Department of Anaesthesiology and Critical Care

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Browsing Department of Anaesthesiology and Critical Care by browse.metadata.advisor "Retief, Francois Wilhelm"

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    Akute postoperatiewe pyn opname in Tygerberg Hospitaal
    (Stellenbosch : Stellenbosch University, 2013-12) Murray, Albertus Adriaan; Retief, Francois Wilhelm; Stellenbosch University. Faculty of Medical and Health Sciences. Dept. of Anaesthesiology & Critical Care.
    AFRIKAANSE OPSOMMING: Doelwit: Om die voorkoms en erns van postoperatiewe pyn te bepaal gedurende die eerste 24 uur periode in 'n tersiëre hospitaal met beperkte hulpbronne. Om spesifieke groepe en risiko faktore wat verband hou met 'n hoër voorkoms van pyn te identifiseer. Ontwerp: Opname met behulp van 'n vraelys. Opset: Ontwikkelende land tersiëre staatshospitaal met alle chirurgiese dissiplines. Populasie: Pasiënte van alle chirurgiese dissilpines bo 12 jaar oud en toegelaat vir 'n minimum van 24 uur postoperatief. Metodiek: Opname 24 uur na die operasie met behulp van 'n vraelys met 3 visuele analoog pyn skale (VAS) en 'n vraag. Verdere data is ingesamel vanaf die narkose en voorskrif kaarte. Resultate: Postoperatiewe pyn is gerapporteer as matig in 25% en erg in 37% van pasiënte. Onafhanklike risikofaktore vir matige of erge postoperatiewe pyn was ‘n jonger ouderdom, vroulike geslag, nood en abdominale chirurgie. Prosedures met die hoogste voorkoms van matige of erge pyn was keisersnitte (87%) en ortopediese chirurgie van die onderste ledemate (80% - 85%). Morfien toediening was baie minder gereeld as voorgeskryf. Gevolgtrekking: Voorkoms van postoperatiewe pyn in hierdie hulpbron beperkte omgewing is hoog, maar vergelyk met ander instansies. Spesiale sorg moet geneem word in die geïdentifiseerde groepe wat verband hou met 'n hoër voorkoms van pyn. Roetine sistemiese analgesie moet meer tydig toegedien word, veral wanneer die effek van regionale narkose termineer.
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    An investigation into the use of condoms as ultrasound probe covers during sterile procedures
    (Stellenbosch : Stellenbosch University, 2015-03) Sooraj, Nayandra Runveer; Retief, Francois Wilhelm; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Anaesthesiology and Critical Care.
    Purpose The purpose of this study was to investigate the use of condoms as an alternative to commercially available ultrasound probe covers for the maintenance of sterility during ultrasound-guided medical procedures. We hypothesised that condoms are sterile in their packaging and are effective barriers to bacterial translocation during sterile procedures. Methods Phase 1 examined whether condoms are sterile in their packaging. Ten condoms were removed from their packaging under sterile conditions and placed into nutrient broth. After 24 hours of incubation, they were checked for turbidity as a measure of contamination. The second phase of the study examined the ability of condoms to prevent translocation of bacteria from heavily contaminated probe head models to growth media. The experimental model was designed to simulate clinical conditions. Rectangular glass coplin jars were dipped into KY jelly inoculated with Klebsiella and Staphylococcus. Condoms were subsequently placed over the ends of the jars. After a brief exposure period, the condoms were removed carefully and the uncontaminated tips dipped individually into different 20ml containers of nutrient broth. The containers were then incubated for 24 hours, after which they were examined for turbidity as an indicator of bacterial translocation. The experiment was conducted using sterile precautions akin to procedures performed in operating theatres. Results In the first phase, one of the ten condoms (10%; 95% confidence intervals 0.3% - 45%) showed bacterial growth. In the second phase, 18 of the 30 samples (60%; 95% confidence intervals 41% - 77%) showed bacterial growth. Conclusion The results of the study suggest that the use of condoms, as sterile ultrasound barriers, may not prevent translocation of bacteria in clinical practice. A number of factors may influence the effectiveness of condoms, such as the probe head size, bacterial load and manufacturing quality of the condom. Further studies are needed to compare condoms to commercially available probe covers.