Joselo D Macachor | Khoo Teck Puat Hospital (original) (raw)

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Papers by Joselo D Macachor

Research paper thumbnail of What works for the management of PDPH; is the current evidence enough?

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 ...

Research paper thumbnail of Effectiveness of single injection sub-Tenon’s block for Pars Plana Vitrectomy and associated procedures

New Frontiers in Ophthalmology, 2017

Background and objective: To determine the efficacy of a single injection sub-Tenon's block for P... more Background and objective: To determine the efficacy of a single injection sub-Tenon's block for Pars Plana Vitrectomy (PPV). Patients and methods: Anaesthetic records and operative databases of patients undergoing PPV and associated procedures who received single injection inferotemporal sub-Tenon's block with 6mls of 2% lignocaine and 10IU/ml hyaluronidase were identified. Onset of surgical anaesthesia, surgery duration, intraoperative discomfort, time and number of supplementary injections, sedation administered and any complications were extracted Results: Sixty-four records were identified. All patients were ready for surgery within 8 minutes. The time of block to start of surgery was 17 (±6) minutes. Mean duration of surgery was 88 (±30) minutes, 72% of patients did not require supplementary injection, 69% did not require sedation and no patient required conversion to general anaesthesia. Conclusion: Single injection inferonasal sub-Tenon's block is effective in 2/3 rd of patient undergoing PPV without requiring supplementary injection.

Research paper thumbnail of Nuts and Bolts of Peripheral Nerve Blocks for Pain After Hip Fracture for Everyday Anesthetist

Anesthesiology and Pain Medicine, 2021

: A range of peripheral nerve blocks is available to treat hip fracture pain, leaving clinicians ... more : A range of peripheral nerve blocks is available to treat hip fracture pain, leaving clinicians confused on choice. No single block appears to be outstanding. The study described the relevant anatomy, technical approach, risk associated, and practicability to facilitate a better understanding of the various approaches available. The clinician should be able to make an informed decision based on local requirements and logistics.

Research paper thumbnail of Choosing the best supraglottic airway for ophthalmic general anaesthesia: a manikin study

Journal of Clinical Monitoring and Computing, 2020

Research paper thumbnail of Managing the marginally raised aPTT-looking beyond the absolute number

Paediatric anaesthesia, Jul 1, 2017

Research paper thumbnail of Ondansetron-induced oculogyric crisis

European Journal of Anaesthesiology, 2014

Research paper thumbnail of Peripheral Nerve Blocks in a Regional Anesthesia Block Area: An Economic Model

Regional anesthesia and pain medicine, May 1, 2018

Research paper thumbnail of Cyclone Nargis—The Experience of Team Singapore

Prehospital and Disaster Medicine, 2010

Research paper thumbnail of Venous thromboembolism prophylaxis during vitreoretinal surgery – a snapshot survey of international ophthalmic anaesthetists

British Journal of Anaesthesia, 2015

Research paper thumbnail of Hyaluronidase for brachial plexus block

Research paper thumbnail of A comparison of 5% dextrose in 0.9% Normal saline versus non-dextrose-containing crystalloids as the initial intravenous replacement fluid in elective surgery

Anaesthesia and intensive care

Research paper thumbnail of Survey of medication errors among anaesthetists in Singapore

Anaesthesia and intensive care, 2011

Research paper thumbnail of Perioperative risk factors in obese patients for bariatric surgery: a Singapore experience

Singapore medical journal, 2011

Morbid obesity and obstructive sleep apnoea (OSA) are increasingly encountered in anaesthetic pra... more Morbid obesity and obstructive sleep apnoea (OSA) are increasingly encountered in anaesthetic practice today. Difficult intubation may be seen more frequently in our practice. This high-risk group may also be more prone to complications in the postoperative period. We reviewed a consecutive series of patients who had undergone laparoscopic gastric banding at our institution from 2001 to 2006. The incidence of difficult intubation, early postoperative complications and its attendant risk factors were studied. Severe OSA and neck circumference greater than 44 cm were factors associated with difficult intubation in morbidly obese patients who presented for bariatric surgery. Asthma and increasing age may be associated risk factors for adverse events in the postoperative period. It is important to anticipate and prepare for a difficult intubation scenario in patients with severe OSA and a larger neck circumference. Close monitoring is recommended for patients with respiratory comorbidit...

Research paper thumbnail of Peripheral nerve block needle defect

Indian Journal of Anaesthesia, 2015

Research paper thumbnail of Continuous versus single-injection sciatic nerve block added to continuous femoral nerve block for analgesia after total knee arthroplasty

Regional anesthesia and pain medicine

Research paper thumbnail of The association of pre-operative STOP-BANG scores with postoperative critical care admission

Research paper thumbnail of Ondansetron-induced oculogyric crisis

Research paper thumbnail of Insertion of the Nasogastric Tube Made Easy

Research paper thumbnail of Insertion of the Nasogastric Tube Made Easy

Anesthesiology, 2004

... Anaesthesia, 62(2): 127-130. 10.1111/j.1365-2044.2006.04910.x CrossRef. Anaesthesia Trachligh... more ... Anaesthesia, 62(2): 127-130. 10.1111/j.1365-2044.2006.04910.x CrossRef. Anaesthesia Trachlight assisted insertion of nasogastric tube Mahajan, R; Gupta, R; Shafi, F; Charak, DS Anaesthesia, 63(7): 785. Annali Italiani Di Chirurgia ...

Research paper thumbnail of What works for the management of PDPH; is the current evidence enough?

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 ...

Research paper thumbnail of Effectiveness of single injection sub-Tenon’s block for Pars Plana Vitrectomy and associated procedures

New Frontiers in Ophthalmology, 2017

Background and objective: To determine the efficacy of a single injection sub-Tenon's block for P... more Background and objective: To determine the efficacy of a single injection sub-Tenon's block for Pars Plana Vitrectomy (PPV). Patients and methods: Anaesthetic records and operative databases of patients undergoing PPV and associated procedures who received single injection inferotemporal sub-Tenon's block with 6mls of 2% lignocaine and 10IU/ml hyaluronidase were identified. Onset of surgical anaesthesia, surgery duration, intraoperative discomfort, time and number of supplementary injections, sedation administered and any complications were extracted Results: Sixty-four records were identified. All patients were ready for surgery within 8 minutes. The time of block to start of surgery was 17 (±6) minutes. Mean duration of surgery was 88 (±30) minutes, 72% of patients did not require supplementary injection, 69% did not require sedation and no patient required conversion to general anaesthesia. Conclusion: Single injection inferonasal sub-Tenon's block is effective in 2/3 rd of patient undergoing PPV without requiring supplementary injection.

Research paper thumbnail of Nuts and Bolts of Peripheral Nerve Blocks for Pain After Hip Fracture for Everyday Anesthetist

Anesthesiology and Pain Medicine, 2021

: A range of peripheral nerve blocks is available to treat hip fracture pain, leaving clinicians ... more : A range of peripheral nerve blocks is available to treat hip fracture pain, leaving clinicians confused on choice. No single block appears to be outstanding. The study described the relevant anatomy, technical approach, risk associated, and practicability to facilitate a better understanding of the various approaches available. The clinician should be able to make an informed decision based on local requirements and logistics.

Research paper thumbnail of Choosing the best supraglottic airway for ophthalmic general anaesthesia: a manikin study

Journal of Clinical Monitoring and Computing, 2020

Research paper thumbnail of Managing the marginally raised aPTT-looking beyond the absolute number

Paediatric anaesthesia, Jul 1, 2017

Research paper thumbnail of Ondansetron-induced oculogyric crisis

European Journal of Anaesthesiology, 2014

Research paper thumbnail of Peripheral Nerve Blocks in a Regional Anesthesia Block Area: An Economic Model

Regional anesthesia and pain medicine, May 1, 2018

Research paper thumbnail of Cyclone Nargis—The Experience of Team Singapore

Prehospital and Disaster Medicine, 2010

Research paper thumbnail of Venous thromboembolism prophylaxis during vitreoretinal surgery – a snapshot survey of international ophthalmic anaesthetists

British Journal of Anaesthesia, 2015

Research paper thumbnail of Hyaluronidase for brachial plexus block

Research paper thumbnail of A comparison of 5% dextrose in 0.9% Normal saline versus non-dextrose-containing crystalloids as the initial intravenous replacement fluid in elective surgery

Anaesthesia and intensive care

Research paper thumbnail of Survey of medication errors among anaesthetists in Singapore

Anaesthesia and intensive care, 2011

Research paper thumbnail of Perioperative risk factors in obese patients for bariatric surgery: a Singapore experience

Singapore medical journal, 2011

Morbid obesity and obstructive sleep apnoea (OSA) are increasingly encountered in anaesthetic pra... more Morbid obesity and obstructive sleep apnoea (OSA) are increasingly encountered in anaesthetic practice today. Difficult intubation may be seen more frequently in our practice. This high-risk group may also be more prone to complications in the postoperative period. We reviewed a consecutive series of patients who had undergone laparoscopic gastric banding at our institution from 2001 to 2006. The incidence of difficult intubation, early postoperative complications and its attendant risk factors were studied. Severe OSA and neck circumference greater than 44 cm were factors associated with difficult intubation in morbidly obese patients who presented for bariatric surgery. Asthma and increasing age may be associated risk factors for adverse events in the postoperative period. It is important to anticipate and prepare for a difficult intubation scenario in patients with severe OSA and a larger neck circumference. Close monitoring is recommended for patients with respiratory comorbidit...

Research paper thumbnail of Peripheral nerve block needle defect

Indian Journal of Anaesthesia, 2015

Research paper thumbnail of Continuous versus single-injection sciatic nerve block added to continuous femoral nerve block for analgesia after total knee arthroplasty

Regional anesthesia and pain medicine

Research paper thumbnail of The association of pre-operative STOP-BANG scores with postoperative critical care admission

Research paper thumbnail of Ondansetron-induced oculogyric crisis

Research paper thumbnail of Insertion of the Nasogastric Tube Made Easy

Research paper thumbnail of Insertion of the Nasogastric Tube Made Easy

Anesthesiology, 2004

... Anaesthesia, 62(2): 127-130. 10.1111/j.1365-2044.2006.04910.x CrossRef. Anaesthesia Trachligh... more ... Anaesthesia, 62(2): 127-130. 10.1111/j.1365-2044.2006.04910.x CrossRef. Anaesthesia Trachlight assisted insertion of nasogastric tube Mahajan, R; Gupta, R; Shafi, F; Charak, DS Anaesthesia, 63(7): 785. Annali Italiani Di Chirurgia ...