4^th International Anesthesia and Pain Medicine Conference December 13-14, 2018 Abu Dhabi, UAE

Hany Mohamed Elzahaby is the Professor and Head of Anesthesia, Intensive Care and Pain Management Department, Ain Shams University, Egypt. His

Achievements include: Head of Pediatric Anesthesia Unit, Ain Shams University, 2010-2018, Specialist Registered in Anesthesia, United Kingdom 2007, Consultant Anesthetist, North West Armed Forces Hospital, Kingdom Of Saudi Arabia 1999-2007, Degree of Doctor in Anesthesia, Ain Shams University, 1994, Fellowship in Anesthesia, University of Iowa, United States of America 1992-1994, Master Degree in Anesthesia, Ain Shams University, 1989, Bachelor Degree in Medicine and Surgery, Ain Shams University.

The Micropremies are preterm neonates is borne before 30 gestational weeks and have extremely low birth weight infants (<1000 g). Morbidity and mortality in this population has decreased over the past decades and general anesthesia is increasingly needed for surgical and diagnostic procedures. Knowing their unique physiological features is necessary. Common complications of prematurity include: postoperative apnea, broncho-pulmonary dysplasia, patent ductus arteriosus (PDA), right to left shunt, intraventricular hemorrhage, long term cognitive impairment, retinopathy of prematurity, altered temperature regulation with impaired renal and metabolic functions. The debate continues upon who should provide the care and where to do these cases. Preoperative preparation focuses on optimization of cardiac and respiratory status and on treatment of anemia, electrolyte abnormalities, metabolic acidosis and coagulopathy. There are 2 common scenarios, the first is a relatively stable micropremie with a secured IV access coming for ligation of PDA where a high dose fentanyl and a relaxant will do the job. The second scenario is an unstable micropremie with difficult venous access, hypothermic,

hemodynamically unstable with coagulopathy and thrombocytopenia coming for laparotomy for NEC. Management differs if they are on conventional ventilation or on HFOV. Permissive hypercarbia is common in NICU setting. The decision to conventionally or manually ventilate them is critial as they usually go hypocapnic and hypocalcemic that may be detrimental to their myocardium.

Common problems are hypotension and hypovolenia, hypothetmia, hypocapnia and hypocalcemia.

Ayesha Ali work as a consultant paediatric Anesthesia and paediatric pain management in KKH, which is theonly paediatric hospital in Singapore. The hospital has all the sub-specialty in paediatric surgery and do about 600+ theatre cases per year in all the sub-specialty excluding cardiac surgery and manage over 700+cases for paediatric pain management per year. The specialties in general surgery include thoracic, upper GI, lower GI, oncology and urology, orthopedic specialty including scoliosis surgery. ENT including airway surgery, plastic specialty including cleft surgery. There are regular endoscopy lists where I teach deep sedation with TCI intravenous agents, and sedation for procedural pain. She is also involved in cardiac catheter lists and paediatric radiology lists.

Concern has been raised on the potential deleterious neurocognitive effects of general anesthesia during infancy and early life. Although there are no definitive data to prove this effect, the neonatal and infancy period has been suggested to be the most vulnerable period, and some studies observed an association between exposure to general anesthesia as an infant, and later neurobehavioral problems in childhood. The potential neurocognitive effects of various general anesthetic agents have been demonstrated in laboratory animals and suggested from retrospective clinical trials. The anesthetic agents identified as possible neurotoxins include either γ-amino-butyric-acid (GABA) agonists including the volatile anesthetic agents, benzodiazepines, barbiturates or N-methyl-D-aspartate (NMDA) antagonists such as ketamine. Although regional anesthesia is an acceptable alternative, many surgical procedures may not be amenable to regional anesthesia. Dexmedetomidine and remifentanil on the

other hand, seem to be spared of such controversy, however limited data are available regarding their combined use during surgery in infants and Anesthesia. We herein present a case of a 3 month 3 week old infant who presented for examination under anesthesia of bilateral ears as well as Posterior Sagittal Anorectoplasty for anorectal malformation, for which general

anesthesia was provided by using a combination of remifentanil and dexmedetomidine.

Fouz Alzahrani has completed her master degree of human resource management at the age of 33 years from Alyamamah university. With 6 years’ of experience

as anesthesia technologist at KFSHRC Riyadh. She has researched about 2030 Saudi vision implementation among health care practitioners. She designed

special KPIs specifically applicable for anesthesia technologist.

Successful organizations that concerned of quality of work environment have implemented many efforts for integrating employee customer and shareholders values. In this framework, research shows that employee engagement has positive effect on productivity and attitude of employees more than intrinsic motivation, satisfaction and recognition. This research paper about designed CPR engagement program, Researchers aimed to find the reasons behind disengaged health care practitioners by interviewing the respondents, comparing the facts with another role model, and by reviewing the research conducted by expertise. Then were able to summaries the facts scientifically and design a unique engagement program fit for doctors’ nurse’s and allied health practitioners who are working in high loaded work environment. The idea comes with recommendations that going to success the engagement project. This research is conceptual in nature that they target to have complete vision about engagement effect on employees’ patients and organizations. And how to synchronize the engagement benefits for busy employee who are not able to attend the engagement activities outside work place. Present the information in designed form fit for non-managerial audiences to reach the target from such topic which is health career development.

After completing her undergraduate degree in Poland, Dr. Steiner earned her medical degree at the Medical University of Warsaw where she was named junior lecturer in the Department of Human Anatomy and Biochemistry; then completed an internship at the Postgraduate Medical Center of The Military Medical School. She completed a residency in general surgery at the Cabrini Medical Center in New York City, and a residency in anesthesiology and a fellowship in pain

management at New York University Medical Center. Dr. Steiner is past faculty at the University of California San Diego and Harvard Medical Faculty Physicians

Over 80% of the population will suffer from lower back pain during their lives, it is the fifth most common reason for all physician visits in the US. Most cases of lower back pain can be linked to a general cause—such as muscle strain, injury, or overuse—or can be attributed to a specific condition of the spine, most commonly: Herniated Disc, Degenerative Disc Disease, Spondylolisthesis, Spinal Stenosis, Osteoarthritis. A number of less common conditions can cause low back pain as well, such as sacroiliac joint dysfunction, spinal tumors, fibromyalgia, and piriformis syndrome. Patients with back pain radiating to the leg(s) report worse symptoms and poorer recovery than those with back pain alone. In primary care, approximately 60 % of patients presenting with low back pain (LBP) also report pain in the leg(s). Leg pain associated with LBP is generally considered to be either referred or radicular pain. The latter is commonly labelled sciatica and is often characterized by pain radiating to below the knee, into the foot and toes, and may be accompanied by objective findings of nerve root entrapment such as sensory deficits, reflex changes or muscle weakness. The most common reasons for sciatica are a disc bulge/prolapse or stenosis (either of the central canal or the foramen) impinging or irritating a nerve root(s). Referred leg pain from the low back is unrelated to nerve root involvement and is considered as pain referred from any other structure such as muscle, ligament, joint or intervertebral disc. It is generally acknowledged that the differentiation between sciatica and referred leg pain is not always straightforward in clinical practice, but ultimately it is a clinical diagnosis. Overall, patients who complain of back and leg pain and/or sciatica suffer more severe pain and disability, take longer to recover and incur most of the indirect costs and lost workdays compared to those with back pain alone. When determining the underlying cause of lower back and lower extremity pain, both the type (a description of how the pain feels) and the area of pain distribution (where the pain is felt) help

guide the physician in making a preliminary diagnosis and determining the appropriate treatment plan.

It has been more than Teen years since Mr. Ahmed Ayoub have become an official healthcare provider. He finished his Bachelor’s Degree from Philadelphia University in Jordan 2009. Eventually he proceeds to Study Master’s in Oncology Nursing from Hashemite University in 2013. He has an impressive work experience as a Senior Charge Nurse at King Hussein Cancer Center, Jordan in Medical/Surgical/VIP/OPD. He is currently working now in Al Dhafra Hospitals (Madinate Zayed Hospital) / SEHA United Arab Emirates as Outpatient Staff Nurse for more than three years. Mr. Ahmed Ayoub is a Champion of Nursing Research in Al Dhafra Hospitals and follows up around 9 hospitals. He has published 4 papers entitled: Do Not Resuscitate: An Argumentative Essay, Distributed in Ethics eJournal Vol 6, Issue 81, May 14, 2013. Consent Form Analysis, Distributed in Health Care Law & Policy eJournal Vol 5, Issue 20, April 08, 2013. The Effectiveness of Initial Assessment on Pressure Ulcer Prevention among Adult Jordanian Cancer Patients, Under Review. Assessment of Nurse’s Knowledge about Glasgow Coma Scale at Al Dhafra Hospitals, Abu Dhabi, United Arab Emirates. Journal of Clinical Review & Case ReportsVol3, Issue7, 01 Sep 2018.

Cancer is a worldwide health problem. In Jordan, cancer is the second leading cause of death. Approximately 2000 people die from cancer every year, 70% of them experiencing varying high levels of pain due to ineffective pain relief. This study aims to identify the attitudinal barriers to effective cancer pain relief in patients and their family caregivers in Jordan. A cross-sectional questionnaire survey was used. A convenience sample of 300 cancer patients and 246 family caregivers were recruited from 4 different Jordanian hospitals between August 2009 and May 2010. Patients completed the Arabic version of

the Barriers Questionnaire II (ABQ-II), the Arabic Brief Pain Inventory (A-BPI) and a demographic questionnaire. Family caregivers completed the ABQ-II and a demographic questionnaire. The A-BPI results identified that over 70% of cancer patients in localized stage and over 90% of the patients with advanced cancer experienced substantial pain. Four major barriers to pain control were highlighted: fears related to addiction, side-effects, communication concerns and fatalistic beliefs. This study contributes to provide baseline information about the barriers to effective cancer pain control in Jordan.