Optimal dose of phenylephrine infusion in the prevention of spinal anaesthesia-induced hypotension in elderly patients

Elderly patients (aged ≥ 65 years) have surgery at a rate of two to three times that of younger patients. Spinal anaesthesia is one of the most frequently used anaesthetic techniques in this population because many of the procedures they present with are amenable to this technique. Some known advantages of spinal anaesthesia include a reduction in perioperative blood loss as well as a reduction in the incidence of deep venous thrombosis and pulmonary embolism. However, hypotension is the most common complication with a reported incidence of 66% in elderly patients.

The profile of female anaesthesiologists in South Africa: past and present

Before the eighteenth century in Europe, women had a limited role in medicine. Women administered herbs for basic medicinal purposes. This threatened the church’s religious doctrine, power and influence, and these women were accused of witchcraft. The medical practice of women was limited to midwifery. Medicine was primarily a masculine space until the twentieth century. World War I and World War II increased the opportunity for women to study medicine as the men left to fight.

Quality of anaesthesia care in elective surgery at a Western Cape academic hospital in South Africa: a perioperative patient satisfaction survey

Patients’ experiences and levels of satisfaction with healthcare should be continually evaluated to allow for improvement in healthcare services to the highest and safest standard possible. Satisfaction is defined as the result of the comparison between the expectations and perceived outcomes and it is considered a valuable measure of the outcome of healthcare processes. Patient dissatisfaction occurs when there is a discrepancy between a patient’s expectation and the actual outcome of the experience.

When CO2 goes wild – a tale of surgical emphysema, pneumothorax and a gas-filled adventure in laparoscopic hernia repair

Case Study: A 69-year-old male presented with an irreducible inguinal hernia for an extraperitoneal laparoscopic repair. He had an American Society of Anesthesiologists (ASA) classification of II, weighed 80 kg and measured 190 cm (thus a body mass index of 22.16). He had a smoking history of 30-pack-years with no other comorbidities. Preoperatively he presented with mild bilateral expiratory wheezes and a hyperinflated chest with associated hyperresonance on percussion. He reported shortness of breath when walking up a hill which indicated a modified medical research council (mMRC) score of. To address the respiratory symptoms, he received salbutamol nebulisation four hours before the procedure, continuing for 16 hours. Cardiovascular and systemic examinations yielded unremarkable findings. His preoperative chest X-ray (CXR) displayed features of hyperinflation with clear lung fields, while the electrocardiogram (ECG) results were unremarkable. Informed consent for general anaesthesia was signed. 

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Southern African Journal of Anaesthesia and Analgesia - November/December Vol 29 No 6