Joselo D Macachor | Khoo Teck Puat Hospital (original) (raw)
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Papers by Joselo D Macachor
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 ...
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.
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.
Journal of Clinical Monitoring and Computing, 2020
Paediatric anaesthesia, Jul 1, 2017
European Journal of Anaesthesiology, 2014
Regional anesthesia and pain medicine, May 1, 2018
Prehospital and Disaster Medicine, 2010
British Journal of Anaesthesia, 2015
Anaesthesia and intensive care
Anaesthesia and intensive care, 2011
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...
Indian Journal of Anaesthesia, 2015
Regional anesthesia and pain medicine
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 ...
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 ...
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.
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.
Journal of Clinical Monitoring and Computing, 2020
Paediatric anaesthesia, Jul 1, 2017
European Journal of Anaesthesiology, 2014
Regional anesthesia and pain medicine, May 1, 2018
Prehospital and Disaster Medicine, 2010
British Journal of Anaesthesia, 2015
Anaesthesia and intensive care
Anaesthesia and intensive care, 2011
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...
Indian Journal of Anaesthesia, 2015
Regional anesthesia and pain medicine
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 ...