Benjamin Olusomi Bolaji
@unilorin.edu.ng
Professor, Faculty of Clinical Sciences
Professor, Faculty of Clinical Sciences
University of Ilorin, Ilorin, Nigeria
Prof. Bolaji is a graduate of the University of Ibadan, Ibadan, MBBS 1983. He had his internship at the Ahmadu Bello University Teaching Hospital, Kaduna 1983/84 He joined the residency training in anaesthesia at the University of Ilorin Teaching Hospital (UITH) in 1990, had his residency training at the University of Calabar Teaching Hospital, Calabar (1990/91) and the University College Hospital, Ibadan (1992-1997), obtain the DA (1991) and the FMCA (1998). He joined the services of the University of Ilorin in 1998 as a Las a Lecturer I in the Department of Anaesthesia. He was promoted Professor of Anaesthesia in 2017. his research interests are: Critical care and airway management.
EDUCATION
University of Ibadan, Ibadan, Nigeria. 1977-1983. MBBS (1983)
University of Calabar, Calabar, Nigeria. 1990-1992. Diploma in Anaesthesiology (DA, 1992)
National Postgraduate Medical College of Nigeria. 1992-1998. Fellow of the Medical College in Anaesthesia (FMCA, 1998)
RESEARCH, TEACHING, or OTHER INTERESTS
Anesthesiology and Pain Medicine, Critical Care and Intensive Care Medicine
Scopus Publications
Scopus Publications
O. Oyedepo, O. Ige, Emmanuel Ikechukwu Oparanozie, Benjamin Olusomi Bolaji, S. O. Idris, Abdulrahman Olusola Afolabi, Akeem Mohammed and Adekunle David Dunmade
O. O Oladosu, B. O. Bolaji, O. A. Ige, I. I. Enaworu, and A. Alawode
African Journals Online (AJOL)
INTRODUCTION: Laryngoscopy and endotracheal intubation at induction of anaesthesia have been associated with awareness and haemodynamic fluctuations. Agents that can mitigate these effects should create better anaesthetic conditions. This study aimed to compare the effects of intravenous esmolol and lidocaine on the bispectral index (BIS) and haemodynamic responses during induction of general anaesthesia with propofol/fentanyl in adult patients scheduled for elective surgical procedures.
 METHODS: This was a prospective randomized controlled study in ninety patients aged 18-65 years who were randomized into three groups to receive either IV esmolol 0.5 mg/kg, IV lidocaine 1.5 mg/kg or normal saline prior to induction of general anaesthesia.
 RESULTS: The esmolol group had a significantly shorter induction time (p<0.0001) and a lower dose of propofol consumed (p<0.0001) than the lidocaine group. The mean pulse rate was significantly lower at the 1st min to 4th min post-intubation in esmolol and lidocaine groups compared to the control group (p values; 1 min= 0.005, 2 min= 0.008, 3 min= 0.023, 4 min= 0.018). There was a significant difference in the systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in the three groups at 2 min post-intubation.
 CONCLUSION: Pre-induction intravenous esmolol 0.5 mg/kg was more effective than intravenous lidocaine 1.5 mg/kg in reducing the induction dose of propofol and the induction time. Esmolol also prevented increases in BIS better than lidocaine following endotracheal intubation but both agents were equally effective in attenuating the haemodynamic changes associated with laryngoscopy and endotracheal intubation.
AM Adedapo, BO Bolaji, MB Adegboye, PM Kolo, JA Ogunmodede, ZA Suleiman, OO Adedapo, and OS Jimoh
Medknow
Aim: This study aimed to compare the effect of spinal anesthesia on QT interval in severe pre-eclamptic and normotensive parturients who underwent cesarean section in a Nigerian tertiary hospital. Patients and Methods: Twelve-lead electrocardiogram (ECG) was obtained before, and at intervals after spinal anaesthesia on fifty severe pre-eclamptic (Group A) and fifty normotensive parturients (Group B) who underwent caesarean section. The effect of spinal anaesthesia on QT interval was compared. Results: The preoperative (baseline) mean QT interval was longer in group A than in group B; 453.10 ± 34.11 ms versus 399 ± 18.79 ms, P < 0.001. The prevalence of prolonged QT interval in the severe pre-eclamptic group before spinal anesthesia was 80% while in the normotensive group it was 0%, P < 0.001. At 5, 30, 60, and 120 min after the establishment of spinal anesthesia, the mean QT interval in the severe pre-eclamptic group was shortened and maintained within normal limits; 414.74 ± 28.05, 418.28 ± 30.95, 411.18 ± 19.21 and 401.36 ± 17.52 ms with P < 0.001 throughout. In the normotensive group, there was no significant change in the mean QT interval. Conclusions: This study demonstrated that the QT interval was more prolonged among the severe pre-eclamptic parturients. Spinal anesthesia using 0.5% hyperbaric bupivacaine normalized the QT interval and maintained it within normal limits during the study period.
Ajibade Okeyemi, AliyuZakari Suleiman, OlubukolaOlanrewaju Oyedepo, BenjamiOlusomi Bolaji, BabajideMajeed Adegboye, and OlufemiAdebayo Ige
Medknow
Background: Insertion of laryngeal mask airway (LMA) with propofol in children may cause hypotension, laryngospasm and apnoea. Ketamine and fentanyl have been combined separately with propofol to prevent depression of cardiovascular system during LMA insertion, especially in paediatric patients. Ketamine-fentanyl and propofol-fentanyl combinations have analgesic effect, prevent coughing and apnoea and regarded as agents of choice for LMA insertions. However, the cardiovascular effects of the two admixtures for LMA insertions have not been fully assessed in children. We compared the haemodynamic effects of ketamine-fentanyl and propofol-fentanyl combinations for LMA insertion in paediatric patients who underwent herniotomy in our facility. Patients and Methods: This comparative study was conducted on 80 children aged 1–15 years, ASA physical Statuses I and II, who had herniotomy under general anaesthesia. The patients were randomised into two groups (A and B) of 40 patients each and LMA was inserted following administrations of the two different drug combinations. Patients in Group A received pre-mixed ketamine 2 mg/kg and fentanyl 2 μg/kg while the patients in Group B received pre-mixed propofol 2.5 mg/kg and fentanyl 2 μg/kg. The blood pressure and incidence of apnoea were determined in the two groups during and after the LMA insertion. Results: The haemodynamic states of the patients were not comparable statistically as the heart rate, systolic, diastolic and mean arterial blood pressure were significantly higher and stable in the ketamine-fentanyl group than the propofol-fentanyl group (P < 0.05). The incidence of apnoea was significantly lower in the ketamine-fentanyl group compared with propofol-fentanyl group (P = 0.045), but post-anaesthesia discharge scores were similar, with no significant difference in both groups (P = 0.241). Conclusion: The use of ketamine-fentanyl combination for LMA insertion in paediatric patients was associated with better haemodynamic changes and lower incidence of apnoea when compared with propofol-fentanyl combination.
OlurotimiI Aaron, AramideF Faponle, BenjaminO Bolaji, SamuelK Mosaku, AnthonyT Adenekan, and OlakunleA Oginni
Medknow
Background: Suxamethonium has been shown to have a superior modification of the convulsion associated with ECT compared to other muscle relaxants. The dosage of suxamethonium used in ECT varies widely based on the experiences of practitioners. The study aimed to determine and compare the effectiveness and side effect profile of 0.5 mg/kg and 1 mg/kg in modified ECT. Subjects and Methods: This was a prospective randomized crossover study, comparing the effects of suxamethonium at a dose of 0.5 mg/kg, and 1.0 mg/kg in 27 patients who had a total of 54 sessions of modified ECT. The primary outcome parameters were quality of convulsion and onset and duration of apnoea. The secondary outcome parameters were hemodynamic variables, arterial oxygen saturation, delayed recovery, muscle pain, vomiting, headache, prolonged convulsion, and serum potassium. Data collected were entered into proforma and analyzed using Statistical Package for Social Sciences (SPSS) version 17.0. Parametric variables are presented as means and standard deviations while non-parametric variables are presented as frequencies and percentages. The level of significance (P-value) was considered at 0.05. Results: Sixteen patients (59%) had acceptable convulsion modification with 0.5 mg/kg suxamethonium compared to 23 patients (85%) with the use of 1.0 mg/kg suxamethonium (P = 0.016). There was no statistically significant difference in the duration of convulsion, the onset of apnoea, and the duration of apnoea with the two doses. Changes in heart rate, blood pressure, arterial oxygen saturation, and serum potassium level that accompany the mECT were comparable with the two doses of suxamethonium studied. Conclusions: A better modification of convulsion with comparable hemodynamic and side effect profile is achieved during mECT with the use of 1.0 mg/kg suxamethonium compared to 0.5 mg/kg.
COVIDSurg Collaborative
Oxford University Press (OUP)
Background The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. Methods A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β-regression model was used to estimate 12-week cancellation rates for 190 countries. Elective surgical case-mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. Results The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID-19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. Conclusion A very large number of operations will be cancelled or postponed owing to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely.
AdemolaAlabi Popoola, BenjaminOlusomi Bolaji, TimothyOlusegun Olanrewaju, and TajudeenOlalekan Ajiboye
Medknow
Organ transplantation is the gold standard for treating end-stage organ diseases, many of whom are on waiting lists. The reasons for this include the nonavailability of suitable organs to be transplanted. In many nations, most of these challenges have been surmounted by the adoption of deceased donor program, which is not so in sub-Saharan countries such as Nigeria. This study is to audit the potentially transplantable organs available from potential deceased donors from a Nigerian tertiary hospital. This is a study of deaths in the intensive care unit (ICU) and the accident and emergency units of the University of Ilorin Teaching Hospital, Nigeria. Data included the biodata, social history, diagnosis or indications for admission, time of arrival and death, causes of death, associated comorbidities, potential organs available, social history, and availability of relations at the time of death. There were 104 deaths in the ICU and 10 patients in the accident and emergency unit. There were 66 males (57.9%) and 48 females (42.1%). Eighty patients were Muslims (70.2%) and 34 were Christians (19.8%). A total of 33 participants were unmarried (28.9%),whereas 81 (71.1%) were married. The tribes of the patients were Yoruba (105, 92.1%), Igbo (7, 6.1%), Hausa (1, 0.9%), and Nupe (1, 0.9%). The age range was 0.08-85 years. Twenty-two (19.3%) had primary and the remaining had at least secondary education. The causes of death were myriad, and there were relatives available at the times of all deaths. The Maastricht classification of the deaths were Class I - 1 (0.9%), Class II - 37 (32.2%), Class III - 9 (7.8%), Class IV - 20 (17.4%), and Class V - 47(40.9%). There were no transplantable organs in 42 (36.5%), one organ in eight (7%), two organs in two (7%), three organs in one (0.9%), four organs in 13 (11.3%), five organs in six (5.2%), six organs in 11 (9.6%), seven organs in 11 (9.6%), eight organs in five (13%), and nine organs in five (4.3%). Deceased donor sources of organs are worthy of being exploited to improve organ transplantation in Nigeria.
Olanrewaju O. Oyedepo, Abdulrasheed A. Nasir, Olufemi A. Ige, Benjamin O. Bolaji, Israel K. Kolawole, and Adeyemi J. Olufolabi
Ovid Technologies (Wolters Kluwer Health)
A term baby was delivered by cesarean and found to have an unexpected large teratoma attached to its mouth. Surgical excision was planned within 24 hours. Anesthesia concern of airway control required multidisciplinary team consultation, airway and patient preparation, and anticipation for failure. Challenging airway cases in low-resource countries can be successfully managed with deliberate attention to detail, preparation, and experience.
, T E F Abbott, K E Greaves, A Patel, T Ahmad, J Haddow, E Futier, M Biais, K Slim, R M Pearse,et al.
Oxford University Press (OUP)
AbstractBackgroundThe Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs).MethodsThis was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs.ResultsA total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59).ConclusionCaution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally.
AdemolaAlabi Popoola, TimothyOlusegun Olanrewaju, BenjaminOlusomi Bolaji, and TajudeenOlalekan Ajiboye
Medknow
Kidney transplantation is the gold standard for end-stage renal disease. All over the world there are several challenges preventing sufficient organ donation to meet the growing needs of patients on the waiting list. One major challenge which is common to most countries is the shortage of organs from willing living donors. Many countries, especially, the developed countries, have devised several models of expanding their donor pools to meet the growing needs of patients on the waiting list. Nigeria, a developing country has very low kidney transplantation rate even though some progress have been made in making the procedure feasible in about a dozen hospitals in Nigeria. One very major challenge has been the shortage of donor organ supply. This paper intends to proffer suggestions on how to expand the organ donor pool in Nigeria.
MB Adegboye, IK Kolawole, and BO Bolaji
African Journals Online (AJOL)
Introduction The duration of action of sub-arachnoid block is short, and one of the ways to overcome this is the use of oral clonidine. Methods 108 patients of ASA I and II, aged 18 to 65 years undergoing lower abdominal surgeries under spinal anaesthesia were randomized into three groups.. Control group A (n=36) no oral clonidine pre-medication, Group B (n=36) and group C (n=36) received 100 µg and 200 µg of oral clonidine pre-medication respectively, 1hr before spinal anaesthesia. Haemodynamic parameters were recorded. Sensory block, degree of motor blockage, and sedation were assessed. Results Clonidine prolonged the mean duration of motor block by 189.98±26.93 min (100µg) and 191.89±28.13 min (200µg) compared to 117.92±25.13 min in the control group p<0.05. The mean duration of analgesia was 188.19±35 min (100µg) and194±24.58 min (200µg) in the clonidine groups compared to 115.89±26.66 min in control group p<0.05. All the patients were awake in the control group while 71.43% and 100% were drowsy in groups B and C respectively. Conclusion Oral clonidine produces better clinical effects on the onset and duration of Bupivacaine spinal anaesthesia.
T.E.F. Abbott, T. Ahmad, M.K. Phull, A.J. Fowler, R. Hewson, B.M. Biccard, M.S. Chew, M. Gillies, R.M. Pearse, Rupert M. Pearse,et al.
Elsevier BV
T. Ahmad, R.A. Bouwman, I. Grigoras, C. Aldecoa, C. Hofer, A. Hoeft, P. Holt, L.A. Fleisher, W. Buhre, and R.M. Pearse
Elsevier BV
Background
The incidence and impact of postoperative complications are poorly described. Failure-to-rescue, the rate of death following complications, is an important quality measure for perioperative care but has not been investigated across multiple health care systems.
Methods
We analysed data collected during the International Surgical Outcomes Study, an international 7-day cohort study of adults undergoing elective inpatient surgery. Hospitals were ranked by quintiles according to surgical procedural volume (Q1 lowest to Q5 highest). For each quintile we assessed in-hospital complications rates, mortality, and failure-to-rescue. We repeated this analysis ranking hospitals by risk-adjusted complication rates (Q1 lowest to Q5 highest).
Results
A total of 44 814 patients from 474 hospitals in 27 low-, middle-, and high-income countries were available for analysis. Of these, 7508 (17%) developed one or more postoperative complication, with 207 deaths in hospital (0.5%), giving an overall failure-to-rescue rate of 2.8%. When hospitals were ranked in quintiles by procedural volume, we identified a three-fold variation in mortality (Q1: 0.6% vs Q5: 0.2%) and a two-fold variation in failure-to-rescue (Q1: 3.6% vs Q5: 1.7%). Ranking hospitals in quintiles by risk-adjusted complication rate further confirmed the presence of important variations in failure-to-rescue, indicating differences between hospitals in the risk of death among patients after they develop complications.
Conclusions
Comparison of failure-to-rescue rates across health care systems suggests the presence of preventable postoperative deaths. Using such metrics, developing nations could benefit from a data-driven approach to quality improvement, which has proved effective in high-income countries.
Brennan C. Kahan, , Desponia Koulenti, Kostoula Arvaniti, Vanessa Beavis, Douglas Campbell, Matthew Chan, Rui Moreno, and Rupert M. Pearse
Springer Science and Business Media LLC
H. Hemmings, R. Pearse, S. Beattie, P. Clavien, N. Demartines, L. Fleisher, M. Grocott, J. Haddow, A. Hoeft, P. Holt,et al.
Elsevier BV
Background: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. Methods: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. Results: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2–7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. Conclusions: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. Study registration: ISRCTN51817007
AS Adeniran, BO Bolaji, AA Fawole, and OO Oyedepo
African Journals Online (AJOL)
AIM
Evaluation of the predictors of maternal mortality among critically ill obstetric patients managed at the intensive care unit (ICU).
METHODS
A case control study to evaluate the predictors of maternal mortality among critically ill obstetric patients managed at the intensive care unit (ICU) of the University of Ilorin Teaching Hospital, Ilorin, Nigeria from 1st January 2010 to 30th June 2013. Participants were critically ill obstetric patients who were admitted and managed at the ICU during the study period. Subjects were those who died while controls were age and parity matched survivors. Statistical analysis was with SPSS-20 to determine chi square, Cox-regression and odds ratio; p value < 0.05 was significant.
RESULTS
The mean age of subjects and controls were 28.92 ± 5.09 versus 29.44 ± 5.74 (p = 0.736), the level of education was higher among controls (p = 0.048) while more subjects were of low social class (p = 0.321), did not have antenatal care (p = 0.131) and had partners with lower level of education (p = 0.156) compared to controls. The two leading indications for admission among subjects and controls were massive postpartum haemorrhage and severe preeclampsia or eclampsia. The mean duration of admission was higher among controls (3.32 ± 2.46 versus 3.00 ± 2.58; p = 0.656) while the mean cost of ICU care was higher among the subjects (p = 0.472). The statistical significant predictors of maternal deaths were the patient's level of education, Glasgow Coma Scale (GCS) score, oxygen saturation, multiple organ failure at ICU admission and the need for mechanical ventilation or inotrophic drugs after admission.
CONCLUSION
The clinical state at ICU admission of the critically ill obstetric patients is the major outcome determinant. Therefore, early recognition of the need for ICU care, adequate pre-ICU admission supportive care and prompt transfer will improve the outcome.
OA Ige, BO Bolaji, and IK Kolawole
African Journals Online (AJOL)
BACKGROUND
Subcutaneous or intrafascial wound infiltration of local anaesthetic with systemic opioids has been shown to enhance patient comfort with improved analgesia and reduced opioid requirements.
OBJECTIVE
To demonstrate improved pulmonary function when postoperative analgesia was provided by combined bupivacaine wound infiltration and systemic opioid.
METHODS
In a prospective, randomized, placebo-controlled study, 46 patients (23 per group) scheduled for elective gynaecological surgery under general anaesthesia had subcutaneous and intrafascial wound infiltration of 40 ml, 0.25% bupivacaine (study patients) or 40 ml 0.9% saline (control) just before the end of surgery. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate (PEFR) were done before surgery and at 6, 12 and 24 hours postoperatively. Student's T and chi-square tests were used for tests of significance set at P < 0.05. Postoperative analgesia was provided with intramuscular morphine 0.15 mg/kg 4 hourly and 10mg/kg of intravenous paracetamol as rescue analgesia.
RESULTS
PEFR, FVC and FEV1 were reduced in both the control and study groups but the reduction was greater in the control group.
CONCLUSION
Bupivacaine wound infiltration produced statistically significant elevations in pulmonary function tests results at all assessment periods.
F.O. Omosofe, B.O. Bolaji, I.K. Kolawole, and A.B. Makanjuola
Medwell Publications
R. Saidu, B. O. Bolaji, A. W. O. Olatinwo, C. M. Mcintosh, A. P. Alio, and H. M. Salihu
Informa UK Limited
We reviewed 450 cases of caesarean delivery (January–December 2009) at the University of Ilorin Teaching Hospital in Nigeria. We analysed the association between caesarean delivery status (primary or previous) and the following outcomes: abnormal blood-loss, blood transfusion and perinatal mortality. Although significant differences were observed between primary and previous caesarean delivery groups in regards to maternal age, urgency of the caesarean delivery, booking status, and cadre of birth attendant staff, no association was noted between caesarean delivery status and any of the three outcomes. Further analyses identified parity as an important predictor for blood transfusion and abnormal blood loss. In addition, we found a dose–response relationship between parity and abnormal blood loss (< 0.05). Also, mothers with an emergency caesarean delivery of the index pregnancy were more than twice as likely to have a blood transfusion as compared with those with an elective caesarean delivery.