Journal of Anesthesia and Clinical Research最新文献

{"title":"Development and Feasibility of Two Novel Scores (DX-OSA and A-OSA) for the Identification of Significant Obstructive Sleep Apnoea in Surgical Patients with Obesity","authors":"D. Godoroja, M. Sorbello, D. Cioc","doi":"10.4172/2155-6148.1000788","DOIUrl":"https://doi.org/10.4172/2155-6148.1000788","url":null,"abstract":"Background: There is a high prevalence of undiagnosed obstructive sleep apnoea (OSA) in patients with obesity undergoing bariatric surgery. We developed two novel scores in order to investigate the extent to which anthropometric and other objective measurements can be used to identify the presence of moderate-severe OSA (Apnoea/Hypopnoea Index (AHI) ≥ 15/h) in surgical patients with obesity.Methods: We prospectively evaluated 1870 adult patients scheduled for elective laparoscopic bariatric surgery. Prior to surgery, body mass index (BMI), sex, neck circumference, STOP-Bang score, SpO2, and neck/trunk fat were recorded. Basic anthropometric measurements were obtained, and the A Body Shape Index (ABSI) was calculated using the Krakauer formula. Patients at high risk for OSA were referred for polysomnography. Auto-titrated positive airway pressure (APAP) therapy was initiated when AHI ≥ 15/h. The Dual-X Ray-Obstructive Sleep Apnoea (DXOSA) score included six items: STOP-Bang score, BMI, neck fat, trunk fat, baseline SpO2, and expiratory reserve volume (ERV). The Anthropometric-OSA (A-OSA) score included STOP-Bang score, BMI, NC, ABSI coupled with WC, baseline SpO2, and ERV. We then compared sensitivity, specificity, positive-predictive values, negativepredictive values, likelihood ratios, and post-test probabilities in these patients.Results: Using a cut-off of 3, the DX-OSA and A-OSA scores exhibited similar sensitivity to STOP-Bang scores, but were associated with improved specificity, lower false positive rates, and increased probability for the diagnosis of moderate-severe OSA.Conclusion: The A-OSA and DX-OSA scores may be useful in the identification of obese surgical patients requiring CPAP treatment for significant OSA, without the need for formal polysomnography.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"64 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2017-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79638795","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":"Chronic Subdural Hematoma Complicated Spinal Anesthesia: Report and Pilot Study of Five Surgically Treated Cases","authors":"A. Eldemrdash, M. Elsharkawy, Gamal Shams, K. Ismail","doi":"10.4172/2155-6148.1000795","DOIUrl":"https://doi.org/10.4172/2155-6148.1000795","url":null,"abstract":"Background: Spinal anesthesia (SA) is generally considered a simple and safe procedure, but post spinal headache is a very common symptom appears later SA. Appearance of cranial subdural hematoma after SA is a very rare but life-threatening complication state. PDPH is the primary symptom of hematoma formation, and it should be regarded as a warning sign. Differentiation between subdural hematoma and PDPH may be difficult. Substitutional diagnoses for PDPH should be considered whenever the headache is severe, prolonged or not related to patient position. PDPH should be investigated immediately to exclude any intracranial complications.Objective: The objectives of this study are to increase awareness of hemorrhagic complications following SA and assess post-SA headache to encourage early diagnosis and management. Methods: The study was a pilot study of five cases. Four cases involved postpartum patients after SA who developed small to large subdural hematomas, as assessed by full neurological examination and neurological studies, and one case involved an elderly patient with a stone ureter.Results: One patient was managed conservatively, and the other four patients improved after surgical evacuation.Conclusions: Alternative diagnoses to post spinal headache must be considered for severe, prolonged headaches that are not related to patient position and do not respond to bed rest and analgesia. Early assessment of PDPH and early neuroradiological evaluation are recommended to diagnose post-SA subdural hematoma for early intervention to prevent avoidable morbidity and mortality.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"1 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86047690","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":"Accurate Measurement of Intraoperative Blood Loss during Wound Excision Leads to More Appropriate Transfusion and Reduced Blood Utilization","authors":"N. Bernal, J. M. Castro, Kimberly Burton, R. Thurer","doi":"10.4172/2155-6148.1000783","DOIUrl":"https://doi.org/10.4172/2155-6148.1000783","url":null,"abstract":"Objective: To determine if accurate measurement of surgical blood loss using a novel device that photographs surgical sponges and calculates their hemoglobin content affects transfusion practice. \u0000Methods: We retrospectively compared transfusion events for patients having wound excisions using visual estimation of blood loss (traditional group; n=178) to similar events following device implementation (study group; n=221). \u0000Results: The study group (age 43 ± 22 years, body surface area burn 11.2 ± 18.0%, excision area 624, IQR 757 cm2, preoperative hemoglobin 10.7 ± 2.4 g/dl) did not differ significantly from the traditional group (age 42 ± 23 years (p=0.527), body surface area burn 12.2 ± 22.6% (p=0.661), excision area 753, IQR 505 cm2 (p=0.485), and preoperative hemoglobin 10.7 ± 2.2 g/dl (p=0.833). \u0000Postoperative transfusion rates were significantly lower in the study group (6.3% vs. 12.9%; p=0.024), as was the proportion of transfused patients undergoing multiple transfusion events (13.0% vs. 34.9%; p=0.01). Red cell dose (units/transfused patient) was less in the study group compared to the traditional group (1.83 ± 1.09 vs. 2.51 ± 1.61 units; p=0.021). \u0000In a subgroup of patients requiring excision of burned areas ≥ 1,000 cm2 (traditional group n=36, study group n=43), these differences were more significant. The postoperative transfusion rate fell from 44.4% to 14.0% (p=0.003), as did the percent of transfused patients experiencing multiple transfusion events (50.0% vs. 14.3%; p=0.004). \u0000Conclusions: Accurate measurement of surgical blood loss was associated with a decrease in transfusions suggesting more timely decision making. Informed transfusion decisions may result in fewer transfusions by avoiding over-transfusion related to both excessive hemodilution and inaccurate visual estimates.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"9 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82157784","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 Ultrasound-Guided Thoracocentesis on Clinical and Physiological Outcomes in Mechanically Ventilated Patients","authors":"M. Ammar","doi":"10.4172/2155-6148.1000784","DOIUrl":"https://doi.org/10.4172/2155-6148.1000784","url":null,"abstract":"Background: Pleural effusions are common in critically ill patients, causes are multifactorial. Mechanical ventilation and critical illness lead to disturbance of the normal physiological processes which regulate pleural fluid homeostasis. Ultrasound can detect small volume of pleural effusion up to 20 mL. \u0000Aim of the work: We investigated the influence of large pleural effusion drainage on oxygenation, hemodynamics, and respiratory mechanics in mechanically ventilated patients. \u0000Methodology: We performed a prospective observational study on 65 mechanically ventilated patients examining the effects of large pleural fluid drainage on oxygenation; PaO2/FiO2 and Respiratory mechanics; peak inspiratory pressures, plateau pressures, dynamic compliance and total PEEP. Hemodynamics and complications also recorded at baseline, 6 h and 24 h after drainage. \u0000Results: Among 65 patients, the mean volume of effusion drained was (1868 ± 640) ml at 24 h. Uncomplicated pneumothorax occurred in two patients. When compared baseline; 6 h and 24 h after drainage,PaO2/FiO2 ratio significantly improved (196.69 ± 34.27, 227.02 ± 35.81, 269.78 ± 48.39; p<0.001), with a decrease in peak inspiratory pressure (38.23 ± 5.71, 34.14 ± 4.70, 29.89 ± 4.58 cm H2O, p<0.001) and plateau pressures (21.06 ± 3.47, 18.77 ± 3.17, 15.49 ± 2.91 cm H2O, p<0.001) and a large increase in dynamic compliance (17.48 ± 4.12, 21.79 ± 4.47, 26.77 ± 4.94 ml/cm H2O, p<0.001). Hemodynamics were not changed by drainage apart from respiratory rate which decreased significantly (19.4 ± 5.5, 17.4 ± 5, 16.5 ± 6.8 breaths/min, P=0.019). \u0000Conclusions: Ultrasound pleural effusion drainage in mechanically ventilated patients is safe. It appears to ameliorate oxygenation and respiratory mechanics and reducing the respiratory rate without affecting hemodynamics.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"8 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79481332","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":"Intravenous versus Ultrasound Guided Thoracic Paravertebral Morphine-Dexmedetomidine Combination in Patients with Multiple Rib Fractures","authors":"M. Mogahed, E. Salama, M. Elkahwagy","doi":"10.4172/2155-6148.1000786","DOIUrl":"https://doi.org/10.4172/2155-6148.1000786","url":null,"abstract":"Background: Severe pain caused by multiple rib fractures (MRF) can compromise oxygenation, ventilation and pulmonary functions so can affect patient outcome. Adequate pain control helps to avoid these complications. Thoracic paravertebral analgesia is comparable to thoracic epidural with fewer side effects. \u0000Methods: Seventy-five patients were randomly allocated into three groups, (n=25 each). Group (GM) received intravenous morphine with a loading dose of 0.1-0.2 mg/kg followed by PCA bolus of 1mg with a six min lockout. Group (GMD) received also intravenous morphine with a loading dose of 0.1-0.2 mg/kg then PCA bolus of 1 mg morphine plus 5 μg dexmedetomidine with a six min lockout. Group (GPV) received paravertebral morphine loading dose of 0.2 mg/kg then PCA bolus of 0.1 ml/kg of a solution with a concentration of 0.5 mg/ml morphine mixed with 1 μg/ml dexmedetomidine and 60 min lockout. Any patient with VAS score more than 4, a top-up dose was given until VAS ≤ 4 \u0000Results: No significant difference between the three groups as regards age, BMI, sex, and ASA. Road traffic accident was the main cause of blunt chest trauma (64%, 76% and 68% in GM, GMD, and GPV respectively). Total morphine requirements were significantly lower in GMD and GPV than GM and in GPV than GMD (GM=190.9 ± 45.26, GMD=117.1 ± 31.9 and GPV=86.2 ± 21.7). There was a significant decrease in nausea and vomiting in GMD and GPV than GM. No significant difference in RR between the three groups although 8 patients in GM developed respiratory depression which was significantly higher than in GMD (2 patients) and GPV (0 patient). No significant difference in HR, MAP, and SpO2 between the groups. VAS scores at rest and with cough were significantly lower in both GMD and GPV than GM. FVC, FEV1 and PaO2/FiO2 ratio were significantly increased and PaCO2 significantly decrease in GMD and GPV than GM. \u0000Conclusion: Adding dexmedetomidine to morphine either TPV or IV PCA significantly decreases VAS scores, improves pulmonary functions and also decrease morphine consumption with fewer side effects in patients with MRF.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"32 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2017-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80058676","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":"A Comparison of Ketamine-Dexmedetomidine versus Ketamine-Propofolfor Sedation in Children during Upper Gastrointestinal Endoscopy","authors":"M. Mogahed, E. Salama","doi":"10.4172/2155-6148.1000785","DOIUrl":"https://doi.org/10.4172/2155-6148.1000785","url":null,"abstract":"Background: Upper gastrointestinal endoscopy in pediatric patients have increased and become more frequent. Selection of a sedative with hemodynamic stability, rapid onset, short action and few side effects is essential. \u0000 Material and methods: 60 ASAI/II patients between the age of 2-12 yrs of both sexes undergoing upper gastrointestinal endoscopy randomly allocated into two groups, 30 patients each, all patients received ketamine 1 mg/kg intravenous, then group KD received dexmedetomidine 1 μg/kg bolus dose slowly IV and patients in Group KP received propofol 1 mg/kg as initial doses then top-up doses of 2-4 ml of the prepared solutions were given till RSS of ≥ 5. Hemodynamic parameters, total ketamine dose, time to RSS ≥ 5 and PADSS of 9-10, side effects and Parents’ and Endoscopists’ satisfaction were recorded. Results: HR was significantly lower in group KD at T1, T2 and T3, no significant difference as regard MAP, RR, SpO2 and time to achieve RSS and PADSS (p>0.05), significantly higher total ketamine dose in group KD than group KP (P=0.001), Parents’ and Endoscopists’ satisfaction was significantly higher in group KD than KP (p<0.05). Conclusion: Ketamine-dexmedetomidine for sedation in children during upper gastrointestinal endoscopy is an effective, reliable and safe alternative to ketamine-propofol without hemodynamic or respiratory drawbacks with comparable onset and recovery time.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"64 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89759988","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":"A Comparative Study between Protective Lung Ventilation versus Conventional Ventilation in Obese Patients Undergoing Abdominal Laparoscopic Surgery","authors":"A. Eldemrdash, Nagwa Mohamed Gamaleldeen, M. Ahmed, Shazly Ahmed","doi":"10.4172/2155-6148.1000777","DOIUrl":"https://doi.org/10.4172/2155-6148.1000777","url":null,"abstract":"Background: Obesity is a serious problem worldwide. During general anesthesia and post-operative period, obese patients more likely to develop post-operative pulmonary complications as atelectasis and impaired pulmonary function compared to non-obese. Intraoperative protective ventilation consisting of low tidal volume, high PEEP and recruitment maneuvers resulted in alveolar recruitment and optimization of intraoperative respiratory mechanics. \u0000Objective: This study tested two strategies of mechanical ventilation in obese patients to find out which is best regarding gas exchange optimization, airway mechanics and atelectasis score. \u0000Methods: Study was a randomized prospective comparative control study was carried out on 50 obese patients with BMI 30-50 kg/m2. Patients were prepared for laparoscopic cholecystectomy. Patient’s selection according to attendees at time of operation as a single numbers were protective ventilation (group A) and a double numbers were conventional ventilation (group B). \u0000Results: Study showed significance between preoperative and postoperative pulmonary function tests and revealed better POST FVC in group A mean 86.04 (± 10.35) L, while in group B was 74.96 (± 14.73) L, p value (0.021). Better POST FEV1 in group A mean 73.56 (± 16.49) L, while in group B was 56.92 (± 8.340) L, p value (0.046). Better post-operative oxygenation in protective ventilation (group A). Mean Post P (A-a) O2 in group A was 27.93 (±7.76) mmHg, while in group B was 35.82 (±11.98) mmHg, p value (0.022). \u0000Study found peak and plateau airway pressures were higher in protective group with no change in airway resistance. Pulmonary compliance was improved but, in this study revealed more alterations of the hemodynamics in the patients who were subjected to protective ventilation despite adequate preoperative fluid preload. \u0000Hemodynamic instability observed in 24% in group A, but only occurred in 8% in group B. Study found that protective ventilation was superior to standard ventilation in prevention of atelectasis development 64%of the cases in group A revealed normal postoperative CT Chest and 36% showed lamellar atelectasis. In group B, 48% of the cases showed normal postoperative CT Chest, 40% revealed lamellar atelectasis and 12% showed plate atelectasis. \u0000Conclusions: Study found protective ventilation was superior to conventional ventilation in prevention of lung atelectasis and associated with better oxygenation and pulmonary function tests in the post-operative in obese laparoscopic cholecystectomy. In spite of it was very effective in optimizing gas exchange, but associated with more hemodynamic affection.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"151 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2017-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77776587","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 of Intubation Performance between Macintosh, the Channeled King Vision and the C-MAC D-Blade Videolaryngoscope in Controlled Hypertensive Patients","authors":"M. Mogahed, Mona Raafat Elghamri, Atteia Gad Anwar","doi":"10.4172/2155-6148.1000780","DOIUrl":"https://doi.org/10.4172/2155-6148.1000780","url":null,"abstract":"Background: The common cause of anesthesia related injury is inability to intubate the trachea. Video laryngoscopes present an enlarged video image of glottis while intubating the trachea. The aim of this study is to compare efficacy of intubation by Macintosh with C-MAC D-Blade and King Vision video laryngoscope (VL) in controlled hypertensive patients. \u0000Patients and methods: 105 ASA II T2: just before intubation; T3: 2 min after intubation; T4: 5 min after intubation. Primary outcome: time and number of attempts required to successful intubation. Secondary outcomes: ease of laryngoscope insertion, Quality of view, Assist maneuvers, Intubation difficulty, Complications. \u0000Results: Differences in heart rate and mean blood pressure between all groups were statistically significant at T3&T4. Differences in duration of successful intubation were statistically significant between group (M) and group(C), also between group (M) and group (K). Statistically significant differences were obtained between all groups regarding quality of view of glottis, ease of insertion of laryngoscope, and use of assist maneuvers for intubation. \u0000Conclusion: Video laryngoscopes provide hemodynamic stability and better view of glottis than Macintosh during intubation. King Vision VL has advantages of ease of insertion, less need of assist maneuvers for intubation, with less complication. Thus, it is beneficial to use King Vision for intubation in hypertensive patients.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"35 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2017-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78836124","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":"Effectiveness of Intravenous Prophylactic Phenylephrine for the Prevention of Spinal Anaesthesia Induced Hypotension during Caesarean Section. A Prospective Observational Study","authors":"A. Agegnehu, Amare Hailekiros Gebreegzi, G. Lemma, Nigussie Simeneh Endalew, E. G. Gebremedhn","doi":"10.4172/2155-6148.1000779","DOIUrl":"https://doi.org/10.4172/2155-6148.1000779","url":null,"abstract":"Background: Hypotension is one of the common complications of spinal anaesthesia. It has many detrimental effects to the mother and fetus if left untreated. Recently, phenylephrine is introduced for the treatment of hypotension in our hospital. However, its efficacy on the prevention of spinal anaesthesia induced hypotension is still under controversy. We aimed to assess the effectiveness of phenylephrine prophylaxis on spinal hypotension after caesarean section. \u0000 Methods: A prospective observational study was conducted at the University of Gondar Hospital. Patients were allocated based on treatment received; 50/100 μgm phenylephrine prophylaxis vs. no prophylaxis. PR, SBP, DBP, SPO2 and APGAR score were measured before, immediately after spinal anaesthesia, every 2 min intra operatively till the delivery of the baby and every 5 min after delivery for 20 min, and every 10 min for 1 h in postoperative period. \u0000 Results: The incidence of hypotension was significantly lower for those participants with prophylactic phenylephrine (26% vs. 81.6%, p<0.001) compared to the non-treatment group. Systolic and diastolic blood pressures immediately after spinal anaesthesia till delivery and after delivery of the baby were significantly lower in the none treatment group at all times (p<0.05). Moreover, the number of rescue treatments and total amount of fluid given during the intraoperative period for the treatment of hypotension were more in the non-treatment group P=0.001). The APGAR scores at 1 and 5 min and postoperative vital signs were comparable between groups. \u0000Conclusion and recommendation: The incidence of spinal anaesthesia induced hypotension was high. Prophylactic intravenous phenylephrine bolus remarkably reduced the incidence of spinal induced hypotension compared to the non-treatment group. We recommend prophylactic phenylephrine for parturients undergoing caesarean section under spinal anaesthesia. Moreover, other pharmacological and non-pharmacological methods need to be considered as the incidence of hypotension is still high in the treatment group.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"109 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2017-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83447137","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":"Audit on Wastage of Commonly Used Anaesthetic and Analgesic Agentsin Developing Country: The Case of Ethiopian University Teaching Hospital","authors":"H. Yimer, Salh Yalew","doi":"10.4172/2155-6148.1000778","DOIUrl":"https://doi.org/10.4172/2155-6148.1000778","url":null,"abstract":"Background: Anaesthetic drug wastage is a common challenge encountered in current anaesthetic care. Drug wastage is a potential area that significantly contribute for unnecessary health care budget allocation and financial lose. The aim of this study was to assess the amount of anaesthetic drug wastage and to analyze the cost of wasted drug in four operation room. Methods: A prospective observational study was conducted from January 10 to January 26, 2017 in the threemajor surgical and one obstetric operation room of university of Gondar teaching hospital. During consecutive period, data on amount of drug used or discarded were collected on patients undergoing surgical procedures under general or spinal anaesthesia. The total cost of used and wasted drug was estimated. Result: Of 86 patients included in the study, 54.6% were operated under general anaesthesia and 31.4% were under spinal anaesthesia. From 18 commonly used anaesthetic drugs, 16 of drugs were included into the final analysis. Of 16 different anaesthetic drugs, the maximum amount of wastage after loaded in syringes but not used, partially unused in ampoules or vials per case basis were seen in propofol, tramadol, and diclofenac (23.72 mg, 18 mg, and 10.6 mg, respectively). A total of 1967.8 Ethiopian birr (89.44 USD) were the cost of wasted drugs, of these the cost of wasted bupivacaine was maximum (33.8%). Conclusion: There was a significant amount of anaesthetic drugs and financial wastage during perioperative anaesthetic management for different surgical procedure. The use of drugs like neostigmine, metoclopramide, cimetidine and acetaminophen was best practice of usage during the study period no wastage was seen in those drugs. The use of fentanyl was also good which is 3.7% compared to other drugs.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"35 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85387294","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}