Browsing by Author "Kiyaka, Sonye Magugu"

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Local anesthesia versus saddle block for open hemorrhoidectomy: cost-analysis from a randomized, double blind controlled trial
(BMC Springer Nature, 2023-11-22) Sikakulya, Franck Katembo; Ssebuufu, Robinson; Okedi, Francis Xaviour; Baluku, Moris; Lule, Herman; Kiyaka, Sonye Magugu; Muhumuza, Joshua; Molen, Selamo Fabrice; Bassara, Godefroy Nyenke; Waziri, Musa Abbas; Kithinji, Stephen Mbae; Mugisho Munyerenkana, Leocadie; Kagenderezo, Byamungu Pahari; Munihire, Jeannot Baanitse; Vahwere, Bienfait Mumbere; Kiswezi, Ahmed; Kyamanywa, Patrick
Despite the benefits attributed to the use of local anesthesia (LA) for open hemorrhoidectomy (OH) in developed countries, this technique is still not considered as the first line technique in low-income countries such as Uganda; therefore, we aimed at comparing the cost of OH under LA versus Saddle block among patients with 3rd or 4th degree hemorrhoids. This trial was conducted from December 2021 to May 2022 among patients with primary uncomplicated 3rd or 4th degree hemorrhoids. The operating time, and direct costs in (US$) including medical and non-medical were recorded. We analysed the cost in the two groups (local anesthesia versus saddle block) using SPSS version 23.0. Findings of fifty-eight patients were analysed including 29 participants per group. There was a significant difference in operating time and cost among the two groups (p<0.05). The mean operating time was 15.52±5.34(SD) minutes versus 33.72±11.54 min for OH under LA and SB respectively. The mean cost of OH under LA was 57.42±8.90 US$ compared to 63.38±12.77US$ in SB group. The use of local anesthesia for OH was found to have less operating time with high-cost effectiveness. Being affordable, local anesthesia can help to increase the turnover of patients who would otherwise wait for the availability of anesthesia provider. Policy makers should emphasize its applicability in low-income settings to help in the achievement of 2030 global surgery goals.
Pain assessment following open hemorrhoidectomy under local anesthesia versus saddle block: a multicenter randomized controlled trial
(BMC Springer Nature, 2023-05-12) Sikakulya, Franck Katembo; Ssebuufu, Robinson; Okedi, Francis Xaviour; Baluku, Moris; Lule, Herman; Kiyaka, Sonye Magugu; Kyamanywa, Patrick
There is disparity in evidence on pain assessment post open hemorrhoidectomy (OH) using local anesthesia and its use in developing countries compared to developed countries. Therefore, we conducted this study to assess the occurrence of postoperative pain following open hemorrhoidectomy under local anesthesia versus saddle block for uncomplicated 3rd or 4th degree hemorrhoids. This was a prospective equivalence randomized, double blind controlled trial conducted from December 2021 to May 2022 among patients with primary uncomplicated 3rd or 4th degree hemorrhoids. Pain severity was assessed at 2, 4 and 6 h post open hemorrhoidectomy using visual analogue scale (VAS). Data was analysed using SPSS version 26 at a p<0.05 as statically signifcant using visual analogue scale (VAS). We recruited 58 participants in this study who underwent open hemorrhoidectomy under local anesthesia or saddle block (29 participants per group). The sex ratio was of 1.15 of female to male and a mean age of 39±13. VAS was found to be diferent at 2 h post OH compare to other time of pain assessment but not statically signifcant by area under the cover (AUC) (95% CI=486–0.773: AUC=0.63; p=0.09) with a none signifcance by Kruskal–Wallis’s test (p:0.925). Local anesthesia was found to be having a similar pain severity occurrence in post operative period among patients undergoing open hemorrhoidectomy for primary uncomplicated 3rd or 4th degree hemorrhoids. Close monitoring of pain in postoperative period is mandatory especially at 2 h to assess need of analgesia.
Surgery of COVID-19-infected patients in Africa: a scoping
(Annals of African Surgery, 2021) Sikakulya, Franck K; Soria, Jorge; Ssebuufu, Robinson; Kiyaka, Sonye Magugu; Molen, Selamo Fabrice; Kyamanywa, Patrick
Objective: The aim of this scoping review was to highlight the nature and scope of research and publications about surgery in COVID-19-infected patients in Africa in order to inform guidelines applicable in Africa. Methods: We considered peerreviewed and gray literature from PubMed, Google Scholar, and Word Health Organization COVID-19 online databases published from February 1, 2020, to February 28, 2021, about surgery for/in COVID-19- infected patients. The review is reported using the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews. Results: of 530 studies screened, only 11 (2.08%) were found eligible, including 4 cohort studies, 3 cross-sectional studies, 2 letters to the editor, 1 case series, and 1 review. The key emphasis areas by the eligible studies were vaccination, testing prior to surgery, clinical guidelines to reduce complications related to COVID-19 among infected patients, and protection of the surgical team. Conclusion: There is a dearth of studies on surgery in COVID-19-infected patients in Africa. There is an urgent need for more reports and publications from the African experiences so as to inform contextualized guidelines for surgical care in low-resource settings during the COVID-19 pandemic.