Khalil Shibli - Academia.edu (original) (raw)

Papers by Khalil Shibli

International Journal of Obstetric Anesthesia, Jul 1, 2000

Trends in Anaesthesia and Critical Care, 2015

Introduction: We report on the use of Somastosensory Evoked Potential (SSEP) and Motor Evoked Pot... more Introduction: We report on the use of Somastosensory Evoked Potential (SSEP) and Motor Evoked Potential (MEP) monitoring in a patient with Brugada syndrome. Objectives: The concern in this case was that the amount of current/voltage generated by SSEP/MEP might trigger arrhythmias in a patient with underlying Brugada syndrome. Methods: A 42 year-old male patient with Brugada syndrome underwent excision of an intramedullary tumour with the use of SSEP and MEP monitoring. Preoperatively, he was not on antiarrhythmic medication, nor had an Implantable Cardioverter Device (ICD) in-situ. Results: The patient remained stable & in sinus rhythm throughout the operation and was successfully extubated postoperatively. Conclusion: This case report indicates that SSEP/MEP monitoring may be used in patients with Brugada syndrome.

Postoperative shivering and feeling of cold associated with it is rated as worse than pain by som... more Postoperative shivering and feeling of cold associated with it is rated as worse than pain by some patients. It has been a problem not only after general anesthesia, but also during and after spinal anesthesia. This editorial compliments an original article in this issue of ‘Anesthesia, Pain & Intensive Care’ on comparison of three different drugs for the treatment of postoperative shivering, and draws attention towards pathogenesis of shivering and its control. Shivering is not a point in time event and its cessation with pharmacological intervention does not guarantee against its recurrence. Citation: Taqi A. Can you stop this shivering doctor? Anaesth Pain & Intensive Care 2013;17(1):4-5

![Research paper thumbnail of QIM19-115: Barriers and Trends in Cancer Patients` Pain Management in Qatar: A Randomized Cohort Prospective Study](https://a.academia-assets.com/images/blank-paper.jpg)

Journal of the National Comprehensive Cancer Network, 2019

Background: Up to 70% of cancer patients experience pain during the course of illness (Fallon, Su... more Background: Up to 70% of cancer patients experience pain during the course of illness (Fallon, Support Care Cancer 2008). Studies showed that 40%–50% of patients with cancer pain receive insufficient analgesia due to different factors. Physicians are facing different challenges to accurately assess pain which might affect drug selection and pain control (Beyeler et al, Support Care Cancer 2008; Salminen et al, Support Cancer Care 2008; Stewart, Ulster Med J 2014). In NCCCR, treating physicians may prescribe analgesics to their patients or refer them to the Pain Management Service (PMS) based on their evaluation or as requested by patients. This study explored the factors which might lead to undertreatment of cancer pain in Qatar. In addition, focused on cancer patients’ pain management satisfaction and PMS awareness. Objectives: To assess the existing PMS at NCCCR from patients' perspective. Methods: In this study, we evaluated patients’ pain management perception via a validate...

BJOG: An International Journal of Obstetrics and Gynaecology, 2002

Objective To compare the analgesic requirement in the post-operative period after closure or non-... more Objective To compare the analgesic requirement in the post-operative period after closure or non-closure of the peritoneum at the caesarean delivery with a standardised anaesthetic and surgical technique. Design A randomised double-blind controlled trial was performed on 100 women who underwent elective caesarean delivery. Main outcome measures Analgesic requirement assessed by morphine usage via patient controlled analgesia pump over the first 24-hour period after surgery, oral analgesia used during the first four days, postoperative pain assessed by a visual analogue scale and a verbal rating scale, and patient satisfaction assessed by verbal rating scale were the main outcome measures. Results Pain scores at 24 hours were similar in both groups (43.5 in closure and 40.5 in non-closure) but during the first 24 hours the non-closure group had used significantly less morphine than the closure group (0.64mg/kg of body weight vs 0.82mg/kg, P ¼ 0.04). The patients in non-closure group had significantly higher satisfaction scores after 24 hours than the closure group. Conclusion Non-closure of both visceral and parietal peritoneum at the caesarean section produces a significant reduction in the post-operative use of patient controlled analgesia pump morphine and significantly higher patient satisfaction at 24 hours post-operatively.

Anesthesia & Analgesia, 1978

PIDERMOLYSIS bullosa dystrophica poly-E dysplastica is a rare disease (1 : 3O0,OoO) characterized... more PIDERMOLYSIS bullosa dystrophica poly-E dysplastica is a rare disease (1 : 3O0,OoO) characterized by (1) extensive bullae formation with scarring of skin as well as mucosa of the lips, tongue, oropharynx, and esophagus, particularly following friction; (2) severe scar contracture and nail dystrophy of the hands and feet; and (3) dental complications.'-5 Mutilation is severe, and survival beyond the 2nd decade is un-usuaI. To our knowledge, pregnancy with this disease is unreported. The following case report describes the anesthetic management of a patient with advanced epidermolysis bullosa dystrophica polydysplastica who underwent emergency cesarean section. Airway management is emphasized based upon the propensity for bullae formation in the upper, but not the lower, airway.

Clinical Science, 2001

We studied the effects of spinal intrathecal fentanyl on oxytocin secretion in 20 healthy women p... more We studied the effects of spinal intrathecal fentanyl on oxytocin secretion in 20 healthy women prior to an elective caesarean delivery at term under spinal anaesthesia. The women were randomly allocated into two groups with respect to spinal anaesthesia. Group I (n l 10) received intrathecal bupivacaine (15 mg) plus fentanyl (25 µg), and Group II (n l 10) received intrathecal bupivacaine (15 mg) alone, prior to caesarean section. The two groups were comparable demographically. Altogether, ten samples of 4.5 ml of blood (taken every 60 s) were obtained before and ten samples were obtained after the intrathecal administration of the drug and establishment of the T6 block, and plasma oxytocin concentrations were assayed for each subject. Oxytocin was measured by RIA. We found no significant differences in plasma oxytocin concentrations of individual subjects before and after intrathecal injection. In addition, there were no significant differences in plasma oxytocin concentrations between the two groups when pooled samples from the subjects were compared for the pre-and post-intrathecal injection phases. We conclude that the spinal intrathecal administration of fentanyl does not suppress oxytocin secretion in pregnant women who are not in labour at term.

Post Dural Puncture Headache (PDPH) is apparently not an uncommon occurrence and in most cases ne... more Post Dural Puncture Headache (PDPH) is apparently not an uncommon occurrence and in most cases need seriousattention. Conservative, supportive non-pharmacological management to interventional invasive and pharmacologicaltreatment of PDPH are reported in the literature. The PDPH treatment strategies can be divided into symptom managementand mechanism directed therapies, both of which complement each other. Supportive management for symptom reliefincludes soft pain killers, non-steroidal anti-inflammatory drugs, oral hydration and caffeinated drinks. If PDPH doesnot resolve then epidural blood patch is considered a definitive intervention. Novel pharmacological therapies testedand reported include use of triptans. Over two decades, sumatriptan has been used in a staggered manner and somereports of its success and lack of effectiveness appeared in the literature. In this issue Riaz A. et al have reported thefirst successful use of Zolmitriptan for PDPH. Although recent Cochrane review ...

Journal of the National Comprehensive Cancer Network

Background: Studies showed that 40%–50% of patients with cancer pain receive insufficient analges... more Background: Studies showed that 40%–50% of patients with cancer pain receive insufficient analgesia due to different factors (Beyeler et al, Support Care Cancer 2008; Salminen et al, Support Cancer Care 2008), beside the challenges to accurately assess pain, which might affect drug selection and pain control (Stewart, Ulster Med J 2014). In NCCCR, the treating primary physicians (PP) may prescribe analgesics to their patients or refer them to the Pain Management Team (PMT), based on evaluation or as requested by patients. This study will address the clinical concerns of PP, which may lead to refer the patients to PMT, moreover the clinical judgement of PMT on the referred cases whether they need to be refereed or not. Objectives: To determine the efficiency of the referral pathway to the pain clinic by PMT. Methods: PMT is going to assess the referred patient to their clinics according to pain assessment methods. Patients will be evaluated whether they have been appropriately referr...

Oxford Textbook of Anaesthesia for the Elderly Patient, 2014

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie, 2017

To compare medical students' preference of smart phone television display (SPTD) to a slit-la... more To compare medical students' preference of smart phone television display (SPTD) to a slit-lamp teaching telescope (SLTT) in undergraduate clinical ophthalmology education. This is a randomized, crossover, comparative study. Pairs of medical students were randomly assigned to 2 teaching sessions using either SPTD first followed by SLTT or in reverse order. Students were asked to give feedback on the 2 teaching devices by answering 6 questions using a numeric rating score from 1 to 10. All participating students were sent the results of the study 1 month after the completion of the study and were asked to reflect upon the outcome. Thirty-eight students were recruited. The overall satisfaction scores were significantly higher for SPTD than SLTT (8.6 ± 1.4 vs 7.5 ± 1.0, p < 0.01). The students preferred SPTD compared with SLTT in terms of "visualization" (8.5 ± 1.4 vs 7.0 ± 1.3, p < 0.01), "ocular sign description" (8.4 ± 1.3 vs 7.2 ± 1.2, p < 0.01), &q...

Indian Journal of Anaesthesia, 2015

Indian journal of anaesthesia, 2015

Lipoid proteinosis is a rare autosomal recessive disorder of generalized thickening of the skin, ... more Lipoid proteinosis is a rare autosomal recessive disorder of generalized thickening of the skin, mucosa, and certain viscera due to deposition of numerous small clumps of proteins that give the skin a yellowish color. Lipoid deposits in upper respiratory tract, mucous membranes of the mouth and in vocal cords may interfere with airway management during general anesthesia, and hence the regional techniques are usually preferred in known cases. Here the authors present a typical known case of lipoid proteinosis, which presented for emergency cesarean section due to abruptio placentae. She was meticulously managed with spinal anesthesia.