Research Articles (Anaesthesiology and Critical Care)

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Browsing Research Articles (Anaesthesiology and Critical Care) by Author "Chetty, Sean"

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    Improving perioperative pain management: a preintervention and postintervention study in 7 developing countries
    (Wolters Kluwer Health, 2019-01-01) Zaslansky, Ruth; Chapman, C. Richard; Baumbach, Philipp; Bytyqi, Adem; Lopes, Jose M. Castro; Chetty, Sean; Kopf, Andreas; Li, Li; Ming, Lim Ern; Olawoye, Olayinka; Parico, Jane Rizza; Soyannwo, Olaitan; Stamenkovic, Dusica; Wang, Hongwei; Meissner, Winfried
    Introduction: The burden of untreated postoperative pain is high. Objective: This study assessed feasibility of using quality improvement (QI) tools to improve management of perioperative pain in hospitals in multiple developing countries. Methods: The International Pain Registry and Developing Countries working groups, from the International Association for the Study of Pain (IASP), sponsored the project and PAIN OUT, a QI and research network, coordinated it, and provided the research tools. The IASP published a call about the project on its website. Principal investigators (PIs) were responsible for implementing a preintervention and postintervention study in 1 to 2 surgical wards in their hospitals, and they were free to choose the QI intervention. Trained surveyors used standardized and validated web-based tools for collecting findings about perioperative pain management and patient reported outcomes (PROs). Four processes and PROs, independent of surgery type, assessed effectiveness of the interventions. Results: Forty-three providers responded to the call; 13 applications were selected; and PIs from 8 hospitals, in 14 wards, in 7 countries, completed the study. Interventions focused on teaching providers about pain management. Processes improved in 35% and PROs in 37.5% of wards. Conclusions: The project proved useful on multiple levels. It offered PIs a framework and tools to perform QI work and findings to present to colleagues and administration. Management practices and PROs improved on some wards. Interpretation of change proved complex, site-dependent, and related to multiple factors. PAIN OUT gained experience coordinating a multicentre, international QI project. The IASP promoted research, education, and QI work.
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    The prevalence of chronic postmastectomy pain syndrome in female breast cancer survivors
    (Taylor & Francis Group, 2016) Variawa, Muhammed Luqmaan; Scribante, Juan; Perrie, Helen; Chetty, Sean
    Background: Breast cancer is one of the most common cancer diagnoses in women. Surgical treatment is indicated in most patients. Postmastectomy pain syndrome (PMPS) is a debilitating neuropathic pain syndrome that develops after breast surgery. A review of the literature revealed no studies determining the prevalence of PMPS conducted in South Africa. The current anecdotal perception is that the prevalence of PMPS in the African population is low. Objectives: The objectives of this study were to determine the prevalence of PMPS in adult female breast cancer patients following general anaesthesia without regional anaesthesia at the Chris Hani Baragwanath Academic Hospital (CHBAH), as well as the impact of various clinical and demographic variables on the prevalence of PMPS. Methods: The research design was a cross-sectional descriptive study. The validated DN4 pain questionnaire was used in this study. Results: The study included 92 patients. The prevalence of PMPS was found to be 38.04% (n = 35). The average duration that patients experienced neuropathic pain symptoms was 12.22 months (range 3–39 months). The average age of patients interviewed was 58.54 years (range 30–90 years). There was no statistically significant difference between age group and PMPS (p = 0.47). The study also showed that no statistically significant association existed between pain experienced and adjuvant therapy administered. Conclusion: Even though surgical procedures are becoming less invasive, the prevalence of PMPS after treatment for breast cancer remains a clinically significant problem, comparable to international literature. This necessitates the development of more effective prevention and treatment strategies to improve patients’ quality of life.
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    Priority areas for cannabis and cannabinoid product research in South Africa
    (AOSIS, 2018-06) Augustine, Tanya N.; Cairns, Carel J.; Chetty, Sean; Dannatt, Lisa G.; Gravett, Nadine; Grey, Glenda; Grobler, Gerhard; Jafta, Zukiswa; Kamerman, Peter; Lopes, John; Matsabisa, Motlalepula G.; Mugabo, Pierre; Mulder, Michelle; Parry, Charles; Rataemane, Solomon; Siegfried, Nandi; Steenkamp, Vanessa; Thomas, Eileen; Van Zyl-Smit, Richard
    The legalisation of cannabis for medicinal use is a contentious space both politically and in the medical community. In 2014, the Medical Innovation Bill introduced by Mario Oriani-Ambrosini MP, aimed to shift the political and legal positions of cannabis as an illegal substance to one available for research and medical use. To date, progress on this has been slow. Cannabis and cannabinoid products are currently available for medicinal use in several countries, including the Netherlands and 29 states in the United States. Locally, anecdotal reports suggest that many of our patients with chronic medical conditions are using cannabis and cannabis-derived or cannabinoid products for symptom alleviation.