Journal of Anesthesia and Critical Care: Open access最新文献

{"title":"Early extubation of a patient in the operating room after prolonged glomus jugulare tumor surgical resection: a case report","authors":"Masoud Tarbiat, Mahdi Arjipour, Rohollah Abbasi, Sayed Ahmadreza Salimbahrami","doi":"10.15406/jaccoa.2023.15.00558","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00558","url":null,"abstract":"The excision of glomus jugulare tumor as an infrequently highly vascular tumor has many risks and problems for anesthesiologists. Early extubation causes short length of hospitalization and less complications. As there are scant articles about early extubation for it, this encouraged us to report early extubation after prolonged anesthesia for glomus jugulare tumor excision. General anesthesia was performed with the combined use of intravenous anesthetic agents and isoflurane in a convulsive female. After 13 hours and 40 minutes of surgery, she was successfully extubated in the operative room. Therefore, early extubation in selected patient is possible after such a prolonged surgery.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127131578","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":"Combined lumbar plexus sciatic nerve block for hip fracture: a case series with 442 patients","authors":"Prof. Dr. Saffet Karaca","doi":"10.15406/jaccoa.2023.15.00557","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00557","url":null,"abstract":"Introduction: Hip fractures are a global health problem in the elderly population. The mortality and morbidity after anesthesia are high in the elderly population with hip fractures due to numerous comorbidities. In recent years, the combined lumbar sciatic block (CLSB) method is safely applied in high-risk hip fracture surgeries. This study aims to examine 442 cases of hip fracture surgery in our clinic. Method: 442 high-risk patients operated in Istanbul University Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Orthopedics and Traumatology between 2004 and 2016 are included in this retrospective study. Neurostimulation technique combined with lumbar plexus and sciatic nerve block applied in all cases. The Lumber plexus block consists of bupivacaine 15 cc 0.5 % and prilocaine 15 cc 2%. Sciatic nerve block consists of bupivacaine 10 cc 0.5 % and prilocaine 10 cc 2%. Cases are evaluated for anesthesia quality and complication rate. Results: There was no need for any sedation or analgesia in 199 cases. Sedation was required in 147 cases. In 82 cases, the need for sedation combined with analgesia occurred. The conversion to general anesthesia was required in 14 cases. Complication wise, the epidural spread was observed in 5 cases and 3 cases got convulsions. Conclusion: It is concluded that CLSB is a safe alternative technique to use in high-risk hip fracture surgery.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122108860","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":"Caudal block in combination with general anesthesia as the best method of anesthesia for large joint replacement","authors":"Nasibova Em, Nasir Ja","doi":"10.15406/jaccoa.2023.15.00554","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00554","url":null,"abstract":"Operations of total hip and knee arthroplasty are currently one of the most frequent surgical interventions performed for functional rehabilitation of patients with osteoarthritis or patients who have received a fracture of the femoral neck. The best method for providing anesthesia and pain relief for total joint replacement has not been determined. Until now, a unified point of view on the choice of the optimal method of anesthesia and analgesia in surgical interventions for arthroplasty has not been formed. Purpose of the study.: To study the effectiveness of caudal anesthesia in hip and knee arthroplasty. Material and research methods: The study was conducted in the surgical clinic of the AMU in 56 patients who underwent surgery for hip and knee arthroplasty. The age of the patients varied from 57 to 99 years. Depending on the chosen anesthesia technique, the patients were divided into 2 groups: in the 1st group (n=28) endotracheal anesthesia was performed, induction of anesthesia with propofol and rocuronium bromide, anesthesia based on sevoflurane 1.0 vol% with caudal administration of ropivacaine 2 mg/kg in combinations with dexamethasone 0.2 mg/kg; group 2 (n=28 patients) underwent multicomponent endotracheal anesthesia (propofol 3 mg/kg, rocuronium bromide 0.6 mg/kg, sevoflurane 1.5–2.5 vol/% with high doses of fentanyl 5–6 µg /kg/hour. Research results: During the traumatic moment of the operation, the average heart rate in group I (general anesthesia + caudal block) was significantly lower than in group II (general anesthesia) (69.4±2.0 versus 89.40±3.0, p=0.010), but there are significant differences in SBP or DBP between the two groups. Conclusion: The inclusion of caudal blockade in the protocol of general anesthesia provides adequate pain relief, both intra- and postoperatively, in patients undergoing arthroplasty of large joints of the lower extremities.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114497610","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":"Myasthenia gravis – can i relax my patient? a case report","authors":"Ana Sofia Cunha, Ana Paula Santos, R. Andrade","doi":"10.15406/jaccoa.2023.15.00553","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00553","url":null,"abstract":"Myasthenia gravis is a neuromuscular disease with a multisystemic involvement and multiple drug interactions not restricted to neuromuscular blockers, but also including anaesthetic and analgesic agents, increasing the risk of anaesthesia-related complications. In this case report, we describe our safe and effective anaesthetic technique for a Myasthenia Gravis patient submitted to Video-Assisted Thoracoscopy thymectomy, requiring neuromuscular block. Since we are dealing with an increasingly frequent disease, the authors wish to highlight the need for appropriate consensus, as no standardized recommendations have been brought through, encouraging scientific societies in the provision of guidelines, especially whenever neuromuscular blocking agents are necessary.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131916162","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":"Importance of fasting abbreviation and analgesia in the satisfaction and recovery of elderly patients with hip and femur fractures. retrospective study with 1,001 patients","authors":"L. E. Imbelloni, T. Ventura, Bruno Brasileiro, M. Duarte, R. Barbosa, Siddharta Lacerda, Geraldo Borges de Morais Filho","doi":"10.15406/jaccoa.2023.15.00552","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00552","url":null,"abstract":"Background and objectives: There are several ways to assess patient satisfaction, as it is a standard indicator of the quality of care provided. The aim of this study was to evaluate whether the abbreviation of fasting with 200 ml CHO, the intake of the same beverage in the PACU, the return to oral feeding in the ward, and postoperative analgesia can improve comfort and satisfaction with anesthesia in elderly patients. with hip and femur fracture. Methods: A retrospective trial carried out in a Brazilian public health hospital (SUS), with 1,001 patients physical status ASA I-III submitted to hip and femur fracture surgery. The following items were evaluated: preoperative fasting time, evaluation of thirst and hunger upon arrival in the operating room, time of CHO administration in the PACU, time of reintroduction of oral feeding in the ward, and at this moment, the degree of satisfaction with the anesthetic conduct, abbreviation of fasting and early feeding. A satisfaction assessment was performed with YES and NO answers regarding the pre-anesthetic visit, the fasting abbreviation, the use of CHO in PACU, refeeding in the ward, and postoperative analgesia. Family members were also asked to return immediately to the ward, without intravenous hydration and without going through the ICU. Results: All patients had the fasting abbreviation between 1:20 h and 4:00 h. None of the 1,001 patients reported being thirsty when they arrived in the operating room, against only 26 patients reporting being hungry. The time of administration of dextrinomaltose in PACU ranged from 20 minutes to 5:45 h, and the reintroduction of oral feeding in the ward ranged from 4 h to 8:15 h. Analgesia with lumbar plexus block with a neurostimulator and levobupivacaine before or after providing mean analgesia of 22±4 h, with a minimum time of 13 h and a maximum of 34 h. All patients were able to be discharged from the hospital on the second postoperative day. Conclusion: This study with 1,001 patients clearly shows that in hospitalized elderly, the liberal use of CHO before surgery and immediately in PACU, and better quality analgesia is an easy and practical way to increase patient comfort and satisfaction with anesthesia care and with better outcomes.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131658652","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":"Renal angina index as a predictor of acute kidney injury in patients admitted to the emergency department","authors":"Michell E Montalvo Aguila, Victor A Castro Valdez, Ulises Espinoza","doi":"10.15406/jaccoa.2023.15.00551","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00551","url":null,"abstract":"Acute renal failure (ARF) is a syndrome that occurs due to multiple causes of injury and is characterized by an abrupt decrease in glomerular filtration rate. The concept of renal angina is made to highlight the characteristics of renal injury, as an analogy to the concept of angina pectoris, which is used to increase the suspicion of acute coronary syndrome in cardiology. Material and methods: Prospective, observational and descriptive study. The present study will be carried out on patients admitted and attended in the Emergency Department of the Hospital de Alta Especialidad (UMAE) No. 14. Adolfo Ruiz Cortínez from September 1 to November 30, 2022. The data described in the data collection instrument will be collected in order to later concentrate them in a database for analysis. Results: Of the 73 patients who entered the study, 42 patients were male, the mean age was 55 years, the minimum 18 and the maximum 75, the mode was 70 years. Of the patients included 49 were diabetic and of these 38.36% were male, only 11 had sepsis without much difference between the two sexes, representing 15.07% of the total number of patients. Of the total number of patients only 12 were admitted to the intensive care unit, 16.44%; the male sex was the most prevalent group, only 23.9% of the total number of patients required mechanical ventilation and 10.96% required vasopressor (Of the total number of patients only 15 (20.5%) had acute renal injury and of these the most affected age group was 61 to 80 years old). Conclusion: The percentage of patients with a positive renal angina index (>8) who had AKI was 100% of the 73 patients only 15 developed AKI. Sepsis, vasopressor use and mechanical ventilation did not have a significant value for the development of AKI within this study in comparison to the study \"Renal angina: \"The beginning of the end\" where out of 95 patients included in their study, sepsis, vasopressor use and mechanical ventilation did have a significant value for the development of AKI.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131346915","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 the behavioral effects of ketamine and propofol sedation in the pediatric endoscopy unit","authors":"M. Çakırca, Devrim Tanil Kurt","doi":"10.15406/jaccoa.2023.15.00549","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00549","url":null,"abstract":"Introduction: Hospitalization and anesthesia can have a harmful psychological impact on children, leading to behavioral abnormalities. Using the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS) version of the Post Hospitalization Behavior Questionnaire for daycase patients, the objective of this study is to assess the differences between ketamine and propofol and propofol alone use following anesthesia. Materials and methods: After receiving approval from the ethics committee, 84 children ages 2 to 18 who would undergo sedation surgery at the pediatric endoscopy-colonoscopy unit at Ankara City Hospital were enrolled in the study. Group K consisted of 27 patients sedated with ketamine and propofol, while group P consisted of 57 children sedated with propofol. To detect postoperative behavioral alterations in these youngsters, a questionnaire (POBQ-AS) was administered soon prior to the procedure and on the third day following it. Results: Pre-procedural Behavior Assessment Questionnaire Total scores were comparable for both groups. The measures on the third day following the surgery were also comparable. The Post-procedure Behavior Evaluation Questionnaire Total Score increased significantly (p 0.05) in both groups compared to the pre-procedure score. In Group K, the answers to the questions \"Is he disconnected to his environment?\" and \"Does he become depressed when left alone?\" increased significantly more than in the other group (p 0.05). Conclusion: Pediatric perioperative behavioral problem may be common. On the third postoperative day, sedative applications involving ketamine and propofol induce detrimental behavioral alterations, according to this study. In our patient group selected from the endoscopy unit to exclude factors such as mask induction, muscle relaxants, inhalation anesthetics, and surgical incision pain, we believe that only the negative behavioral changes of the intravenous anesthetics ketamine and propofol, as well as factors such as inflammation, surgical stress, and neurotoxicity, should be the focus of future research.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114147012","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":"Factors associated with maternal decision against hospital delivery despite ANC attendance in Kakamega central sub county","authors":"C. Lusweti, Thomas Ngambwa","doi":"10.15406/jaccoa.2023.15.00548","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00548","url":null,"abstract":"Despite a large proportion of woman attending ANC during pregnancy, a significant percentage still avoid delivering at the health facility. This increases the risk of adverse pregnancies outcomes and deaths. Knowledge of factors associated with the decision against health facility delivery is limited. The main objective was to describe health facility factors associated with maternal decision against despite ANC attendance in Kakamega Central Sub-County. A community based cross sectional study was undertaken focused on a structured interview method in collecting quantitative data. Sample of 332 mothers who attended ANC but did not deliver in a health facility were drawn from a study population. A multistage random sampling method was applied in the selection of a primary data. Factors that made mothers to decide against health facility delivery despite ANC attendance included costs of transport and lunch, lack of supplies and commodities and lack of sufficient preparatory service for delivery emerges as more crucial determinant for decision against health facility. Chi-square tests were used describe single variables and to assess associations between variables. The statistical significance level was set at p<0.05. Income source of the women were also associated with the perception on all staff always being available at the facility. We found significant associations between costs, and other costs. Availability of different levels of health facility will not alone solve the problem of low health facility delivery rates. These facilities need to be equally empowered with supplies, staffs who can give quality comprehensive service. Furthermore the women need to be economically empowered to be able to meet other costs like transport and lunch. Focus on increasing financing for maternity service by the government and intersectoral approach for maternal health is crucial in Kakamega Central Sub County. The county government should provide ambulance services for pregnant women, decentralization of delivery services in all health facilities and provide with staffs, supplies and commodities for equity of usage of delivery services, improved road network. Need for constructive and collaborative approach to promote maternal health and need to multi-sectoral approach to overcoming the barriers to health facility deliveries.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121098228","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":"Awake brain surgery in epilepsy: a case report and review of the literature","authors":"Javier Bryan Nieto Rizo MD, Oscar Daniel Guerrero Ortiz, Daniela Della Valle Gutiérrez","doi":"10.15406/jaccoa.2023.15.00547","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00547","url":null,"abstract":"Awake craniotomy is a frequent procedure in the practice of neurosurgery. In functional neurosurgery, this anesthetic technique has been described for Deep-Brain- Stimulators (DBS) placement in Parkinson’s disease and for tumor resection in eloquent areas. We describe a case of transoperative identification of epileptogenic foci with successful real-time resection. A 26-year-old patient who presented to our emergency room with seizures of difficult control despite a three-drug scheme. Brain image was performed that showed evidence of a left temporal lobe glioma. Due to the eloquent situation of the tumor, a resection under Awake-Sleep-Awake (AAA) technique was performed. Conclusion: Awake craniotomy is a very well stablished neurological procedure that has been increasing in frequency and indications. Profound knowledge of the perioperative and anesthetic management is key for the anesthesiologist to successfully perform the intricate procedure of managing the sleep and awake periods, as well as all its potential complications. Awake craniotomy allows for a very precise resection, having a positive impact in the short- and long-term quality of life of these patients.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114133775","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":"Risk factors related to delayed post-anesthetic awakening in the elderly operated by elective video laparoscopic surgery","authors":"Assel Antonio Villalón Castillo, C. Sánchez, Y. Bazán, Kenia Dalia León Paz, Titania Grecia Rodríguez Ginarte, S. Martínez","doi":"10.15406/jaccoa.2023.15.00546","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00546","url":null,"abstract":"In all surgical procedures, the organism presents different physiological alterations that expose the patient to a series of difficulties that, if not taken into account, can cause very severe complications in the post-anesthetic awakening of elderly patients. A longitudinal prospective cohort study was carried out on elderly people who underwent laparoscopic video surgery at the general provincial hospital \"Carlos Manuel de Céspedes de Bayamo, from the Cauto region during the period from January 1, 2019 (,) to December 31, 2019. December 2021; with the aim to identify the risk factors related to a delay in post- anesthetic awakening. It was established that the exposed cohort consisted of 39 elderly people with delayed post-anesthetic awakening in the study period who met the inclusion criteria. The magnitude of the associations was estimated by calculating the relative risks (RR) of delay. There is an association between patient-dependent risk factors: smoking, obesity, presence of comorbidities and use of chronic pharmacological therapy, with a delay in post-anesthetic awakening in the elderly. The duration of the intervention, fasting time greater than 12 hours and hypoglycemia were the factors dependent on the surgical-anesthetic act associated with a delay in post-anesthetic awakening in the elderly.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131288252","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}