Ain-Shams Journal of Anesthesiology最新文献

{"title":"Anesthetic management of diphallia with anorectal malformation posted for colostomy: a rare association","authors":"Aakriti Sharma, Neelam Dogra, Rama Chatterjee, Pratibha Rathore, Hardika Mangal","doi":"10.1186/s42077-023-00399-3","DOIUrl":"https://doi.org/10.1186/s42077-023-00399-3","url":null,"abstract":"Duplication of the penis or Diphallia is a rare abnormality of the urogenital tract present once in every 5–6 million live births with varied presentations and associated systemic anomalies. We present the anesthetic management of a neonate presenting with duplication of penis, urethra, and anorectal malformation. With this rare case, we aim to shed light on the various perioperative anesthetic concerns of such neonates presenting with surgical emergencies and their successful management.","PeriodicalId":7686,"journal":{"name":"Ain-Shams Journal of Anesthesiology","volume":"24 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138579857","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":"APACHE IV, SAPS III, and SOFA scores for outcome prediction in a surgical/trauma critical care unit: an analytical cross-sectional study","authors":"Huda F. Ghazaly, Ahmed Alsaied A. Aly, Marwa H. Sayed, Mahmoud M. Hassan","doi":"10.1186/s42077-023-00383-x","DOIUrl":"https://doi.org/10.1186/s42077-023-00383-x","url":null,"abstract":"Patients’ outcomes in surgical/trauma intensive care units (ICUs) are still challenging to predict. There has been a lack of consensus over the efficacy of Acute Physiology and Chronic Health Evaluation IV (APACHE IV), Simplified Acute Physiology Score III (SAPS III), and Sequential Organ Failure Assessment (SOFA) scores in predicting patient outcomes. This analytical cross-sectional study was designed to determine how well APACHE IV, SAPS III, and SOFA scores predict ICU mortality and the length of stay in a surgical ICU. APACHE IV, SAPS III, and SOFA scores were calculated on admission. The effectiveness of these scores in predicting mortality was determined using logistic regression models. The accuracy of these discriminative abilities was measured using the area under the receiver operating characteristic curve (AUC). The Hosmer and Lemeshow calibration test was calculated to test the model fit. The agreement between APACHE IV, SAPS III, and SOFA scores in the prediction of mortality was examined using the Bland–Altman curve. A total of 148 patients met the study criteria. APACHE IV was the only significant predictor of mortality, with a 1-point increase in the APACHE IV score resulting in a 5% increase in death probability (AOR = 1.049, 95% CI 1.028–1.069) (P-value < 0.001). The APACHE IV score was superior to the SAPS III and SOFA scores regarding accuracy, with an AUC of 0.766 (95% CI, 0.670–0.862) (P-value < 0.001). Furthermore, there was a significant positive correlation between APACHE IV score and ICU length of stay (r = 0.22, P = 0.004). APACHE IV outperformed SAPS III and SOFA scores in predicting mortality in a surgical/trauma critical care unit and showed a significant positive correlation with the ICU length of stay.","PeriodicalId":7686,"journal":{"name":"Ain-Shams Journal of Anesthesiology","volume":"3 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138526579","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":"Broken epidural catheter: individualize your management","authors":"Sanjay Kumar, Shalvi Mahajan, Vishal Kumar, Komal Anil Gandhi","doi":"10.1186/s42077-023-00381-z","DOIUrl":"https://doi.org/10.1186/s42077-023-00381-z","url":null,"abstract":"Epidural anaesthesia is one of the most used neuraxial anaesthesia techniques. It has been utilized as the principal anaesthesia modality involving lower limb surgery. Breakage of epidural catheters is an unusual occurrence whose subsequent therapy lacks uniformity due to the absence of a consensus and defined standards. A 39-year-old male with no comorbidities was scheduled for right lower limb reconstruction surgery due to non-union of the tibia. Combined spinal-epidural anaesthesia was planned. During epidural catheter insertion, there was difficulty threading the catheter, and upon its removal, a long segment of catheter (8 cm) was left inside the body. Following informed consent from the patient, the retained fragment was surgically extracted in the same sitting under general anaesthesia. Even when faced with such a circumstance, it is best to explore surgically and remove a long segment broken catheter to allay patient anxiety.","PeriodicalId":7686,"journal":{"name":"Ain-Shams Journal of Anesthesiology","volume":"91 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138543001","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":"Abiraterone, a rare cause of severe perioperative hypokalemia with unusual presentation as aphonia and quadriparesis: a case report","authors":"Sakshi Thakore, Ankita Kaasat, Nirdesh Thakore, Yatendra Singh Chundawat","doi":"10.1186/s42077-023-00392-w","DOIUrl":"https://doi.org/10.1186/s42077-023-00392-w","url":null,"abstract":"Oral Abiraterone acetate is a novel antineoplastic agent approved by the FDA for the treatment of metastatic prostate cancer. Abiraterone is an irreversible inhibitor of the 17α-hydroxylase (CYP17) enzyme complex resulting in a reduction of androgens and corticosteroids. It may cause mineralocorticoid excess syndrome; hence, it is prescribed with steroids. Here we describe a case of postoperative severe hypokalemia with unusual presentation in a patient after spine surgery in which abiraterone with prednisolone was continued preoperatively. Anesthetic concerns about the perioperative administration of abiraterone have not been reported in the literature. An 80-year-old male with a known case of metastatic prostate cancer was posted for spine surgery under general anesthesia. Surgery was uneventful and the patient was extubated after ensuring adequate muscle power and respiratory parameters. Postoperatively, the patient developed aphonia, quadriparesis, and respiratory distress leading to reintubation. After evaluation, severe grade 4 hypokalemia was found to be the causative factor. The patient recovered well after potassium and steroid supplementation. Low potassium and cortisol levels indicate a diagnosis of abiraterone-induced hypokalemia. Patients on abiraterone require more stringent and vigilant monitoring of potassium and cortisol levels. In such circumstances, it might be advantageous to add additional steroids or substitute alternative steroids.","PeriodicalId":7686,"journal":{"name":"Ain-Shams Journal of Anesthesiology","volume":"18 7","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138526620","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":"An incidental finding of xanthochromia during spinal anaesthesia in a patient posted for lower limb surgery","authors":"Sumedha Mehta, Kavita Adate, Kiran Valake","doi":"10.1186/s42077-023-00398-4","DOIUrl":"https://doi.org/10.1186/s42077-023-00398-4","url":null,"abstract":"Xanthochromia is the yellowish discoloration of cerebrospinal fluid associated with serious conditions like subarachnoid haemorrhage and spinal cord tumour which raises concerns regarding safety when presented during spinal anaesthesia. There is limited literature regarding the clinical implications of spinal anaesthesia in xanthochromia. We report a case of a 31-year-old male patient with an incidental finding of xanthochromia cerebrospinal fluid during spinal anaesthesia. The patient with a history of fall was posted for lower limb orthopaedic surgery under subarachnoid block. In the process of administering the block, the pale yellow coloured cerebrospinal fluid was encountered. We conclude that proceeding with spinal anaesthesia in xanthochromia should be at the discretion of the anaesthesiologist and further investigations for the diagnosis can be considered for the management in such cases.","PeriodicalId":7686,"journal":{"name":"Ain-Shams Journal of Anesthesiology","volume":"2005 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138526580","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":"Obesity and postoperative pulmonary complications: other potential factors carrying “weight”","authors":"Rohan Magoon, Varun Suresh","doi":"10.1186/s42077-023-00393-9","DOIUrl":"https://doi.org/10.1186/s42077-023-00393-9","url":null,"abstract":"&lt;p&gt;A recent study concluded that body mass index (BMI) was not significantly associated with postoperative pulmonary complications (PPCs) in a retrospective evaluation of 231 patients undergoing elective upper abdominal surgery (Shiramoto et al. 2023). The authors notably assessed a pertinent complication in a homogenous surgical cohort, nonetheless their analysis being limited by a rather “slim” cohort of obese when defined by the World Health Organization (WHO) criterion. Herein, we are concerned that the research results could have been influenced by factors other than those discussed in the index article.&lt;/p&gt;&lt;p&gt;Cross-sectional population-based surveys (Vold et al. 2012) exist outlining pivotal links between an increasing BMI and low arterial oxygen saturation (SpO&lt;sub&gt;2&lt;/sub&gt;). The same becomes especially relevant when researchers delineate almost ten times elevated risk of PPCs following abdominal surgery in background of a preoperative SpO&lt;sub&gt;2&lt;/sub&gt; &lt; 94% (adjusted odds ratio; 95% confidence interval: 10.67; 3.79–30.02, &lt;i&gt;p&lt;/i&gt;-value &lt; 0.001) (Gebeyehu et al. 2022). The fact however remains that Gebeyehu et al. prospectively included 287 elective-emergency abdominal surgical subset with 33% incidence of PPCs when compared to 11.69% patients with PPCs in the Shiramoto et al. retrospective study staged in an elective surgical setting. Having said that, the importance of accounting for respiratory infections within the month prior to surgical intervention cannot be overemphasized while assessing PPCs as an outcome of interest. Indeed, the PPC predictive risk indices, such as the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT score, inculcating preoperative SpO&lt;sub&gt;2&lt;/sub&gt; and respiratory infections in the last month, in addition to factors like preoperative anemia), have demonstrated encouraging results, as depicted in a large external risk-predictive validation endeavor (Mazo et al. 2014).&lt;/p&gt;&lt;p&gt;Furthermore, retrospective surgical literature highlights the concurrent role of nutritional status and perioperative inflammation in determining the propensity to developing PPCs. Thus, amidst independent studies assigning significant PPC “weight” to serum albumin cholesterol, platelets (Xue et al. 2021), and prognostic nutritional index (Yu et al. 2021), the former could also have been potential players, particularly in the context of a predisposed surgical cohort of obese patients.&lt;/p&gt;&lt;p&gt;Not applicable.&lt;/p&gt;&lt;dl&gt;&lt;dt style=\"min-width:50px;\"&gt;&lt;dfn&gt;ARISCAT:&lt;/dfn&gt;&lt;/dt&gt;&lt;dd&gt;\u0000&lt;p&gt;Assess Respiratory Risk in Surgical Patients in Catalonia&lt;/p&gt;\u0000&lt;/dd&gt;&lt;dt style=\"min-width:50px;\"&gt;&lt;dfn&gt;BMI:&lt;/dfn&gt;&lt;/dt&gt;&lt;dd&gt;\u0000&lt;p&gt;Body mass index&lt;/p&gt;\u0000&lt;/dd&gt;&lt;dt style=\"min-width:50px;\"&gt;&lt;dfn&gt;PPC:&lt;/dfn&gt;&lt;/dt&gt;&lt;dd&gt;\u0000&lt;p&gt;Postoperative pulmonary complications&lt;/p&gt;\u0000&lt;/dd&gt;&lt;dt style=\"min-width:50px;\"&gt;&lt;dfn&gt;SpO&lt;sub&gt;2&lt;/sub&gt; :&lt;/dfn&gt;&lt;/dt&gt;&lt;dd&gt;\u0000&lt;p&gt;Arterial oxygen saturation&lt;/p&gt;\u0000&lt;/dd&gt;&lt;dt style=\"min-width:50px;\"&gt;&lt;dfn&gt;WHO:&lt;/dfn&gt;&lt;/dt&gt;&lt;dd&gt;\u0000&lt;p&gt;World Health Organization&lt;/p&gt;\u0000&lt;/dd&gt;&lt;/dl&gt;&lt;ul dat","PeriodicalId":7686,"journal":{"name":"Ain-Shams Journal of Anesthesiology","volume":"87 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138526607","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":"Prevalence and outcome of chronic hepatitis C patients admitted with COVID-19 to intensive care units: a blessing in disguise","authors":"Essamedin M. Negm, Rehab H. El-Sokkary, Mai M. Malek, Heba M. Ezzat, Ahmed E. Tawfik, Heba Ali Abed, Seham Mahmoud ELdeeb, Mohamed Sorour Mohamed, Hamdy M. Kassem, Ahmed Mosallem, Sherif M. S. Mowafy","doi":"10.1186/s42077-023-00396-6","DOIUrl":"https://doi.org/10.1186/s42077-023-00396-6","url":null,"abstract":"Managing COVID-19 pneumonia is, in reality, one of the biggest challenges in the history of intensive care medicine. The link between comorbidity and COVID-19 remains unclear. Worldwide, Egypt has the highest prevalence of hepatitis C virus (HCV). The study’s objectives were to assess the prevalence of chronic hepatitis C as a risk factor among COVID-19 patients and to investigate the impact of it and the prior exposure to different HCV management protocols on the clinical characteristics and outcome of COVID-19 patients. Of 2106 confirmed cases of COVID-19, CLD, malignancy, and chronic kidney disease were significant risk factors for death [OR (95% CI) = 2.78 (1.29–5.98), 2.72 (1.14–6.46) and 3.79 (1.39–10.36) respectively]. The mortality rate was 24.3%. A total of 99 cases (4.7%) with CLD were investigated during the study period; 69 patients (3.3%) were categorized as HCV-positive. Among the positive HCV cases, 49 patients (2.3%) received anti-hepatitis C medications. The mortality rate was 46.4% and 73.3% between HCV and non-HCV hepatic patients, respectively. Triple therapy showed a statistically significant association with a better outcome (p value = 0.009). In the present report, chronic liver diseases, chronic kidney disease, and malignancy were significant risk factors for mortality among COVID-19 patients. The Egyptian mass management of chronic hepatitis C may explain the favorable outcome of COVID-19 among these patients. Intervention trials are required to prove that direct-acting antivirals are effective in preventing COVID-19.","PeriodicalId":7686,"journal":{"name":"Ain-Shams Journal of Anesthesiology","volume":"15 8","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138526606","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":"i-gel as an interface before intubation to buy safe apnea time in a patient with anticipated difficult airway due to multiple facial fractures","authors":"Sony Sony, Manasmita Dalai, Boney John, Abhilash D. Sadhankar","doi":"10.1186/s42077-023-00397-5","DOIUrl":"https://doi.org/10.1186/s42077-023-00397-5","url":null,"abstract":"Any traumatic injury to the face can be uniquely challenging to the anesthesiologist. A difficult airway in a chronic obstructive pulmonary disease patient, non-consenting for awake intubation can pose quite a conundrum. Our patient had multiple facial fractures with limited mouth opening, making mask ventilation difficult. We found that i-gel® was easy to insert in a lighter plane of anesthesia maintaining spontaneous ventilation, without much manipulation. The benefits were twofold, it confirmed the ability to ventilate and secondly bought us safe apnea time before attempts of intubation were made. Supra-glottic devices are an integral part of difficult airways but i-gel® is uniquely simple and easy to use.","PeriodicalId":7686,"journal":{"name":"Ain-Shams Journal of Anesthesiology","volume":"20 5","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138526617","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":"ESPB and post cardiac surgery recovery: reading between the lines","authors":"Sunaakshi Puri, Anjishnujit Bandyopadhyay, Rohan Magoon","doi":"10.1186/s42077-023-00394-8","DOIUrl":"https://doi.org/10.1186/s42077-023-00394-8","url":null,"abstract":"","PeriodicalId":7686,"journal":{"name":"Ain-Shams Journal of Anesthesiology","volume":"53 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134902330","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":"Type of post-cardiac arrest rhythm should not be labelled","authors":"Srinivasan Suganya, Muthapillai Senthilnathan","doi":"10.1186/s42077-023-00395-7","DOIUrl":"https://doi.org/10.1186/s42077-023-00395-7","url":null,"abstract":"","PeriodicalId":7686,"journal":{"name":"Ain-Shams Journal of Anesthesiology","volume":"52 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136281768","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}