Dr. Endale Gebreegziabher Gebremedhn
@uog.edu.et
Department of Aanaesthesia, School of Medicine, Gondar College of Medicine and Health Sciences.
University of Gondar
EDUCATION
1. PhD in OXINP and treatment (2022), Western Sydney University, Australia.
2. MSc in Advanced Clinical Anaesthesia (2012) and BSc in Anaesthesia (2008), University of Gondar, Ethiopia
RESEARCH INTERESTS
Mechanisms and management of perioperative pain, chemotherapy-induced neuropathic pain management, regional anaesthesia (nerve blocks), perioperative anaesthetic patient care, resuscitation, perioperative patient care, perioperative patient safety and outcome, critical care and .clinical trials.
Scopus Publications
Scopus Publications
Atalay Eshetie Demilie, Zewditu Abdissa Denu, Yosef Belay Bizuneh, and Endale Gebreegziabher Gebremedhn
Springer Science and Business Media LLC
Abstract Background Failed spinal anaesthesia causes prolonging of operation time, insufficient analgesia for surgery and needs repeating spinal anaesthesia which in turn causes local anaesthesia toxicity, high spinal and total spinal, and conversion to general anaesthesia. However, the problem remains unexplored in Amhara regional state comprehensive specialized hospitals. Objective To determine incidence and factors associated with failed spinal anaesthesia among patients undergoing surgery in selected Amhara National Regional State comprehensive specialized hospitals, Northwest Ethiopia, 2023. Methods Multi-center prospective observational study was conducted. Data was collected using questionnaire and checklist. All consecutive scheduled emergency and elective patients were included in the study. Data was transformed from Epi data to SPSS and logistic regression analysis was done. Both crude and adjusted odds ratio were used to assess the strength of association. Variables with a p-value of less than 0.05 were considered as statistically significant. Results A total of 532 patients were included in this study with a response rate of 98%. Incidence of failed spinal anaesthesia was 22.4% (CI = 19-25.9). Emergency surgery (AOR = 7.01, CI = 4.5–12.7), dose of bupivacaine of ≤ 10 mg (AOR = 3.02, CI = 1.3–10.2), work experience of anaesthetist < 2 years (AOR = 3.1, CI = 1.7–5.72), bloody CSF (AOR = 8.5, CI = 2.53–18.5), hyperbaric local anaesthetic drug (AOR = 3.3, 95% CI = 3.2–8.2) and local anaesthetist without adjuvants (AOR = 5.25, CI = 2.62–14.2) were associated failed spinal anaesthesia. Conclusion and recommendation The incidence of failed spinal anaesthesia was high in Amhara Region comprehensive specialized hospitals. We suggest that anaesthesia providers should minimize failure by using adjuvants and appropriate dose of local anaesthetic. Additionally, simulation training should be given for anaesthesia trainees to improve their skills and to produce competent professionals.
Temesgen Agegnehu Abebe, Liknaw Bewket Zeleke, Mulunesh Alemayehu Assega, Worku Mekonnen Sefefe, and Endale Gebreegziabher Gebremedhn
Informa UK Limited
Background Cardiac arrest is one of the leading causes of death worldwide. Good knowledge, attitudes, and practices of health-care providers regarding cardiopulmonary resuscitation are vital to improve patient outcomes after cardiac arrest. This study aimed to assess knowledge, attitudes, and practices with regard to management of adult patients with cardiac arrest among health-care providers at Debre Markos Referral Hospital, Debre Markos, northwest Ethiopia in 2019. Methods A hospital-based cross-sectional study was conducted from January to February, 2019 at Debre Markos Referral Hospital. All health-care providers who fulfilled the inclusion criteria were enrolled in the study. A pretested structured questionnaire was used for data collection. Data were entered into EpiData 3.1 and transferred to SPSS 20 for analysis. Results Of the 352 health-care providers, 324 participated in the study for a response rate of 92%. Amajority (63%) were male. The age of male (80%) was 26–35 years old, with a mean of 29.28±4.8 years. A majority (77.8%) had inadequate knowledge about cardiopulmonary resuscitation. Almost all (97.8%) had no knowledge about cardiocerebral resuscitation. More than half (64.2%) had unfavorable attitudes toward CPR. Moreover, 288 (88.9%) had unsafe practices regarding cardiopulmonary resuscitation. The site and depth of chest compression was answered correctly by only 33 (10.2%) and 59 (18.2%) of participants, respectively. Conclusion Health-care providers’ knowledge, attitudes, and practices were inadequate, unfavorable, and unsafe regarding the management of cardiac arrest. Training on the assessment of critically ill patients, cardiopulmonary resuscitation, and cardiocerebral resuscitation should be provided for health-care providers. Additionally, resuscitation equipment like defibrillators and emergency drugs should be available in all wards and emergency rooms.
Endale G. Gebremedhn, Peter J. Shortland, and David A. Mahns
Hindawi Limited
Oxaliplatin-induced neuropathic pain limits treatment compliance. However, the variability of neuropathic pain symptoms in each cycle for individual patients and the impacts on treatment compliance remain untested. Data from 322 adult patients who received oxaliplatin-based chemotherapy were extracted based on pattern of chemotherapy, adverse events, and patient survival. Cox regression and survival analyses were employed. Seventy-eight percent of patients developed neuropathic pain that oscillated between a complete absence and presence on a cycle-by-cycle basis. Consequently, the presence of neuropathy in one cycle did not predict the incidence of neuropathy in subsequent cycles. This implies that neuropathic pain need not be a sufficient criterion to reduce, delay, or cease chemotherapy. In the case of multiple system adverse events during combined drug treatment, the responsible cause for dose reduction was not identified. Cox regression analysis revealed that middle age (61–78 years old,P=0.003) and oxaliplatin cumulative dose <850 mg/m2(P=0.002) were associated with patient mortality. Completion of chemotherapy (8 cycles) and cumulative dose >850 mg/m2of oxaliplatin prolonged the median survival time by 8 and 5 months, respectively. As oxaliplatin-induced neuropathic pain fluctuates across cycles in a manner that varies from patient-to-patient, current assumptions on the predictive nature of the emergence of neuropathy (and its impact on treatment compliance) need to be reconsidered. Detailed patient-by-patient analysis of adverse events should be applied to future studies in order to determine the efficacy of current treatments (and future interventions) and whether neuropathic pain should be retained as a criterion to vary the treatment. Additionally, when two or more system toxicities occurred in cases of combined drug treatment, the causes for drug reduction should be separately recorded.
Endale Gebreegziabher Gebremedhn, Abatneh Feleke Agegnehu, and Bernard Bradley Anderson
Elsevier BV
Endale Gebreegziabher Gebremedhn, Peter John Shortland, and David Anthony Mahns
Springer Science and Business Media LLC
Girmay Fitiwi Lema, Endale Gebreegziabher Gebremedhn, Amare Hailekiros Gebregzi, Yilkal Tadesse Desta, and Adugna Aregawi Kassa
Informa UK Limited
Background Shivering is a frequent and undesirable complication of spinal anesthesia. It is a physiologic response to increase the body core temperature in an attempt to raise metabolic heat production. However, shivering may trigger myocardial ischemia; increase intraocular and intracranial pressures, increase wound pain, delay wound healing and interfere with pulse rate, blood pressure and electrocardiogram monitoring. We aimed to compare the efficacy of intravenous (IV) ketamine with IV tramadol for the prevention of shivering in patients who underwent cesarean delivery under spinal anesthesia. Patients and methods A prospective, randomized, double-blind study was conducted. One hundred and twenty-three American Society of Anesthesiologist I and II patients, aged between 18 and 39 years, who underwent cesarean section were included in the study. Patients were randomly allocated to one of three groups: group S (n=41; control group) received saline, group K (n=41) received ketamine 0.2 mg/kg and group T (n=41) received tramadol 0.5 mg/kg. Incidence and grade of shivering and side effects between the treatment groups were recorded. Results The incidence of shivering was significantly reduced in the ketamine and tramadol groups (41.5% and 53.7%, respectively) compared to the saline group (70.7%; p=0.028). Grade 3 shivering occurred in 16 (39%) patients in the saline group, compared to 9 (22%) in the tramadol group and 8 (19.5%) in the ketamine group (p=0.011). Only two cases in the saline group developed grade 4 shivering (p<0.01). Neonatal outcome and perioperative complications were comparable among the three groups. Conclusion The prophylactic administration of low-dose IV ketamine or IV tramadol is effective for reducing the incidence and intensity of shivering. We recommend low-dose IV ketamine or tramadol prophylaxis for parturients undergoing cesarean section under spinal anesthesia.
Demeke Yilkal Fentie, Endale Gebreegziabher Gebremedhn, Zewditu Abdissa Denu, and Amare Gebreegzi
Informa UK Limited
Background Cholecystectomy can be associated with considerable postoperative pain. While the benefits of paravertebral block (PVB) on pain after thoracotomy and mastectomy have been demonstrated, not enough investigations on the effects of PVB on pain after open cholecystectomy have been conducted. We tested the hypothesis that a single-injection thoracic PVB reduces pain scores, decreases opioid consumption, and prolongs analgesic request time after cholecystectomy. Methods Of 52 patients recruited, 50 completed the study. They were randomly allocated into two groups: the paravertebral group and the control group. The outcome measures were the severity of pain measured on numeric pain rating scale, total opioid consumption, and first analgesic request time during the first postoperative 24 hours. Result The main outcomes recorded during 24 hours after surgery were Numerical Rating Scale (NRS) pain scores (NRS, 0–10), cumulative opioid consumption, and the first analgesic request time. Twenty four hours after surgery, NRS at rest was 4 (3–6) vs 5 (5–7) and at movement 4 (4–7) vs 6 (5–7.5) for the PVB and control groups, respectively. The difference between the groups over the whole observation period was statistically significant (P<0.05). Twenty-four hours after surgery, median (25th–75th percentile) cumulative morphine consumption was 0 (0–2) vs 2.5 (2–4) mg (P<0.0001) and cumulative tramadol consumption was 200 (150–250) mg vs 300 (200–350) mg in the paravertebral and in the control group, respectively (P=0.003). After surgery, the median (25th–75th percentile) first analgesic requirement time was prolonged in the PVB group in statistically significant fashion (P<0.0001). Conclusion and recommendations Single-shot thoracic PVB as a component of multi-modal analgesic regimen provided superior analgesia when compared with the control group up to 24 postoperative hours after cholecystectomy, and we recommend this block for post cholecystectomy pain relief.
Endale Gebreegziabher Gebremedhn and Girmay Fitiwi Lemma
Pan African Medical Journal
Introduction Globally, increasing consideration has been given to the assessment of patient satisfaction as a method of monitor of the quality of health care provision in the health institutions. Perioperative patient satisfaction has been contemplated to be related with the level of postoperative pain intensity, patients’ expectation of the outcome, patient health provider relationship, inpatient services, hospital facilities, access to care, waiting time, cost and helpfulness of treatments received. The study aimed to assess the level of patient satisfaction with perioperative surgical services and associated factors. Methods Hospital based quantitative cross-sectional study was conducted in University of Gondar teaching hospital from April1-30, 2014. Structured Amharic version questionnaire and checklist used for data collection. All patients who operated upon during the study period were included. Both bivariate and multivariate logistic regression model used to identify the variables which had association with the dependent variable. P-values < 0.05 were considered statistically significant. Results Two hundred and seventy eight patients underwent surgery during the study period. Nine patients were excluded due to refusal to participate in the study. A total of 269 out of 278 patients were included in the study with a response rate of 96.8%. The overall level of patient satisfaction with perioperative surgical services was 98.1%. The variables that had association with the outcome variable from the multivariate analysis were patient admission status (AOR=0.073, CI=0.007-0.765, P=0.029), information about the disease and operation (AOR=0.010, CI=0.001-0.140, P=0.001) and operation theatre staff attention to the patients complains (AOR=0.028, CI=0.002-0.390, P=0.008) respectively. Conclusion The level of patient satisfaction with perioperative surgical services was high compared with previous studies conducted in the country and other countries in the world. Health professionals need to give emphasis for information on care provision processes, patients' health progress and patients' complaints.
Biruk Melkamu Gemechu, Endale Gebreegziabher Gebremedhn, and Tadesse Belayneh Melkie
Pan African Medical Journal
Introduction Postoperative sore throat is listed from the top as patients’ most undesirable outcome in the postoperative period. It is believed to originate from mucosal dehydration or edema, tracheal ischemia secondary to the pressure of endotracheal tube cuffs, aggressive oropharyngeal suctioning, and mucosal erosion from friction between delicate tissues and the endotracheal tube. Even if the problem was indicated in many literatures, it has never been studied in our country. The study aimed to assess prevalence and factors associated with postoperative sore throat among patients who were operated under general anesthesia with endotracheal intubation. Methods Hospital based cross sectional study was conducted from February 25 - April 10, 2014 in Gondar University hospital. Patient interview and chart review were employed for data collection. Bivariate and multivariate logistic regressions were used to determine the association. Results A total of 240 out of 299 patients were included in this study with a response rate of 80.3%. The prevalence of postoperative sore throat within 48 hours after operation was 59.6%. Factors which had association with postoperative sore throat from the multivariate logistic regression were female sex (AOR = 3.3, 95% CI: 1.07, 10.375), repeated number of attempts to intubate (AOR = 3.291, 95% CI: 1.658, 6.531), and the use of nasogastric tube (AOR = 0.41, 95% CI: 0.174, 0.965) respectively. Conclusion The prevalence of postoperative sore throat was high in Gondar University Hospital. Awareness creation about the problem should be made for health professionals and postoperative sore throat management protocol need to be introduced.
Endale Gebreegziabher Gebremedhn, Gebremedhn Berhe Gebregergs, Bernard Bradley Anderson, and Vidhya Nagaratnam
Informa UK Limited
Background Cardiopulmonary resuscitation (CPR) is an emergency procedure used to treat victims following cardiopulmonary arrest. Graduate health professionals at the University of Gondar Teaching Hospital manage many trauma and critically ill patients. The chance of survival after cardiopulmonary arrest may be increased with sufficient attitude and skill levels. The study aimed to assess the attitude and skill levels of graduate health professionals in performing CPR. Methods A hospital-based cross-sectional study was conducted from May 1 to 30, 2013, at the University of Gondar Teaching Hospital. The mean attitude and skill scores were compared for sex, original residence, and department of the participants using Student’s t-test and analysis of variance (Scheffe’s test). P-values <0.05 were considered to be statistically significant. Results Of the 506 graduates, 461 were included in this study with a response rate of 91.1%. The mean attitude scores of nurse, interns, health officer, midwifery, anesthesia, and psychiatric nursing graduates were 1.15 (standard deviation [SD] =1.67), 8.21 (SD =1.24), 7.2 (SD =1.49), 6.69 (SD =1.83), 8.19 (SD =1.77), and 7.29 (SD =2.01), respectively, and the mean skill scores were 2.34 (SD =1.95), 3.77 (SD =1.58), 1.18 (SD =1.52), 2.16 (SD =1.93), 3.88 (SD =1.36), and 1.21 (SD =1.77), respectively. Conclusion and recommendations Attitude and skill level of graduate health professionals with regard to CPR were insufficient. Training on CPR for graduate health professionals needs to be given emphasis.
Endale Gebreegziabher Gebremedhn, Wubie Birlie Chekol, Wubet Dessie Amberbir, and Tesera Dereje Flatie
Springer Science and Business Media LLC
Endale Gebreegziabher Gebremedhn and Vidhya Bates Nagaratnam
Springer Science and Business Media LLC
RECENT SCHOLAR PUBLICATIONS
GRANT DETAILS
1. Western Sydney University, School of Medicine Postgraduate Research Award (funded by Western Sydney University, Sydney, Australia): Scholarship for PhD study, 2016-2019. $26,000 AUD/year.
2. Research Grant (funded by the University of Gondar, Gondar, Ethiopia): Project on postoperative patient outcome after emergency laparotomy and associated factors at the University of Gondar teaching and referral hospital, Northwest Ethiopia, 2014/2016. $10,000 (ETB).
3. Research Grant (funded by the University of Gondar, Gondar, Ethiopia): Project on Knowledge and skills of neonatal resuscitation of health professionals at the University of Gondar teaching and referral hospital, Northwest Ethiopia, 2013. $5,000(ETB).