Sri Lankan Journal of Anaesthesiology最新文献

Successful management of a postpartum mother with severe COVID-19 associated ARDS complicated by life-threatening respiratory events 成功管理1例产后母亲合并严重COVID-19相关急性呼吸窘迫综合征并发危及生命的呼吸事件

Sri Lankan Journal of Anaesthesiology Pub Date : 2023-10-04 DOI: 10.4038/slja.v31i2.9277

Kavisha P. Dissanayake, P. T. R. Makuloluwa

引用次数: 0

The Effect of Single-Dose Dexmedetomidine on Cough Response During Tracheal Extubation 单剂量右美托咪定对气管拔管时咳嗽反应的影响

Sri Lankan Journal of Anaesthesiology Pub Date : 2023-10-04 DOI: 10.4038/slja.v31i2.9148

Bhavish Reddy, Leena H. Parate, Suresh Govindswamy

{"title":"The Effect of Single-Dose Dexmedetomidine on Cough Response During Tracheal Extubation","authors":"Bhavish Reddy, Leena H. Parate, Suresh Govindswamy","doi":"10.4038/slja.v31i2.9148","DOIUrl":"https://doi.org/10.4038/slja.v31i2.9148","url":null,"abstract":"Introduction: Optimal strategy for smooth, cough less extubation is still not well established. We aimed to study the effect of single dose of dexmedetomidine (0.5ug/kg) given prior to extubation on cough response during extubation.Methods: 220 patients undergoing laparoscopic cholecystectomy under general anaesthesia were included in the study. Group D (n=110) received IV dexmedetomidine 0.5ug/kg diluted in 100 ml saline and Group S (n=110) received 100ml saline 15 minutes before extubation. Primary outcome was incidence and severity of cough at the time of extubation. Secondary outcome was haemodynamic parameters and sedation. The severity of cough was graded on a four-point scale. Statistical analysis was performed using chi square test and independent t test.Results: The incidence of coughing was significantly lower in Group D than Group S (49.1% vs.70.9%, p = 0.002). Lower grades of cough was observed more in Group D than Group S (17.2% vs. 30.9% p = 0.018). The mean heart rate and blood pressure were lower in Group D. (p <0.001) Sedation score was similar in both groups. (p=0.07)Conclusion: Use of single bolus dose of dexmedetomidine prior to extubation reduces the incidence and severity of cough grade. In addition, it also attenuated haemodynamic response to tracheal extubation without affecting recovery.","PeriodicalId":41531,"journal":{"name":"Sri Lankan Journal of Anaesthesiology","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135645273","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}

引用次数: 0

Serotonin syndrome: A case report 血清素综合征1例报告

Sri Lankan Journal of Anaesthesiology Pub Date : 2023-10-04 DOI: 10.4038/slja.v31i2.9108

Sasika Wijayasinghe, Roshana Mallawaarachchi, Ruwani Dharmabandu

引用次数: 0

Study on Ward-Based Practice of Vasopressor Administration for Patients with Sepsis, in National Hospital of Sri Lanka (NHSL) 斯里兰卡国立医院(NHSL)脓毒症患者以病房为单位给药血管加压素的研究

Sri Lankan Journal of Anaesthesiology Pub Date : 2023-10-04 DOI: 10.4038/slja.v31i2.9144

H. S. Vitharana, Ramya Amarasena

{"title":"Study on Ward-Based Practice of Vasopressor Administration for Patients with Sepsis, in National Hospital of Sri Lanka (NHSL)","authors":"H. S. Vitharana, Ramya Amarasena","doi":"10.4038/slja.v31i2.9144","DOIUrl":"https://doi.org/10.4038/slja.v31i2.9144","url":null,"abstract":"Background: Vasopressors are administrated peripherally in hemodynamically unstable patients with sepsis in the initial period. International guidelines are available for peripheral administration of vasopressors, including Surviving Sepsis guidelines 2021.Objective: Assess the ward-based practice regarding peripheral administration of vasopressors in patients with sepsis, in NHSL.Methods: A prospective cross-sectional study, during a period of six weeks in 2022, setting of Medical and surgical wards in NHSL, in a group of 52 patients.Results: Noradrenaline was the vasopressor used for all patients with septic shock. 93% of patients had peripheral noradrenaline infusions for a medium duration of 77.7 hours. Peripheral cannula for noradrenaline was sited in the forearm at 46% and in the dorsum of the hand at 34%. Only 7% had a central line for vasopressors. Other infusions along with noradrenaline in the same cannula were given in 75%. Approximately 90% were monitored hourly during the infusion of vasopressors. ICU referral was done only in 5.7% of patients. Adverse reactions were noted in 38% of patients, all minor complications.Conclusion: Peripheral administration of vasopressors was prolonged compared to standard. Adverse reactions were identified, but all were minor complications.","PeriodicalId":41531,"journal":{"name":"Sri Lankan Journal of Anaesthesiology","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135645415","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}

引用次数: 0

Randomized Double-Blind Trial Comparing Efficacy of Intravenous Nalbuphine vs Intrathecal Nalbuphine for Prevention of Intrathecal Morphine Induced Pruritus in Orthopaedic Surgeries 静脉注射纳布啡与鞘内注射纳布啡预防骨科手术鞘内吗啡性瘙痒的随机双盲试验比较

Sri Lankan Journal of Anaesthesiology Pub Date : 2023-10-04 DOI: 10.4038/slja.v31i2.9031

Pranjali Kurhekar, J. Shesha dhiviya Krishna

{"title":"Randomized Double-Blind Trial Comparing Efficacy of Intravenous Nalbuphine vs Intrathecal Nalbuphine for Prevention of Intrathecal Morphine Induced Pruritus in Orthopaedic Surgeries","authors":"Pranjali Kurhekar, J. Shesha dhiviya Krishna","doi":"10.4038/slja.v31i2.9031","DOIUrl":"https://doi.org/10.4038/slja.v31i2.9031","url":null,"abstract":"Intrathecal morphine provides excellent postoperative pain relief but results in pruritus in 30-60% of patients. Nalbuphine, an opioid agonist-antagonist prevents intrathecal morphine-induced itch when given by intravenous route. In this study, we compared efficacy of intrathecal and intravenous nalbuphine for the prevention of intrathecal morphine-induced pruritus. 90 patients were randomly divided into two groups. IT group received 100 mcg of morphine with 400 mcg of nalbuphine intrathecally. IV group received 100 mcg of morphine intrathecally and 400 mcg of nalbuphine intravenously. Incidence of itching, respiratory depression, hypotension, nausea, vomiting, sedation and analgesia were compared between the groups every 4th hourly for 24 hours. Data were analyzed with Chi-square test and Mann-Whitney test. Incidence of itching in 24 hours period was 11.6% (5 patients) in IV group and 4.8% (2 patients) in IT group which was comparable. (P= 0.250) Two patients in IV group had intractable itching requiring naloxone. Incidence of itching at all time intervals was comparable between the groups. Analgesia was prolonged in IV group (P=0.03) Incidence of nausea, vomiting, sedation and respiratory depression was comparable. We conclude that intrathecal nalbuphine and intravenous nalbuphine were equally effective in preventing intrathecal morphine induced pruritus. The duration of analgesia was more when nalbuphine was given by IV route as compared to IT route.","PeriodicalId":41531,"journal":{"name":"Sri Lankan Journal of Anaesthesiology","volume":"221 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135646266","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}

引用次数: 0

Myoclonus in the Post-Operative Period: A Case Report 术后肌阵挛1例报告

Sri Lankan Journal of Anaesthesiology Pub Date : 2023-10-04 DOI: 10.4038/slja.v31i2.9153

B. Chandana, Prapti Rath, Akshita Niranjan, Sharmila Narayana, C. A. Tejesh

引用次数: 0

Prediction model for the need of postoperative organ support in an adult population undergoing elective major general surgery - Utilizing the American College of Surgeons - National quality improvement project (ACS-NSQIP) surgical risk calculator 成人择期大普外科术后器官支持需求预测模型——利用美国外科医师学会-国家质量改进项目(ACS-NSQIP)手术风险计算器

Sri Lankan Journal of Anaesthesiology Pub Date : 2023-10-04 DOI: 10.4038/slja.v31i2.9243

Kavya Galle Kankanamge Botejue, Aloka Pathirana, Shamini Prathapan

{"title":"Prediction model for the need of postoperative organ support in an adult population undergoing elective major general surgery - Utilizing the American College of Surgeons - National quality improvement project (ACS-NSQIP) surgical risk calculator","authors":"Kavya Galle Kankanamge Botejue, Aloka Pathirana, Shamini Prathapan","doi":"10.4038/slja.v31i2.9243","DOIUrl":"https://doi.org/10.4038/slja.v31i2.9243","url":null,"abstract":"An accepted model for predicting the need for postoperative organ support and intensive care, in patients undergoing elective surgery, is lacking worldwide. A reliable tool that could predict the need for postoperative organ support would facilitate the efficient utilisation of ICU beds while ensuring patient safety. The American College of Surgeons - National Quality Improvement Project (ACS-NSQIP) surgical risk calculator is validated for the prediction of the risk of serious complications in the postoperative period. We aimed to validate this calculator to predict the need for post-operative organ support. We obtained perioperative data from 126 patients who underwent elective major general surgery. We calculated the percentage risk of serious complications for each patient using the ACS-NSQIP calculator and correlated it with the level of postoperative organ support needed. The mean predicted percentage risk of serious complications, for the group that did not require any organ support was 10.5% and the group requiring 1 or more organ support was 18.1%. The standard error was 0.49 (p= 0.001). A receiver-operating characteristic (ROC) curve gave an area under the curve of 0.71. We chose a cutoff for the percentage risk of serious complications for needing postoperative organ support and 10.8% was chosen as a fair value as it had a sensitivity of 71.4% and a specificity of 66%. The percentage risk of serious complications calculated by the ACS-NSQIP surgical risk calculator has a strong positive correlation with the need for postoperative organ support. Multi-center data is needed to determine definite cut-offs.","PeriodicalId":41531,"journal":{"name":"Sri Lankan Journal of Anaesthesiology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135645563","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}

引用次数: 0

C-MAC VL as Saviour Following Failed Intubation Attempts in an Infant with Huge Hydrocephalous C-MAC VL作为巨大脑积水婴儿插管失败后的救星

Sri Lankan Journal of Anaesthesiology Pub Date : 2023-10-04 DOI: 10.4038/slja.v31i2.9081

Farah Nasreen, Atif Khalid, Sobia Manaal Siddiqui

引用次数: 0

Anaphylaxis: Unveiling the silent killer 过敏反应:揭开沉默杀手的面纱

Sri Lankan Journal of Anaesthesiology Pub Date : 2023-10-04 DOI: 10.4038/slja.v31i2.9288

Vasanthi Pinto, Ashani Ratnayake

引用次数: 0

A quality improvement project to establish accuracy in completing Early Warning Score chart and appropriate clinical response depending on the score in acute care wards at Asiri Surgical Hospital 在Asiri外科医院的急性护理病房中，根据评分确定完成早期预警评分表的准确性和适当的临床反应的质量改进项目

Sri Lankan Journal of Anaesthesiology Pub Date : 2023-10-04 DOI: 10.4038/slja.v31i2.9132

Nimali Lochanie, Kalsara Haresh Abeyasekara, Gayani Senanayaka

{"title":"A quality improvement project to establish accuracy in completing Early Warning Score chart and appropriate clinical response depending on the score in acute care wards at Asiri Surgical Hospital","authors":"Nimali Lochanie, Kalsara Haresh Abeyasekara, Gayani Senanayaka","doi":"10.4038/slja.v31i2.9132","DOIUrl":"https://doi.org/10.4038/slja.v31i2.9132","url":null,"abstract":"Failure or delay in recognition of acutely deteriorating patients in acute care ward setting leads to preventable morbidity, cardiac arrest, and death. Assessment and responding to Early Warning Score (EWS) adapted from National Early Warning Score 2 is implemented at Asiri Surgical Hospital to capture these patients early and escalate their care appropriately. Though a colour-coded EWS chart and a hospital policy are available, gaps in accurate recording, monitoring, and triggering were reported. Thus, a quality improvement project was conducted with the aim of establishing more than 80% accuracy in completing the EWS chart and appropriate clinical response to EWS score in acute care wards at Asiri Surgical Hospital by August 2022.A multidisciplinary team performed a series of Plan-Do-Study-Act cycles focusing on correct documentation and calculation of EWS score and appropriate monitoring and escalation of care. Key drivers for hindering the pathway were identified and addressed. Over the course of the project, correct recording improved from 81.25% to 99.4%, accurate calculation of total EWS score had improved from 79% to 88%, patients who received recommended monitoring as triggered by EWS score improved from 78.8% to 84.6% and escalation of care when EWS score is 5 or more improved from 70.9% to 91.7%.A step improvement in the clinical response to a deteriorating patient in the acute care ward setting at Asiri Surgical Hospital was attained by the successful quality improvement project involving the frontline care providers.","PeriodicalId":41531,"journal":{"name":"Sri Lankan Journal of Anaesthesiology","volume":"19U 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135645838","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}

引用次数: 0