Faizul Hoque - Academia.edu (original) (raw)

Papers by Faizul Hoque

Research paper thumbnail of Dexmedetomidine for Sedation during Total Abdominal Hysterectomy under Spinal Anesthesia

Journal of the Bangladesh Society of Anaesthesiologists, Jul 31, 2020

Intravenous Dexmedetomidine is associated with stable cardiovascular profile and less associated ... more Intravenous Dexmedetomidine is associated with stable cardiovascular profile and less associated with fear, anxiety and agitation. Spinal anesthesia (SA) offers many advantages over general anesthesia, like providing analgesia and muscle relaxation in a conscious and compliant patient and an uneventful postoperative recovery. But retained consciousness during surgery or patient awake causes fear, anxiety in perioperative period. The fear of surgery, the unfamiliar environment of operation room, the sight and sounds of sophisticated instruments, and the masked faces makes the patient panic. The intense sensory and motor block, continuous supine position and the inability to move the body also brings a feeling of discomfort and phobia in many patients. Thus, adequate sedation and control of stress, pain, fear and patient satisfaction are essential components during anesthesia. Sedation has been shown to increase patient satisfaction during regional anesthesia. I conclude that, during spinal anesthesia, IV supplementation of dexmedetomidine is more effective than midazolam infusion, as it provides longer duration of sensory and motor blockade and postoperative analgesia with minimal and similar side effects. It provides satisfactory arousable sedation without respiratory depression. Haemodynamic changes observed in our patients were very small and could be ignored. Patient remained stable haemodynamically throughout the intra-operative period. So dexmedetomidine seems to be a good choice for sedation in spinal anesthesia (SA).

Research paper thumbnail of Effectiveness of intravenous dexmedetomidine compared to intercostal nerve blocks in patients undergoing simple mastectomy with axillary dissection under general anaesthesia

Journal of the Bangladesh Society of Anaesthesiologists

Background: General anaesthesia is used for breast cancer surgery. The downside of generalanaesth... more Background: General anaesthesia is used for breast cancer surgery. The downside of generalanaesthesia includes inadequate pain control and a high incidence of nausea and vomiting. Generalanaesthesia with intravenous dexmedetomidine or intercostal nerve block reduce the incidence ofpostoperative pain. Objective: To evaluate the effectiveness of intravenous dexmedetomidine compared to intercostal nerveblocks in patients undergoing simple mastectomy with axillary dissection under general anaesthesia.Methods:It was a single-blinded prospective randomized comparative study. This study was conductedat the Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh MujibMedical University (BSMMU), Dhaka from March 2018 to March 2019. A total of 60 patients sufferingfrom breast cancer admitted in the Department of General Surgery of BSMMU Dhaka and scheduledfor simple mastectomy with axillary dissection, were enrolled in this study. Results: Age ,height andweight we...

Research paper thumbnail of Bilateral superficial cervical plexus block with conscious sedation for thyroid surgery

Bangabandhu Sheikh Mujib Medical University Journal, Mar 14, 2022

Research paper thumbnail of Submental intubation in oral maxillofacial surgery

Journal of the Bangladesh Society of Anaesthesiologists, Aug 3, 2014

Background: Oral and maxillofacial surgical procedures present a unique set of problems for both ... more Background: Oral and maxillofacial surgical procedures present a unique set of problems for both the anaesthesists and the surgeons. Simultaneous access to the oral or nasal cavities and dental occlusion is required for the surgical treatment of some craniofacial deformities. Generally, airway is maintained by orotracheal or nasotracheal intubation and some instances by tracheostomy however, nasotracheal intubation is contraindicated in skull base or midface fracture. Tracheostomy has inherent complications ranging from surgical emphysema to disfiguration where as orotracheal route prevents free access to oral cavity. In these circumstances, submento-tracheal intubation may provide a better option to overcome these problems. Objective: The aim of this study was to evaluate outcome of conversion of orotracheal route to submentotracheal route for surgical correction of maxillofacial trauma & deformity and time required to change from oral to submental route, accidental extubation, postoperative complications, and the healing of intraoral and submental scars were evaluated. Patients and Methods: Method: A total of 23 patients were selected from maxillofacial department of BSMMU and other institutions from December 2007 to March 2011 to use this technique. After standard orotracheal intubation, a 2 cm incision was made lateral to the midline in the submentum and a blunt dissection opposite to the skin incision on the lingual aspect of the mandible provides access to the floor of the mouth, the orotracheal tube is disconnected and pulled through the floor of the mouth then to the submental incision, the tube is then sutured to the skin. Surgery was completed without interference from flexometallic endotracheal tube. Following surgery the sequence is reversed and the patients extubated in the conventional manner. Results The technique was used in 13 patients with multiple facial fractures & 10 patients with facial deformity. The mean age of the group was 30 (20-50) years .The submental orotracheal intubation was completed successfully in all patients. No accidental extubations or tube injuries occurred. The mean time required for intubation was 6 minutes. All patients were extubated in the operating theatre. The intraoral and submental accesses healed with minimal scarring in all patients .There were no incidence of intra-or postoperative complications related to submental intubation. Conclusions Submental intubation is a simple, safe, and predictable approach without significant morbidity that facilated safe airway and enhances meticulous surgical procedure of fractured skull base and midface.

Research paper thumbnail of Effects of hypertension on the outcomes of Covid-19 infected patients- A retrospective study

Journal of the Bangladesh Society of Anaesthesiologists

Background: Hypertension has been reported as the most prevalent comorbidity in patients with cor... more Background: Hypertension has been reported as the most prevalent comorbidity in patients with corona virusdisease 2019 (COVID-19) .Since hypertension is exceedingly frequent in the elderly and older people appear tobe at particular risk of being infected with SARS-COV-2 virus and of experiencing severe forms andcomplications of COVID-19. Objective : This retrospective study aim to compare the outcomes in COVID-19 infected patients with orwithout hypertension. Method : Atotal 180 hospitalized patients with laboratory confirmed COVID-19 were included. The medicalrecord including clinical feature, history of hypertension were included in this study. This study wasconducted in COVID-19 ICUof Bangabandhu Sheikh Mujib Medical University from August 2020 to January2021.Informationwere obtained frommedical record including clinical features, complication,treatments andclinical outcome were extracted for the analysis. Results: There were 180 patients selected for this study. 50(27.8%) patien...

Research paper thumbnail of Ultrasound Guided Nerve Stimulation and Nerve Stimulation Alone for Supraclavicular Brachial Plexus Block – A Randomized Comparative Study

Journal of the Bangladesh Society of Anaesthesiologists

Background: The safety of regional anaesthesia become more pronounced by the use of ultrasound an... more Background: The safety of regional anaesthesia become more pronounced by the use of ultrasound andnerve stimulator. Supraclavicular nerve blocks known as ‘spinal of the arm’ are the most attractiveupper extremity blocks to perform in our practice. In this study less experienced hands try to found thebest approach for upper extremity block. Objective: To comparethe success rate when Ultrasound addedwith Peripheral nerve stimulator insupraclavicular brachial plexus block. Methods: After IRB approval and written consents from patients, total 66 patients divided into twogroups,Group USNS had supraclavicular block guided by both ultrasound and Nerve stimulator. Onthe other hand Group BNS had this block by only Nerve stimulator. All the equipments kept ready andmaintaining sterility a mixture of 0.5% Bupivacaine and 2% plain Lignocaine were prepared. The amountinjected according to the body weight without crossing the toxic dose (2mg/Kg 0.5% Bupivacaine, 5mg/Kg 2% Lignocaine). Total volum...

Research paper thumbnail of Comparison of Cardiovascular Status Between Pre- Induction Period and The Different Positions of Anaesthetized Patients in Laparoscopic Cholecystectomy

Journal of the Bangladesh Society of Anaesthesiologists

The laparoscopic cholecystectomy nowadays is the method of choice for treatment of patients with ... more The laparoscopic cholecystectomy nowadays is the method of choice for treatment of patients with cholelithiasis. This surgery involves different types of positioning of the anaesthetized patient. Our study was planned to compare the haemodynamic changes between the pre-induction period with the different positions of the anaesthetized patients during laparoscopic cholecystectomy. Thirty two (32) female patients of ASA physical status - 1 & 11, aged between 18 to 55 years, scheduled for elective laparoscopic cholecystectomy under general anesthesia, were enrolled in the study. All the patients were medicated with tablet clonazepam (0.5mg) on the night before surgery. On arrival to the operation theatre, baseline heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), and arterial oxygen saturation (SpO2) were recorded. The patients were then induced with Inj. propofol (1.5 to 2mg/kg). Endotracheal intubation was facilitated ...

Research paper thumbnail of Submental intubation in oral maxillofacial surgery

Journal of the Bangladesh Society of Anaesthesiologists

Background: Oral and maxillofacial surgical procedures present a unique set of problems for both ... more Background: Oral and maxillofacial surgical procedures present a unique set of problems for both the anaesthesists and the surgeons. Simultaneous access to the oral or nasal cavities and dental occlusion is required for the surgical treatment of some craniofacial deformities. Generally, airway is maintained by orotracheal or nasotracheal intubation and some instances by tracheostomy however, nasotracheal intubation is contraindicated in skull base or midface fracture. Tracheostomy has inherent complications ranging from surgical emphysema to disfiguration where as orotracheal route prevents free access to oral cavity. In these circumstances, submento-tracheal intubation may provide a better option to overcome these problems. Objective: The aim of this study was to evaluate outcome of conversion of orotracheal route to submentotracheal route for surgical correction of maxillofacial trauma & deformity and time required to change from oral to submental route, accidental extubation, pos...

Research paper thumbnail of Post-spinal Headache after Caesarean Section – Effect of Approach Into Dura-Arachnoid Sac

Journal of Bangladesh College of Physicians and Surgeons, 2017

Introduction : Spinal anaesthesia is the technique of choice for caesarian section. But post-spin... more Introduction : Spinal anaesthesia is the technique of choice for caesarian section. But post-spinal headache (PSH) is still a ‘headache’ for the anaesthesiologist even after using modern spinocaine needles.Objective : This study was performed to compare the incidence of PSH between midline and lateral approach when caesarian sections were done by spinal anaesthesia.Methods : After ethical clearance this study was done in Chittagong Medical College Hospital. Two hundred pregnant women of American Society of Anesthesiologists (ASA) physical status I & II who underwent caesarian section were included and randomized into 2 groups. After informed consent spinal needle were inserted by midline approach in Group A patients and by lateral approach in Group B patients. After appearance of free flow of CSF 0.5% hyperbaric bupivacaine 10 mg was injected to each patient. PSH and other complications were evaluated.Results : Incidence of PSH was significantly higher in Group A patients.Conclusion...

Research paper thumbnail of Bilateral superficial cervical plexus block with conscious sedation for thyroid surgery

Bangabandhu Sheikh Mujib Medical University Journal

Total thyroidectomy can safely be performed by bilateral superficial cervical plexus blockade whi... more Total thyroidectomy can safely be performed by bilateral superficial cervical plexus blockade which is a regional anesthetic technique to anaesthetize superficial branches of the anterior primary rami of cervical 3-5 spinal nerves. Conscious sedation with this anesthetic technique enhance safe and faster recovery compared to general anesthesia (GA) with endotracheal intubation which is traditionally employed technique for thyroidectomy. This randomized active control trial was conducted in the department of Anaesthesia, Analgesia and Intensive care medicine, Bangabandhu Sheikh Mujib Medical University from January to December 2018 to compare perioperative outcome between bilateral superficial cervical plexus blockade and GA technique during total thyroidectomy. Total 60 patients of American Society of Anesthesiol- ogists Classification grade I and II who were selected for thyroidectomy were randomly divided into Group-A(n=30) and Group-B (n=30). Group A received with 0.5% bupivacain...

Research paper thumbnail of Role of Serum B-type Natriuretic Peptide before and after 2hours of Spontaneous Breathing Trial among Patients under Mechanical Ventilation

Journal of Current and Advance Medical Research

Background: Weaning of a patient from mechanical ventilation is very important for the outcomes o... more Background: Weaning of a patient from mechanical ventilation is very important for the outcomes of the patients. Objective: The purpose of the study was to evaluate the serum level of BNP before and after 2hours of spontaneous breathing trial (SBT) among patients under mechanical ventilation. Methodology: This prospective cohort study was conducted in the Department of Anesthesia, Analgesia and Intensive Care Medicine at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh over a period of 2 years. Study population was selected for weaning from mechanical ventilation support for the first time in the age group of more than 18 years with both sexes. Plasma BNP level of all patients was measured before and after 2 hours of spontaneous breathing trial. Results: A total number of 30 patients were recruited for this study. One-third (33.3%) of the patients failed on SBT. The mean percent changes of BNP (pg/ml) during 2-h of SBT in weaning success and failure groups were 38.41±9...

Research paper thumbnail of Assessment of Anxiety at Three Different Point of Adult Elective Surgical Patient

Scholars Journal of Applied Medical Sciences, 2021

Original Research Article Background: Anxiety is a common experience it occurs adult patients und... more Original Research Article Background: Anxiety is a common experience it occurs adult patients undergoing elective surgery. It may alter autonomic and neuroendocrine function leading to increased anaesthetic consumption, delayed recovery, postoperative pain, prolonged hospital staying. Preoperative anxiety level and responsible factors should be measured. Objective: To evaluates the anxiety level at different time points during preoperative period in adults undergoing elective surgery. Methodology: This observational study was conducted on 117 patients of 18 -65 years and ASA I & II who were presented for surgery at Bangabandhu Sheikh Mujib Medical University from Jan-Dec2018. Consecutive sampling data were collected using sociodemographic and APAIS questionnaire. All data are collected analyses by using SPSS version 20 software. A p-value < 0.05 was considered as statistically significant. Results: Adult patients undergoing elective surgery had significant anxiety at PACU 67.5% f...

Research paper thumbnail of Role of Dexmedetomidine as Preemptive Analgesic on Postoperative Pain Following Open Abdominal Hysterectomy under General Anaesthesia: A Placebo Controlled Study

Scholars Journal of Applied Medical Sciences

Original Research Article Background: Abdominal hysterectomy is a common and major surgery associ... more Original Research Article Background: Abdominal hysterectomy is a common and major surgery associated with moderate to severe pain. Various short and long term complications may occur if the pain is treated inadequately. Different drugs and interventions are currently being practiced for adequate pain management. Among them, preemptive analgesia was adopted with the aim to reduce the dose of opioid by preventing central sensitization. Thereby, avoiding dose related side effects despite providing adequate analgesia. The dexmedetomidine, a highly potent 2 agonist with several perioperative beneficial properties, was investigated for its status as preemptive analgesic. Objective: The present study was designed to evaluate the role of preemptive dexmedetomidine on postoperative analgesia following open abdominal hysterectomy under general anaesthesia. Methods: Forty ASA I and II, aged more than 18 years patients, undergoing open abdominal hysterectomy were allocated into 2 equal groups (n=20 in each group) by a computergenerated randomization table. Group A and B received equal volumetric (0.25ml/kg) dexmedetomidine and normal saline respectively, 20 minutes prior to induction of general anaesthesia. VAS and PCA morphine consumption, heart rate, mean arterial pressure and capillary oxygen saturation was recorded at defined postoperative time points and adverse effects were noted. Results: The total amount of postoperative morphine requirement after 24 hours was 30.98±1.15 mg in group A and 32.15±2.16 mg in Group B (p value=0.039) which is significantly higher in group B. The group A had significantly lower VAS score in both the resting (P= 0.001, 0.001, 0.019, 0.010and 0.042) and movement state (P = 0.001, 0.006, 0.007, 0.029 and 0.035) for time points of 1 st , 2 nd , 6 th , 12 th and 24 th hours postoperatively, compared to the group A. Furthermore, we observed, there was significant obtundation of HR and MAP, evoked by intubation and extubation in group A. Similar response was seen just after extubation. HR was significantly (P<0.05) lower in group A at all postoperative follow up. Additionally, group A had lower MAP compared to group B. The opioid related adverse events were slightly lower in dexmedetomidine group. Conclusion: Preemptive use of intravenous dexmedetomidine reduced postoperative pain intensity, opioid requirement and rendered better haemodynamic stability.

Research paper thumbnail of Dexmedetomidine for Sedation during Total Abdominal Hysterectomy under Spinal Anesthesia

Journal of the Bangladesh Society of Anaesthesiologists, Jul 31, 2020

Intravenous Dexmedetomidine is associated with stable cardiovascular profile and less associated ... more Intravenous Dexmedetomidine is associated with stable cardiovascular profile and less associated with fear, anxiety and agitation. Spinal anesthesia (SA) offers many advantages over general anesthesia, like providing analgesia and muscle relaxation in a conscious and compliant patient and an uneventful postoperative recovery. But retained consciousness during surgery or patient awake causes fear, anxiety in perioperative period. The fear of surgery, the unfamiliar environment of operation room, the sight and sounds of sophisticated instruments, and the masked faces makes the patient panic. The intense sensory and motor block, continuous supine position and the inability to move the body also brings a feeling of discomfort and phobia in many patients. Thus, adequate sedation and control of stress, pain, fear and patient satisfaction are essential components during anesthesia. Sedation has been shown to increase patient satisfaction during regional anesthesia. I conclude that, during spinal anesthesia, IV supplementation of dexmedetomidine is more effective than midazolam infusion, as it provides longer duration of sensory and motor blockade and postoperative analgesia with minimal and similar side effects. It provides satisfactory arousable sedation without respiratory depression. Haemodynamic changes observed in our patients were very small and could be ignored. Patient remained stable haemodynamically throughout the intra-operative period. So dexmedetomidine seems to be a good choice for sedation in spinal anesthesia (SA).

Research paper thumbnail of Effectiveness of intravenous dexmedetomidine compared to intercostal nerve blocks in patients undergoing simple mastectomy with axillary dissection under general anaesthesia

Journal of the Bangladesh Society of Anaesthesiologists

Background: General anaesthesia is used for breast cancer surgery. The downside of generalanaesth... more Background: General anaesthesia is used for breast cancer surgery. The downside of generalanaesthesia includes inadequate pain control and a high incidence of nausea and vomiting. Generalanaesthesia with intravenous dexmedetomidine or intercostal nerve block reduce the incidence ofpostoperative pain. Objective: To evaluate the effectiveness of intravenous dexmedetomidine compared to intercostal nerveblocks in patients undergoing simple mastectomy with axillary dissection under general anaesthesia.Methods:It was a single-blinded prospective randomized comparative study. This study was conductedat the Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh MujibMedical University (BSMMU), Dhaka from March 2018 to March 2019. A total of 60 patients sufferingfrom breast cancer admitted in the Department of General Surgery of BSMMU Dhaka and scheduledfor simple mastectomy with axillary dissection, were enrolled in this study. Results: Age ,height andweight we...

Research paper thumbnail of Bilateral superficial cervical plexus block with conscious sedation for thyroid surgery

Bangabandhu Sheikh Mujib Medical University Journal, Mar 14, 2022

Research paper thumbnail of Submental intubation in oral maxillofacial surgery

Journal of the Bangladesh Society of Anaesthesiologists, Aug 3, 2014

Background: Oral and maxillofacial surgical procedures present a unique set of problems for both ... more Background: Oral and maxillofacial surgical procedures present a unique set of problems for both the anaesthesists and the surgeons. Simultaneous access to the oral or nasal cavities and dental occlusion is required for the surgical treatment of some craniofacial deformities. Generally, airway is maintained by orotracheal or nasotracheal intubation and some instances by tracheostomy however, nasotracheal intubation is contraindicated in skull base or midface fracture. Tracheostomy has inherent complications ranging from surgical emphysema to disfiguration where as orotracheal route prevents free access to oral cavity. In these circumstances, submento-tracheal intubation may provide a better option to overcome these problems. Objective: The aim of this study was to evaluate outcome of conversion of orotracheal route to submentotracheal route for surgical correction of maxillofacial trauma & deformity and time required to change from oral to submental route, accidental extubation, postoperative complications, and the healing of intraoral and submental scars were evaluated. Patients and Methods: Method: A total of 23 patients were selected from maxillofacial department of BSMMU and other institutions from December 2007 to March 2011 to use this technique. After standard orotracheal intubation, a 2 cm incision was made lateral to the midline in the submentum and a blunt dissection opposite to the skin incision on the lingual aspect of the mandible provides access to the floor of the mouth, the orotracheal tube is disconnected and pulled through the floor of the mouth then to the submental incision, the tube is then sutured to the skin. Surgery was completed without interference from flexometallic endotracheal tube. Following surgery the sequence is reversed and the patients extubated in the conventional manner. Results The technique was used in 13 patients with multiple facial fractures & 10 patients with facial deformity. The mean age of the group was 30 (20-50) years .The submental orotracheal intubation was completed successfully in all patients. No accidental extubations or tube injuries occurred. The mean time required for intubation was 6 minutes. All patients were extubated in the operating theatre. The intraoral and submental accesses healed with minimal scarring in all patients .There were no incidence of intra-or postoperative complications related to submental intubation. Conclusions Submental intubation is a simple, safe, and predictable approach without significant morbidity that facilated safe airway and enhances meticulous surgical procedure of fractured skull base and midface.

Research paper thumbnail of Effects of hypertension on the outcomes of Covid-19 infected patients- A retrospective study

Journal of the Bangladesh Society of Anaesthesiologists

Background: Hypertension has been reported as the most prevalent comorbidity in patients with cor... more Background: Hypertension has been reported as the most prevalent comorbidity in patients with corona virusdisease 2019 (COVID-19) .Since hypertension is exceedingly frequent in the elderly and older people appear tobe at particular risk of being infected with SARS-COV-2 virus and of experiencing severe forms andcomplications of COVID-19. Objective : This retrospective study aim to compare the outcomes in COVID-19 infected patients with orwithout hypertension. Method : Atotal 180 hospitalized patients with laboratory confirmed COVID-19 were included. The medicalrecord including clinical feature, history of hypertension were included in this study. This study wasconducted in COVID-19 ICUof Bangabandhu Sheikh Mujib Medical University from August 2020 to January2021.Informationwere obtained frommedical record including clinical features, complication,treatments andclinical outcome were extracted for the analysis. Results: There were 180 patients selected for this study. 50(27.8%) patien...

Research paper thumbnail of Ultrasound Guided Nerve Stimulation and Nerve Stimulation Alone for Supraclavicular Brachial Plexus Block – A Randomized Comparative Study

Journal of the Bangladesh Society of Anaesthesiologists

Background: The safety of regional anaesthesia become more pronounced by the use of ultrasound an... more Background: The safety of regional anaesthesia become more pronounced by the use of ultrasound andnerve stimulator. Supraclavicular nerve blocks known as ‘spinal of the arm’ are the most attractiveupper extremity blocks to perform in our practice. In this study less experienced hands try to found thebest approach for upper extremity block. Objective: To comparethe success rate when Ultrasound addedwith Peripheral nerve stimulator insupraclavicular brachial plexus block. Methods: After IRB approval and written consents from patients, total 66 patients divided into twogroups,Group USNS had supraclavicular block guided by both ultrasound and Nerve stimulator. Onthe other hand Group BNS had this block by only Nerve stimulator. All the equipments kept ready andmaintaining sterility a mixture of 0.5% Bupivacaine and 2% plain Lignocaine were prepared. The amountinjected according to the body weight without crossing the toxic dose (2mg/Kg 0.5% Bupivacaine, 5mg/Kg 2% Lignocaine). Total volum...

Research paper thumbnail of Comparison of Cardiovascular Status Between Pre- Induction Period and The Different Positions of Anaesthetized Patients in Laparoscopic Cholecystectomy

Journal of the Bangladesh Society of Anaesthesiologists

The laparoscopic cholecystectomy nowadays is the method of choice for treatment of patients with ... more The laparoscopic cholecystectomy nowadays is the method of choice for treatment of patients with cholelithiasis. This surgery involves different types of positioning of the anaesthetized patient. Our study was planned to compare the haemodynamic changes between the pre-induction period with the different positions of the anaesthetized patients during laparoscopic cholecystectomy. Thirty two (32) female patients of ASA physical status - 1 & 11, aged between 18 to 55 years, scheduled for elective laparoscopic cholecystectomy under general anesthesia, were enrolled in the study. All the patients were medicated with tablet clonazepam (0.5mg) on the night before surgery. On arrival to the operation theatre, baseline heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), and arterial oxygen saturation (SpO2) were recorded. The patients were then induced with Inj. propofol (1.5 to 2mg/kg). Endotracheal intubation was facilitated ...

Research paper thumbnail of Submental intubation in oral maxillofacial surgery

Journal of the Bangladesh Society of Anaesthesiologists

Background: Oral and maxillofacial surgical procedures present a unique set of problems for both ... more Background: Oral and maxillofacial surgical procedures present a unique set of problems for both the anaesthesists and the surgeons. Simultaneous access to the oral or nasal cavities and dental occlusion is required for the surgical treatment of some craniofacial deformities. Generally, airway is maintained by orotracheal or nasotracheal intubation and some instances by tracheostomy however, nasotracheal intubation is contraindicated in skull base or midface fracture. Tracheostomy has inherent complications ranging from surgical emphysema to disfiguration where as orotracheal route prevents free access to oral cavity. In these circumstances, submento-tracheal intubation may provide a better option to overcome these problems. Objective: The aim of this study was to evaluate outcome of conversion of orotracheal route to submentotracheal route for surgical correction of maxillofacial trauma & deformity and time required to change from oral to submental route, accidental extubation, pos...

Research paper thumbnail of Post-spinal Headache after Caesarean Section – Effect of Approach Into Dura-Arachnoid Sac

Journal of Bangladesh College of Physicians and Surgeons, 2017

Introduction : Spinal anaesthesia is the technique of choice for caesarian section. But post-spin... more Introduction : Spinal anaesthesia is the technique of choice for caesarian section. But post-spinal headache (PSH) is still a ‘headache’ for the anaesthesiologist even after using modern spinocaine needles.Objective : This study was performed to compare the incidence of PSH between midline and lateral approach when caesarian sections were done by spinal anaesthesia.Methods : After ethical clearance this study was done in Chittagong Medical College Hospital. Two hundred pregnant women of American Society of Anesthesiologists (ASA) physical status I & II who underwent caesarian section were included and randomized into 2 groups. After informed consent spinal needle were inserted by midline approach in Group A patients and by lateral approach in Group B patients. After appearance of free flow of CSF 0.5% hyperbaric bupivacaine 10 mg was injected to each patient. PSH and other complications were evaluated.Results : Incidence of PSH was significantly higher in Group A patients.Conclusion...

Research paper thumbnail of Bilateral superficial cervical plexus block with conscious sedation for thyroid surgery

Bangabandhu Sheikh Mujib Medical University Journal

Total thyroidectomy can safely be performed by bilateral superficial cervical plexus blockade whi... more Total thyroidectomy can safely be performed by bilateral superficial cervical plexus blockade which is a regional anesthetic technique to anaesthetize superficial branches of the anterior primary rami of cervical 3-5 spinal nerves. Conscious sedation with this anesthetic technique enhance safe and faster recovery compared to general anesthesia (GA) with endotracheal intubation which is traditionally employed technique for thyroidectomy. This randomized active control trial was conducted in the department of Anaesthesia, Analgesia and Intensive care medicine, Bangabandhu Sheikh Mujib Medical University from January to December 2018 to compare perioperative outcome between bilateral superficial cervical plexus blockade and GA technique during total thyroidectomy. Total 60 patients of American Society of Anesthesiol- ogists Classification grade I and II who were selected for thyroidectomy were randomly divided into Group-A(n=30) and Group-B (n=30). Group A received with 0.5% bupivacain...

Research paper thumbnail of Role of Serum B-type Natriuretic Peptide before and after 2hours of Spontaneous Breathing Trial among Patients under Mechanical Ventilation

Journal of Current and Advance Medical Research

Background: Weaning of a patient from mechanical ventilation is very important for the outcomes o... more Background: Weaning of a patient from mechanical ventilation is very important for the outcomes of the patients. Objective: The purpose of the study was to evaluate the serum level of BNP before and after 2hours of spontaneous breathing trial (SBT) among patients under mechanical ventilation. Methodology: This prospective cohort study was conducted in the Department of Anesthesia, Analgesia and Intensive Care Medicine at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh over a period of 2 years. Study population was selected for weaning from mechanical ventilation support for the first time in the age group of more than 18 years with both sexes. Plasma BNP level of all patients was measured before and after 2 hours of spontaneous breathing trial. Results: A total number of 30 patients were recruited for this study. One-third (33.3%) of the patients failed on SBT. The mean percent changes of BNP (pg/ml) during 2-h of SBT in weaning success and failure groups were 38.41±9...

Research paper thumbnail of Assessment of Anxiety at Three Different Point of Adult Elective Surgical Patient

Scholars Journal of Applied Medical Sciences, 2021

Original Research Article Background: Anxiety is a common experience it occurs adult patients und... more Original Research Article Background: Anxiety is a common experience it occurs adult patients undergoing elective surgery. It may alter autonomic and neuroendocrine function leading to increased anaesthetic consumption, delayed recovery, postoperative pain, prolonged hospital staying. Preoperative anxiety level and responsible factors should be measured. Objective: To evaluates the anxiety level at different time points during preoperative period in adults undergoing elective surgery. Methodology: This observational study was conducted on 117 patients of 18 -65 years and ASA I & II who were presented for surgery at Bangabandhu Sheikh Mujib Medical University from Jan-Dec2018. Consecutive sampling data were collected using sociodemographic and APAIS questionnaire. All data are collected analyses by using SPSS version 20 software. A p-value < 0.05 was considered as statistically significant. Results: Adult patients undergoing elective surgery had significant anxiety at PACU 67.5% f...

Research paper thumbnail of Role of Dexmedetomidine as Preemptive Analgesic on Postoperative Pain Following Open Abdominal Hysterectomy under General Anaesthesia: A Placebo Controlled Study

Scholars Journal of Applied Medical Sciences

Original Research Article Background: Abdominal hysterectomy is a common and major surgery associ... more Original Research Article Background: Abdominal hysterectomy is a common and major surgery associated with moderate to severe pain. Various short and long term complications may occur if the pain is treated inadequately. Different drugs and interventions are currently being practiced for adequate pain management. Among them, preemptive analgesia was adopted with the aim to reduce the dose of opioid by preventing central sensitization. Thereby, avoiding dose related side effects despite providing adequate analgesia. The dexmedetomidine, a highly potent 2 agonist with several perioperative beneficial properties, was investigated for its status as preemptive analgesic. Objective: The present study was designed to evaluate the role of preemptive dexmedetomidine on postoperative analgesia following open abdominal hysterectomy under general anaesthesia. Methods: Forty ASA I and II, aged more than 18 years patients, undergoing open abdominal hysterectomy were allocated into 2 equal groups (n=20 in each group) by a computergenerated randomization table. Group A and B received equal volumetric (0.25ml/kg) dexmedetomidine and normal saline respectively, 20 minutes prior to induction of general anaesthesia. VAS and PCA morphine consumption, heart rate, mean arterial pressure and capillary oxygen saturation was recorded at defined postoperative time points and adverse effects were noted. Results: The total amount of postoperative morphine requirement after 24 hours was 30.98±1.15 mg in group A and 32.15±2.16 mg in Group B (p value=0.039) which is significantly higher in group B. The group A had significantly lower VAS score in both the resting (P= 0.001, 0.001, 0.019, 0.010and 0.042) and movement state (P = 0.001, 0.006, 0.007, 0.029 and 0.035) for time points of 1 st , 2 nd , 6 th , 12 th and 24 th hours postoperatively, compared to the group A. Furthermore, we observed, there was significant obtundation of HR and MAP, evoked by intubation and extubation in group A. Similar response was seen just after extubation. HR was significantly (P<0.05) lower in group A at all postoperative follow up. Additionally, group A had lower MAP compared to group B. The opioid related adverse events were slightly lower in dexmedetomidine group. Conclusion: Preemptive use of intravenous dexmedetomidine reduced postoperative pain intensity, opioid requirement and rendered better haemodynamic stability.