To determine the effect of adding dexmedetomidine to bupivacaine for neuraxial anesthesia. Sixty-... more To determine the effect of adding dexmedetomidine to bupivacaine for neuraxial anesthesia. Sixty-six patients were studied between April and May 2008 in the University of Jordan, Amman Jordan. They were randomly assigned into 3 groups, each receiving spinal bupivacaine 12.5mg combined with normal saline (group N) Dexmedetomidine 5 microg (group D5), or dexmedetomidine 10 microg (group D10). The onset times to reach T10 sensory and Bromage 3 motor block, and the regression times to reach S1 sensory level and Bromage 0 motor scale, were recorded. The mean time of sensory block to reach the T10 dermatome was 4.7 +/- 2.0 minutes in D10 group, 6.3 +/- 2.7 minutes in D5, and 9.5 +/- 3.0 minutes in group N. The mean time to reach Bromage 3 scale was 10.4 +/- 3.4 minutes in group D10, 13.0+/-3.4 minutes in D5, and 18.0 +/- 3.3 minutes in group N. The regression time to reach S1 dermatome was 338.9 +/- 44.8 minutes in group D10, 277.1 +/- 23.2 minutes in D5, and 165.5 +/- 32.9 minutes in gro...
Background: The surgical approach for varicocelectomy is similar to that of herniorraphy. Iliohyp... more Background: The surgical approach for varicocelectomy is similar to that of herniorraphy. Iliohypogastric-ilioinguinal (IHII) nerve block reduces postoperative pain after herniorrhaphy, The effect of preemptive intramuscular injection of 0.1mg/kg of morphine was studied in ambulatory surgery for patients undergoing unilateral varicocoelectomy and the results were compared with those of IHII nerve block. Methods: This study was performed at Jordan University Hospital, Amman, Jordan, between August 2005 and December 2006. After obtaining the approval of the ethical committee, an informed consent was taken from 68 adult male patients in ASA (American Society of Anesthesiologist) who are І-ІІ scheduled for unilateral varicocoelectomy. Those patients were included in a prospective, randomized, double blind study. 34 patients have received IHII nerve block 10 minutes before the incision with 20 mls of bupivacaine 0.5% (B group), and 34 patients received 0.1mg/kg of morphine 10 minutes als...
Background and Objectives: Venous Thromboembolism (VTE) is potentially a life threatening complic... more Background and Objectives: Venous Thromboembolism (VTE) is potentially a life threatening complication in patients undergoing major neurosurgical procedures. There has been a general reluctance over the years to use anticoagulant prophylaxis for patients with head injury or in patients who need intracranial surgery. Intermittent Pneumatic Compression (IPC) and elastic stocking are widely used as prophylaxis against venous thrombo-embolism in these patients. The aim of the study is to assess and compare the value of VTE prophylaxis using a control group with Low Dose Unfractionated Heparin (LDUH) every eight hours alone with a study group using Intermittent Pneumatic Compression (IPC) and elastic stocking along with Single Dose Unfractionated Heparin (SDUH) at the time of anaesthesia induction on patients undergoing brain and spinal surgery. Methods: A prospective case–control study was conducted at Jordan University Hospital, over 15 months during the period 2005-2006. A total of 22...
OBJECTIVES To determine the effect of adding dexmedetomidine to bupivacaine for neuraxial anesthe... more OBJECTIVES To determine the effect of adding dexmedetomidine to bupivacaine for neuraxial anesthesia. METHODS Sixty-six patients were studied between April and May 2008 in the University of Jordan, Amman Jordan. They were randomly assigned into 3 groups, each receiving spinal bupivacaine 12.5mg combined with normal saline (group N) Dexmedetomidine 5 microg (group D5), or dexmedetomidine 10 microg (group D10). The onset times to reach T10 sensory and Bromage 3 motor block, and the regression times to reach S1 sensory level and Bromage 0 motor scale, were recorded. RESULTS The mean time of sensory block to reach the T10 dermatome was 4.7 +/- 2.0 minutes in D10 group, 6.3 +/- 2.7 minutes in D5, and 9.5 +/- 3.0 minutes in group N. The mean time to reach Bromage 3 scale was 10.4 +/- 3.4 minutes in group D10, 13.0+/-3.4 minutes in D5, and 18.0 +/- 3.3 minutes in group N. The regression time to reach S1 dermatome was 338.9 +/- 44.8 minutes in group D10, 277.1 +/- 23.2 minutes in D5, and 16...
Perioperative Care and Operating Room Management, 2021
Background Few studies have comprehensively examined death associated with surgery and anesthesia... more Background Few studies have comprehensively examined death associated with surgery and anesthesia in teaching and referral hospitals. This study evaluated the mortality in patients undergoing various surgeries under anesthesia at Jordan University Hospital. Methods Mortality data from the medical charts of patients who underwent surgery from January 1, 1990 to December 31, 2007 were reviewed to determine the cause of death following adverse anesthetic or surgical events during the course of management. The cause of death was classified into one of the following groups: surgical adverse events, anesthetic adverse events, patient disease or condition, and indeterminate cause of death. Results Overall, 1,290 subjects died after 241,300 procedures performed on 200,901 patients with a death rate of 0.64%. Versus survivors, the patients who died had higher ASA physical status scores and underwent more emergency surgical procedures. Death was significantly higher in males, in children unde...
Background: Inguinal hernia repair in children is one of the commonest surgical procedures. As a ... more Background: Inguinal hernia repair in children is one of the commonest surgical procedures. As a day-case procedure, it requires adequate post-operative pain control. A prospective randomized double-blinded study was designed to compare the effectiveness of postoperative pain control and incidence of complications between combined ilioinguinal/iliohypogastric nerve block and intravenous morphine. Methods: Sixty patients aged 2-12 years were randomly allocated to two groups of thirty. One group received intravenous morphine 100 microgram/kg before skin incision and the other had an ilioinguinal and iliohypogastric nerve block with 0.5% bupivacaine (0.25 ml/kg) also before skin incision. All patients have received standardized anaesthesia. Pain was assessed using 0- 10 scale at 0.30 minutes and 1, 2, 3 and 4 hours postoperative. Time to first analgesia, number of paracetamol doses and the incidence of respiratory depression, vomiting and itching were assessed during the first 24 hours...
OBJECTIVES To compare sedoanalgesia achieved using propofol-fentanyl-ketamine (PFK) combination w... more OBJECTIVES To compare sedoanalgesia achieved using propofol-fentanyl-ketamine (PFK) combination with general anesthesia (GA) in terms of safety, hemodynamic stability, and perioperative complications. METHODS Patients in the GA group were anesthetized using fentanyl (2 μg kg-1) and propofol (2 mg kg-1). The PFK group was anesthetized using a mixture of which each one ml contains 0.005 mg of fentanyl, 5 mg of propofol, 5 mg of ketamine, and 2 mg of lidocaine. Patients received an initial dose of 0.05 ml kg-1, followed by 0.05 mg kg-1 60 seconds later. Maintenance boluses of 0.025 ml kg-1 were administered every 3-5 minutes. Respiration occurred spontaneously through a simple face mask with 3 L min-1 O2. RESULTS The GA group had 37 (37%) patients develop hypotensive episodes, compared to one (1%) episode in the PFK group (p<0.001). Five (5%) patients in the PFK group had an episode of transient O2 desaturation, compared to one (1%) patient in the GA group (p=0.212). The duration of...
International Journal of Environmental Research and Public Health
The number of COVID-19 (Coronavirus Disease of 2019) cases in Jordan is rising rapidly. A serious... more The number of COVID-19 (Coronavirus Disease of 2019) cases in Jordan is rising rapidly. A serious threat to the healthcare system appears on the horizon. Our study aims to evaluate preparedness of Jordanian frontline doctors to the worsening scenario. It has a questionnaire-based cross-sectional structure. The questionnaire was designed to evaluate preparedness according to knowledge about virus transmission and protective measures, adherence to protection guidelines, and psychological impacts affecting doctors. Institutional factors affecting doctors’ readiness like adopting approach protocols and making protection equipment available were investigated; 308 doctors from different healthcare facilities participated (response rate: 53.9%). Approximately 25% of doctors (n = 77) previously took care of COVID-19 patients, and 173 (56.2%) have institutional COVID-19 approach protocols. Only 57 doctors (18.5%) reported all PPE (Personal Protective Equipment) available. The self-reported s...
International Journal of Environmental Research and Public Health
Vaccination is the most promising strategy to counter the spread of Coronavirus Disease 2019 (COV... more Vaccination is the most promising strategy to counter the spread of Coronavirus Disease 2019 (COVID-19). Vaccine hesitancy is a serious global phenomenon, and therefore the aim of this cross-sectional study was to explore the effect of educational background, work field, and social media on attitudes towards vaccination in Jordan. We compared between medical personnel who were in direct contact with patients and non-medical individuals at Jordan University Hospital in terms of demographics, knowledge about COVID-19 vaccines, rumors received via social media, their trust in these vaccines, and the encouraging factors for vaccination. 646 individuals were enrolled in this study, of which 287 (44.4%) were from medical field, and 359 (55.6%) from non-medical field. 226 (35%) were planning to take the vaccine once available, with a positive response from 131 (45.6%) medical field workers, compared to 94 (26.2%) non-medical individuals (p < 0.001). The social media rumor that was belie...
Abdelkarim S AlOweidi 1 MD , FACHARZT, Mahmoud M Al-Mustafa 1 MD, FACHARZT, Jihad M. Al Ajlouni 2... more Abdelkarim S AlOweidi 1 MD , FACHARZT, Mahmoud M Al-Mustafa 1 MD, FACHARZT, Jihad M. Al Ajlouni 2 MD,FRCSI(Orth.& Trauma). Diana F. Mas'ad 3 MD, Mohammad Q Hamdan 2 MD, Subhi M Alghanem 1 MD, FFARCSI, Ibraheem Y.Qudaisat 1 MD, Sami A. Abu ...
To determine the effect of adding dexmedetomidine to bupivacaine for neuraxial anesthesia. Sixty-... more To determine the effect of adding dexmedetomidine to bupivacaine for neuraxial anesthesia. Sixty-six patients were studied between April and May 2008 in the University of Jordan, Amman Jordan. They were randomly assigned into 3 groups, each receiving spinal bupivacaine 12.5mg combined with normal saline (group N) Dexmedetomidine 5 microg (group D5), or dexmedetomidine 10 microg (group D10). The onset times to reach T10 sensory and Bromage 3 motor block, and the regression times to reach S1 sensory level and Bromage 0 motor scale, were recorded. The mean time of sensory block to reach the T10 dermatome was 4.7 +/- 2.0 minutes in D10 group, 6.3 +/- 2.7 minutes in D5, and 9.5 +/- 3.0 minutes in group N. The mean time to reach Bromage 3 scale was 10.4 +/- 3.4 minutes in group D10, 13.0+/-3.4 minutes in D5, and 18.0 +/- 3.3 minutes in group N. The regression time to reach S1 dermatome was 338.9 +/- 44.8 minutes in group D10, 277.1 +/- 23.2 minutes in D5, and 165.5 +/- 32.9 minutes in gro...
Background: The surgical approach for varicocelectomy is similar to that of herniorraphy. Iliohyp... more Background: The surgical approach for varicocelectomy is similar to that of herniorraphy. Iliohypogastric-ilioinguinal (IHII) nerve block reduces postoperative pain after herniorrhaphy, The effect of preemptive intramuscular injection of 0.1mg/kg of morphine was studied in ambulatory surgery for patients undergoing unilateral varicocoelectomy and the results were compared with those of IHII nerve block. Methods: This study was performed at Jordan University Hospital, Amman, Jordan, between August 2005 and December 2006. After obtaining the approval of the ethical committee, an informed consent was taken from 68 adult male patients in ASA (American Society of Anesthesiologist) who are І-ІІ scheduled for unilateral varicocoelectomy. Those patients were included in a prospective, randomized, double blind study. 34 patients have received IHII nerve block 10 minutes before the incision with 20 mls of bupivacaine 0.5% (B group), and 34 patients received 0.1mg/kg of morphine 10 minutes als...
Background and Objectives: Venous Thromboembolism (VTE) is potentially a life threatening complic... more Background and Objectives: Venous Thromboembolism (VTE) is potentially a life threatening complication in patients undergoing major neurosurgical procedures. There has been a general reluctance over the years to use anticoagulant prophylaxis for patients with head injury or in patients who need intracranial surgery. Intermittent Pneumatic Compression (IPC) and elastic stocking are widely used as prophylaxis against venous thrombo-embolism in these patients. The aim of the study is to assess and compare the value of VTE prophylaxis using a control group with Low Dose Unfractionated Heparin (LDUH) every eight hours alone with a study group using Intermittent Pneumatic Compression (IPC) and elastic stocking along with Single Dose Unfractionated Heparin (SDUH) at the time of anaesthesia induction on patients undergoing brain and spinal surgery. Methods: A prospective case–control study was conducted at Jordan University Hospital, over 15 months during the period 2005-2006. A total of 22...
OBJECTIVES To determine the effect of adding dexmedetomidine to bupivacaine for neuraxial anesthe... more OBJECTIVES To determine the effect of adding dexmedetomidine to bupivacaine for neuraxial anesthesia. METHODS Sixty-six patients were studied between April and May 2008 in the University of Jordan, Amman Jordan. They were randomly assigned into 3 groups, each receiving spinal bupivacaine 12.5mg combined with normal saline (group N) Dexmedetomidine 5 microg (group D5), or dexmedetomidine 10 microg (group D10). The onset times to reach T10 sensory and Bromage 3 motor block, and the regression times to reach S1 sensory level and Bromage 0 motor scale, were recorded. RESULTS The mean time of sensory block to reach the T10 dermatome was 4.7 +/- 2.0 minutes in D10 group, 6.3 +/- 2.7 minutes in D5, and 9.5 +/- 3.0 minutes in group N. The mean time to reach Bromage 3 scale was 10.4 +/- 3.4 minutes in group D10, 13.0+/-3.4 minutes in D5, and 18.0 +/- 3.3 minutes in group N. The regression time to reach S1 dermatome was 338.9 +/- 44.8 minutes in group D10, 277.1 +/- 23.2 minutes in D5, and 16...
Perioperative Care and Operating Room Management, 2021
Background Few studies have comprehensively examined death associated with surgery and anesthesia... more Background Few studies have comprehensively examined death associated with surgery and anesthesia in teaching and referral hospitals. This study evaluated the mortality in patients undergoing various surgeries under anesthesia at Jordan University Hospital. Methods Mortality data from the medical charts of patients who underwent surgery from January 1, 1990 to December 31, 2007 were reviewed to determine the cause of death following adverse anesthetic or surgical events during the course of management. The cause of death was classified into one of the following groups: surgical adverse events, anesthetic adverse events, patient disease or condition, and indeterminate cause of death. Results Overall, 1,290 subjects died after 241,300 procedures performed on 200,901 patients with a death rate of 0.64%. Versus survivors, the patients who died had higher ASA physical status scores and underwent more emergency surgical procedures. Death was significantly higher in males, in children unde...
Background: Inguinal hernia repair in children is one of the commonest surgical procedures. As a ... more Background: Inguinal hernia repair in children is one of the commonest surgical procedures. As a day-case procedure, it requires adequate post-operative pain control. A prospective randomized double-blinded study was designed to compare the effectiveness of postoperative pain control and incidence of complications between combined ilioinguinal/iliohypogastric nerve block and intravenous morphine. Methods: Sixty patients aged 2-12 years were randomly allocated to two groups of thirty. One group received intravenous morphine 100 microgram/kg before skin incision and the other had an ilioinguinal and iliohypogastric nerve block with 0.5% bupivacaine (0.25 ml/kg) also before skin incision. All patients have received standardized anaesthesia. Pain was assessed using 0- 10 scale at 0.30 minutes and 1, 2, 3 and 4 hours postoperative. Time to first analgesia, number of paracetamol doses and the incidence of respiratory depression, vomiting and itching were assessed during the first 24 hours...
OBJECTIVES To compare sedoanalgesia achieved using propofol-fentanyl-ketamine (PFK) combination w... more OBJECTIVES To compare sedoanalgesia achieved using propofol-fentanyl-ketamine (PFK) combination with general anesthesia (GA) in terms of safety, hemodynamic stability, and perioperative complications. METHODS Patients in the GA group were anesthetized using fentanyl (2 μg kg-1) and propofol (2 mg kg-1). The PFK group was anesthetized using a mixture of which each one ml contains 0.005 mg of fentanyl, 5 mg of propofol, 5 mg of ketamine, and 2 mg of lidocaine. Patients received an initial dose of 0.05 ml kg-1, followed by 0.05 mg kg-1 60 seconds later. Maintenance boluses of 0.025 ml kg-1 were administered every 3-5 minutes. Respiration occurred spontaneously through a simple face mask with 3 L min-1 O2. RESULTS The GA group had 37 (37%) patients develop hypotensive episodes, compared to one (1%) episode in the PFK group (p<0.001). Five (5%) patients in the PFK group had an episode of transient O2 desaturation, compared to one (1%) patient in the GA group (p=0.212). The duration of...
International Journal of Environmental Research and Public Health
The number of COVID-19 (Coronavirus Disease of 2019) cases in Jordan is rising rapidly. A serious... more The number of COVID-19 (Coronavirus Disease of 2019) cases in Jordan is rising rapidly. A serious threat to the healthcare system appears on the horizon. Our study aims to evaluate preparedness of Jordanian frontline doctors to the worsening scenario. It has a questionnaire-based cross-sectional structure. The questionnaire was designed to evaluate preparedness according to knowledge about virus transmission and protective measures, adherence to protection guidelines, and psychological impacts affecting doctors. Institutional factors affecting doctors’ readiness like adopting approach protocols and making protection equipment available were investigated; 308 doctors from different healthcare facilities participated (response rate: 53.9%). Approximately 25% of doctors (n = 77) previously took care of COVID-19 patients, and 173 (56.2%) have institutional COVID-19 approach protocols. Only 57 doctors (18.5%) reported all PPE (Personal Protective Equipment) available. The self-reported s...
International Journal of Environmental Research and Public Health
Vaccination is the most promising strategy to counter the spread of Coronavirus Disease 2019 (COV... more Vaccination is the most promising strategy to counter the spread of Coronavirus Disease 2019 (COVID-19). Vaccine hesitancy is a serious global phenomenon, and therefore the aim of this cross-sectional study was to explore the effect of educational background, work field, and social media on attitudes towards vaccination in Jordan. We compared between medical personnel who were in direct contact with patients and non-medical individuals at Jordan University Hospital in terms of demographics, knowledge about COVID-19 vaccines, rumors received via social media, their trust in these vaccines, and the encouraging factors for vaccination. 646 individuals were enrolled in this study, of which 287 (44.4%) were from medical field, and 359 (55.6%) from non-medical field. 226 (35%) were planning to take the vaccine once available, with a positive response from 131 (45.6%) medical field workers, compared to 94 (26.2%) non-medical individuals (p < 0.001). The social media rumor that was belie...
Abdelkarim S AlOweidi 1 MD , FACHARZT, Mahmoud M Al-Mustafa 1 MD, FACHARZT, Jihad M. Al Ajlouni 2... more Abdelkarim S AlOweidi 1 MD , FACHARZT, Mahmoud M Al-Mustafa 1 MD, FACHARZT, Jihad M. Al Ajlouni 2 MD,FRCSI(Orth.& Trauma). Diana F. Mas'ad 3 MD, Mohammad Q Hamdan 2 MD, Subhi M Alghanem 1 MD, FFARCSI, Ibraheem Y.Qudaisat 1 MD, Sami A. Abu ...
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