Faculty of Medicine
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Item type:Publication, PATIENT SATISFACTION WITH KNEE ARTHROSCOPY UNDER LOCAL ANESTHESIA AND SEDATION(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024-12-21); ; Popovska, DanicaIntroduction: Knee arthroscopy can be performed under general, regional (spinal or epidural) or local anesthesia with different patients’ satisfaction after surgery. Purpose: The aim of our study was to evaluate the level of satisfaction in patients after knee arthroscopy under local anesthesia. Patients and methods: The study included 52 patients where knee arthroscopy under local anesthesia was performed at the University Clinic for Orthopedic Surgery in Skopje, North Macedonia in the period from February 2021 to February 2022. The study did not include patients with allergy to the used drugs, infection at the portal sites of injection, any previous surgery to the knee, patients with chronic extensive synovitis or gross deformity of the knee (severe varus or valgus knee), as well as those with psychological problems, severe systemic disease, consumption of analgesics or non-steroidal anti-inflammatory drugs within 24 h of surgery, bleeding diathesis or coagulopathy. Evaluation of patients’ satisfaction after surgery was done one to three months later by determining the level of satisfaction, pain during surgery, anesthesia-related postoperative complications and preference of this anesthetic technique in the future. Results: The majority of patients were either very satisfied (84.6%) or satisfied (9.6%) with local anesthesia for knee arthroscopy. Only 1.9% of them were not satisfied at all. Most of the patients reported no pain (80.8%) or mild pain (11.5%) during knee arthroscopy under local anesthesia. Only 1.9% of patients complained of strong or very strong pain during arthroscopy. Of all patients, 51 (98%) had no anesthesia-related problems after surgery except one patient who had redness, pain, swelling and blisters formation on the portal where local anesthetic and adrenaline were previously injected. Most of the patients (96%) reported that they would choose local anesthesia for knee arthroscopy again. Conclusion: Our study showed that most patients had no pain, were very satisfied and would choose local anesthesia for knee arthroscopy again. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, USAGE OF DIFFERENT TYPES OF ANESTHESIA IN ORTHOPEDIC PATIENTS TREATED WITH DAY CASE SURGERY(MIT University Skopje, 2016); ; ; ; Introduction: Orthopedic patients treated with day case surgery expect rapid recovery, high postoperative satisfaction and low postoperative pain and complications. Aim: The aim of our study is to report the annual frequency of the day case surgeries in our clinic, as well as to point out the types of orthopedics surgical procedures used. Material and methods: Between 2013 and 2015, at the University clinic for orthopedic surgery, patients were selected for day case surgery on hands and feet. Local anesthesia, intravenous regional anesthesia or peripheral nerve blocks were used for different types of operations. Results: In 3 years period, we operated 5124 patients, 1143 of them were treated as day case surgery. We found that our day case surgery rate was 22%. Out of 1143 patients, 657 (57%) were operated under local anesthesia, 237 (21%) with intravenous regional anesthesia and 249 (22%) with peripheral nerve blocks. 645 were females and 498 were males with average age of 47 ± 15 years. The procedures performed under local anesthesia were; 399 (35%) release of carpal tunnel, 171 (15%) release of trigger finger, 84 (7%) release of de Quervain’s and 3 (0.3%) minimal invasive suture of Achilles tendon rupture. Procedures performed with intravenous regional anesthesia were; 156 (14%) excision of fascia palmaris in Dupuytren contracture and 81 (7%) excision of ganglion of the wrist. Operations performed with peripheral nerve blocks were; 171 (15%) correction of hallux valgus deformities and 78 (7%) bunion deformities. Conclusion: The rate of day case surgery in our clinic is low. We use local anesthesia, intravenous regional anesthesia and peripheral nerve blocks for hand and foot operations. Day case surgery can offer a number of advantages for patients; it can minimize the costs, reduces the surgery waiting time and lowers the postoperative complications. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Is general anesthesia necessity for subdural hematoma drainage?(2022-05); ; ; Introduction. Neurosurgery and anesthesia have made amazing advancements in recent years. Despite this, in nations with limited resources, chronic subdural hema toma (CSDH) is usually treated surgically. Burr hole craniotomy under general anesthe sia is the most common procedure for its removal. However, because this group of pa tients is typically older and has several comorbidities, local anesthetic with sedation will improve recovery while reducing complications. The goal of this study is to assess the prognosis of using a local anesthetic potentiate with sedative for CSDH management. Material and methods. Five patients with CSDH were operated on under seda tion and local anesthetic from June to December 2020. Patients were enrolled in this study after receiving written consent from them. All patients under the age of 19, those with multilocular hematomas, and those who were unwilling to cooperate were elim inated from this study. The patient was given local anesthetic by injecting 10ml Lido caine 2% subperiosteally and subcutaneously. Sedation was provided by boluses of mid azolam and continuous propofol on an infusion pump. The CSDH was emptied after a burr hole craniotomy was done. All patients were evaluated for clinical appearance, he modynamic stability, complications, and satisfaction. The neurological state of patients was graded on admission and discharge using Markwalder's neurologic grading system. Results. Patients' demographic data ranged from 54 to 85 years old (mean 72). There were two females (40%) and three males (60 %). Trauma was the cause of all of the cases of CSDH. One patient had a disturbed state of consciousness, and all of the patients had a headache as a symptom. Markwalder's neurologic grading method iden tified grade 1 in four cases (80%) and grade 2 in one (20%). Markwalder's neurologic grading system improved after the evacuation. Grade 0 was classified in four patients (80%), and grade 1 was noticed in one patient (20%). During in the perioperative and postoperative periods, all patients were hemodynamically stable. In the two weeks fol lowing surgery, no bad outcomes or deaths had happened. There were no complaints from any of the patients. PROCEEDINGS 325 Discussion: It is vital to define the safest, simplest, and most successful surgical method, especially for developing nations. The gold standard for surgical therapy of persistent subdural hematoma is burr hole craniotomy. During CSDH surgery, a local anesthetic is usually chosen for patients with concomitant complicated systemic illness. Many studies have shown that both general and local anesthesia are safe in chronic subdural hematomas with a modest consequence. Furthermore, general anesthesia may affect the return to preoperative levels of awareness after such procedures, which must be evaluated early postoperatively to rule out the need for redoing due to early postop erative remembrance. Conclusion: Under local anesthetic with sedation, the treatment of CSDH is suc cessful, adequate, and safe. It will reduce the length of stay in the hospital, as well as the cost and complication rates - Some of the metrics are blocked by yourconsent settings
Item type:Publication, EVALUATION OF NEAR-INFRARED SPECTROSCOPY MONITORING IN SELECTIVE SHUNTING DURING CAROTID ENDARTERECTOMY(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, R.N. Macedonia, 2020-12); ; ; - Some of the metrics are blocked by yourconsent settings
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);