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The successful use of the laryngeal mask airway in children partly depends on the correct selection of size. Most anaesthesiologists rely on the weight-based table which is often difficult to remember. A simple method allowing an adequate... more
The successful use of the laryngeal mask airway in children partly depends on the correct selection of size. Most anaesthesiologists rely on the weight-based table which is often difficult to remember. A simple method allowing an adequate choice of the correct size may be highly desirable. To test the hypothesis that the size of the external ear (pinna) of the child may be used as proxy for the required size of laryngeal mask airway. A descriptive study. King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Two hundred and ten paediatric patients aged 6 months to 15 years, of either sex, American Society of Anesthesiologists (ASA) 1-2 and scheduled for routine ophthalmological procedures from 1 March to 31 December 2010. Emergency cases, patients with a full stomach or with a history of any oropharyngeal lesion other than tonsillar hypertrophy were excluded. The size of the external ear was measured with a ruler in vertical and horizontal dimensions in the first 30 patients, and visually evaluated for the remaining patients. For all, the nearest corresponding size of partially inflated laryngeal mask airway was chosen and inserted after induction. The correct placement was assessed using predefined criteria. Insertion and good ventilation was achieved in 196 (93.3%) on first attempt. Fourteen patients (6.7%) required a second attempt and the main reason for failure was an audible leak because of smaller size. Choosing the size of the laryngeal mask airway in children according to the size of the external ear was associated with a success rate of 93% which is comparable with that reported in the literature when the tables are used. This simple method may allow a rapid choice of the correct size of laryngeal mask airway and may eliminate the need to remember different tables or formulae.
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Research Interests: Medicine, Strabismus, Anesthesia, Analgesia, Nausea, and 4 moreClinical Sciences, Analgesic, Fentanyl, and Vomiting
The outbreak of the novel coronavirus (COVID-19) has been declared a global pandemic. With a mortality rate reaching up to 5%, healthcare professionals treating patients with COVID-19 are at a significantly higher risk for exposure... more
The outbreak of the novel coronavirus (COVID-19) has been declared a global pandemic. With a mortality rate reaching up to 5%, healthcare professionals treating patients with COVID-19 are at a significantly higher risk for exposure themselves. Given the rapidly progressing rate of COVID-19, there is an urgent need for developing guidelines within each specialty. This article discusses guidelines specifically for anesthesiologists dealing with ophthalmic surgeries with suspected or confirmed COVID-19 patients. Anesthesiologists always work in the proximity of the patient's face while performing either ocular regional anesthesia or while managing the airway in the process of intubation/extubation. Within these guidelines, the emphasis is provided on thorough preoperative screening to identify COVID-19 patients and to prevent the exposure of healthcare staff by following standard personal protective equipment (PPE) precautions.
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Research Interests: Medicine and The Internet
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To compare the outcomes such as postoperative nausea/vomiting, analgesic requirements, and hospital stay following the use of topical oxybuprocaine hydrochloride 0.4% or intravenous (IV) fentanyl in children undergoing strabismus surgery.... more
To compare the outcomes such as postoperative nausea/vomiting, analgesic requirements, and hospital stay following the use of topical oxybuprocaine hydrochloride 0.4% or intravenous (IV) fentanyl in children undergoing strabismus surgery. This was a prospective cohort study. Children operated under general anesthesia for strabismus were given topical oxybuprocaine hydrochloride 0.4% (Group T) and IV fentanyl (Group F) before surgery. The episodes of nausea/vomiting, pain score, requirement of additional analgesia during postoperative period, and duration of hospital stay were compared in two groups. There were 47 children in Group T and 59 children in Group F. The median pain score in two groups were 2.38 (25% quartile; 2.0) and 3.00 (25% quartile; 3.00), respectively. The difference was significant (K W P < 0.03). The episodes of nausea/vomiting in two groups were in 2 and 6 children in Group T and Group F, respectively. The median hospital stay of children of Group T and Group ...
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To compare the efficacy of the olive tipped (OT) cannula to the conventional Steven's cannula for sub-Tenon block (STB) before cataract surgery. This prospective, randomized, double-masked compared STB delivered in cataract surgery... more
To compare the efficacy of the olive tipped (OT) cannula to the conventional Steven's cannula for sub-Tenon block (STB) before cataract surgery. This prospective, randomized, double-masked compared STB delivered in cataract surgery patients with an OT cannula or a conventional Steven's cannula (ST). Outcome variables included the akinesia score and lid movement scores at 5 and 10 min. The patient perception of pain during delivery of the STB and surgery were also compared between groups. Surgeon satisfaction with anesthesia was compared between groups. P <0.05 was statistically significant. There were sixty patients in each group. The age between groups was not statistically different (P = 0.4). The body mass index was higher in the ST group compared to the OT group (P < 0.001). The akinesia score at 5 and 10 min did not differ between groups (P = 0.07 and P = 0.6, respectively). The patient perception of pain during STB and surgery were similar between groups (P = 0.1...
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Peribulbar block is commonly used for ocular posterior segment surgery. This work aimed to compare the efficacy of using 12.5 mm to 25 mm standard needle length in performing single injection peribulbar block for retinal surgery.... more
Peribulbar block is commonly used for ocular posterior segment surgery. This work aimed to compare the efficacy of using 12.5 mm to 25 mm standard needle length in performing single injection peribulbar block for retinal surgery. Peribulbar block was performed in 120 patients using either standard 25 mm or 12.5 mm 30 G needle (insulin needle). While applying digital pressure around the needle hub, 8–10 mL of local anesthetic are injected. Ocular movement was assessed at 5 and 10 min using simple akinesia score (0–8). If after 10 min score was >1, supplementary injection was given. Visual analogue scale (0–10) was used at the end of the procedure to assess surgeons’ satisfaction and patients’ intraoperative pain. No differences in akinesia score at 5 & 10 min (P=0.34and 0.36, resp.). Initial volume injected was comparable between groups (P=0.31), however total volume of local anesthesia and supplementary injections were significantly higher in 12.5 mm group (P=0.03and 0.01, resp.)...
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To set up and validate a patient satisfaction questionnaire based on Iowa Satisfaction in Anesthesia Scale (ISAS) for evaluating the degree of patient satisfaction in anesthesia. We established and validated a survey questionnaire of 13... more
To set up and validate a patient satisfaction questionnaire based on Iowa Satisfaction in Anesthesia Scale (ISAS) for evaluating the degree of patient satisfaction in anesthesia. We established and validated a survey questionnaire of 13 questions measuring the following dimensions adequacy of patient information; participation in decision making, nurse patient relation, accessibility of communication with the anesthesiologist, patient fear and anxiety and the post anesthesia care management. The process passed through three steps: instrument validation, survey conduction and data analysis. Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha was used to measure the reliability and standard psychometric techniques were used to measure instrument validity. Our modified instrument shows good reliability which is obvious with a Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha value of 0.72 and all the perspectives of validity (face, content and construct). Also, 173 (21.54%) patients achieved an overall satisfaction score of less than 85% female patients are were less satisfied than male patients. Educated patients were less satisfied, and those belonging to ASA group I and II were significantly less satisfied. Dimensions pinpointed are related to information and decision making, adverse events in recovery room, fear and anxiety contributed to patient dissatisfaction. The instrument used for the evaluation of patient satisfaction in anesthesia is a valid tool for the Arabic speaking patients. There is room for improvement in the anesthesia care, mainly in the dimension of information, decision making and postoperative anesthesia care.