pour une étude à double insu, ont reçu : soit une sédation par une perfusion de propofol de 200 µg•kg-1 •min-1 pendant dix minutes, réduite ensuite à 50-150 µg•kg-1 •min-1 ajustée par un anesthésiologiste en fonction de la réaction du patient (groupe SCA), soit du propofol en analgésie autocontrôlée (bolus de 300 µg•kg-1 , période réfractaire de trois minutes, sans perfusion initiale), (groupe SCP). Avant l'opération, tous les patients ont reçu 10µg•kg-1 de midazolam iv et 1 µg•kg-1 de fentanyl iv, puis une perfusion de fentanyl à 0,5 µg•kg

Saudi Journal of Anaesthesia, 2018

Annals of Saudi Medicine, May 1, 2008

BACKGROUND AND OBJECTIVES: Inguinal hernia repair is frequently associated with persistent postop... more BACKGROUND AND OBJECTIVES: Inguinal hernia repair is frequently associated with persistent postoperative discomfort and pain and late discharge from the hospital. We evaluated the postoperative analgesic effect of local wound infiltration with tramadol following herniorrhaphy among adult patients. PATIENTS AND METHODS: Forty-three adult male patients were randomly assigned to two groups; group T (n=23) received tramadol 1 mg/kg in 10 mL 0.9% normal saline and group B (n=20) received 10 mL of 0.25% bupivacaine, both as a local wound infiltration prior to skin closure. Postoperatively, pain severity, time to first analgesic requirement, analgesic consumption, and incidence of side effects were recorded. RESULTS: During the first postoperative day, there was a significant difference between the two groups in the recorded visual analog scale rating higher in group B (P<.05) and the time to first analgesic requirement (6.6±0.99 hours in group B vs 3.7±0.74 hours in group T; P<.05). There was no difference in the incidence of side effects among the two groups. Postoperative consumption of fentanyl and diclofenac was higher in group B than group T (65% vs 18% and 80% vs 21.7%, respectively, P≤.005). CONCLUSIONS: Locally infiltrated tramadol prior to herniorrhaphy wound closure provides better pain relief compared to bupivacaine in adult patients.

PubMed, 2015

Objective: To enhance the modified laparoscopic Vecchietti procedure. Materials and methods: A ca... more Objective: To enhance the modified laparoscopic Vecchietti procedure. Materials and methods: A case series of five women with Mayer-Rokitansky-Küster-Hauser syndrome at the Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia underwent the modified laparoscopic Vecchietti procedure with intraperitoneal placement of sutures. This involved perforation of the vaginal dimple by a straight thread guide with two threads attached to the olive followed by pulling the two threads intra-peritoneally and through the abdominal wall to the traction device by grasping instruments under laparoscopic control. Results: Intraperitoneal placement of the sutures was easily done without complications in all five women. The operative time was 50 ± 10 (mean ± SD) minutes. After five postoperative days, the average vaginal length was seven to 7.5 cm. Two women were able to have vaginal intercourse without problems. After six months to one year of follow up, the vaginal length was at least ten cm and no postoperative complications occurred. Conclusions: Intraperitoneal placement of sutures makes the modified laparoscopic Vecchietti procedure easy and appealing. Furthermore, it avoids potential damage to the vital structures at the pelvic side walls.

PubMed, Jun 1, 2012

Objective: To determine the effect of modifying the GlideScope (GVL) blade on the intubation time... more Objective: To determine the effect of modifying the GlideScope (GVL) blade on the intubation time. Methods: This prospective study was conducted at the Department of Anesthesia, King Abdulaziz University Hospital, Jeddah, Saudi Arabia between June 2011 and October 2011. Sixty patients requiring endotracheal tube (ETT) intubation for elective surgery in whom airway was anticipated normal were randomly allocated to one of 2 groups. Group M (n=30): intubated via a modified GVL blade in which a tube conduit along the side of the GVL blade was created to allow the passage of ETT through the cords. Group C (n=30): intubated with the conventional GVL blade and rigid intubating stylet. Results: Time to successful tracheal intubation (TTI) was 39.6+/-2.1 seconds in Group M versus 66.4+/-8.3 seconds in Group C (p=0.0001), tracheal intubation was deemed more easily in Group M than in Group C (VAS 2+/-1 versus 6+/-1, p=0.0001), and all patients in Group M were successfully intubated on the first attempt when compared with 90% in Group C (p=0.009). Conclusion: The addition of a conduit to the GVL blade made the passage of the ETT easier and TTI shorter without increasing adverse events or intubation failure.

PubMed, Nov 1, 2012

Objective: To assess the efficacy of pressure volume loop (PV-L) closure as an indicator of adequ... more Objective: To assess the efficacy of pressure volume loop (PV-L) closure as an indicator of adequate endotracheal tube cuff (ETTc) function, and to compare this with commonly used methods of checking cuff pressure. Methods: We conducted a randomized clinical trial at the Department of Anesthesia, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia from October 2011 to February 2012. One hundred and forty patients were intubated, and the ETTc was inflated using one of 3 techniques. The intubating anesthesiologist inflated the cuff at his discretion until he detected no further air leak in the first technique. In the second technique, we maintained the ETTc pressure at 20 centimeter water, while the third technique used PV-L closure. Results: The PV-L technique required lower amounts of air to inflate the ETTc than the other 2 techniques (3.89+/-0.26 for PV-L versus 4.4+/-0.36 for fixed preset pressure, and 5.26+/-0.46 for pilot balloon palpation, p=0.00001) and the mean cuff pressure was lower than other techniques (18.67+/-0.72 for PV-L versus 20 for fixed preset pressure, and 33.48+/-3.49 for pilot balloon palpation, p=0.00001). Conclusion: The PV-L closure technique is an alternative way to check for ETTc function with a significantly lower ETTc pressure and volume than those recorded with a manually inflated cuff, or with preset cuff pressure of 20 cmH2O.

Saudi Medical Journal, Aug 1, 2017

Objectives: To investigated the rate of occurrence of lumbosacral transitional vertebrae (LSTV), ... more Objectives: To investigated the rate of occurrence of lumbosacral transitional vertebrae (LSTV), spinal variant, in kidney urinary bladder (KUB) plain radiographs in a Saudi population.

Regional Anesthesia and Pain Medicine, Mar 1, 1998

Saudi Journal of Anaesthesia, 2014

Background: The main function of an endotracheal tube (ETT) cuff is to prevent aspiration. High c... more Background: The main function of an endotracheal tube (ETT) cuff is to prevent aspiration. High cuff pressure is usually associated with postoperative complications. We tried to compare cuff infl ation guided by pressure volume loop closure (PV-L) with those by just to seal technique (JS) and assess the postoperative incidence of sore throat, cough and hoarseness. Materials and Methods: In a prospective, randomized clinical trial, 100 patients' tracheas were intubated. In the fi rst group (n = 50), ETT cuff infl ation was guided by PV-L, while in the second group (n. = 50) the ETT cuff was infl ated using the JS technique. Intracuff pressures and volumes were measured. The incidence of postoperative cuff-related complications was reported. Results: Demographic data and durations of intubation were comparable between the groups. The use of PV-L was associated with a lesser amount of intracuff air [4.05 (3.7-4.5) vs 5 (4.8-5.5), P < 0.001] and lower cuff pressure than those in the JS group [18.25 (18-19) vs 33 (32-35), P ≤ 0.001]. The incidence of postextubation cuff-related complications was signifi cantly less frequent among the PV-L group patients as compared with the JS group patients (P ≤ 0.009), except for hoarseness of voice, which was less frequent among the PV-L group, but not statistically signifi cant (P ≤ 0.065). Multiple regression models for prediction of intra-cuff pressure after intubation and before extubation revealed a statistically signifi cant association with the technique used for cuff infl ation (P < 0.0001). Conclusions: The study confi rms that PV-L-guided ETT cuff infl ation is an effective way to seal the airway and associates with a lower ETT cuff pressure and lower incidence of cuff-related complications .

Anesthesia & Analgesia, Dec 1, 2009

Cervical plexus blocks are used for operative anesthesia, postoperative pain control and chronic ... more Cervical plexus blocks are used for operative anesthesia, postoperative pain control and chronic pain management indications.

Anesthesia & Analgesia, Oct 1, 2006

... Binay Kumar Biswas, MD Satyendra Nath Singh, MD Bikash Agarwal, MD Birendra Prasad Sah, MD Ar... more ... Binay Kumar Biswas, MD Satyendra Nath Singh, MD Bikash Agarwal, MD Birendra Prasad Sah, MD Arvind Chaturvedi, MD Department of ... M. Kaki, MD, FRCPC Department of Anesthesia Faculty of Medicine King Abdalaziz Unversity Hospital amkaki@yahoo.com Walid A. Alyafi ...

Canadian Journal Of Anesthesia/journal Canadien D'anesthésie, May 1, 2006

PubMed, Feb 1, 2009

Objective: To assess the nursing knowledge of acute pain management in a tertiary hospital. Metho... more Objective: To assess the nursing knowledge of acute pain management in a tertiary hospital. Methods: Three hundred closed-answer questionnaires were distributed in various hospital departments at King Khalid National Guard Hospital in Jeddah, Saudi Arabia in 2007. Three main topics were tested in the questionnaire; nursing opinion on patient self-report of pain as a main indicator of pain intensity, the need to increase opioids dose when the first dose had been safe but ineffective, and nurses' attitude toward the incidence of addiction, tolerance, and physical dependence. Results: Of the respondents, 45.8% used the patient self-report of pain as an indicator of pain intensity in the smiling patient (A), and 55.1% relied on that in the grimacing patient (B). Fifty percent of respondents in patient A and 30.5% in patient B decided to give no more morphine to both patients despite their pain, while 7.6% and 19.5% of nurses selected the option of giving higher morphine dose to both patients. Only 38.1% of nurses chose the correct answer for risk of addiction (<1%) and 41.6% selected an exaggerated response range from 25-100% as a chance of addiction. Very few nurses recognized the problem of tolerance and physical dependence and picked the right answers. Conclusion: Nurses' knowledge of acute pain management is deficient in many aspects. Proper education is needed to improve their knowledge of pain.

Saudi Journal of Anaesthesia, 2012

a 7-year-old boy, weighing 18 kg, was diagnosed with maple syrup urine disease (MSUd). He suffere... more a 7-year-old boy, weighing 18 kg, was diagnosed with maple syrup urine disease (MSUd). He suffered from spasticity of the lower limbs and pain that did not respond to oral medications. injections of botulinum toxin a (BtX-a) at 10 sites and epidural analgesia with 0.125% bupivacaine were used to treat spasticity with good results. We conclude that BtX-a combined with epidural analgesia may be a useful treatment option for incapacitating, painful spasticity related to MSUd. this treatment modality allowed a comprehensive rehabilitation program to be completed and it lasted longer than 9 months.

Saudi Medical Journal, Mar 1, 2008

Saudi Medical Journal, Dec 1, 2006

PubMed, Jun 1, 2011

Objective: To assess the final year medical students' knowledge, beliefs, and attitude toward can... more Objective: To assess the final year medical students' knowledge, beliefs, and attitude toward cancer pain, and the need for a formal pain curriculum in medical schools. Methods: An epidemiological study was conducted from May 2008 to October 2009 at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia to assess the students' knowledge and attitude toward cancer pain management. A survey in the form of self-conducted questionnaire was distributed among them. Results: Response rate was 55% (N=325). Fifty-four percent of the respondents believed that <40% of cancer patients suffered from pain. Forty-six percent of them considered cancer pain as untreatable, while 41.6% considered pain as a minor problem, and 58.6% considered the risk of addiction is high with legitimate opioids' prescription. There are 23.1% of students believed that patients are poor judges of their pain, 68% of them limited opioids prescription to patients with poor prognosis, and 77.1% believed that drug tolerance or psychological dependence, rather than advanced stages' cancer is the cause of increasing analgesic doses. The students' knowledge on the causes of cancer pain, pain clinic rule, and pain inclusion in the medical curriculum was poor. The correlation between personal life experience and respondents' attitude toward cancer pain management did not reveal any statistical significant. Conclusion: The study revealed poor knowledge and negative attitude of medical students' toward cancer pain. A structured teaching pain program is needed to improve the knowledge and attitude of future doctors toward pain.