Mohamed Daabiss

Bio: Mohamed Daabiss is an academic researcher from Pharos University in Alexandria. The author has contributed to research in topics: Tracheal intubation & Lornoxicam. The author has an hindex of 6, co-authored 16 publications receiving 545 citations. Previous affiliations of Mohamed Daabiss include Riyadh Military Hospital.

American Society of Anaesthesiologists physical status classification

Abstract: Although the American Society of Anaesthesiologists' (ASA) classification of Physical Health is a widely used grading system for preoperative health of the surgical patients, multiple variations were observed between individual anaesthetist's assessments when describing common clinical problems. This article reviews the current knowledge and evaluation regarding ASA Classification of Physical Health as well as trials for possible modification.

Assessment of different concentration of Ketofol in procedural operation.

Abstract: Propofol is an IV anesthetic that is often used as an adjuvant during monitored anesthesia care, the addition of ketamine to propofol may counteract the cardiorespiratory depression seen with propofol used alone. Ketofol (ketamine/propofol combination) was used for procedural sedation and analgesia. However, evaluation of the effectiveness of different concentrations of Ketofol in procedural operation regarding changes in haemodynamics, emergence phenomena, recovery time, the doses, and adverse effects was not yet studied, so this randomized, double blinded study was designed to compare the quality of analgesia and side effects of intravenous different concentrations of ketofol in hundred children of both sex undergoing procedural operation, e.g. esophgoscopy, rectoscopy, bone marrow aspiration and liver biopsy participated in this randomized, double-blinded study. Patients received an infusion of a solution containing either combination of propofol: ketamine (1:1) (Group I) or propofol: ketamine (4:1) (Group II). Subsequent infusion rates to a predetermined sedation level using Ramsay Sedation Scale. Heart rate, noninvasive arterial blood pressure (NIBP), oxygen saturation (SpO2), end tidal carbon dioxide (Etco2) and incidence of any side effects were recorded. There were no significant hemodynamic changes in both groups after induction. However, there was an increase in postoperative nausea , psychomimetic side effects, and delay in discharge times with the largest ketamine dosage (Group I). We concluded that the adjunctive use of smaller dose of ketamine in ketofol combination minimizes the psychomimetic side effects and shorten the time to discharge.

Assessment of different concentrations of ketofol in procedural operations

Abstract: Background. Propofol is an intravenous anesthetic that is often used as an adjuvant during monitored anesthesia care, the addition of ketamine to propofol may counteract the cardiorespiratory depression seen with propofol used alone. Ketofol (ketamine/propofol combination) was used for procedural sedation and analgesia. However, evaluation of the effectiveness of different concentrations of Ketofol in procedural operation regarding changes in haemodynamics, emergence phenomena, recovery time, the doses, and adverse effects was not yet studied, so this randomized, double blinded study was designed to compare the quality of analgesia and side effects of intravenous different concentrations of ketofol Patient and Methods. One hundred children of both sex undergoing procedural operation, e.g. esophgoscopy, rectoscopy, bone marrow aspiration and liver biopsy participated in this. Patients received an infusion of a solution containing either combination of propofol: ketamine (1:1) (Group I) or propofol: ketamine (4:1) (Group II). Subsequent infusion rates to a predetermined sedation level using Ramsay Sedation Scale. Heart rate, noninvasive arterial blood pressure (NIBP), oxygen saturation (SpO2), end tidal carbon dioxide (Etco 2 ) and incidence of any side effects were recorded. Results. There were no significant hemodynamic changes in both groups after induction. However, there was an increase in postoperative nausea, psychomimetic side effects, and delay in discharge times in group I compared to group II. Conclusion. The adjunctive use of smaller dose of ketamine in ketofol combination minimizes the psychomimetic side effects and shortens the time of hospital discharge.

Evaluation of the effect of magnesium vs. midazolam as adjunct to epidural bupivacaine in patients undergoing total knee replacement

Abstract: Background and objectives: Effective pain management is an important component of intraoperative and postsurgical care; it can prevent pain related clinical complications and improve the patient quality of life. This prospective, randomized, double-blind study was designed to evaluate analgesic efficacy of adding magnesium and midazolam to epidural bupivacaine in patients undergoing total knee replacement. Methods: 120 patients ASA I and II, undergoing total knee replacement surgery were enrolled to receive either bupivacaine 0.5 % or bupivacaine 0.5 % plus magnesium sulphate 50 mg as an initial bolus dose followed by a continuous infusion of 10 mg/h or bupivacaine 0.5 % plus midazolam 0.05 mg/kg as intraoperative epidural analgesia. Postoperatively, all patients were equipped with a patient-controlled epidural analgesia device. Heart rate, mean arterial pressure, oxygen saturation, respiratory rate, pain assessment using a visual analogue scale (VAS),sedation score, patients’ first analgesic requirement times and postoperative fentanyl consumption were recorded. Results: The intraoperative VAS was significantly less in magnesium and midazolam groups. Whereas, in the first postoperative hour, VAS was significantly less in magnesium group. The postoperative rescue analgesia as well as the PCEA fentanyl consumption was significantly reduced in magnesium group. Conclusion: Co-administration of epidural magnesium provides better intraoperative analgesia as well as analgesic-sparing effect on PCEA consumption

Perioperative Anesthetic Management of a Case with Severe Dilated Cardiomyopathy

Abstract: Dilated cardiomyopathy (DCM) is characterized by dilatation and impaired systolic function of one or both ventricles. Five to eight people per 100,000 develop this disorder each year. It is more common in men. Malignant arrhythmias are the most common cause of death in DCM1. Around 50% of cases of nonischaemic dilated cardiomyopathy are idiopathic. Other causes are familial, infectious, infi ltrative and connective tissue diseases. Thi s is a report of successful anesthetic management of a patient with severe DCM undergoing a surgical procedure using combined thoracic epidural analgesia (TEA) and general anesthesia (GA).

Low risk of thromboembolic complications with tranexamic acid after primary total hip and knee arthroplasty.

Abstract: Background The use of antifibrinolytic medications in hip and knee arthroplasty reduces intraoperative blood loss and decreases transfusion rates postoperatively. Tranexamic acid (TXA) specifically has not been associated with increased thromboembolic (TE) complications, but concerns remain about the risk of symptomatic TE events, particularly when less aggressive chemical prophylaxis methods such as aspirin alone are chosen.

Postoperative pain treatment after total knee arthroplasty: A systematic review.

Abstract: Introduction The aim of this systematic review was to document efficacy, safety and quality of evidence of analgesic interventions after total knee arthroplasty (TKA). Methods This PRISMA-compliant and PROSPERO-registered review includes all-language randomized controlled trials of medication-based analgesic interventions after TKA. Bias was evaluated according to Cochrane methodology. Outcomes were opioid consumption (primary), pain scores at rest and during mobilization, adverse events, and length of stay. Interventions investigated in three or more trials were meta-analysed. Outcomes were evaluated using forest plots, Grading of Recommendations Assessment, Development and Evaluation (GRADE), L’Abbe Plots and trial sequential analysis. Results The included 113 trials, investigating 37 different analgesic interventions, were characterized by unclear/high risk of bias, low assay sensitivity and considerable differences in pain assessment tools, basic analgesic regimens, and reporting of adverse events. In meta-analyses single and continuous femoral nerve block (FNB), intrathecal morphine, local infiltration analgesia, intraarticular injection of local anaesthetics, non-steroidal anti-inflammatory drugs, and gabapentinoids demonstrated significant analgesic effects. The 24-hour morphine-sparing effects ranged from 4.2 mg (CI: 1.3, 7.2; intraarticular local anaesthetics), to 16.6 mg (CI: 11.2, 22; single FNB). Pain relieving effects at rest at 6 hours ranged from 4 mm (CI: -10, 2; gabapentinoids), to 19 mm (CI: 8, 31; single FNB), and at 24 hours from 3 mm (CI: -2, 8; gabapentinoids), to 16 mm (CI: 8, 23; continuous FNB). GRADE-rated quality of evidence was generally low. Conclusion A low quality of evidence, small sample sizes and heterogeneity of trial designs prohibit designation of an optimal procedure-specific analgesic regimen after TKA.

Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta‐analysis

Abstract: This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To compare the efficacy and safety of different prophylactic pharmacological interventions (antiemetic drugs) either against no treatment, placebo or against each other (as mono- or combination prophylaxis) for the prevention of postoperative nausea and vomiting in adults undergoing any type of surgery under general anaesthesia. To explore the best dose or dose range of the antiemetic drugs in terms of efficacy and safety. To generate a clinically useful ranking of antiemetic drugs (mono- and combination prophylaxis) according to efficacy and safety.

Economic impact of tranexamic acid in healthy patients undergoing primary total hip and knee arthroplasty.

Abstract: Tranexamic acid (TA) has been shown to reduce perioperative blood loss and blood transfusion. While concern remains about the cost of antifibrinolytic medication, we hypothesized that routine use of tranexamic acid would result in lower direct hospital total cost by decreasing costs associated with blood transfusion, laboratory testing, and room & board. Patients with an American Society of Anesthesiologists (ASA) class II or less undergoing primary total hip or knee arthroplasty at a single institution during 2007–2008 were retrospectively reviewed. The estimated mean direct hospital total cost, operating room, blood/lab, room & board, and pharmacy costs were compared between patients who did and did not receive TA. The study population included 1018 patients, and 580 patients received TA. The mean direct total cost of hospitalization with and without TA was $15,099 and $15,978 ( P P

Using the ACS-NSQIP to identify factors affecting hospital length of stay after elective posterior lumbar fusion

Abstract: Study Design Retrospective cohort study of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2010 that included 1,861 patients who had undergone elective posterior lumbar fusion.