Egyptian Journal of Anaesthesia最新文献

{"title":"Continuous thoracic epidural versus continuous paravertebral analgesia in patients undergoing open renal surgery: Evaluation of pulmonary function; randomized double-blinded clinical trial","authors":"S. Hassan, Khaled Abdelrahman, Ahmed M. Mandor, George Magdy, M. Galal, F. Askar, A. M. Thabet","doi":"10.1080/11101849.2023.2247246","DOIUrl":"https://doi.org/10.1080/11101849.2023.2247246","url":null,"abstract":"ABSTRACT Background This study aimed to assess pulmonary functions after either continuous thoracic paravertebral block (cTPVB) or thoracic epidural block (cTEB) in open renal surgeries. Methodsː The double-blinded, randomized clinical trial included 40 patients scheduled for open renal surgeries at Urology Hospital-Assiut University, equally assigned into group E (n = 20) and group P (n = 20), both at the level of 7th-8th thoracic vertebra. Initially, 7.5–12 mL of bupivacaine 0.25% was started before the induction of general anesthesia, followed by bupivacaine 0.125% continuously at a rate of 5–15 ml/h. Forced vital capacity (FVC) measured every  6 hours postoperatively within the first 24 hours was the primary outcome. Secondary outcomes were peak expiratory flow rate (PEFR), forced expiratory volume in the first second (FEV1), diaphragmatic excursion (DE), postoperative analgesia, total opioid consumption, total local anesthetic dose, hemodynamics and complications. Resultsː FVC, FEV1 and DE were better preserved in cTPVB where the lowest postoperative readings as a fraction of preoperative control were 0.7 ± 0.11 vs 0.65 ± 0.11 L, 0.74 ± 0.11 vs 0.64 ± 0.10 L and 0.73 ± 0.1 vs 0.58 ± 0.1 cm, respectively. The lowest postoperative PEFR was reported in cTEB (p-value = 0.128). Analysis of numeric rating pain scale, total opioid consumption and time of first rescue analgesic request revealed a statistical nonsignificant difference. The total infused dose of local anesthetic was significantly higher in cTPVB group. Incidence of sympatholytic complications was higher in cTEB. Conclusion cTEB and cTPVB had convergent effect on respiratory function and diaphragmatic motility and equivalent analgesic efficacy after open renal surgeries. Although cTPVB was technically easier and less time-consuming than cTEB, higher dose of local anaesthetic was required in cTPVB.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":"176 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59762328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Adding Infiltration between The Popliteal Artery and Capsule of The Knee Block (IPACK) to Continuous Adductor Canal Block after Total Knee Arthroplasty","authors":"Hatem Mohammed Ahmed Abdo, Mohamed Abd elaziz, Amr Essam Eldin Abd Elhamid, Amr Ahmed Kassem, D. M. Haiba","doi":"10.1080/11101849.2023.2246732","DOIUrl":"https://doi.org/10.1080/11101849.2023.2246732","url":null,"abstract":"ABSTRACT Background Total knee arthroplasty (TKA) is a major surgical procedure that can be extremely upsetting. There are several methods available for postoperative pain management after knee surgery. One commonly used method is multimodal analgesia based on continuous adductor canal block. Aim of The Work Comparing the effect of the addition of posterior knee block, known as the infiltration between the popliteal artery and capsule of the knee (IPACK) block, to continuous adductor canal block (CACB) after total knee arthroplasty. Patients and Methods A total of 52 patients who underwent total knee arthroplasty were included and randomly divided into two groups receiving ultrasound-guided continuous adductor canal block or a combination of continuous ultrasound guided adductor canal block and the Infiltration between the popliteal artery and capsule of the knee block at the end of the surgery. Results Regarding the criteria for pain control, there was a statistically significant difference between the two groups regarding the postoperative visual analog score at 2, 4, 8, and 12 h after following up, which was not reported at 16 or 24 h postoperatively. The total nalbuphine consumption on the first day postoperative also showed a significant difference. A comparison of the basic demographic data, the onset of ambulation, the Timed Up and Go (TUG) test, and the straight leg raising test revealed no significant difference between the two groups. Conclusion Our study found that the use of continuous ultrasound guided adductor canal block and the Infiltration between the popliteal artery and capsule of the knee block together resulted in better postoperative pain management and reduced the need for nalbuphine. Despite this, there were no significant differences between the groups in terms of motor power or ambulation abilities. Trial registration number: PACTR202301536928551","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47833866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baska mask vs ProSeal Laryngeal mask on airway seal pressure in cases undergoing general anesthesia by mechanical ventilation: A randomized controlled trial","authors":"Shady Rady Abdalla, A. Mohamed, Marianne Magdy Roshdy, Maha Mohamed Ismail, Ashraf Mohamed Abdelreheem, W. M. Bahnas, M. Soliman","doi":"10.1080/11101849.2023.2240662","DOIUrl":"https://doi.org/10.1080/11101849.2023.2240662","url":null,"abstract":"ABSTRACT Background Supraglottic Airway Devices (SGAs) are designed to counteract the drawbacks of endotracheal intubation. They have proven to be easy to use, robust, versatile, and usable in many difficult situations. This work aims to investigate the use of the Baska Mask (BM) airway and ProSeal™ Laryngeal Mask Airway (PLMA) as SGAs for ventilation. Methods This randomized controlled trial was carried out on 74 cases aged 21–65 years old for elective surgery of a planned duration of up to 2 h during general anaesthesia with intermittent positive pressure ventilation. Cases were divided into two equal groups. Ventilation was done either by BM® Airway (group BM) or PLMA (group PLMA). Results BM had a shorter insertion time and lower leak fraction versus PLMA, while seal pressure elevated significantly with BM versus PLMA (P < 0.001). PLMA had significantly more cases than the BM mask group complaining of a sore throat at 2 h (P = 0.042). Complication after gastric tube insertion was parallel between both groups. Conclusions BM can be used successfully during anesthesia as it displays a shorter insertion time, lower leak fraction, higher seal pressure, and lower incidence of sore throat and gastric tube insertion complications than PLMA.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45725309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dexmedetomidine versus magnesium sulfate for controlled hypotension during rhinoplasty surgeries: A prospective randomized comparative study","authors":"M. Aboelsuod, S. Seyam","doi":"10.1080/11101849.2023.2242645","DOIUrl":"https://doi.org/10.1080/11101849.2023.2242645","url":null,"abstract":"ABSTRACT Background General anesthesia organizes the best option for controlled blood pressure during rhinoplasty surgery. The primary agent applied in controlling hypotension should have particular unique characteristics. The peripheral and central sympatholytic attainment of dexmedetomidine is usually indicated by low blood pressure and low heart rate. Magnesium sulfate is among the best agents used. Objective Determine the influence of both dexmedetomidine and magnesium sulfate on hemodynamic parameters for patients undergoing rhinoplasty surgeries after general anesthesia. Patients and methods This is a randomized prospective comparative study. Fifty-six patients got enrolled and divided into two categories. Group 1 (n = 28): Received a priming dose of dexmedetomidine 1 microgram/kg before induction then 0.4 µg/kg/h. Group 2 (n = 28): Received 30 mg/kg of magnesium sulfate as a priming dose before induction and then 10 mg/kg/h during the time of the procedure. Results No significant differences were seen between the two groups regarding the MAP. There were significant differences among the groups in heart rate (p < 0.05). The patients in the second group experienced higher bleeding scores than those in the first group. The first group had a higher surgeon satisfaction rate than the second group (p < 0.05). The first group had more time to arrive at the Aldrete score of less than or equal to 9 than that of the second group of patients. Conclusion Dexmedetomidine has high effectiveness in attaining controlled hypotension in patients undergoing rhinoplasty. Magnesium sulfate requires extra nitroglycerine. Dexmedetomidine possesses a potent analgesic impact with a reduced analgesic requirement duration compared to magnesium sulfate. Registration trial The study was approved by clinical trials registration (NCT05880693).","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45478273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of esmolol versus magnesium sulphate on quality of recovery in patients undergoing laparoscopic cholecystectomy: Randomized controlled study","authors":"H. ElHoshy, Ahmed Galal El-Din Yacout","doi":"10.1080/11101849.2023.2240659","DOIUrl":"https://doi.org/10.1080/11101849.2023.2240659","url":null,"abstract":"ABSTRACT Background Ambulatory procedures have a universal objective of rapid, efficient and secure recovery and release. Preliminary advances utilizing intraoperative esmolol infusion have registered a postoperative opioid saving outcomes. In the current study, we compared intraoperative esmolol versus magnesium sulphate infusions on postoperative recovery profile and stay in the postanaesthesia care unit (PACU). Patients and methods Sixty patients, of both sexes, of ASA I or II planned for ambulatory laparoscopic cholecystectomy under general anaesthesia were engaged into two groups. Esmolol group was given loading dose (1 mg/kg) over a period of 10 minutes followed by (30 μg/kg/min) all through the surgery, whereas magnesium sulphate (MgSo4) group was given loading dose (40 mg/kg) over 10 minutes then maintenance dose (15 mg/kg/h) till end of surgery. General anaesthesia and postoperative analgesia were standardized for all patients. Variables denoting immediate recovery from anaesthesia, pain score and time for first call to analgesia were recorded. White-Song score ≥ 12 were employed as a tool to review the rapidity of recovery. Results Compared to MgSo4 group, the esmolol group exhibited statistically significant shorter times for sponteaous eye opening, tongue extension, extubation and patients’ capability to recall their names. Incidence of vomiting as well as the total amount of ondansetron consumed in the PACU were evidently less among the esmolol group, whereas pain scores and the time of recall for first rescue analgesia did not vary significantly among the two studied groups. Members of the esmolol group displayed significant higher White -Song score at all times of measurements except at 120 minutes compared to those of MgSo 4 group. Conclusions Perioperative esmolol infusion is accompanied by superior and fast-tracked recovery profile compared to MgSo4 infusion.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45743628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study between dexmedetomidine and fentanyl as adjuvants to bupivacaine for postoperative epidural analgesia in abdominal surgeries: A randomized controlled trial","authors":"Mohammed Waheed Mahmoud Emam, B. Hassan, Hadeel Magdy Abd El-Hamid, Ibrahim Al Shahat Ibrahim, Mohamed Abd El-Mawla Saleh","doi":"10.1080/11101849.2023.2238520","DOIUrl":"https://doi.org/10.1080/11101849.2023.2238520","url":null,"abstract":"ABSTRACT Background Epidural analgesia is an efficient strategy to relieve postoperative pain after abdominal surgeries. This study aimed to evaluate dexmedetomidine or fentanyl when added to bupivacaine, providing postoperative epidural analgesia after abdominal procedures. Patients and methods Epidural catheter was placed on 75 patients scheduled for lower abdominal procedures under general anesthesia, and they were randomly assigned into three equal groups. Epidural analgesia was activated before the procedure was completed by injection of bupivacaine (0.125%) plus dexmedetomidine or fentanyl or normal saline mixture, according to the study groups. After complete recovery from general anesthesia, the epidural block was evaluated. Then, the infusion started through an elastomeric pump with an infusion rate of 5 ml/hr and continued for 24 hr postoperatively. Group D Dexmedetomidine 1 ml (100 μg) plus normal saline 1 ml were added to bupivacaine (0.125%) 48 ml (a total volume of 50 ml). Group F: 2 ml (100 μg) fentanyl was added to bupivacaine (0.125%) 48 ml (a total volume of 50 ml). Group C: Normal saline 2 ml was added to bupivacaine (0.125%) 48 ml (a total volume of 50 ml). Measured outcomes Primary outcomes The onset of sensory analgesia (from the beginning of epidural infusion until scoring 1 on a 3-point scale) and the duration of analgesia (from the start of epidural infusion till the first demand for further pain medication) were observed and recorded. Secondary outcomes Postoperative pain was evaluated using a visual analogue scale (VAS), and the number of patients requesting additional analgesia with pethidine over paracetamol as well as the pethidine consumption during postoperative 24 hr were recorded. The hemodynamic parameters, including heart rate (HR) and mean arterial blood pressure (MAP), were monitored and recorded at baseline, 2, 6, 12, and 24 hr, and any adverse events were properly recorded and managed during the study period. Results The dexmedetomidine group showed an earlier onset and longer duration of analgesia, with a highly significant difference (P-value &lt;0.001) than other groups. The study groups differed significantly concerning pethidine needs and consumption (P-value &lt;0.05). The VAS revealed a considerable decrease in the dexmedetomidine group compared to other groups, with a significant difference (P-value &lt;0.05) at the intervals of (baseline, 12 hr, and 24 hr) and a highly significant difference (P-value &lt;0.001) at the intervals of (2 and 6 hr). Postoperative blood pressure and heart rate measurements in the dexmedetomidine group were lower than in other groups. MAP showed a statistically highly significant difference at 6 and 24 hr (P-value &lt;0.001) and a significant difference after 12 hr (P-value &lt;0.05), while HR showed a statistically significant difference after 6 hr (P-value &lt;0.05) and a highly significant difference at 12 and 24 hr (P-value &lt;0.001). Regarding postoperative adverse events, no statistical d","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48448954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of tramadol versus dexamethasone in ultrasound guided supraclavicular block for forearm fractures. Does it make a difference?","authors":"Wesam Nashat Ali, M. Bakri, M. Abdelrady, N. Bakri, Esraa Gamal Abdel Nasser Fathy, Ola Wahba","doi":"10.1080/11101849.2023.2238528","DOIUrl":"https://doi.org/10.1080/11101849.2023.2238528","url":null,"abstract":"ABSTRACT Background Application of supraclavicular block generally comprises elbow, forearm, and hand surgery. Tramadol and dexamethasone were tested and compared in the current study as adjuvants to levobupivacaine in the supraclavicular block. Patients and Methods 60 ASA Grade I and II patients of either sex, older than 18, participated in the current study. Two groups of patients were created: Group D (n = 30), who received 30 ml of 0.5% levobupivacaine and 2 ml of dexamethasone (8 mg). 30 ml of 0.5% levobupivacaine and 2 ml of 5% tramadol (100 mg) were given to Group T (n = 30). Statistics were used to compare the two groups. Results The tramadol group required substantially less time (13.4 ± 2.6 h) than the dexamethasone group (15.3 ± 2.8 h) for the first rescue analgesia request (P-value = 0.009). Within the first 24 hours following surgery, the mean total dose of rescue analgesia was considerably lower in group D (36 ± 12.2 mg) than in group T (44 ± 15.2 mg, P-value = 0.029). Group D had no side effects and considerably higher patient satisfaction (P = 0.042). Conclusion When levobupivacaine was used with dexamethasone in a supraclavicular brachial plexus block for forearm fractures, it worked better as an adjuvant than tramadol. Sensory and motor blockage, a quicker onset and longer duration of analgesia, and higher satisfaction levels were all present.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48431936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The perioperative analgesic effect of opioid free anesthesia using combination of dexmedetomidine, ketamine and lidocaine in adolescent patients undergoing Scoliosis Surgery; A randomized Controlled Trial","authors":"Laila Elahwal, M. Elmazny, S. Elrahwan","doi":"10.1080/11101849.2023.2239034","DOIUrl":"https://doi.org/10.1080/11101849.2023.2239034","url":null,"abstract":"ABSTRACT Background Posterior spinal fusion treatment is one of the most painful options accessible to teenagers with idiopathic scoliosis. Objectives This study evaluated the opioid-sparing anesthesia analgesic effect using a combination of dexmedetomidine, ketamine and lidocaine versus opioid-based anesthesia (OBA) with fentanyl in adolescent patients undergoing scoliosis surgery. Methods This prospective, double-blinded, randomized study was conducted on 50 patients, American Society of Anesthesiologists (ASA) physical state I–II, scheduled for surgical correction of adolescent idiopathic scoliosis under general anesthesia. Patients were equally categorized into two groups: group I – opioid-free anesthesia (OFA) and group II – OBA. Intraoperative magnesium, total postoperative morphine consumption, time to first postoperative rescue analgesia and adverse effects were recorded. Results Total postoperative morphine consumption at 24 h was insignificantly different between groups. The proportion of patients requiring intraoperative magnesium was significantly higher in OBA (P < 0.001). Visual analog scale was only significant at 1 and 2 h which was significantly higher in group OBA than group OFA (P = 0.012 and < 0.001, respectively). Time to first postoperative rescue analgesia was significantly earlier in OBA than in OFA. Hemodynamic stability was insignificantly different between both groups. Bradycardia, postoperative nausea and vomiting and respiratory depression were insignificantly different between groups. Conclusions In adolescent patients ASA I-II undergoing scoliosis correction surgery, OFA with a combination of dexmedetomidine, ketamine and lidocaine could provide adequate intra- and postoperative pain management, which can obviate the use of intraoperative opioids minimizing the total postoperative opioid requirements compared to OBA using fentanyl.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45272159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Free Anesthesia versus Opioid Based Anesthesia for Hemodynamic Stability in Geriatric Patients Undergoing Arthroscopic Shoulder Surgery, A Randomized Comparative Study","authors":"Dalia Khaled, Osama Mohamed, Iman Alaa, Antony Adel","doi":"10.1080/11101849.2023.2238531","DOIUrl":"https://doi.org/10.1080/11101849.2023.2238531","url":null,"abstract":"ABSTRACT Background Physiological and pharmacological variances from younger patients make geriatric patients anesthetically challenging. Opioids though effectively controlling pain may cause serious complications in elderly. Non-opioid analgesics are being considered for adequate analgesia with fewer complications. Methods Reaching OR, MAP and HR were recorded (T0), thirty patients were assigned into: OFA group received dexmedetomidine 1 µg/kg over 10 min loading dose, then infusing dexmedetomidine (0.3 µg/kg/h), lidocaine (2 mg/kg/h) and magnesium sulfate (1.5 g/h) during surgery and OA group received fentanyl 2 µg/kg loading dose then infusion (1 µg/kg/h) during surgery. MAP and HR were documented after starting infusions (T1), after intubation (T2), visualizing surgical field with arthroscope (T3) then every 10 min till end. Surgeon graded surgical field (T3) then every 10 min till end. Postoperatively OAA/S, MAP and HR were recorded. NRS was assessed in PACU, at 1 h, 2 h, 8 h, 16 h and 24 h. Patients scoring ≥ 4 received paracetamol 1 gm IV infusion (4 g/24 h maximum dose) documenting first 24 hours total dose and postoperative complications. AMT was assessed postoperatively for three days. Patients scoring<8 were presumed having postoperative cognitive dysfunction (POCD) and were psychiatrically assessed. Results MAP and endoscopic surgical field grading (T3) were significantly lower in OFA group than OA group (P values 0.008 and 0.001). MAP was significantly lower in OFA group intraoperative (T3 till T9) and two postoperative hours. HR was significantly lower in OFA group at T3 till surgery end and two postoperative hours (except T13). NRS scores were significantly higher in OA group at P0 and P1 than OFA group (P-value 0.001 and 0.007). Postoperative paracetamol dose was significantly higher in OA group than OFA group (P-value 0.005). Conclusion OFA offered better hemodynamic control, endoscopic surgical field grading, lower NRS readings and paracetamol dose, presenting better anesthetic option for elderly undergoing arthroscopic shoulder surgery with no POCD or other postoperative complications.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49658725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perfusion index as a predictor of hypotension after induction of general anesthesia in elderly patients – a prospective observational study","authors":"Sherif Abdullah Mohamed, Mona Yousry Helmy, Sara A Khattab, Ayman Mohammed Hossam, Mohamed S. Arafa","doi":"10.1080/11101849.2023.2238524","DOIUrl":"https://doi.org/10.1080/11101849.2023.2238524","url":null,"abstract":"ABSTRACT Introduction The elderly patients are at a greater risk for hypotension after induction of anesthesia. Perfusion index (PI) predicted patients vascular responses in many situations. This study hypothesized that baseline value of PI would predict hypotension in geriatric patients after anesthetic induction as population at risk for postinduction hypotension. Methods This observational, prospective study involved 30 patients aged >65 years who were scheduled for elective procedures under general anesthesia. From baseline to 15 min after propofol induction of anesthesia, the PI, heart rate, and blood pressure (BP) were recorded every minute. Hypotension was defined as a decrease greater than 30% in systolic BP from baseline. Results Early hypotension within 3 min after induction was experienced in 53.3%, while 36.7% had late hypotension within 15 min. Receiver operating characteristic (ROC) curves for PI as a predictive test of hypotension at 3 min showed good predictability of the baseline PI for early postinduction hypotension with area under receiver operating characteristic curve (AUC) 0.97, sensitivity 88%, specificity 93%, positive predictive value (PPV) 93%, negative predictive value (NPV) 87%, and a cutoff value of ≤1.3. After intubation, the predictive value decreased, with PI > 0.91 to predict late hypotension with sensitivity 91%, specificity 58%, PPV 56%, NPV 92%, and AUC 0.66. Conclusions PI could predict early hypotension following propofol induction in the geriatric population. So, it can be considered a valuable tool in monitoring this vulnerable population after induction of anesthesia.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45721207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}