Faculty of Medicine
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Item type:Publication, HARVESTING BUCCAL MUCOSA UNDER LOCAL ANESTHESIA – FEASIBILITY AND ACCEPTANCE FOR SUBSTITUTION URETHROPLASTY(Department of Anesthesia and reanimation, Faculty of Medicine, "Ss.Cyril and Methodius", University Skopje Macedonia, 2020-10); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ERECTOR SPINAE PLANE BLOCK AS ADD ON ANESTHETIC TECHNIQUE TO GENERAL ANESTHESIA FOR CHOLECYSTECTOMY(Department of Anesthesia and reanimation, Faculty of Medicine, "Ss.Cyril and Methodius", University Skopje Macedonia, 2020-06); ; Stefanovski DOpen cholecystectomy is a surgical procedure which is followed by severe peroperative and postoperative pain. The use of Erector Spine Plane Block (ESPB) as a part of multimodal analgesia in a patient classified as ASA 4, significantly reduced the need for opiates during the operation, as well as in the postoperative period. Erector spinae plane block provides excellent analgesia and cardio circulatory stability during and after the operation. This block can be used as part of multimodal analgesia. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, TACHYCARDIA - BRADYCARDIA SYNDROME IN A PATIENT UNDERGOING PERTROCHANTERIC FRACTURE REPAIR UNDER SPINAL ANESTHESIA(Department of Anesthesia and reanimation, Faculty of Medicine, "Ss.Cyril and Methodius", University Skopje Macedonia, 2018-12); ; ; ; Trposka ABackground: Sick sinus syndrome (SSS) is an abnormality of a cardiac impulse formation as a result of sinus node dysfunction that could be presented as a diverse heart rate and rhythm abnormalities. SSS is the most common in the elderly people. In most of the cases the etiology of the SSS remains unknown, but the majority of the patients are experiencing some stage of coronary artery disease (1). Case Report: We present an 89 years old female patient undergoing pertrochanteric fracture repair under spinal anesthesia. Her preoperative evaluation did not reveal any pathologic findings. All vital signs were stable prior to the surgery. The patient has received 2.4 ml of Bupivacaine 0.5% and 10 mcg of Fentanyl. Dural puncture was done in an aseptic technique at the L3-L4 level and clear liquor was seen prior to the anesthetic application. The first hour of the surgery went uneventful, after what abrupt onset of tachycardia of 109bpm was seen followed by bradycardia of 48bpm. The episodes of tachycardia followed with bradycardia were repeating till the patient entered a bigeminy rhythm with the lowest hearth rate of 45, after what 0.5 mg of atropine was given and restoration of normal sinus rhythm was seen. The patient was monitored postoperatively in PACU and followed up at the Traumatology ward while there were not seen any vital signs deterioration. Discussion: We’ve researched PubMed from 1994-2017 and we’ve found 8 case reports in patients undergoing general anesthesia, one undergoing general and epidural anesthesia and one under spinal anesthesia. Eight of 10 patients were previously healthy without known cardiac disease and one with peripheral artery disease. Different types of conduction and heart rate abnormalities, including asystole, were seen in all of the cases after induction of the patients under anesthesia. In our case during the surgery the patient developed multiple episodes of tachycardia followed with bradycardia without subjective discomfort. The resolution of the tachycardia-bradycardia syndrome after giving the 0.5 mg of atropine shows a possible relationship between the local anesthetic application and the onset of the SSS manifestation. References: 1. Brignole M1.; Sick sinus syndrome; Clin Geriatr Med. 2002 May;18(2):211-27. Learning points: SSS can be precipitated perioperatively because of increased vagal tone caused by anesthesia or surgical intervention. As general anesthetics, local anesthetics could also trigger intraoperative manifestation of SSS. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THE ANALGESIC EFFECT OF ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK FOR LAPAROSCOPIC BILATERAL INGUINAL HERNIA REPAIR(Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University, Skopje, Macedonia, 2017-04); ; ; Background: Transversus abdominis plane (TAP) block is a (new) regional anesthetic technique that provides analgesia to the parietal peritoneum, as well as the skin and muscles of the anterior abdominal wall, by introducing local anesthetic into the neuro-fascial plane between the internal oblique and the transversus abdominis muscles. Pain after laparoscopic bilateral inguinal hernia surgery can be moderate to severe and can result in prolonged hospital stay, unanticipated hospital admission and delayed return to normal daily activities. We evaluated the efficacy of TAP block in patients undergoing laparoscopic bilateral inguinal hernia repair in a randomized controlled clinical trial. Material and methods: Sixty patients undergoing laparoscopic bilateral inguinal hernia repair were randomized to undergo standard care (n=30) or to undergo a bilateral TAP block with bupivacaine (n=30). All patients received standard anesthetic, and after induction of anesthesia, the TAP group received an ultrasound-guided bilateral TAP block. Each patient was assessed after operation at 2, 6, 12 and 24 hours after surgery. Results: Bilateral ultrasound-guided TAP block significantly reduced postoperative visual analogue scale (VAS) pain scores at rest and on moving, reduced ketonal and tramadol postoperative consumption and reduced incidence of PONV in the TAP block group after surgery compared to control group. Conclusion: Bilateral ultrasound-guided TAP block provides effective postoperative analgesia during the 24 postoperative hours after laparoscopic bilateral inguinal hernia repair. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Analgesic effect of ultrasound-guided bilateral erector spinae plane block in abdominal surgery - a case report(2019) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Preoperative magnesium sulphate usage as a medical challenge in postoperative pain management.(Department of Anesthesia and reanimation, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Macedonia, 2018-12); ;