Singap Med J
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Randomized Controlled Trial
Melatonin premedication does not enhance induction of anaesthesia with sevoflurane as assessed by bispectral index monitoring.
Exogenous melatonin has sedating and hypnotic actions. The present prospective double-blind randomised study investigated the effect of melatonin premedication on the induction of anaesthesia with sevoflurane. ⋯ Melatonin premedication under the present study design failed to enhance the induction of anaesthesia with sevoflurane.
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Randomized Controlled Trial Comparative Study
Comparison of effects of anaesthesia with desflurane and enflurane on liver function.
Although most general anaesthesia procedures are performed without any complications, volatile agents may have adverse effects on various living systems. This study aimed to compare the effects of desflurane and enflurane on liver function. ⋯ Subclinical hepatic injury after anaesthesia continues to be an issue of interest, particularly with the development of new, more sensitive methods of measuring GST levels. The increase in GST concentration after anaesthesia is thought to be a result of reduced hepatic blood flow. This study has shown that desflurane has fewer effects than enflurane on liver function tests in lengthy operations of up to 330 minutes.
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Bomb blast injuries are no longer confined to battlefields. With the ever present threat of terrorism, we should always be prepared for bomb blasts. Bomb blast injuries tend to affect air-containing organs more, as the blast wave tends to exert a shearing force on air-tissue interfaces. ⋯ The presence of a tympanic membrane perforation is not a reliable indicator of the presence of a blast injury in the other air-containing organs elsewhere. Radiological imaging of the head, chest and abdomen help with the early identification of blast lung injury, head injury, abdominal injury, eye and sinus injuries, as well as any penetration by foreign bodies. In addition, it must be borne in mind that bomb blasts could also be used to disperse radiological and chemical agents.
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The clinical and economic advantages of intraoperative magnetic resonance (MR) imaging for neurosurgery are apparent. Hence, more medical institutions are setting up such services. Establishing such a service can be daunting because of the cost and specifications, its highly technical nature and many safety considerations. ⋯ This article describes the role, the practical considerations and the difficulties experienced by the neurosurgical anaesthetists in setting up an intraoperative MR imaging operating theatre at Singapore General Hospital, from planning to equipment procurement and streamlining the workflow. Safety concerns and training are vital aspects of this article. It is hoped that our experiences will be of help to others who will be called upon at some point in a similar undertaking.
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The number of total knee replacements far exceeds the number of primary total hip replacements (THR) in Singapore. There is a paucity of data regarding patients who undergo THR in Singapore. This paper aimed to study the epidemiology and early postoperative outcomes of patients receiving primary THR in a single tertiary institution. ⋯ In Asian patients, the three commonest aetiologies for degenerative hip arthritis were inflammatory arthropathies, primary osteoarthritis and avascular necrosis. Regardless of diagnosis, the patient groups had comparable functional outcomes following THR.