Browsing by Author "Kasumba, John Mark"

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    Analgesic Effects of Preincision Ketamine on Postspinal Caesarean Delivery in Uganda’s Tertiary Hospital: A Randomized Clinical Trial
    (Anesthesiology Research and Practice, 2017) Mwase, Richard; Luggya, Tonny Stone; Kasumba, John Mark; Wanzira, Humphrey; Kintu, Andrew; Obua, Daniel
    Good postoperative analgesic management improves maternal satisfaction and care of the neonate. Postoperative pain management is a challenge in Mulago Hospital, yet ketamine is accessible and has proven benefit. We determined ketamine’s postoperative analgesic effects. Materials and Methods. We did an RCT among consenting parturients that were randomized to receive either intravenous ketamine (0.25 mg/kg) or placebo after spinal anesthetic. Pain was assessed every 30 mins up to 24 hours postoperatively using the numerical rating scale. The first complaint of pain requiring treatment was noted as “time to first breakthrough pain.” Results. We screened 100 patients and recruited 88 that were randomized into two arms of 44 patients that received either ketamine or placebo. Ketamine group had 30-minute longer time to first breakthrough pain and lower 24-hour pain scores. Postoperative diclofenac consumption was lesser in the ketamine group compared to placebo and Kaplan-Meier graphs showed a higher probability of experiencing breakthrough pain earlier in the placebo group. Conclusion. Preincision intravenous ketamine (0.25 mg/kg) offered 30-minute prolongation to postoperative analgesia requirement with reduced 24-hour pain scores. We recommend larger studies to explore this benefit. This trial is registered with Pan African Clinical Trial Registry number PACTR201404000807178.
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    Knowledge, Attitudes and Practices Regarding Use of Local Anaesthetics Among Non-Anaesthesia Healthcare Professionals at Mulago National Referral Hospital
    (Dove, 2024-03) Abdi, Intisar Ahmed; Kasumba, John Mark; Wabule, Agnes; Nabukenya, Mary T; Kayongo, Joseph; Kyoheirwe, Bernadette; Sheikdon, Abdirizak Abdullahi; Osman, Kamaludin D
    Abstract Intisar Ahmed Abdi,1 John Mark Kasumba,1 Agnes Wabule,1 Mary T Nabukenya,1 Joseph Kayongo,1 Bernadette Kyoheirwe,1 Abdirizak Abdullahi Sheikdon,2 Kamaludin D Osman3 1Department of Anaesthesia and Critical Care, Makerere University, Kampala, Uganda; 2Department of Orthopedics, Royal Hospital, Mogadishu, Somalia; 3Department of General Surgery, Royal Hospital, Mogadishu, SomaliaCorrespondence: Intisar Ahmed Abdi, Department of Anaesthesia and Critical Care, Makerere University, Kampala, Uganda, Tel +256762635165, Email dr.intisar16@gmail.comIntroduction: Local anaesthetics (LA) are commonly used in dental and surgical emergency wards by both anaesthesia professionals and non-anaesthesia professionals. Anecdotal evidence shows that non-anaesthesia health-care professionals do not monitor vital signs during the use of local anaesthesia, and there are no standard hospital guidelines on the use of LA and management of LA toxicity by non-anaesthesia professionals.Purpose: This study sought to assess the knowledge, attitudes and practices regarding local anaesthetic use among non-anaesthesia health-care professionals at Mulago National Referral Hospital.Patients and Methods: This was a cross-sectional study that utilized a quantitative research approach. The sample size of the study was 43 non-anaesthesia healthcare professionals from the casualty and surgical outpatient wards and Mulago dental ward. Data was collected using a questionnaire and analyzed using STATA 15.Results: Overall, 66.67% of the Specialist, 76.47% of the senior house officers, 100% of medical officers, and 80% of the clinical orthopedic house officers had unsatisfactory levels of knowledge in Mulago casualty and surgical outpatient wards. 20% of the specialist and 16.67% of the senior house officers had unsatisfactory levels of knowledge in Mulago dental ward. 87.5% of the non-anaesthesia health-care professionals do not give a test dose on a routine basis in Mulago casualty and surgical outpatient wards. A total of 63.64% of the non-anaesthesia healthcare professionals in Mulago dental ward do not sterilize the site of injection.Conclusion: Non-anaesthesia health-care professionals had unsatisfactory levels of knowledge, somewhat good practices, and negative attitudes toward LA use.Keywords: local anesthetics, LA toxicity, non-anaesthesia healthcare professionals, knowledge, attitude, practices