Publications by authors named "Mohamad Hasyizan Hassan"

6 Publications

  • Page 1 of 1

Comparison of Esmolol and Dexmedetomidine Infusion in Attenuating Haemodynamic and Blood Glucose Response to Laryngoscopy and Intubation: A Single Blinded Study.

Malays J Med Sci 2021 Jun 30;28(3):46-55. Epub 2021 Jun 30.

Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Background: This study aims to compare the effect of infusions of two agents, dexmedetomidine and esmolol, with the control group in attenuating the haemodynamic stress response and neuroendocrine modulation surrogated by capillary blood glucose (BG) during the procedures.

Methods: Sixty patients aged 18-70 years old who underwent elective surgeries involving endotracheal intubation were randomised into three groups of equal size: i) control; ii) dexmedetomidine and iii) esmolol. Heart rate (HR) was measured at baseline (T0), after drug administration (T1), after induction of anaesthesia (T2), immediately after intubation (T3), and 3 min, 5 min and 10 min after intubation (T4, T5 and T6). BG was measured pre-operatively and 30 min post-intubation.

Results: Two-way repeated-measures analysis of variance showed significant time [within-group changes, (3.2, 182.5) = 30.39, < 0.001], treatment [between-group differences regardless of time, (2, 57) = 50.24, < 0.001] and interaction [between-group differences based on time, (6.4, 182.5) = 37.65, < 0.001] effects on HR. A significantly higher HR was observed in the control group compared to the dexmedetomidine and esmolol groups from T2 to T6. BG exhibited a significant time effect [(1, 57) = 41.97, < 0.001] with no significant treatment and interaction effects. All three groups showed a significant increase in BG from baseline.

Conclusion: Both dexmedetomidine and esmolol are equally effective in attenuating haemodynamic responses to laryngoscopy and intubation. However, both do not significantly modulate neuroendocrine stress.
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June 2021

Comparing the Effects of Pre-loading with Gelatine 4% Plasma Volume Expander and 6% Hydroxyethyl Starch Solution Before Spinal Anaesthesia for Lower Limb Orthopaedic Surgery.

Malays J Med Sci 2020 Dec 29;27(6):68-78. Epub 2020 Dec 29.

Department of Anaesthesiology & Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.

Background: Hypotension is a common complication following spinal anaesthesia. The administration of intravenous fluids prior to spinal anaesthesia, known as pre-loading, has been used to offset the hypotension effect; however, the ideal fluid for pre-loading is still a matter of debate. The objective of this study was to compare the effects of Gelaspan 4% and Volulyte 6% as pre-loading fluids.

Methods: A total of 93 patients with American Society of Anaesthesiologists (ASA) physical status I or II having lower limb orthopaedic surgery under spinal anaesthesia were randomised into two groups that received either Volulyte ( 47) or Gelaspan ( 46). Before the spinal anaesthesia, these patients were pre-loaded with 500 mL of the fluid of their respective group. Blood samples were taken before pre-loading and again after spinal anaesthesia and sent for venous blood gas and electrolyte level measurement. Baseline and intraoperative records of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and the requirement of ephedrine to treat hypotension were also recorded.

Results: Both fluids could not prevent significant reductions in SBP ( 0.011), DBP ( 0.002) and MAP ( 0.001). There was also significant reduction in HR over time ( 0.001). There was no significant difference in terms of ephedrine usage between both groups. Neither Volulyte 6% nor Gelaspan 4% caused significant changes in acid-base status.

Conclusion: The use of 500 mL of either Gelaspan 4% or Volulyte 6% as pre-loading fluids did not significantly prevent the incidence of post-spinal anaesthesia hypotension following orthopaedic lower limb surgery; however, both were useful in the maintenance normal acid-base balance.
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December 2020

Undiagnosed chicken meat aspiration as a cause of difficult-to-ventilate in a boy with traumatic brain injury.

Respir Med Case Rep 2018 8;23:93-95. Epub 2018 Jan 8.

Department of Otorhinolaryngology - Head & Neck Surgery, Universiti Sains Malaysia Health Campus, 16150, Kota Bharu, Kelantan, Malaysia.

Introduction: Bronchoscopy is a commonly used procedure in the context of aspiration in the Intensive Care Unit setting. Despite its ability to remove mucus plug and undigested gastric contents, aspiration of gastric content into the trachea is one of the most feared complications among anesthesiologist.

Discussion: The scenario is made worst if the aspiration causes acute hypoxemic respiratory failure immediately post intubation. However, in the event of desaturation, the quick decision to proceed with bronchoscopy is a challenging task to the anesthesiologist without knowing the causes.

Case Presentation: We present a case of a 12-year-old boy who had a difficult-to-ventilate scenario post transferring and immediately connected to ventilator in operation theatre (OT) from portable ventilator from the emergency department. She was successfully managed by bronchoscopy.

Conclusion: Special attention should be given to the difficult-to-ventilate scenario post intubation of traumatic brain injury patient prior to operation. Prompt diagnosis and bronchoscope-assisted removal of foreign body was found to be a successful to reduce morbidity and mortality.
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January 2018

Balanced Fluid Versus Saline-Based Fluid in Post-operative Severe Traumatic Brain Injury Patients: Acid-Base and Electrolytes Assessment.

Malays J Med Sci 2017 Oct 26;24(5):83-93. Epub 2017 Oct 26.

Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.

Background: Normal saline (NS) is a common fluid of choice in neurosurgery and neuro-intensive care unit (ICU), but it does not contain other electrolytes and has the potential to cause hyperchloremic metabolic acidosis with prolonged infusion. These problems may be reduced with the availability of balanced fluid (BF), which becomes a more physiological isotonic solution with the presence of complete electrolyte content. This study aimed to compare the changes in electrolytes and acid-base between NS and BF (Sterofundin® ISO) therapy for post-operative severe traumatic brain injury (TBI) patients in neuro-ICU.

Methods: Sixty-six severe TBI patients who required emergency craniotomy or craniectomy and were planned for post-operative ventilation were randomised into NS ( 33) and BF therapy groups ( 33). The calculation of maintenance fluid given was based on the Holliday-Segar method. The electrolytes and acid-base parameters were assessed at an 8 h interval for 24 h. The data were analysed using repeated measures ANOVA.

Results: The NS group showed a significant lower base excess (-3.20 versus -1.35, 0.049), lower bicarbonate level (22.03 versus 23.48 mmol/L, 0.031), and more hyperchloremia (115.12 versus 111.74 mmol/L, 0.001) and hypokalemia (3.36 versus 3.70 mmol/L, 0.001) than the BF group at 24 h of therapy. The BF group showed a significantly higher level of calcium (1.97 versus 1.79 mmol/L, 0.003) and magnesium (0.94 versus 0.80 mmol/L, 0.001) than the NS group at 24 h of fluid therapy. No significant differences were found in pH, pCO, lactate, and sodium level.

Conclusion: BF therapy showed better effects in maintaining higher electrolyte parameters and reducing the trend toward hyperchloremic metabolic acidosis than the NS therapy during prolonged fluid therapy for postoperative TBI patients.
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October 2017

Epilepsy Surgery in Hospital Universiti Sains Malaysia: Our Experiences since 2004.

Malays J Med Sci 2017 Dec 29;24(6):97-102. Epub 2017 Dec 29.

Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Jalan Hospital USM, 16150 Kubang Kerian, Kelantan, Malaysia.

Epilepsy surgery has been performed by a few centres in Malaysia, including Hospital Universiti Sains Malaysia (HUSM). To date, a total of 15 patients have undergone epilepsy surgery in HUSM. The epilepsy surgery included anterior temporal lobectomy (ATL) with amygdalohippocampectomy (AH) and Vagal nerve stimulation (VNS). The surgical outcomes of the patients were assessed using the International League Against Epilepsy (ILAE) outcome scale. The ILAE scores for patients who underwent ATL with AH were comparatively better than those who underwent VNS. One of the patient who underwent ATL with AH and frontal lesionectomy was found to have psychosis during follow up. Epilepsy surgery has proven to be an important treatment for medically resistant epilepsy. Thus it is important to raise public awareness regarding epilepsy and its treatment.
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December 2017

Overcoming airway challenges with the C-MAC video laryngoscope in a child with Goldenhar syndrome.

Indian J Anaesth 2016 Nov;60(11):868-869

Department of Anaesthesiology and Critical Care, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kelantan, Malaysia.

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November 2016