http://hdl.handle.net/10386/183 Tue, 07 Apr 2026 07:16:05 GMT 2026-04-07T07:16:05Z http://hdl.handle.net/10386/1087 Should etomidate be the induction agent of choice in the emergency department? Netshandama, Betty Purpose: The purpose of this study was to determine whether etomidate should be the induction agent of choice for Rapid Sequence Intubation in the Emergency department due to its haemodynamic stability. Objective: To measure the haemodynamic effects of etomidate post- induction in patients undergoing Rapid sequence intubation. Methods: This was a prospective, randomized, observational and unblinded study. The study was conducted at DR GEORGE MUKHARI HOSPITAL theatre unit on 45 patients between the ages of 11 and 65 years of age who fall under the American Society of Anaesthesiology classification (ASA) IE – IIIE. Each patient had an established intravenous line, was pre-oxygenated and then received etomidate (0.2 mg – 0.3 mg/kg). Cricoid pressure was applied immediately following loss of consciousness. Suxamethonium 1.5 mg/kg or Rocuronium 1.2 mg/kg was administered and this was followed by endotracheal intubation 60 seconds later. Data collected included amongst others vital signs:- Heart Rate, Systolic Blood Pressure, Diastolic Blood Pressure and Mean Arterial Pressure which were measured pre-induction, immediately post-intubation, 2.5 minutes, 5 minutes and 7.5 minutes later by a non invasive automated blood pressure monitor. Statistical Analysis: Descriptive statistical analysis was applied using the SPSS (Statistical Programme for Social Sciences) to demonstrate the demographics and ASA classifications of the patients in the study. Mean standard deviations were calculated for both males and 10 females in the study. Changes in vital signs immediately post-intubation were graphically demonstrated. The changes in vital signs (HR, SBP, DBP and MAP) were calculated and differences in such changes over-time were expressed as p-value. Significant differences in changes of the vital signs were noted if p ≤ 0.05. Results: The blood pressure increased immediately following intubation due to laryngoscopy and intubation. As anaesthesia progressed (i.e. 2.5 minutes, 5 minutes and 7.5 minutes later) the blood pressure gradually declined to levels lower than pre-induction values but at acceptable levels. Conclusion: Etomidate is an effective anaesthetic induction agent as it is haemody-namically stable and thus should be used in an Emergency department Thesis (M Med (Anaesthesiology)) -- University of Limpopo, 2013. Wed, 01 Jan 2014 00:00:00 GMT http://hdl.handle.net/10386/1087 2014-01-01T00:00:00Z http://hdl.handle.net/10386/1082 Comparison of the effect of co-administration of crystalloid versus colloid, with phenylephrine infusion for the prevention of hypotension from spinal anesthesia during elective caesarian section Frans, L. J. Aim: To determine whether there is any difference when phenylephrine in-fusion is combined with either a crystalloid or a colloid in the prevention of symptomatic hypotension during spinal anaesthesia for caesarian section. Objectives: 1. To determine whether there is any difference in the total dose of phenylephrine needed to maintain normal blood pressure when crystalloid or a colloid is used. 2. To determine the number of women who develop symptoms (viz. dizziness, restlessness, nausea and vomiting) when phenylephrine infusion is combined with either a crystalloid or a colloid. 3. To determine the severity of symptoms in the phenylephrine plus crystalloid group versus the phenylephrine plus colloid group. 1 Sampling methods ,study designs and procedures Study design: A prospective, randomised, comparative study of women who had caesarian section under spinal anaesthesia was conducted. The aim was to determine whether giving a phenylephrine infusion plus a crys-talloid versus a phenylephrine infusion plus a colloid made a difference in the prevention of symptomatic hypotension. Sample criteria: Pregnant women undergoing caesarian section under spinal anaesthesia were selected and divided randomly into two groups; one to receive a phenylephrine infusion plus a crystalloid (group A), the other to receive a phenylephrine infusion plus a colloid (group B). Patients were excluded for the following reasons: 1. Absolute contra indications to spinal anaesthesia. 2. Emergency Caesarian section 3. Diabetes mellitus 4. Renal disease 2 Sample size: The necessary sample was determined to be 122 patients, each group having 61 patients. Procedures: Each patient received bupivacaine with dextrose (12.5 mg) plus sufentanyl 2.5μg intrathecally at L3-L4 intervertebral space. Patients in group A received 350ml of Ringer's Lactate over 15 minutes, started immediately after administration of anaesthesia, and 3ml of the same fluid for each 1ml of blood lost. Patients in group B received 150ml of Voluven (Hydroxyethyl starch 130/40) over 15 minutes, started immediately after administration of anaesthesia, and 1ml of the same fluid for each 1ml of blood lost. Each patient also received an infusion of phenylephrine (50μg/min), started within a minute of giving anaesthesia and stopped if the mean blood pressure exceeded the baseline by 20%. A 50ug bolus was given any time the mean blood pressure was 20% below the original. Non-invasive blood pressure measurements were taken every 2.5 minutes for 45 minutes. 3 At the end of the procedure patients were questioned for the following symptoms: dizziness, nausea, vomiting and restlessness (as observed by researcher).They were then classified as follows: asymptomatic, mildly symptomatic (symptoms discovered only on questioning), moderately symptomatic (patient complained about symptoms but not restless), or se-verely symptomatic (patient complained about symptoms and was rest-less). Statistical analysis The analysis was based on descriptive statistics with variables expressed as Mean± Standard deviation. Differences between the two groups were determined using the student t-test and conversion of the value of (t) to p-value. Differences were considered significant when the p-value was ≤ 0.05. Relational statistics were calculated using the Chi-Square analysis to reflect the association of the use of a crystalloid or colloid plus phe-nylephrine infusion, with prevention of hypotension during spinal anaesthe-sia for elective Caesarian section. 4 Results Blood pressure readings at the beginning and the end of measurement period were statistically similar between the two groups, suggesting equal effectiveness in maintaining blood pressure. The medians for the infused amounts and total amounts of phenylephrine were the same for both groups (2200μg).There was no statistically significant difference in the number of patients requiring rescue boluses of phenylephrine (p=0.52),nor was there a significant difference in the total amount of drug used as bo-lus(p=0.7).The majority of patients in both groups were asymptomatic(57% in group B and 69% in group A),with a p-value of 0.2. Most of these pa-tients experienced mild symptoms (63% in group A versus 64% in group B, p=0.8). Conclusion The results of this study suggest there is no added advantage in using a colloid co-administration with a phenylephrine infusion to prevent hypoten-sion during spinal anaesthesia for elective caesarian section. A crystalloid co-administration is equally effective. Thesis (M Med (Anaesthesiology)) -- University of Limpopo, 2012. Wed, 01 Jan 2014 00:00:00 GMT http://hdl.handle.net/10386/1082 2014-01-01T00:00:00Z http://hdl.handle.net/10386/876 The Causes of non-compliance to tuberculosis treatment in patients at Matlala District Hospital Linzamo, Freddy Moba Thesis (M Med (Family Medicine)) -- University of Limpopo(Medunsa Campus), 2011. Sat, 01 Jan 2011 00:00:00 GMT http://hdl.handle.net/10386/876 2011-01-01T00:00:00Z http://hdl.handle.net/10386/875 Diagnostic value of fluoro-deoxyglucose-position emission tomography/computed tomography scan in patients with acral lentiginous melanoma Nkosi, J. N. Thesis (General Surgery)) -- University of Limpopo, 2012. Sun, 01 Jan 2012 00:00:00 GMT http://hdl.handle.net/10386/875 2012-01-01T00:00:00Z