Yonas, Girum (2017) Magnitude of Hemodynamic and Airway Pressure Change and Factors Associated with Intraoperative Hypotension during Elective Neurosurgery. Masters thesis, Addis Ababa University.
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Abstract
Background: Neurosurgery is a medical specialty which is concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system. Hemodynamic change is one of the complications of neurosurgery with an incidence differing with multiple factors. Positioning during neurosurgery has an impact on airway pressure. Poor anesthetic management during neurosurgery will lead to permanent injuries to the patient, which otherwise are largely preventable. Objective: The aim of this study is to assess magnitude of hemodynamic and airway pressure change and factors associated with intraoperative hypotension during elective neurosurgery in Tikur Anbessa specialized hospital and Empress Zewditu memorial hospital, 2017 Method: Institutional based cross sectional study was used from December 20, 2016 to May 20, 2017 using pre-tested, interviewer administered questionnaire for 208 patients. Due to rarity of the procedure all eligible patients who underwent elective neurosurgery at Tikur Anbessa Specialized hospital and Empress Zewditu memorial hospital during the data collection period were included in the study. The data was entered to Epi Info version 7.2.1 and analyzed by SPSS version 20 software performing descriptive statistics, bivariate and multivariate logistic regression. Result: The magnitude of intraoperative hypotension is found to 29.3% (95% CI: 22%-35%). Intraoperative Hypertension had magnitude of 1% (95%CI: 0.0%-2.4%) with bradycardia and tachycardia having 2.4% (95%CI: 0.5%-4.8%) and 1% (95%CI: 0.0%-2.9%) respectively. Blood loss of >10ml/Kg has >5 times [AOR=5.77; 95% CI: (1.97, 16.83)] more risk for developing intraoperative hypotension and Phenytoin use [AOR=6.96; 95% CI: (1.97, 24.50)] had significant association with intraoperative hypotension. Conclusion and recommendation: The magnitude of intraoperative hypotension is high. Some of the identified factors were Blood loss of >10ml/Kg and Phenytoin use. Therefore early anticipation and preparation of intraoperative hypotension in patients especially taking phenytoin and risk of increased blood loss can improve patient outcome.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry R Medicine > RD Surgery |
| Divisions: | Africana |
| Depositing User: | Emmanuel Ndorimana |
| Date Deposited: | 29 Jun 2018 12:23 |
| Last Modified: | 29 Jun 2018 12:23 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/6267 |
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