Saudi Journal of Anaesthesia最新文献

{"title":"Effects of adding intravenous midazolam to a dual postoperative nausea and vomiting regimen in patients undergoing breast surgery: A pragmatic randomized controlled trial.","authors":"Kullaporn Mingvoramethakul, Wirinaree Kampitak, Ratikorn Anusorntanawat, Pornarun Charoenraj, Nattaporn Songborassamee, Punyanuch Wongsupha","doi":"10.4103/sja.sja_72_24","DOIUrl":"10.4103/sja.sja_72_24","url":null,"abstract":"<p><strong>Background: </strong>For high-risk patients, adding a third antiemetic drug to dual postoperative nausea and vomiting (PONV) prophylaxis is controversial. Given the established antiemetic properties of midazolam, this study compared the combination of low-dose dexamethasone-ondansetron and midazolam with high-dose dexamethasone-ondansetron.</p><p><strong>Methods: </strong>A total of 300 female patients scheduled for breast surgery were recruited and randomly assigned to two groups. The DO group received dexamethasone 8 mg and ondansetron 4 mg, whereas the DOM group received dexamethasone 4 mg, ondansetron 4 mg, and midazolam 0.04 mg/kg. The primary outcome was the incidence of PONV within 24 h. Secondary outcomes were PONV severity, antiemetic requirement, blood glucose levels, satisfaction and sedation scores, time to eye opening and extubation, pain outcome, and sore throat.</p><p><strong>Results: </strong>Primary outcome analysis included 298 patients. Incidence of PONV within the first 24 h after surgery occurred in 52 of 150 (35%) patients in the DO group and 33 of 148 (22%) patients in the DOM group (adjusted risk ratio, 0.63; 95% confidence interval, 0.45-0.88; <i>P</i> = 0.007). The antiemetic requirement was significantly greater in the DO group compared with the DOM group (<i>P</i> = 0.034). However, a significantly higher sedation level and longer time for eye-opening and extubation were observed in the DOM group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Compared to high-dose dexamethasone and ondansetron alone, midazolam combined with low-dose dexamethasone and ondansetron decreased the incidence of PONV in patients undergoing breast surgery; however, it increased the sedation level in the early postoperative period.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"471-481"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Blockbuster® LMA in a pediatric patient with cleft palate for laparoscopic surgery.","authors":"Vikram Chandra, Chandni Sinha, Shagufta Naaz, Ashmi Latheef","doi":"10.4103/sja.sja_296_24","DOIUrl":"10.4103/sja.sja_296_24","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"614-615"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and characteristics of intraoperative pressure injuries caused by medical devices and adhesives: A case-control retrospective study.","authors":"Abdulrhman M Altamimi, Hatan Mortada, Adel A Alqarni, Ali A Alsubaie, Reem J Alsafar","doi":"10.4103/sja.sja_228_24","DOIUrl":"10.4103/sja.sja_228_24","url":null,"abstract":"<p><strong>Background: </strong>Undesirable injuries during the intraoperative period, such as pressure injuries caused by improper positioning, medical devices, or adhesive tapes, can lead to patient harm and decreased satisfaction. This study aims to identify the risk factors of pressure injuries during the intraoperative period and the characteristics of these injuries.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted at King Khaled University Hospital in Riyadh, Saudi Arabia. Data were collected from the hospital incident reporting system and electronic medical records for incidents reported from January 1, 2022 to December 31, 2022. Inclusion criteria consisted of all patients with a reported pressure injury, including pressure ulcers, medical adhesive-related skin injuries, or medical device-related pressure injuries, occurring at least once during surgery.</p><p><strong>Results: </strong>Among the 113 patients, 57 (50.44%) had intraoperative pressure injuries (cases), while 56 (49.56%) did not (controls). The most common locations for pressure injuries were the lips (33.33%). Most of these injuries were classified as Medical Adhesive-Related Skin Injury (61.40%). Stage 1 injuries were observed in 47 cases (82.46%), while Stage 2 injuries were observed in 10 cases (17.54%). Duration of surgery and device tightness were identified as significant risk factors (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>This case-control study identified the duration of surgery and device tightness as significant risk factors for intraoperative pressure injuries. The findings emphasize the importance of implementing evidence-based prevention strategies. Healthcare professionals should prioritize staff education and training, while future research should focus on conducting prospective, multicenter studies and developing risk assessment tools and innovative medical devices.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"482-487"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Success rate and outcome of labor epidural among variable levels of residents and practicing anesthesiologists in an academic medical center in Saudi Arabia.","authors":"Sara H Farsi","doi":"10.4103/sja.sja_302_24","DOIUrl":"10.4103/sja.sja_302_24","url":null,"abstract":"<p><strong>Background and aims: </strong>This study aimed to highlight differences in success rates and patient outcomes during epidural insertion among anesthesia staff, junior trainees, and staff anesthesiologists.</p><p><strong>Methods: </strong>We included all women who received a labor epidural between January 1, 2020 and April 30, 2022. The cases were divided into three groups: junior residents, senior residents, and staff anesthesiologists.</p><p><strong>Results: </strong>Among 822 cases included in analysis, 92, 240, and 490 catheters were placed by junior residents, senior residents, and staff anesthesiologists, respectively. Although the success rate among junior residents (90.7%) was lower than those of senior residents (97%) and staff anesthesiologists (95.1%), the difference was not significant (<i>P</i> = 0.067). The mean procedural time in minutes was significantly longer in the junior resident's group (18.1 min) compared to the senior residents (14.18 min) and staff anesthesiologists (14.87 min) (<i>P</i> < 0.001). A significant difference was observed in the number of needle pricks and catheter insertion attempts when comparing the junior residents, senior residents, and staff anesthesiologists' groups (<i>P</i> < 0.001). In the logistic regression analysis, procedural time remained the only predictor of epidural success.</p><p><strong>Conclusions: </strong>With the success rate above 90%, junior anesthesia trainees require more time and attempts to insert labor epidurals. It is essential that training programs provide opportunities for anesthesia trainees to become proficient in their epidural insertion techniques prior to clinical practice.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"516-520"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total intravenous anesthesia using midazolam and dexmedetomidine as substitutes for propofol in a pediatric patient with egg allergy and a family history of malignant hyperthermia.","authors":"Masashi Inoue, Masato Morita","doi":"10.4103/sja.sja_210_24","DOIUrl":"10.4103/sja.sja_210_24","url":null,"abstract":"<p><p>To avoid inhalational anesthetics, total intravenous anesthesia (TIVA) is required in patients with a predisposition to malignant hyperthermia (MH). However, propofol, which is frequently used, may be avoided in patients with egg allergies because of the contraindications in the drug information. Furthermore, some patients may not consent to the use of propofol. We report a case of TIVA using midazolam and dexmedetomidine as substitutes for propofol in a pediatric patient with egg allergy and a predisposition to MH. A 10-year-old boy was scheduled to undergo perforated drainage of an epidural abscess. He had egg allergy, and his uncle had been diagnosed with MH. He also developed a generalized drug eruption caused by antibiotics. Concerned about allergic reactions, he and his parents did not consent to administrating propofol. The patient's perioperative course was uneventful. The combination of midazolam and dexmedetomidine may be a useful option as substitutes for propofol.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"573-575"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of using a vibration device to ease pain during upper extremity injections: A randomized controlled trial.","authors":"Hatan Mortada, Abdullah A Al Qurashi, Muna F Alnaim, Khalid Arab, Abdullah E Kattan","doi":"10.4103/sja.sja_242_24","DOIUrl":"10.4103/sja.sja_242_24","url":null,"abstract":"<p><strong>Objectives: </strong>The current study aimed to evaluate the effectiveness of using a vibration device to ease pain during upper extremity injections. Specifically, the study aims to compare the pain levels of patients who receive the injection with and without the use of vibration therapy. The results of this study may have implications for improving patient outcomes and satisfaction during routine injection procedures.</p><p><strong>Material and methods: </strong>This randomized controlled trial included patients aged 18 years or older who were scheduled to receive an injection in the upper extremity. A total of 60 patients were enrolled and randomized to either the intervention group or the control group using a computer-generated randomization sequence. The level of satisfaction and pain levels were assessed using a visual analog scale. The study was conducted in accordance with the Declaration of Helsinki and approved by the institutional review board.</p><p><strong>Results: </strong>The mean pain score immediately after the injection was 4.03 ± 2.11 out of 10 in the vibration group (n = 30), compared to 7.4 ± 1.37 out of 10 in the control group (n = 30) (<i>P</i> < 0.001). Patients in the vibration group also reported higher levels of satisfaction and comfort during the injection (<i>P</i> < 0.001). No adverse events were reported in either group.</p><p><strong>Conclusion: </strong>Our study proves that using a vibration device during upper extremity injections can effectively reduce postinjection pain and improve patient satisfaction. Further research is needed to explore this intervention's long-term effects and feasibility in different clinical settings.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"488-495"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction: Adding magnesium sulfate to bupivacaine in transversus abdominis plane block for laparoscopic cholecystectomy: A single blinded randomized controlled trial.","authors":"","doi":"10.4103/SJA.SJA_343_24","DOIUrl":"10.4103/SJA.SJA_343_24","url":null,"abstract":"<p><p>[This retracts the article on p. 187 in vol. 10, PMID: 27051371.].</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"624"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined adductor canal (ACB) and sacral erector spinae plane (S-ESP) blocks for total knee arthroplasty pain in hemophilic arthropathy.","authors":"Francesco Marrone, Pierfrancesco Fusco, Saverio Paventi, Carmine Pullano","doi":"10.4103/sja.sja_177_24","DOIUrl":"10.4103/sja.sja_177_24","url":null,"abstract":"<p><p>We present the case of a successful application of combined adductor canal block (ACB) and sacral erector spinae plane (S-ESP) block for the management of a patient suffering from severe hemophilia A with an end-stage arthropathy who underwent total knee replacement. The implementation of a tailored protocol, not incorporating neuraxial techniques, such as spinal anesthesia, facilitated optimal intra- and postoperative pain management and expedited postoperative recovery and rehab without motor weakness and side effects, highlighting the potential benefit of such strategy in selected cases.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"565-568"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic tracheobronchial rupture in a fragile patient: A case report.","authors":"Beatriz Gonçalves, João Abreu, Ricardo Rodrigues, Mariana Luís","doi":"10.4103/sja.sja_295_24","DOIUrl":"10.4103/sja.sja_295_24","url":null,"abstract":"<p><p>An acute injury of the tracheobronchial system is a rare but potentially life-threatening condition that can be caused by medical procedures. Diagnosis requires a thorough evaluation of the patient's medical history, physical examination, and imaging tests. Identification of a tracheal rupture in patients under sedation or general anesthesia may be difficult, and a strong clinical suspicion is essential. Treatment can be conservative or surgical, depending on the severity of the injury and the patients' clinical status. The key prognostic determinant is a prompt identification and appropriate management.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"593-595"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified lumbar-sacral Esp block for the treatment of low back pain.","authors":"Emanuele Nazzarro, Pierfrancesco Fusco, Francesco Marrone, Carmine Pullano","doi":"10.4103/sja.sja_213_24","DOIUrl":"10.4103/sja.sja_213_24","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"612-614"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}