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  1. Article ; Online: Evaluating simulator sickness and acceptability of virtual reality prototype in pain management in hospitalized patients.

    Li, Lydia Weiling / Beng, Michael Hock / Singh, Prit Anand / Koo, Seok Hwee / Sng, Ban Leong

    Pain management

    2024  Volume 14, Issue 2, Page(s) 53–63

    Abstract: Aim: ...

    Abstract Aim:
    MeSH term(s) Humans ; Pain Management/methods ; Analgesics, Opioid ; Chronic Pain/therapy ; Anxiety/therapy ; Virtual Reality
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2024-02-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2617136-3
    ISSN 1758-1877 ; 1758-1869
    ISSN (online) 1758-1877
    ISSN 1758-1869
    DOI 10.2217/pmt-2023-0072
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Airway management in patients suffering from morbid obesity.

    Liew, Wan Jane / Negar, Asadi / Singh, Prit Anand

    Saudi journal of anaesthesia

    2022  Volume 16, Issue 3, Page(s) 314–321

    Abstract: Obesity is no longer a disease of the affluent. The prevalence of obesity has risen at an exponential rate globally, with an increasing burden on healthcare resources. Perioperative management of patients with morbid obesity is known to be challenging, ... ...

    Abstract Obesity is no longer a disease of the affluent. The prevalence of obesity has risen at an exponential rate globally, with an increasing burden on healthcare resources. Perioperative management of patients with morbid obesity is known to be challenging, and this is particularly so in the management of their airway, a crucial procedure that requires meticulous planning and modifications. Anesthesiologists will expect to see more patients with obesity in their practice presenting for both bariatric and non-bariatric surgery, or even for emergency surgery. Hence, any generalist anesthesiologist should be confident in managing such a patient, with the appreciation that these patients often pose a significant challenge to the practice of anesthesia. This article describes different techniques and looks at the evidence for airway management in the morbidly obese. Other aspects of perioperative management of such patients are beyond the scope of this article.
    Language English
    Publishing date 2022-06-20
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 2562174-9
    ISSN 0975-3125 ; 1658-354X
    ISSN (online) 0975-3125
    ISSN 1658-354X
    DOI 10.4103/sja.sja_90_22
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Postoperative use of high flow nasal insufflation for obstructive sleep apnea.

    Gobindram, Avinash / Singh, Prit Anand / Quek, Kelvin Howyow

    Korean journal of anesthesiology

    2019  Volume 72, Issue 6, Page(s) 610–613

    Abstract: Background: Continuous positive airway pressure (CPAP) therapy is the gold standard treatment for obstructive sleep apnea (OSA), although, associated with poor patient compliance. Conversely, high flow, humidified, temperature-regulated nasal ... ...

    Abstract Background: Continuous positive airway pressure (CPAP) therapy is the gold standard treatment for obstructive sleep apnea (OSA), although, associated with poor patient compliance. Conversely, high flow, humidified, temperature-regulated nasal insufflation of oxygen or air is well tolerated.
    Case: We describe our experience of three patients with known or suspected moderate to severe OSA who were poorly compliant to CPAP therapy and received high flow nasal insufflation (HFNI) postoperatively. None had significant episodes of desaturation (SpO2 < 95%) and all patients uniformly reported superior comfort levels than with the CPAP therapy. HFNI generates small amounts of positive end-expiratory pharyngeal pressure, increases inspiratory airflow and decreases dead space ventilation. Due to the open system, less difficulty with the patient-mask interface and improved patient comfort is experienced. These factors help prevent hypopnea and lead to enhanced sleep continuity.
    Conclusions: HFNI may be a promising alternative to CPAP therapy in the perioperative setting.
    MeSH term(s) Adult ; Aged ; Continuous Positive Airway Pressure ; Female ; Humans ; Insufflation/methods ; Male ; Middle Aged ; Nasal Cavity ; Oxygen/blood ; Oxygen Inhalation Therapy/methods ; Patient Compliance ; Postoperative Care/methods ; Respiratory Rate ; Sleep Apnea, Obstructive/blood ; Sleep Apnea, Obstructive/physiopathology ; Sleep Apnea, Obstructive/therapy ; Tonsillectomy
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2019-07-15
    Publishing country Korea (South)
    Document type Case Reports
    ZDB-ID 2557340-8
    ISSN 2005-7563 ; 2005-6419
    ISSN (online) 2005-7563
    ISSN 2005-6419
    DOI 10.4097/kja.d.18.00368
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Early Experience of a Multidisciplinary Group Pain Program with Cognitive Behavioural Strategies, Physiotherapy and Peer Support for Patients with Chronic Noncancer Pain.

    Yu, Xia / Convoy, Sean / Singh, Prit Anand / Png, Constance / Yoong, Chee Seng / Pal, Poonam

    Pain management nursing : official journal of the American Society of Pain Management Nurses

    2020  Volume 22, Issue 3, Page(s) 293–301

    Abstract: Background: Chronic non-cancer pain affects about 20% of the population worldwide. The effect of medical treatment in isolation is often limited. A multidisciplinary approach has been strongly advocated to help manage patients' pain more effectively.: ...

    Abstract Background: Chronic non-cancer pain affects about 20% of the population worldwide. The effect of medical treatment in isolation is often limited. A multidisciplinary approach has been strongly advocated to help manage patients' pain more effectively.
    Aims: The primary purpose was to reduce pain severity, pain interference on patients'daily activities and improve their levels of self-efficacy despite pain. The secondary aim was to evaluate the possible changes in patients' depression, anxiety, and stress symptoms after amultidisciplinary group pain program. The program content and structure were also evaluated.
    Design: This scholarly project used within-subject pre- and post-test design.
    Settings/subjects: Fifty-six patients were recruited from the project center pain clinic.
    Methods: An evidence-based eight-hour multidisciplinary group pain program was implemented. Data was collected before and 3 months after the program.
    Interventions: The program covered pain physiology, cognitive behavioural strategies, demonstration of various exercises, self-management skills, medication management, and peer support.
    Results: Three months postprogram, there was a statistically significant improvement in patients' pain severity (β = -0.9, 95% CI: -1.73 to -0.14, p = .023) and self-efficacy (β = 5.6, 95% CI: 0.85 to 10.41, p = .023). Pain interference on their daily activities was also significantly reduced (β = -2.0, 95% CI: -2.90 to -0.83, p = .001). Patients provided positive and encouraging feedback about the program.
    Conclusion: Initial improvements in patients' ability to cope with pain and to perform daily activities were demonstrated following participation in the brief multidisciplinary group pain program. Future randomized controlled trials are needed to confirm that the results are due to patients' participation in the program.
    MeSH term(s) Analgesics, Opioid ; Chronic Pain/therapy ; Cognition ; Cognitive Behavioral Therapy ; Humans ; Peer Group ; Physical Therapy Modalities ; Quality of Life ; Social Support
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2020-11-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2213260-0
    ISSN 1532-8635 ; 1524-9042
    ISSN (online) 1532-8635
    ISSN 1524-9042
    DOI 10.1016/j.pmn.2020.10.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Efficacy of high flow nasal cannula as an alternative to continuous positive airway pressure therapy in surgical patients with suspected moderate to severe obstructive sleep apnea.

    Tsai, Fung Chen / Chen, Ning Lynn / Gobindram, Avinash / Singh, Prit Anand / Hsu, Pon Poh / Tan, Alvin Kah Leong

    American journal of otolaryngology

    2021  Volume 43, Issue 2, Page(s) 103295

    Abstract: Purpose: To compare the efficacy of High flow nasal cannula (HFNC) as an alternative to Continuous Positive Airway Pressure (CPAP) therapy on the first postoperative night in patients with suspected moderate to severe obstructive sleep apnea (OSA).: ... ...

    Abstract Purpose: To compare the efficacy of High flow nasal cannula (HFNC) as an alternative to Continuous Positive Airway Pressure (CPAP) therapy on the first postoperative night in patients with suspected moderate to severe obstructive sleep apnea (OSA).
    Methods: This is randomised controlled trial conducted in a tertiary hospital which included elective surgical patients with STOP-BANG score of 5 and above. Forty patients were randomised into one of the four postoperative treatment groups: CPAP, or HFNC at three different flow rates (20 L/min, 30 L/min and 40 L/min). The primary outcome measured was the number of recorded drops in baseline SpO2 of >4%. Secondary outcomes measured included the need for supplemental oxygen or other interventions and the total number of hours of usage of the device. Patient satisfaction, preference for device and reasons for their preference were also collected.
    Results: CPAP was used for a significantly fewer number of hours compared to HFNC (at all flow rates) during the first postoperative night. There was no significant difference in the primary outcome or in the requirement for other interventions between the four treatment groups. 73.3% of patients in the HFNC group preferred the use of HFNC to the use of CPAP. Reasons for user preference for HFNC include device comfort, ease of use, reduced noise levels and perception of efficacy.
    Conclusions: HFNC could be an useful alternative to CPAP as it is not inferior to CPAP in the perioperative management of OSA and is better tolerated.
    MeSH term(s) Cannula ; Continuous Positive Airway Pressure ; Humans ; Oxygen Inhalation Therapy ; Sleep Apnea, Obstructive/surgery
    Language English
    Publishing date 2021-12-03
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 604541-8
    ISSN 1532-818X ; 0196-0709
    ISSN (online) 1532-818X
    ISSN 0196-0709
    DOI 10.1016/j.amjoto.2021.103295
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Enhanced Experiential Learning in Airway Management: Surgical Modification of Cadavers.

    Chandran, Rajkumar / Koo, Seok Hwee / Lim, Yin Yu / Ramadorai, Ashok / Tan, Alvin Kah Leong / Singh, Prit Anand / Negar, Asadi / Lai, Juen Bin

    Simulation in healthcare : journal of the Society for Simulation in Healthcare

    2020  Volume 16, Issue 2, Page(s) 142–150

    Abstract: Introduction: Failure of airway management remains a significant source of morbidity and mortality. Advanced airway management has been addressed effectively by simulation-based training. However, simulation of difficult airways in manikins is limited ... ...

    Abstract Introduction: Failure of airway management remains a significant source of morbidity and mortality. Advanced airway management has been addressed effectively by simulation-based training. However, simulation of difficult airways in manikins is limited by the pre-set conditions provided by the manufacturer. Life-like conditions in the form of the softness of the tissue and true anatomy as seen in cadaver models are needed to create simulated models with a closer resemblance to real patients. The goal of this study was to determine the feasibility of simulating difficult airway from submandibular abscess in cadaver models by surgical modification of the cadaver heads for use in enhanced experiential learning of the management of difficult airways.
    Methods: The cadaver heads were modified surgically to simulate a submandibular abscess. The models were used in an airway course where participants provided feedback on the realistic nature of the model and its benefits for difficult airway training. The ease of tracheal intubation of the models with the assistance of video laryngoscopy was assessed.
    Results: The modified cadavers were acceptable in simulating difficult airway as demonstrated by the feedback from the participants. All participants (100% [95% confidence interval = 89.1%-100%]) found the models to be realistic and beneficial for difficult airway training. A good proportion (56.3%) felt that the intubation technique was made easier with the video laryngoscopy.
    Conclusions: Cadavers can be modified to simulate pathologies associated with difficult airways. These models can be used to enhance experiential learning and the management of difficult airways.
    MeSH term(s) Airway Management ; Cadaver ; Humans ; Intubation, Intratracheal ; Laryngoscopes ; Problem-Based Learning
    Language English
    Publishing date 2020-08-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2223429-9
    ISSN 1559-713X ; 1559-2332
    ISSN (online) 1559-713X
    ISSN 1559-2332
    DOI 10.1097/SIH.0000000000000488
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: A randomized controlled trial to compare the interface pressures of alternating pressure overlay with gel pad versus gel pad alone during prolonged surgery.

    Neo, Tze Guan / Koo, Seok Hwee / Chew, Samuel Teong Huang / Png, Gek Kheng / Lacuesta, Mary Jojie / Wu, Margie Ya Lan / Tay, Ramona Yu Ching / Singh, Prit Anand / Chandran, Rajkumar

    Journal of tissue viability

    2021  Volume 30, Issue 2, Page(s) 222–230

    Abstract: Introduction: Prolonged surgery is a known risk of pressure ulcer formation. Pressure ulcers affect the quality of life, are a significant cause of morbidity and mortality, and pose a burden on the healthcare system. This study aimed to compare the ... ...

    Abstract Introduction: Prolonged surgery is a known risk of pressure ulcer formation. Pressure ulcers affect the quality of life, are a significant cause of morbidity and mortality, and pose a burden on the healthcare system. This study aimed to compare the effectiveness of an alternating pressure (AP) overlay with Gel pad against the Gel pad in reducing interface pressure (IP) during prolonged surgery.
    Methods: A total of 180 participants from a tertiary hospital were randomized to AP overlay with Gel pad group (n = 90) and Gel pad group (n = 90). Patients were placed supine on the pressure redistributing surfaces, and IP data under the sacrum and ischial tuberosities were collected at an interval of 30 min from 0 min up to a maximum of 570 min.
    Results: Based on data from 133 participants, the average IPs during all the deflation cycles of the AP overlay (with Gel pad) were significantly lower than the average continuous IP recorded for Gel pad throughout the measuring period (p < 0.001). Only three patients (2.26% of study participants) - Gel pad group (n = 2; 2.99%) and AP overlay with Gel pad group (n = 1; 1.52%) developed post-operative pressure ulcer (p = 0.5687).
    Conclusions: The lower IP during deflation cycles of the AP overlay (with Gel pad) suggests its potential effectiveness in preventing pressure ulcer formation in patients undergoing prolonged surgery. The prevention and reduction of pressure ulcers will have a considerable impact on the improved quality of life and cost savings for the patient. The study findings may facilitate the formulation of policies for preventing pressure ulcer development in the perioperative setting.
    MeSH term(s) Adult ; Beds/adverse effects ; Beds/standards ; Beds/statistics & numerical data ; Body Mass Index ; Female ; Humans ; Male ; Middle Aged ; Operating Rooms/statistics & numerical data ; Postoperative Complications/prevention & control ; Pressure ; Pressure Ulcer/prevention & control ; Risk Factors ; Sacrococcygeal Region/physiology ; Surgical Procedures, Operative/methods ; Weights and Measures/instrumentation
    Language English
    Publishing date 2021-02-06
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 1282604-2
    ISSN 0965-206X
    ISSN 0965-206X
    DOI 10.1016/j.jtv.2021.02.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Experiential learning in simulated parapharyngeal abscess in breathing cadavers.

    Chandran, Rajkumar / Kiew, Anne Sheng Chuu / Zheng, Jin Xi / Singh, Prit Anand / Lim, Jerry Kian Teck / Koo, Seok Hwee / Lim, Yin Yu / Lai, Juen Bin / Tan, Alvin Kah Leong / Lim, Noelle Louise Siew Hua

    Journal of anesthesia

    2021  Volume 35, Issue 2, Page(s) 232–238

    Abstract: Purpose: Education in airway management is a fundamental component of anesthesiology training programs. There has been a shift towards the use of simulation models of higher fidelity for education in airway management. The goal of this study was to ... ...

    Abstract Purpose: Education in airway management is a fundamental component of anesthesiology training programs. There has been a shift towards the use of simulation models of higher fidelity for education in airway management. The goal of this study was to create a novel cadaveric model of a simulated parapharyngeal abscess with features of a difficult airway such as distorted anatomy and narrow airway passages presenting as stridor. The model was further assessed for its suitability for enhanced experiential learning in the management of difficult airways.
    Methods: Cadaver heads were modified surgically to simulate parapharyngeal abscess. Airtight torso of the cadaver was connected to an Oxylog ventilator to simulate respiratory movements-the opening and closing of air channels with breaths in a patient with parapharyngeal abscess. Advanced airway workshop facilitators conducted directed one-to-one learning, and provided feedback to participants. A paper-based feedback was obtained from 72 participants on their confidence level, and the realism, attractiveness, beneficial, and difficulty levels of the simulated cadaveric models.
    Results: The modified cadavers were reliable in simulating difficult airways. The majority of participants (91%) reported an increase in confidence level for management of the difficult airway after the experience with the modified cadavers and found the models realistic (93%), attractive (92%), beneficial (93%), and difficult (85%).
    Conclusions: Surgical modifications of cadavers to simulate difficult airways such as parapharyngeal abscess with edema and stridor can be incorporated into advanced airway management courses to enhance experiential learning in airway management by awake fibreoptic intubation, and promote patient safety.
    MeSH term(s) Abscess/surgery ; Airway Management ; Cadaver ; Humans ; Intubation, Intratracheal ; Problem-Based Learning
    Language English
    Publishing date 2021-02-08
    Publishing country Japan
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1107821-2
    ISSN 1438-8359 ; 0913-8668
    ISSN (online) 1438-8359
    ISSN 0913-8668
    DOI 10.1007/s00540-021-02904-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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