Publications by authors named "Essam M Manaa"

2 Publications

  • Page 1 of 1

Effects of intrapartum epidural analgesia at high altitudes: maternal, fetal, and neonatal outcomes. A randomized controlled trial of two formulations of analgesics.

Acta Obstet Gynecol Scand 2010 Jul;89(7):909-15

Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt.

Objectives: To investigate whether intrapartum epidural analgesics (bupivacaine or ropivacaine) have an influence (safety and efficacy) on mothers, fetuses, or newborns at high altitudes (2,200 m above the sea level).

Design: Prospective randomized trial.

Setting: A tertiary referral hospital in Aseer region, Saudi Arabia.

Population: Eighty parturient women with normal full term pregnancy (37-40 weeks) were randomly allocated to a group receiving epidural bupivacaine 0.125% and the other receiving ropivacaine 0.2%, with fentanyl 100 microg given to both groups.

Methods: Intra- and postpartum clinical management of the pregnant women and newborns and fetal Doppler assessments were performed.

Main Outcome Measures: Severity of pain, onset and duration of analgesia, and occurrence of motor blockade were primary outcomes. Progress of labor, need for oxytocin augmentation, mode of delivery, and neonatal condition were secondary outcomes.

Results: Demographic, labor characteristics, and neonatal outcomes of the two groups were comparable. The onset of analgesia was relatively more rapid for ropivacaine group (p = 0.067). Duration of analgesia after the first bolus dose was longer and the need for supplemental epidural analgesic doses was lesser in the bupivacaine group (p = 0.041 and 0.045, respectively). In both groups, the fetal umbilical and middle cerebral artery pulsatility indices showed significant change when compared to the baseline of the same group.

Conclusion: At high altitudes, no major advantage was found for epidural ropivacaine over bupivacaine in addition to fentanyl for labor analgesia and no harmful effects of the medications were found on mothers, fetuses, or newborns.
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http://dx.doi.org/10.3109/00016349.2010.484042DOI Listing
July 2010

The effects of pneumoperitoneum on respiratory mechanics during general anesthesia for bariatric surgery.

Obes Surg 2004 Feb;14(2):212-5

Department of Anaesthesia, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudia Arabia.

Background: The effects of pneumoperitoneum (PPM) on respiratory mechanics during bariatric surgery were investigated.

Patients And Methods: 10 patients with BMI 50.5+/-8 kg/m(2) (range 40.9- 66.8) who underwent laparoscopic adjustable gastric banding with the Swedish band under general anesthesia were studied. Besides routine monitoring of vital signs and lung volumes, respiratory mechanics (compliance and resistance) were measured during positive pressure ventilation using an anesthesia delivery unit (Datex Ohmeda type A_Elec). Data were recorded at the following stages: 1). before PPM, 2). during PPM, and 3). after gas deflation. One-way analysis of variance was used for analysis of data. P <0.05 was considered significant.

Results: The airway, peak inspiratory and plateau pressures increased significantly during PPM. Dynamic lung compliances were 44.6+/-7.8 SD, 31.8+/-5.5 and 44.5+/-8.3 cm/H(2)O before, during and after PPM respectively with significant differences (P <0.05).

Conclusions: Although significant decrease in lung mechanics was found in the present study,these variations were well tolerated in morbidly obese patients with PPM pressure of 15 mmHg.
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http://dx.doi.org/10.1381/096089204322857582DOI Listing
February 2004