Endale Gebreegziabher Gebremedhn

@uog.edu.et

Department of Aanaesthesia, School of Medicine, Gondar College of Medicine and Health Sciences.
University of Gondar

Endale Gebreegziabher Gebremedhn


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https://researchid.co/endaleg

EDUCATION

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, nerve block, perioperative anaesthetic patient care, resuscitation, perioperative patient care, perioperative patient safety and outcome, critical care, cancer, global health, global surgery
15

Scopus Publications

993

Scholar Citations

16

Scholar h-index

22

Scholar i10-index

Scopus Publications

  • Prevalence and factors associated with chemotherapy-induced adverse events in cancer treatment centers in Amhara national regional state comprehensive referral hospitals, 2024: multicenter prospective follow up study
    Atalay Eshetie Demilie, Habtu Tsehayu Bayu, Mahder Metenu Taye, Fikadu Tadesse Diress, Endale Gebreegziabher Gebremedhn
    BMC Cancer, 2026
    Chemotherapy drugs remain the gold standard treatment for cancer. However, the side effects limit chemotherapy treatment and make treatment outcome poor. This makes chemotherapy side effects a big public health problem globally. To assess prevalence and factors associated with chemotherapy-induced adverse events in cancer treatment centers in Amhara national regional state comprehensive referral hospitals, Norwest Ethiopia 2024. Multi-center prospective observational study was conducted. Data was collected using questionnaire and checklist. Adverse events were collected and graded using National Cancer Institute Common Terminology CTCAE version 4.0. 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. A total of 572 patients were included in the study with a response rate of 99.5%. The overall prevalence of chemotherapy related adverse events was 78.49% with (95%, CI = 0.7783–0.7817). Cisplatin causes adverse events in 152 (95%), oxaliplatin 59 (100%), paclitaxel 28 (100%), docetaxel 42 (76.4%), gemcitabine 68 (68%) patients, 5-Flurouracil 65 (51.2%) and cyclophosphamide 10 (29.4%) patients respectively. The commonest severe (grades 3–4) adverse events were peripheral neuropathy or pain (36.7%), nausea and vomiting (28.5%), hair loss (22.9%), fatigue (22%), itching (19.1%), cyanosis (18%), leukopenia (16.9%) and diarrhea (16.3%). Being female (AOR = 4.201, CI = 2.580–6.217), history of motion (AOR = 3.001, CI = 2.410–5.201), history of morning sickness (AOR = 1.610, CI = 101 − 3.1), second cycle chemotherapy (AOR = 2.701, CI = 201 − 8.09) and third cycle of chemotherapy (AOR = 3.201, CI = 2.91–5.302) were associated with chemotherapy related adverse events. The prevalence of chemotherapy-induced adverse events was high in the study settings. We recommend early cycle by cycle risk assessment of patients and management of adverse events. Additionally, training should be given for oncologic nurses about the risk assessment and management of adverse events. High emphasis should be given for patients who will receive oxaliplatin, cisplatin, paclitaxel, docetaxel and gemcitabine.
  • Prevalence and factors associated with acute pain among emergency trauma patients
    Elias Alemayehu Worku, Habtu Adane Aytolign, Zemenay Ayinie Mekonnen, Endale Gebreegziabher Gebremedhn
    World Journal of Emergency Medicine, 2026
    BACKGROUND: Acute pain is a sudden experience secondary to injuries and varies in perception among individuals. In trauma patients, it can negatively affect respiratory function, immune response, and wound healing, making it a significant public health concern. This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients. METHODS: -value <0.05 were considered statistically significant. RESULTS: : 1.36-11.43) were associated with acute pain experience. CONCLUSION: The prevalence of acute pain among emergency trauma patients was high in the study area. Analgesia should be administered prior to admission, and non-pharmacological pain management should be implemented. Moreover, training on pain assessment and management should be provided for healthcare providers in the emergency department.
  • Setting Priorities for African Postoperative Pain Research Through an International Delphi Process
    Gebrehiwot Asfaw, Tadesse B. Melkie, Ananya A. Shiferaw, Timothy M. Mwiti, Gaston Nyirigira, Francois Retief, Alfa A. Mikailu, Amos Zacharia, Ensa Jarju, Esubalew Lakew, Isabella Epiu, Kissoon Vishaal, Lynda Abed, Mequanent Yimer, Mubarak Mohamed, Oluwayemisi E. Ekor, Prudence Bukuru, Robert Djagbletey, Amany E. Ayad, Patrice Forget, Endale G. Gebremedhn
    Anesthesia and Analgesia, 2025
    Perioperative pain management is essential for patients’ well-being and efficient health service delivery.1 Alleviating pain is not merely a matter of goodwill but also part of the duty to prevent harm and protect human rights.2 Biological, psychological, and social dimensions of the pain experience should be considered and understood to provide optimum pain management in the postoperative setting.3 However, in low- and middle-income countries (LMICs), a surgeon-led prescription of postoperative analgesia4 may not address the biopsychosocial dimension of pain and interdisciplinary and multimodal approaches. Despite the declarations that access to pain management is a fundamental human right5 and different initiatives, like the Pain-Free Hospital Initiative (PFHI) and pain as the fifth Vital Sign6 acute postoperative pain remains a challenge across the continent of Africa.4 The global prevalence of moderate-to-severe postoperative pain ranges between 50 and 80%.7 A meta-analysis of 27 studies involving 22,108 patients found that the average prevalence rates of moderate to severe postoperative pain were 31% and 58% 1 day and 1 to 2 weeks after discharge, respectively.8 In Africa, the prevalence of moderate-to-severe postoperative pain has been reported as high as 91.4–95%.4 On the other hand, it is now widely accepted that the severity of untreated postoperative pain is 1 of the most important predictors of prolonged postoperative pain and the development of chronic postsurgical pain.9 The burden of acute pain is compounded by undertreatment and disparity in the availability of analgesic treatments and multimodal analgesia practices.10,11 Significant barriers to effective pain treatment include, among others, the failure of many governments to put in place functioning drug supply systems, the failure to enact policies on pain treatment, poor training of health care workers, and the existence of unnecessarily restrictive drug control regulations.12,13 These barriers are unequally distributed between high-income and LMICs, with the most disadvantaged patients bearing the burden of this disparity.14 Except for a few institutional attempts,4 no comprehensive studies have been conducted to identify research priorities in Africa related to postoperative pain. Establishing key priorities for African postoperative pain research is a logical first step in addressing this issue. Therefore, we used a modified Delphi method to delineate the top 10 research priorities and the 3 principal strategies to address them. STUDY SETTING, EVIDENCE REVIEW, AND CONSENSUS PROCESS Health care providers in Africa who are actively engaged in perioperative pain management and research were invited as study participants inclusive of different educational backgrounds and areas of clinical expertise. We preferred a broad professional mix of experts instead of single-specialty experts. As part of the preparatory phases for the Delphi process, a literature review was conducted at the PubMed and Scopus databases and using the Google Scholar search engine. The search used key terms, and Medical Subject Headings (MeSH) terms (“Postoperative pain, “postsurgical pain,” “pain after surgery,” Africa, African regions). Boolean operators such as “AND” and “OR” were also used to identify the evidence gaps in the literature. The review substituted the open-ended round typically used in classical Delphi studies, thereby reducing participants’ attrition rates and response fatigue.15 After the literature review, the questions were thematized, and a survey template was prepared using Google Forms. A pilot test was subsequently conducted. Semistructured electronic Delphi questionnaires were used as they allowed flexibility and reach.16 Participants were instructed to select 10 statements from a list of 41 potential questions and select 3 strategies from lists of 7 possible options to address the established key priorities (see Supplemental Digital Content I, https://links.lww.com/AA/F419). Each selection was guided by criteria including problem severity, magnitude, feasibility, scientific, practical, and societal relevance, as well as community and government concern. Additionally, participants were invited to propose research questions or strategies beyond those listed in the questionnaire during the first-round survey. The commencement/intention of the research was circulated to different national anesthesia professional societies in Africa, as well as the African Society for Regional Anesthesia (AFSRA); hence, eighteen national leads were attained. The participants were briefed about the Delphi process and deliverables, and the survey template was evaluated and agreed on with minor modifications. The national leads used a multipronged approach of communication to recruit the maximum number of participants for the first-round survey (04/11/2023–21/01/2024); however, it had a limitation in determining the response rates. After the closure of the first-round survey, results were communicated to the participants by email, and a debriefing and consensus virtual meeting was conducted to reframe and decide on the number of questions to be included in the second-round survey. Based on the outcomes of this consensus, statements that achieved more than 25% agreement in the first round (n = 19) and additional statements introduced by participants (n = 7) were deemed eligible for inclusion in the second round. The first-round survey results and the second-round survey form were shared with all participants via email. The round was open from February 2, 2024, through April 20, 2024, and during that time 3 email reminders were sent. The participants reviewed the rating results from the previous round and had the option to modify or retain their initial responses. However, they were restricted to selecting only 10 statements from the list. On the conclusion of the second-round survey, the results were disseminated to the participants. Subsequently, a final virtual consensus meeting was convened to either finalize the top 10 priorities based on their magnitude and stability from the second-round survey results or to determine the necessity of a third-round survey. The participants ultimately agreed to establish the top 10 key priorities and strategies based on the second-round survey results, ordered by magnitude. Modification of the Delphi Technique Common modifications to the classical Delphi method include summarizing existing evidence, conducting in-person or virtual meetings that compromise anonymity, providing group-only vs individualized statistical reports, incorporating focus groups and other qualitative methods, utilizing online survey platforms and discussion forums, and adjusting items and rating criteria across different rounds.15,17 The classical Delphi method starts by identifying unanswered questions through participant input. To mitigate response fatigue, a comprehensive literature search was conducted, generating a long list of statements or questions. Participants prioritized by selecting 10 key priorities or suggesting additional priorities. In the second step, questions from the first-round survey were thematized, though the number of questions remained limited due to the extensive initial list. The third step, involving verification of uncertainties and evidence review, was omitted as the steering committee had already agreed on the long list based on the literature review. The fourth step involved interim prioritization for the second-round online survey. The participants held a virtual consensus meeting to determine the number of questions for this survey. Questions with at least 25% agreement were included, while those with less agreement were excluded (see Figure 1 and Supplemental Digital Content II, https://links.lww.com/AA/F420). Newly added questions from the first-round survey were also included. Based on the results of the second-round survey, a virtual consensus meeting was convened to finalize the top 10 priorities or to determine the necessity of a third round of the online survey. The participants concurred on concluding the survey, as additional rounds could lead to participant attrition and potentially induce forced consensus, wherein participants might alter their responses to align with the majority merely to complete the Delphi process.15 Consequently, the final top 10 priorities for African postoperative pain research and strategies were established after 2 rounds of surveys and 2 virtual consensus meetings.Figure 1.: Flow diagram of the study.Rating the same item on multiple criteria can become too burdensome for participants; hence, stakeholders with different and often opposing preferences need to choose 1 or 2 options from a longer list.18,19 After the recommendation, participants were permitted to select only 10 statements from the extensive lists. A descriptive analysis of participants’ demographic characteristics and statements was conducted to generate interim priorities, ranked by magnitude or percentage of consensus. Comment analyses were performed to integrate participants’ feedback into the second-round survey. The results were summarized in tables, graphs, enumerations, and narrative forms, adhering to published guidelines for reporting Delphi studies.20 A Note on Ethical Approval The Institutional Review Boards (IRBs) of Bahir Dar University determined that no ethical approval or research governance was necessary for this survey. Nevertheless, participants were informed about the study’s purpose, data collection procedures, and the associated risks and benefits of their participation. Informed consent was obtained from the participants through a study information sheet and a consent form programmed using the e-Delphi software. This information was also communicated during a virtual briefing meeting. RESULTS The Delphi technique is a well-established approach to determining clinical research priorities with an iterative process and a predefined criterion, particularly where the opinions and judgments of experts and practitioners are needed but time, distance, and other factors make it unlikely or impossible for the participants to work together in the same physical location.20,21 For this Delphi process, a continental group of experts identified and agreed on the final top 10 research priorities and top 3 strategies to address those (Table 1). Table 1. - Top 10 Postoperative Pain Research Priorities SNo. Top 10 priorities Scope Level of action 1 Practices of Postoperative Pain Management in Africa Evidence on the status quo Research and Policy Direction 2 A cost-effective and efficient way of providing postoperative pain management in Africa Evidence Research and Policy Direction 3 Regional anesthesia training and practice capacities in Africa Education and Pain Management Research and training 4 Patient satisfaction with postoperative pain management in Africa Evidence Research 5 Barriers and enablers to postoperative pain management in Africa Evidence Research and Policy Direction 6 Impact of regional anesthesia and pain management on the surgical outcome Pain management Research and Education 7 The role of regional anesthesia in the prevention and management of pain after surgery Pain management Research and Education 8 Role of preemptive and multimodal analgesia in the prevention of pain after surgery Pain management Research and Education 9 Barriers to postoperative pain management in pediatric surgeries in Africa Evidence Research and Policy Direction 10 Perioperative predictors of acute and chronic postsurgical pain Pain management Research and Education Summary of the top 3 strategies.Development of regional anesthesia training and standards of practice guidelines.Development of a multidisciplinary harmonized continental Curriculum in acute and chronic pain management; tailored training development.Assessing the pain assessment methods in an African context and tool development. In the initial round, 174 participants from 25 of 54 African countries participated, with a predominance of male participants (n = 130, 74.4%). In the subsequent round, 104 participants from 22 African countries participated, resulting in a response rate of 59.8%. This cohort represented all regions of the continent, with a significant proportion from East Africa (12 of 22 countries), as illustrated in Figure 2.Figure 2.: Distribution of experts by country and region.The majority of experts in both the first and second rounds were anesthesia providers (n = 141, 81.1%), with educational backgrounds including anesthesiologists (MD, 44.8%), anesthesia professional specialists (MSc, 22.4%), and nurse anesthetists (BSc, 13.8%). The remaining 33 participants (18.9%) comprised surgeons (general, orthopedic, hepatobiliary, urology, and thoracic), gynecologists and obstetricians, otolaryngologists, emergency and family physicians, radiologists, general practitioners, clinical psychologists, pharmacists, nurses, and midwives (Table 2). Among the 174 participants, 100 (57.5%) were affiliated with academic institutions, holding positions such as Professor (n = 7, 4%), Associate Professor (n = 6, 3.4%), Assistant Professor (n = 43, 24.7%), and Senior Lecturer or Lecturer (n = 44, 25.3%). The remaining 74 participants (42.5%) were nonacademicians used in various health care settings, nongovernmental organizations (NGOs), and research institutions. Table 2. - Educational Background and Area of Specialization of Experts Expert’s professional background and specialization First round Second round Anesthesiologists (MD+) 78 (44.8%) 40 (38.5%) Anesthetist (MSc)a 39 (22.4%) 29 (27.9%) Anesthetist (BSc)b 24 (13.8%) 16 (15.4%) Surgical specialitiesc 17 (9.8%) 15 (14.4%) General practitioners 4 (2.3%) 2 (1.9%) Nursing 4 (2.3%) _ Midwives 3 (1.7%) _ Radiologists, emergency, and family physicians 3 (1.7%) 1 (0.96%) Clinical psychologists, pharmacists 2 (1.2%) 1 (0.96%) Total 174 104 aAn anesthesia provider with a generic or nurse anesthesia background with an MSc.bAn anesthesia provider with a generic or nurse anesthesia background with a BSc.cGeneral surgeon, thoracic surgeon, Hepatobiliary surgeon, orthopedic, urologist, otolaryngologist, obstetrics and gynecology, urogynecologist, and gyneco-oncologist. The top 10 postoperative pain research priorities in Africa underscore the necessity for evidence-based practices, effective pain management strategies, education, and policy direction. Key focus areas include the evaluation of current practices, the identification of cost-effective solutions, and the exploration of barriers and enablers to effective pain management. Additionally, emphasis is placed on leveraging the roles of preemptive analgesia and regional anesthesia in enhancing patient-reported outcomes. To address these priorities, the leading strategies were also established for the African context (Table 1). DISCUSSION Analysis of Priority Agendas The study established the top 10 “highest priority” research questions, which address a wide range of topics pertinent to the unique challenges and needs in Africa. These questions encompass themes such as pain management, training and assessment, clinical practice, and evidence synthesis, with the possible top 3 strategies to address the priority research questions. Priority1. Practices of Postoperative Pain Management in Africa Exploring current practices in Africa reveals challenges in resource-limited settings and highlights opportunities for improvement. This requires evaluating existing practices, identifying trends, and developing strategies to disseminate best practices and address areas for enhancement across the continent.22,23 It will profoundly impact patient care, clinical guidelines, health care policy, and research in Africa. This highlights the need for collaboration with stakeholders across the continent to enhance evidence-based practices and improve patient outcomes.4 Priority 2. A Cost-Effective and Efficient Way of Providing Postoperative Pain Management in Africa Along with other barriers, affordability and technical challenges in different pain management modalities create a greater quality chasm in pain management in Africa.12,13,24 Identifying cost-effective and efficient pain management strategies is crucial for informing policy development and guiding funding agencies in areas such as training, education, innovation, and technology. These strategies aim to enhance patient outcomes and optimize health care resource allocation tailored to the African context. A notable example is Uganda’s implementation of affordable morphine for end-of-life care, which serves as a successful, context-specific pain management model.25 Priority 3. Regional Anesthesia Training and Practice Capacities in Africa Regional anesthesia techniques are extensively advocated due to their numerous advantages, which include a reduction in anesthetic-related complications, decreased opioid consumption, expedited recovery times, cost-effectiveness, enhanced pain management, and overall improved quality of recovery.26–28 Efforts in Africa are concentrated on comprehensively understanding current practices, developing training pathways, guiding targeted interventions, establishing best practice standards, and ensuring resource allocation to areas of greatest need will improve patient outcomes.12,13 Priority 4. Patient Satisfaction With Postoperative Pain Management in Africa Effective postoperative pain relief is essential for patient well-being and satisfaction. Evaluating patient satisfaction serves as a critical metric for assessing the effectiveness of pain management strategies, identifying areas for improvement, and ultimately enhancing the overall quality of care.22,29 Moreover, aligning treatment with patient prospects fosters a patient-centered approach and serves as a benchmark for institutional performance and educational initiatives.11,30 Priority 5. Barriers and Enablers to Postoperative Pain Management in Africa Investigating barriers and enablers of postoperative pain management informs clinical practice improvements, targeted education, multidisciplinary approaches, resource allocation, and policy development.31,32 Identifying knowledge gaps, infrastructure, cultural contexts, training, education, and policy directions in Africa can lead to comprehensive interventions that improve pain management, enhance patient outcomes, and inform tailored policy decisions. Priority 6. Impact of Regional Anesthesia and Pain Management on Surgical Outcome Evidence shows that while regional anesthesia and effective pain management benefit the immediate postoperative period, their long-term impact is still under research and debate.28,33,34 Investigating these areas is crucial for Africa, where the surgical landscape differs due to resource availability, training, disease and cultural Priority Role of Regional Anesthesia in the and Management of Pain After Regional anesthesia is for acute postoperative pain and may the of chronic pain. pain management to the needs and the is essential for Investigating the role of regional anesthesia in the prevention of and chronic surgical pain in Africa is essential for and pain management Priority Role of and in the of Pain After and multimodal analgesia is crucial for acute and prolonged postoperative pain and chronic postsurgical pain, leading to long-term patient However, research is needed on drug long-term outcomes, and regional in availability and Priority Barriers to Postoperative Pain Management in in Africa Investigating barriers to postoperative pain management in pediatric groups is essential due to psychological, and from these in the African context is essential for developing to postoperative pain in ensuring they and Priority Perioperative of and Pain various predictors to identify patients guiding efficient and cost-effective resource allocation and perioperative pain interdisciplinary research is needed to improve perioperative pain assessment and management, with resource and outcomes in the experts on those priority strategies will enhance the work to address the priority as a policy of the research These priorities the consensus of 174 and actively engaged in perioperative pain management and research from 25 African countries that a broad range of topics that are to the challenges and needs in Africa. Despite the extensive of survey, was a as participants were from only 25 African East Africa, with a significant mix of anesthesia and pain Nevertheless, we from health care settings across Africa. a consensus is typically the participants to the top 10 by magnitude than consensus. The other limitation was while is essential in the Delphi process to feedback of or a the was deemed as it a ultimately enhancing the quality of the consensus while ensuring that the survey data remained and AND We conducted a survey and involved in perioperative pain management across Africa to identify the top 10 priority research for postoperative pain through consensus. These priorities are to research collaboration with health care and The established priorities are critical for postoperative pain research in Africa, care resource allocation, enhancing and and patient Research not included in the top 10 priorities and should be considered by the community (see Supplemental Digital Content II, https://links.lww.com/AA/F420). The to their to the experts and who to this study and their informed consent to a crucial role in the Delphi process and the of this of This was
  • Incidence and factors associated with failed spinal anaesthesia among patients undergoing surgery: a multi- center prospective observational study
    Atalay Eshetie Demilie, Zewditu Abdissa Denu, Yosef Belay Bizuneh, Endale Gebreegziabher Gebremedhn
    BMC Anesthesiology, 2024
    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 &lt; 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.
  • Health-care providers’ knowledge, attitudes, and practices regarding adult cardiopulmonary resuscitation at Debre Markos Referral Hospital, Gojjam, Northwest Ethiopia
    Temesgen Agegnehu Abebe, Liknaw Bewket Zeleke, Mulunesh Alemayehu Assega, Worku Mekonnen Sefefe, Endale Gebreegziabher Gebremedhn
    Advances in Medical Education and Practice, 2021
    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.
  • Variability of Oxaliplatin-Induced Neuropathic Pain Symptoms in Each Cycle and Its Implications on the Management of Colorectal Cancer Patients: A Retrospective Study in South Western Sydney Local Health District Hospitals, Sydney, Australia
    Endale G. Gebremedhn, Peter J. Shortland, David A. Mahns
    Journal of Oncology, 2019
    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 &lt;850 mg/m2(P=0.002) were associated with patient mortality. Completion of chemotherapy (8 cycles) and cumulative dose &gt;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.
  • Outcome assessment of emergency laparotomies and associated factors in low resource setting. A case series
    Endale Gebreegziabher Gebremedhn, Abatneh Feleke Agegnehu, Bernard Bradley Anderson
    Annals of Medicine and Surgery, 2018
    BACKGROUND: Emergency laparotomy is a high risk procedure which is demonstrated by high morbidity and mortality. However, the problem is tremendous in resource limited settings and there is limited data on patient outcome. We aimed to assess postoperative patient outcome after emergency laparotomy and associated factors. METHODS: An observational study was conducted in our hospital from March 11- June 30, 2015 using emergency laparotomy network tool. All consecutive surgical patients who underwent emergency laparotomy were included. Binary and multiple logistic regressions were employed using adjusted odds ratios and 95% CI, and P-value < 0.05 was considered to be statistically significant. RESULT: A total of 260 patients were included in the study. The majority of patients had late presentation (>6hrs) to the hospital after the onset of symptoms of the diseases and surgical intervention after hospital admission. The incidences of postoperative morbidity and mortality were 39.2% and 3.5% respectively. Factors associated with postoperative morbidity were preoperative co-morbidity (AOR = 0.383, CI = 0.156-0.939) and bowel resection (AOR = 0.232, CI = 0.091-0.591). Factors associated with postoperative mortality were anesthetists' preoperative opinion on postoperative patient outcome (AOR = 0.067, CI = 0.008-0.564), level of consciousness during recovery from anaesthesia (AOR = 0.114, CI = 0.021-10.628) and any re-intervention within 30 days after primary operation (AOR = 0.083, CI = 0.009-0.750). CONCLUSION AND RECOMMENDATION: The incidence of postoperative morbidity and mortality after emergency laparotomy were high. We recommend preoperative optimization, early surgical intervention, and involvement of senior professionals during operation in these risky surgical patients. Also, we recommend the use of WHO or equivalent Surgical Safety Checklist and establishment of perioperative patient care bundle including surgical ICU and radiology investigation modalities such as CT scan.
  • The incidence of acute oxaliplatin-induced neuropathy and its impact on treatment in the first cycle: A systematic review
    Endale Gebreegziabher Gebremedhn, Peter John Shortland, David Anthony Mahns
    BMC Cancer, 2018
    Although acute oxaliplatin-induced neuropathy (OXIPN) is frequently regarded to be transient, recent studies have reported prolongation of infusion times, dose reduction and treatment cessation following the first dose of oxaliplatin in quarter of patients. Acute OXIPN is also a well-established risk factor for chronic neuropathy. However, there is underreporting of these parameters during the acute phase (≤ 14 days). This paper systematically reviews the incidence of acute OXIPN and its impact on treatment in the first cycle. A systematic literature search was performed using PubMed and Medline. Published original articles were included if they described details about prevalence of oxaliplatin-induced acute neuropathy. Fourteen studies, comprised of 6211 patients were evaluated. The majority of patients were treated with oxaliplatin in combination with leucovorin and fluorouracil (FOLFOX). Most studies used the National Cancer Institute Common Toxicity Criteria to assess acute neuropathy. Acute neuropathy (Grades 1–4) was the most common event with prevalence ranging from 4–98%, followed by haematological (1.4–81%) and gastrointestinal (1.2–67%) toxicities, respectively. Drug regimens, starting dose of oxaliplatin and neuropathy assessment tools varied across studies. In addition, moderate to severe toxicities were common in patients that received a large dose of oxaliplatin (> 85 mg/m2) and/ or combined drugs. The majority of studies did not report the factors affecting acute neuropathy namely the range (minimal) doses required to evoke acute neuropathy, patient and clinical risk factors. In addition, there was no systematic reporting of the number of patients subjected to prolonged infusion, dose reduction, treatment delay and treatment cessation during the acute phase. Despite the heterogeneity of studies regarding oxaliplatin starting dose, drug regimen, neuropathy assessment tools and study design, a large number of patients developed acute neuropathy. To develop a better preventive and therapeutic guideline for acute/chronic neuropathy, a prospective study should be conducted in a large cohort of patients in relation to drug regimen, starting/ranges (minimal) of doses producing acute neuropathy, treatment compliance, patient and clinical risk factors using a standardised neuropathy assessment tool.
  • Efficacy of intravenous tramadol and low-dose ketamine in the prevention of post-spinal anesthesia shivering following cesarean section: A double-blinded, randomized control trial
    Girmay Fitiwi Lema, Endale Gebreegziabher Gebremedhn, Amare Hailekiros Gebregzi, Yilkal Tadesse Desta, Adugna Aregawi Kassa
    International Journal of Women S Health, 2017
    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.
  • Efficacy of single-injection unilateral thoracic paravertebral block for post open cholecystectomy pain relief: A prospective randomized study at gondar university hospital
    Demeke Yilkal Fentie, Endale Gebreegziabher Gebremedhn, Zewditu Abdissa Denu, Amare Gebreegzi
    Local and Regional Anesthesia, 2017
    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.
  • Patient satisfaction with the perioperative surgical services and associated factors at a university referral and teaching hospital, 2014: A cross-sectional study
    Endale Gebreegziabher Gebremedhn, Girmay Fitiwi Lemma
    Pan African Medical Journal, 2017
  • Risk factors for postoperative throat pain after general anaesthesia with endotracheal intubation at the university of Gondar teaching hospital, Northwest Ethiopia, 2014
    Biruk Melkamu Gemechu, Endale Gebreegziabher Gebremedhn, Tadesse Belayneh Melkie
    Pan African Medical Journal, 2017
  • Attitude and skill levels of graduate health professionals in performing cardiopulmonary resuscitation
    Endale Gebreegziabher Gebremedhn, Gebremedhn Berhe Gebregergs, Bernard Bradley Anderson, Vidhya Nagaratnam
    Advances in Medical Education and Practice, 2017
  • Patient satisfaction with anaesthesia services and associated factors at the University of Gondar Hospital, 2013: A cross-sectional study
    Endale Gebreegziabher Gebremedhn, Wubie Birlie Chekol, Wubet Dessie Amberbir, Tesera Dereje Flatie
    BMC Research Notes, 2015
  • Audit on preoperative fasting of elective surgical patients in an African academic medical center
    Endale Gebreegziabher Gebremedhn, Vidhya Bates Nagaratnam
    World Journal of Surgery, 2014

RECENT SCHOLAR PUBLICATIONS

  • Assessment of sleep quality and associated factors in adult patients admitted in intensive care unit at Bahir Dar city comprehensive specialized hospitals, Northwest Ethiopia …
    AE Demilie, HT Bayu, ET Dejen, EG Gebremedhn
    Sleep Science and Practice 10 (1), 9 , 2026
    2026
  • Prevalence and factors associated with acute pain among emergency trauma patients
    EA Worku, HA Aytolign, ZA Mekonnen, EG Gebremedhn
    World Journal of Emergency Medicine 17 (1), 36 , 2026
    2026
  • Prevalence and factors associated with chemotherapy-induced adverse events in cancer treatment centers in Amhara national regional state comprehensive referral hospitals, 2024 …
    AE Demilie, HT Bayu, MM Taye, FT Diress, EG Gebremedhn
    BMC cancer , 2025
    2025
    Citations: 1
  • Prevalence and severity of preoperative anemia, and associated factors among orthopedic patients at public comprehensive referral hospitals, Northwest Ethiopia 2024: multi …
    AE Demile, HT Bayu, EG Gebremedhn
    Perioperative Medicine 14 (1), 125 , 2025
    2025
  • A prospective audit on the current practice of patient care in adult surgical intensive care unit
    AE Demilie, ZA Denu, YB Bizuneh, EG Gebremedhn
    IJS Global Health 8 (5), e00589 , 2025
    2025
  • Audit on the assessment of the practice of storage, labeling, and usage of anesthetic medications in the operation theaters at a comprehensive specialized hospital, 2024 …
    EA Worku, HA Aytolign, ZA Mekonnen, EG Gebremedhn
    IJS Global Health 8 (4), e00573 , 2025
    2025
  • Priorities for African Postoperative Pain Research: An International Delphi Study
    G Tegu, T Melkie, A Shiferaw, T Mwiti, N Gaston, R Francois, A Mikailu, ...
    ANESTHESIA AND ANALGESIA 140 (5), 438-442 , 2025
    2025
  • Audit on physicians’ adherence with the WHO analgesic ladder to treat postoperative pain
    BE Asrat, MM Temesgen, HY Tawuye, EG Gebremedhn
    IJS Global Health 8 (1), e00539 , 2025
    2025
    Citations: 1
  • Incidence and factors associated with failed spinal anaesthesia among patients undergoing surgery: a multi-center prospective observational study
    AE Demilie, ZA Denu, YB Bizuneh, EG Gebremedhn
    BMC anesthesiology 24 (1), 129 , 2024
    2024
    Citations: 20
  • Setting priorities for African postoperative pain research through an international Delphi process
    G Asfaw, TB Melkie, AA Shiferaw, TM Mwiti, G Nyirigira, F Retief, ...
    Anesthesia & Analgesia, 10.1213 , 2022
    2022
    Citations: 4
  • Pre-emptive analgesia for the prevention of chronic postsurgical pain: a systematic review and meta-analysis with trial sequential analysis
    EG Gebremedhn, WM Sefefe
    J Anesth Clin Res 13 (11), 1-11 , 2022
    2022
    Citations: 3
  • Health-care providers’ knowledge, attitudes, and practices regarding adult cardiopulmonary resuscitation at Debre Markos Referral Hospital, Gojjam, Northwest Ethiopia
    TA Abebe, LB Zeleke, MA Assega, WM Sefefe, EG Gebremedhn
    Advances in Medical Education and Practice, 647-654 , 2021
    2021
    Citations: 41
  • Exploring the Incidence and Variability of Oxaliplatin-induced Neuropathic Pain Symptoms in Colorectal Cancer Patients, Comparative in vivo/in vitro Modelling of Oxaliplatin …
    EG Gebremedhn
    Sydney University , 2021
    2021
  • Research Article Variability of Oxaliplatin-Induced Neuropathic Pain Symptoms in Each Cycle and Its Implications on the Management of Colorectal Cancer Patients: A …
    EG Gebremedhn, PJ Shortland, DA Mahns
    2019
  • Variability of oxaliplatin‐induced neuropathic pain symptoms in each cycle and its implications on the management of colorectal cancer patients: A retrospective study in South …
    EG Gebremedhn, PJ Shortland, DA Mahns
    Journal of oncology 2019 (1), 4828563 , 2019
    2019
    Citations: 11
  • Outcome assessment of emergency laparotomies and associated factors in low resource setting. A case series
    EG Gebremedhn, AF Agegnehu, BB Anderson
    Annals of medicine and surgery 36, 178-184 , 2018
    2018
    Citations: 22
  • The incidence of acute oxaliplatin-induced neuropathy and its impact on treatment in the first cycle: a systematic review
    EG Gebremedhn, PJ Shortland, DA Mahns
    BMC cancer 18 (1), 410 , 2018
    2018
    Citations: 135
  • Effectiveness of intravenous metoclopramide prophylaxis on the reduction of intraoperative and early postoperative nausea and vomiting after emergency caesarean section under …
    ENS Endalew, E Gebremedhn, A Gebreegzi, H Kassahun, A Kassa
    J Anesth Clin Res 9 (809), 2 , 2018
    2018
    Citations: 10
  • Magnitude of Airway Problems at a University Teaching and Referral Hospital Recovery Room of Low Resource Setting-A Cross Sectional Study
    EG Gebremedhn, HY Tawuye
    J Anesth Clin Res 9 (825), 2 , 2018
    2018
  • Efficacy of intravenous tramadol and low-dose ketamine in the prevention of post-spinal anesthesia shivering following cesarean section: a double-blinded, randomized control trial
    GF Lema, EG Gebremedhn, AH Gebregzi, YT Desta, AA Kassa
    International journal of women's health, 681-688 , 2017
    2017
    Citations: 80

MOST CITED SCHOLAR PUBLICATIONS

  • The incidence of acute oxaliplatin-induced neuropathy and its impact on treatment in the first cycle: a systematic review
    EG Gebremedhn, PJ Shortland, DA Mahns
    BMC cancer 18 (1), 410 , 2018
    2018
    Citations: 135
  • Audit on preoperative fasting of elective surgical patients in an African academic medical center
    EG Gebremedhn, VB Nagaratnam
    World journal of surgery 38 (9), 2200-2204 , 2014
    2014
    Citations: 91
  • Efficacy of intravenous tramadol and low-dose ketamine in the prevention of post-spinal anesthesia shivering following cesarean section: a double-blinded, randomized control trial
    GF Lema, EG Gebremedhn, AH Gebregzi, YT Desta, AA Kassa
    International journal of women's health, 681-688 , 2017
    2017
    Citations: 80
  • Risk factors for postoperative throat pain after general anaesthesia with endotracheal intubation at the University of Gondar Teaching Hospital, Northwest Ethiopia, 2014
    BM Gemechu, EG Gebremedhn, TB Melkie
    The Pan African Medical Journal 27, 127 , 2017
    2017
    Citations: 77
  • Patient satisfaction with anaesthesia services and associated factors at the University of Gondar Hospital, 2013: a cross-sectional study
    EG Gebremedhn, WB Chekol, WD Amberbir, TD Flatie
    BMC research notes 8 (1), 377 , 2015
    2015
    Citations: 74
  • Patient satisfaction with the perioperative surgical services and associated factors at a University Referral and Teaching Hospital, 2014: a cross-sectional study
    EG Gebremedhn, GF Lemma
    Pan African Medical Journal 27 (1) , 2017
    2017
    Citations: 70
  • Knowledge and skills of neonatal resuscitation of health professionals at a university teaching hospital of Northwest Ethiopia
    E Gebreegziabher, A Aregawi, H Getinet
    World journal of emergency medicine 5 (3), 196 , 2014
    2014
    Citations: 62
  • Assessment of patient satisfaction with the preoperative anesthetic evaluation
    EG Gebremedhn, V Nagaratnam
    Patient related outcome measures, 105-110 , 2014
    2014
    Citations: 50
  • The incidence of oxygen desaturation during rapid sequence induction and intubation
    EG Gebremedhn, D Mesele, D Aemero, E Alemu
    World journal of emergency medicine 5 (4), 279 , 2014
    2014
    Citations: 45
  • Attitude and skill levels of graduate health professionals in performing cardiopulmonary resuscitation
    E Gebreegziabher Gebremedhn, G Berhe Gebregergs, BB Anderson, ...
    Advances in medical education and practice, 43-50 , 2017
    2017
    Citations: 42
  • Health-care providers’ knowledge, attitudes, and practices regarding adult cardiopulmonary resuscitation at Debre Markos Referral Hospital, Gojjam, Northwest Ethiopia
    TA Abebe, LB Zeleke, MA Assega, WM Sefefe, EG Gebremedhn
    Advances in Medical Education and Practice, 647-654 , 2021
    2021
    Citations: 41
  • Efficacy of fascia iliaca compartment nerve block as part of multimodal analgesia after surgery for femoral bone fracture
    FT Kumie, EG Gebremedhn, HY Tawuye
    World journal of emergency medicine 6 (2), 142 , 2015
    2015
    Citations: 40
  • The knowledge level of final year undergraduate health science students and medical interns about cardiopulmonary resuscitation at a university teaching hospital of Northwest …
    EG Gebremedhn, GB Gebregergs, BB Anderson
    World journal of emergency medicine 5 (1), 29 , 2014
    2014
    Citations: 30
  • Outcome assessment of emergency laparotomies and associated factors in low resource setting. A case series
    EG Gebremedhn, AF Agegnehu, BB Anderson
    Annals of medicine and surgery 36, 178-184 , 2018
    2018
    Citations: 22
  • Incidence and factors associated with failed spinal anaesthesia among patients undergoing surgery: a multi-center prospective observational study
    AE Demilie, ZA Denu, YB Bizuneh, EG Gebremedhn
    BMC anesthesiology 24 (1), 129 , 2024
    2024
    Citations: 20
  • Analgesic effect of intrathecal fentanyl as an adjuvant to spinal anaesthesia in comparison with spinal anaesthesia with bupivacaine only for mothers delivered by emergency …
    KA Yesuf, EG Gebremedhn, TB Melkie
    J Anesth Crit Care Open Access 7 (5), 00278 , 2017
    2017
    Citations: 16
  • Analgesic efficacy of bilateral ilioinguinal and iliohypogastric nerve block for post caesarean delivery under spinal anaesthesia, 2016. Double blind randomized study
    YA Nigatu, EG Gebremedhn, HY Tawuye, AH Gebreegzi
    J Anesth Clin Res 8 (751), 2 , 2017
    2017
    Citations: 14
  • Efficacy of single-injection unilateral thoracic paravertebral block for post open cholecystectomy pain relief: a prospective randomized study at Gondar University Hospital
    DY Fentie, EG Gebremedhn, ZA Denu, AH Gebreegzi
    Local and Regional Anesthesia, 67-74 , 2017
    2017
    Citations: 13
  • Audit on anesthetic record completeness at a university teaching hospital operation theater of low-resource setting, 2013
    EG Gebremedhn, V Nagaratnam
    J Anesth Crit Care (Open Access) 8 (2), 00298 , 2013
    2013
    Citations: 13
  • Variability of oxaliplatin‐induced neuropathic pain symptoms in each cycle and its implications on the management of colorectal cancer patients: A retrospective study in South …
    EG Gebremedhn, PJ Shortland, DA Mahns
    Journal of oncology 2019 (1), 4828563 , 2019
    2019
    Citations: 11

GRANT DETAILS

1. 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).
2. 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).