The modern practice of anesthesia is challenged with highly complex operating room environment an... more The modern practice of anesthesia is challenged with highly complex operating room environment and ever increasing number of tasks requiring the anesthesiologist’s undivided instantaneous attention. Automation of repetitive tasks and risky procedures, coupled with clinical decision support, helps to improve safety and reduce stress. Varying degrees of progress have been made in developing robots to undertake various individual components of the anesthesiologist’s multifaceted clinical practice; some semi-autonomous drug delivery systems have reached the stage of obtaining regulatory approvals, whereas fully or semi-automatic mechanical robots undertaking a few procedures are still under research. The current COVID-19 pandemic has highlighted the need to innovate machines to perform mechanical tasks avoiding proximity to the patient’s airway to protect the anesthesia staff from catching infection. This editorial presents a snapshot of the current status of these devices, and attempts...
Technological advances are leading to the possibility of remotely controlled or veven completely ... more Technological advances are leading to the possibility of remotely controlled or veven completely autonomous delivery of anesthesia. Advances in other specialties, as well as the paradigm shift towards functional medicine, are promising improvement in overall state of health, and reducing the numbers and types of surgical procedures, thereby reducing the required numbers of the relevant workforce, including anesthetists, in future. The specialty of anesthesia needs to transform into a more over-arching role of perioperative medicine in order to stay relevant.
This editorial considers studies which establish our current understanding of SARS-CoV-2 and the ... more This editorial considers studies which establish our current understanding of SARS-CoV-2 and the indicated direction for treatment of COVID-19 patients and future research. Recent modelling studies point to the effect of SARS-CoV-2 on hemoglobin as a key element in understanding the pathogenesis of COVID-19. This would suggest that the focus of treatment of COVID-19 would need to shift towards maintaining the oxygen carrying capacity of blood; potentially with blood transfusions and super-oxygenation, perhaps including hyperbaric oxygen therapy. Further, early prevention of thromboembolism, and suppression of the immune response due to hemoglobin damage, may help contain the clinical course. Citation: Majeed A, Shajar MA. Is hemoglobin the missing link in the pathogenesis of COVID-19? Anaesth pain intensive care 2020;24(1):_ DOI: https://DOI.org/10.35975/apic.v24i1. Received : 4 March 2020; Reviewed & Accepted : 6 March 2020;
There are well-defined legal requirements for the safe storage, handling and disposal of controll... more There are well-defined legal requirements for the safe storage, handling and disposal of controlled drugs (CDs): The Misuse of Drugs Act 1971, and Safer Management of Controlled Drugs (Department of Health, 2007). Clinical staff involved in the prescription and administration of CDs to patients are responsible and accountable for the appropriate disposal of these drugs because of the risk of substance abuse. A review of current practice, as followed by staff involved in the use and disposal of CDs, has been evaluated in a multi-centre audit. This audit showed that a wide variation in attitude towards disposal of CDs exists among medical and non-medical staff, and that the sample hospitals are falling short of meeting proposed standards.
The coronavirus disease 2019 (COVID–19) pandemic, caused by the severe acute respiratory syndrome... more The coronavirus disease 2019 (COVID–19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), is still unravelling, and is expected to last for an indefinite time. The historical experience with similar pandemics in the past, and the nature of the viral illnesses as such, explains that not only the mental illnesses worsen in the existing patients during pandemics the new diagnoses increase as well and outlive the pandemic itself. This not only has profound effect on the wellbeing of the survivors of pandemics, the healthcare workers, and the general public alike, the financial implications and restructuring of the social fabric cannot be over stated. There is an urgent need to identify these risks and start planning to devise and implement strategies for effective mental health damage prevention and control. Key words: COVID–19; Pandemic; Anxiety; Depression; Mental health; Healthcare workers; Post–traumatic stress; Psychological distress, Artificial ...
Over the period of four months, corona virus has conquered the world. The rapidity of the spread ... more Over the period of four months, corona virus has conquered the world. The rapidity of the spread of the disease from country to country, and the rapidity of the clinical deterioration of the patients perplexed the medical fraternity. Every day, extremely variable presentation of the signs and symptoms in the same patient as well as from the different patients, left the treating physicians guessing about the most fitting model of pathogenesis and the most suitable or effective treatment modality.
With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically ... more With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically corrected kyphoscoliosis are likely to present for cesarean section (CS) or vaginal delivery requiring anesthesia or analgesia. Despite the surgical correction, these patients have poor cardiopulmonary reserves which increase the risks associated with general anesthesia. Whereas altered vertebral anatomy from previous surgery and the presence of metal work in spine make performing of regional anesthesia (RA) difficult and unpredictable, we report anesthetic management of such a patient who underwent CS using continuous spinal anesthesia technique. Challenges of placement of a spinal catheter in such a patient are discussed, and use of ultrasonography to circumnavigate these challenges is described. We propose that ultrasound can prove extremely valuable in performing of RA in patients with surgically corrected kyphoscoliosis. We could not find a similar case report from Saudi Arabia in the published literature.
The brachial plexus block is a commonly performed procedure in the anesthetic practice today. It ... more The brachial plexus block is a commonly performed procedure in the anesthetic practice today. It is performed for analgesia as well as anesthesia for upper limb procedures. It has been used for amputation and replantation surgeries of the upper limb. We present the case of a 68-year-old gentleman who had brachial plexus block at supraclavicular and interscalene levels as the sole anesthetic for undergoing above elbow amputation. He was deemed to be very high risk for a general anesthetic as he suffered from severe chronic obstructive pulmonary disease (COPD) and a very poor exercise tolerance (NYHA Class III). The supraclavicular brachial plexus block was supplemented with an interscalene brachial plexus block due to inadequate surgical anesthesia encountered with the former. The procedure was successfully completed under regional anesthesia. The brachial plexus block can be performed at different levels in the same patient to achieve desired results, while employing sound anatomica...
This editorial considers studies which establish our current understanding of SARS-CoV-2 and the ... more This editorial considers studies which establish our current understanding of SARS-CoV-2 and the indicated direction for treatment of COVID-19 patients and future research. Recent modelling studies point to the effect of SARS-CoV-2 on hemoglobin as a key element in understanding the pathogenesis of COVID-19. This would suggest that the focus of treatment of COVID-19 would need to shift towards maintaining the oxygen carrying capacity of blood; potentially with blood transfusions and super-oxygenation, perhaps including hyperbaric oxygen therapy. Further, early prevention of thromboembolism, and suppression of the immune response due to hemoglobin damage, may help contain the clinical course.
The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome... more The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is still unravelling, and is expected to last for an indefinite time. The historical experience with similar pandemics in the past, and the nature of the viral illnesses as such, explains that not only the mental illnesses worsen in the existing patients during pandemics the new diagnoses increase as well and outlive the pandemic itself. This not only has profound effect on the wellbeing of the survivors of pandemics, the healthcare workers, and the general public alike, the financial implications and restructuring of the social fabric cannot be over stated. There is an urgent need to identify these risks and start planning to devise and implement strategies for effective mental health damage prevention and control.
The modern practice of anesthesia is challenged with highly complex operating room environment an... more The modern practice of anesthesia is challenged with highly complex operating room environment and ever increasing number of tasks requiring the anesthesiologist's undivided instantaneous attention. Automation of repetitive tasks and risky procedures, coupled with clinical decision support, helps to improve safety and reduce stress. Varying degrees of progress have been made in developing robots to undertake various individual components of the anesthesiologist's multifaceted clinical practice; some semi-autonomous drug delivery systems have reached the stage of obtaining regulatory approvals, whereas fully or semi-automatic mechanical robots undertaking a few procedures are still under research. The current COVID-19 pandemic has highlighted the need to innovate machines to perform mechanical tasks avoiding proximity to the patient's airway to protect the anesthesia staff from catching infection. This editorial presents a snapshot of the current status of these devices, and attempts to envisage a roadmap for further development.
Technological advances are leading to the possibility of remotely controlled or veven completely ... more Technological advances are leading to the possibility of remotely controlled or veven completely autonomous delivery of anesthesia. Advances in other specialties, as well as the paradigm shift towards functional medicine, are promising improvement in overall state of health, and reducing the numbers and types of surgical procedures, thereby reducing the required numbers of the relevant workforce, including anesthetists, in future. The specialty of anesthesia needs to transform into a more over-arching role of perioperative medicine in order to stay relevant.
The modern practice of anesthesia is challenged with highly complex operating room environment an... more The modern practice of anesthesia is challenged with highly complex operating room environment and ever increasing number of tasks requiring the anesthesiologist’s undivided instantaneous attention. Automation of repetitive tasks and risky procedures, coupled with clinical decision support, helps to improve safety and reduce stress. Varying degrees of progress have been made in developing robots to undertake various individual components of the anesthesiologist’s multifaceted clinical practice; some semi-autonomous drug delivery systems have reached the stage of obtaining regulatory approvals, whereas fully or semi-automatic mechanical robots undertaking a few procedures are still under research. The current COVID-19 pandemic has highlighted the need to innovate machines to perform mechanical tasks avoiding proximity to the patient’s airway to protect the anesthesia staff from catching infection. This editorial presents a snapshot of the current status of these devices, and attempts...
Technological advances are leading to the possibility of remotely controlled or veven completely ... more Technological advances are leading to the possibility of remotely controlled or veven completely autonomous delivery of anesthesia. Advances in other specialties, as well as the paradigm shift towards functional medicine, are promising improvement in overall state of health, and reducing the numbers and types of surgical procedures, thereby reducing the required numbers of the relevant workforce, including anesthetists, in future. The specialty of anesthesia needs to transform into a more over-arching role of perioperative medicine in order to stay relevant.
This editorial considers studies which establish our current understanding of SARS-CoV-2 and the ... more This editorial considers studies which establish our current understanding of SARS-CoV-2 and the indicated direction for treatment of COVID-19 patients and future research. Recent modelling studies point to the effect of SARS-CoV-2 on hemoglobin as a key element in understanding the pathogenesis of COVID-19. This would suggest that the focus of treatment of COVID-19 would need to shift towards maintaining the oxygen carrying capacity of blood; potentially with blood transfusions and super-oxygenation, perhaps including hyperbaric oxygen therapy. Further, early prevention of thromboembolism, and suppression of the immune response due to hemoglobin damage, may help contain the clinical course. Citation: Majeed A, Shajar MA. Is hemoglobin the missing link in the pathogenesis of COVID-19? Anaesth pain intensive care 2020;24(1):_ DOI: https://DOI.org/10.35975/apic.v24i1. Received : 4 March 2020; Reviewed & Accepted : 6 March 2020;
There are well-defined legal requirements for the safe storage, handling and disposal of controll... more There are well-defined legal requirements for the safe storage, handling and disposal of controlled drugs (CDs): The Misuse of Drugs Act 1971, and Safer Management of Controlled Drugs (Department of Health, 2007). Clinical staff involved in the prescription and administration of CDs to patients are responsible and accountable for the appropriate disposal of these drugs because of the risk of substance abuse. A review of current practice, as followed by staff involved in the use and disposal of CDs, has been evaluated in a multi-centre audit. This audit showed that a wide variation in attitude towards disposal of CDs exists among medical and non-medical staff, and that the sample hospitals are falling short of meeting proposed standards.
The coronavirus disease 2019 (COVID–19) pandemic, caused by the severe acute respiratory syndrome... more The coronavirus disease 2019 (COVID–19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), is still unravelling, and is expected to last for an indefinite time. The historical experience with similar pandemics in the past, and the nature of the viral illnesses as such, explains that not only the mental illnesses worsen in the existing patients during pandemics the new diagnoses increase as well and outlive the pandemic itself. This not only has profound effect on the wellbeing of the survivors of pandemics, the healthcare workers, and the general public alike, the financial implications and restructuring of the social fabric cannot be over stated. There is an urgent need to identify these risks and start planning to devise and implement strategies for effective mental health damage prevention and control. Key words: COVID–19; Pandemic; Anxiety; Depression; Mental health; Healthcare workers; Post–traumatic stress; Psychological distress, Artificial ...
Over the period of four months, corona virus has conquered the world. The rapidity of the spread ... more Over the period of four months, corona virus has conquered the world. The rapidity of the spread of the disease from country to country, and the rapidity of the clinical deterioration of the patients perplexed the medical fraternity. Every day, extremely variable presentation of the signs and symptoms in the same patient as well as from the different patients, left the treating physicians guessing about the most fitting model of pathogenesis and the most suitable or effective treatment modality.
With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically ... more With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically corrected kyphoscoliosis are likely to present for cesarean section (CS) or vaginal delivery requiring anesthesia or analgesia. Despite the surgical correction, these patients have poor cardiopulmonary reserves which increase the risks associated with general anesthesia. Whereas altered vertebral anatomy from previous surgery and the presence of metal work in spine make performing of regional anesthesia (RA) difficult and unpredictable, we report anesthetic management of such a patient who underwent CS using continuous spinal anesthesia technique. Challenges of placement of a spinal catheter in such a patient are discussed, and use of ultrasonography to circumnavigate these challenges is described. We propose that ultrasound can prove extremely valuable in performing of RA in patients with surgically corrected kyphoscoliosis. We could not find a similar case report from Saudi Arabia in the published literature.
The brachial plexus block is a commonly performed procedure in the anesthetic practice today. It ... more The brachial plexus block is a commonly performed procedure in the anesthetic practice today. It is performed for analgesia as well as anesthesia for upper limb procedures. It has been used for amputation and replantation surgeries of the upper limb. We present the case of a 68-year-old gentleman who had brachial plexus block at supraclavicular and interscalene levels as the sole anesthetic for undergoing above elbow amputation. He was deemed to be very high risk for a general anesthetic as he suffered from severe chronic obstructive pulmonary disease (COPD) and a very poor exercise tolerance (NYHA Class III). The supraclavicular brachial plexus block was supplemented with an interscalene brachial plexus block due to inadequate surgical anesthesia encountered with the former. The procedure was successfully completed under regional anesthesia. The brachial plexus block can be performed at different levels in the same patient to achieve desired results, while employing sound anatomica...
This editorial considers studies which establish our current understanding of SARS-CoV-2 and the ... more This editorial considers studies which establish our current understanding of SARS-CoV-2 and the indicated direction for treatment of COVID-19 patients and future research. Recent modelling studies point to the effect of SARS-CoV-2 on hemoglobin as a key element in understanding the pathogenesis of COVID-19. This would suggest that the focus of treatment of COVID-19 would need to shift towards maintaining the oxygen carrying capacity of blood; potentially with blood transfusions and super-oxygenation, perhaps including hyperbaric oxygen therapy. Further, early prevention of thromboembolism, and suppression of the immune response due to hemoglobin damage, may help contain the clinical course.
The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome... more The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is still unravelling, and is expected to last for an indefinite time. The historical experience with similar pandemics in the past, and the nature of the viral illnesses as such, explains that not only the mental illnesses worsen in the existing patients during pandemics the new diagnoses increase as well and outlive the pandemic itself. This not only has profound effect on the wellbeing of the survivors of pandemics, the healthcare workers, and the general public alike, the financial implications and restructuring of the social fabric cannot be over stated. There is an urgent need to identify these risks and start planning to devise and implement strategies for effective mental health damage prevention and control.
The modern practice of anesthesia is challenged with highly complex operating room environment an... more The modern practice of anesthesia is challenged with highly complex operating room environment and ever increasing number of tasks requiring the anesthesiologist's undivided instantaneous attention. Automation of repetitive tasks and risky procedures, coupled with clinical decision support, helps to improve safety and reduce stress. Varying degrees of progress have been made in developing robots to undertake various individual components of the anesthesiologist's multifaceted clinical practice; some semi-autonomous drug delivery systems have reached the stage of obtaining regulatory approvals, whereas fully or semi-automatic mechanical robots undertaking a few procedures are still under research. The current COVID-19 pandemic has highlighted the need to innovate machines to perform mechanical tasks avoiding proximity to the patient's airway to protect the anesthesia staff from catching infection. This editorial presents a snapshot of the current status of these devices, and attempts to envisage a roadmap for further development.
Technological advances are leading to the possibility of remotely controlled or veven completely ... more Technological advances are leading to the possibility of remotely controlled or veven completely autonomous delivery of anesthesia. Advances in other specialties, as well as the paradigm shift towards functional medicine, are promising improvement in overall state of health, and reducing the numbers and types of surgical procedures, thereby reducing the required numbers of the relevant workforce, including anesthetists, in future. The specialty of anesthesia needs to transform into a more over-arching role of perioperative medicine in order to stay relevant.
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Papers by Amer Majeed