Anesthesiology Research and Practice最新文献

{"title":"Association between Intraoperative Early Warning Score and Mortality and In-Hospital Stay in Lower Gastrointestinal Spontaneous Perforation.","authors":"Kazuya Takada,&nbsp;Yusuke Nagamine,&nbsp;Akira Ishii,&nbsp;Yan Shuo,&nbsp;Takumi Seike,&nbsp;Hanako Horikawa,&nbsp;Kentaro Matsumiya,&nbsp;Tetsuya Miyashita,&nbsp;Takahisa Goto","doi":"10.1155/2023/8910198","DOIUrl":"https://doi.org/10.1155/2023/8910198","url":null,"abstract":"<p><strong>Background: </strong>Early warning scores (EWSs) can be easily calculated from physiological indices; however, the extent to which intraoperative EWSs and the corresponding changes are associated with patient prognosis is unknown. In this study, we investigated whether EWS and the corresponding time-related changes are associated with patient outcomes during the anesthetic management of lower gastrointestinal perforation.</p><p><strong>Methods: </strong>This was a single-center, retrospective cohort study conducted at a tertiary emergency care center. Adult patients who underwent surgery for spontaneous lower gastrointestinal perforations between September 1, 2012, and December 31, 2019, were included. The National Early Warning Score (NEWS) and Modified Early Warning Score (MEWS) were calculated based on the intraoperative physiological indices, and the associations with in-hospital death and length of hospital stay were investigated.</p><p><strong>Results: </strong>A total of 101 patients were analyzed. The median age was 70 years, and there were 11 cases of in-hospital death (mortality rate: 10.9%). There was a significant association between the intraoperative maximum NEWS and in-hospital death (odds ratio (OR): 1.60, 95% confidence interval (CI): 1.10-2.32, <i>p</i>=0.013) and change from initial to maximum NEWS (OR: 1.60, 95% CI: 1.07-2.40, <i>p</i>=0.023) in the crude analysis. However, when adjustments were made for confounding factors, no statistically significant associations were found. Other intraoperative EWS values and changes were not significantly associated with the investigated outcomes. The preoperative sepsis-related organ failure assessment score and the intraoperative base excess value were significantly associated with in-hospital death.</p><p><strong>Conclusions: </strong>No clear association was observed between EWSs and corresponding changes and in-hospital death in cases of lower gastrointestinal perforation. The preoperative sepsis-related organ failure assessment score and intraoperative base excess value were significantly associated with in-hospital death.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2023 ","pages":"8910198"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10480023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10177846","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":"The Underreported Postoperative Suffering after Thyroid Surgery: Dysphagia, Dysphonia, and Neck Pain-A Cross-Sectional Study.","authors":"Hunduma Jisha Chawaka,&nbsp;Zenebe Bekele Teshome","doi":"10.1155/2023/1312980","DOIUrl":"https://doi.org/10.1155/2023/1312980","url":null,"abstract":"<p><strong>Background and aims: </strong>Postoperative voice change, difficulty of swallowing, throat pain, and neck pain are the most commonly complaint after thyroid surgery. However, little emphasis is given to the problem, especially a place where the surgical and anesthesia services' unmet need is highly observed, i.e., the problem gets little attention especially in the countries where the gaps of surgery and anesthesia services are observed. Hence, this study aims to determine the magnitude and associated factors of voice change and related complaints after thyroid surgery.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 151 patients who had had thyroid surgery from June 1 to December 30, 2021. Data were retrieved during the postoperative period after the patient regains consciousness.</p><p><strong>Result: </strong>Out of 151 participants, 98 (64.9%) patients complained of either voice change or difficulty of swallowing and neck pain after thyroid surgery within 24 hours. Majority (58.3%) of the participants aged more than 30 years with a mean age of 33.7 ± 8.3 years and females 102 (67.5%). Neck pain is the most (52.3%) complained suffering after thyroid surgery, followed by voice change 38.4% and difficulty in swallowing 37.7%. Difficulty in swallowing after thyroid surgery significantly associated with a patient who frequently experience intraoperative hypotension (AOR = 23.24, 95% CI 4.6-116.7, and <i>p</i> = 0.01), type of surgical procedure (total thyroidectomy) (AOR = 8.62, 95% CI 1.21-61.50, and <i>p</i> = 0.03), and larger ETT size (AOR = 4.92, 95% CI 1.34-18.01, and <i>p</i> = 0.02). Postoperative voice change is associated with larger endotracheal tube (AOR = 15.47, 95% CI 3.4-69.5, and <i>p</i> ≤ 0.001), surgery lasting more than 2 hours (AOR = 7.34, 95% CI 1.5-35.1, and <i>p</i> = 0.01), and intraoperative hypotension (AOR = 23.24, 95% CI 4.6-116.7, and <i>p</i> ≤ 0.001).</p><p><strong>Conclusion: </strong>The complaint of postthyroidectomy neck pain and throat discomfort is higher than 64.9%. Intraoperative hypotension, blood loss, higher ETT size utilization, and duration of surgical procedure are the identified possible risk factors and have to be minimized as much as possible. Patient reassurance has to be considered during the postoperative time.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2023 ","pages":"1312980"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10388295","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":"ICU-Managed Patients' Epidemiology, Characteristics, and Outcomes: A Retrospective Single-Center Study.","authors":"Ahmed Muhammad Bashir,&nbsp;Marian Muse Osman,&nbsp;Hawa Nuradin Mohamed,&nbsp;Ifrah Adan Hilowle,&nbsp;Halima Abdulkadir Ahmed,&nbsp;Abdirahman Abdikadir Osman,&nbsp;Osman Abubakar Fiidow","doi":"10.1155/2023/9388449","DOIUrl":"https://doi.org/10.1155/2023/9388449","url":null,"abstract":"<p><strong>Background: </strong>Resources are limited, and it is exceedingly difficult to provide intensive care in developing nations. In Somalia, intensive care unit (ICU) care was introduced only a few years ago.</p><p><strong>Purpose: </strong>In this study, we aimed to determine the epidemiology, characteristics, and outcome of ICU-managed patients in a tertiary hospital in Mogadishu.</p><p><strong>Methods: </strong>We retrospectively evaluated the files of 1082 patients admitted to our ICU during the year 2021.</p><p><strong>Results: </strong>The majority (39.7%) of the patients were adults (aged between 20 and 39 years), and 67.8% were male patients. The median ICU length of stay was three days (IQR = 5 days), and nonsurvivors had shorter stays, one day. The mortality rate was 45.1%. The demand for critical care services in low-income countries is high.</p><p><strong>Conclusion: </strong>The country has a very low ICU bed capacity. Critical care remains a neglected area of health service delivery in this setting, with large numbers of patients with potentially treatable conditions not having access to such services.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2023 ","pages":"9388449"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9873425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10632874","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":"Anticipated vs. Experienced Pain at Site of Spinal Needle Insertion in Patients Undergoing Elective Lower Segment Caesarean Section: Perspective from Resource-Limited Region.","authors":"Waleed Bin Ghaffar,&nbsp;Fauzia Minai","doi":"10.1155/2023/5516346","DOIUrl":"https://doi.org/10.1155/2023/5516346","url":null,"abstract":"<p><strong>Background: </strong>Despite significant advantages, approximately 20% of pregnant patients refuse spinal anaesthesia in caesarean section due to fear of spinal needle prick. Studies have shown that the patient's expectation of pain is higher than what they experience in real. The objective was to evaluate the difference between anticipated and actually experienced pain at the spinal needle insertion site in spinal anaesthesia for pregnant women undergoing elective lower segment caesarean section (ELSCS).</p><p><strong>Method: </strong>The cross-sectional study was conducted in a labour room suite of a tertiary care hospital.</p><p><strong>Results: </strong>A total of 50 patients scheduled for ELSCS were included. The median experienced pain at the site of spinal needle insertion was significantly low as compared to anticipated pain (<i>P</i> value < 0.01). For the identification of predictors impacting the anticipated and experienced pain, univariate and multivariate regression models were applied. Amsterdam Preoperative Anxiety and Information Scale ≥11 for anticipated pain showed a statistically significant positive correlation in univariate (coefficient: 2.59; 95% CI: 1.49 to 3.68; <i>P</i> value < 0.001) and multivariable analyses (coefficient: 2.51; 95% CI: 1.36 to 3.67; <i>P</i> value < 0.001). Thus, anxiety was associated with statistically significant higher anticipated pain.</p><p><strong>Conclusion: </strong>In conclusion, there is a remarkable difference in the obstetric population between anticipated and actually experienced pain at the site of spinal needle insertion in ELSCS.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2023 ","pages":"5516346"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10093459","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":"Intramuscular Ketamine Effect on Postnasal Surgery Agitation: A Prospective Double-Blinded Randomized Controlled Trial.","authors":"Husam A Almajali,&nbsp;Ali M Abu Dalo,&nbsp;Nidal M Al-Soud,&nbsp;Ali Almajali,&nbsp;Abdelrazzaq Alrfooh,&nbsp;Thani Alawamreh,&nbsp;Hamza Al-Wreikat","doi":"10.1155/2023/2286451","DOIUrl":"https://doi.org/10.1155/2023/2286451","url":null,"abstract":"<p><p>This study investigates the effect of intramuscular ketamine on emergence agitation (EA) following septoplasty and open septorhinoplasty (OSRP) when administered at subanesthetic doses at the end of surgery. A random sample of 160 ASA I-II adult patients who underwent septoplasty or OSRP between May and October, 2022, was divided into two groups of eighty patients each: ketamine (Group K) and saline (Group S) with the latter serving as the control group. At the end of surgery immediately after turning off the inhalational agent, Group K was administered with intramuscular 2 ml of normal saline containing 0.7 mg/kg ketamine and Group S with 2 ml of intramuscular normal saline. Sedation and agitation scores at emergence from anesthesia were recorded after extubation using the Richmond Agitation-Sedation Scale (RASS). The incidence of EA was higher in the saline group than in the ketamine group (56.3% vs. 5%; odds ratio (OR): 0.033; 95% confidence interval (CI): 0.010-0.103; <i>p</i> < 0.001). Variables associated with a higher incidence of agitation were ASA II classification (OR: 3.286; 95% (CI): 1.359-7.944; <i>p</i>=0.008), longer duration of surgery (OR: 1.010; 95% CI: 1.001-1.020; <i>p</i>=0.031), and OSRP surgery (OR: 2.157; CI: 1.056-5.999; <i>p</i>=0.037). The study concluded that the administration of intramuscular ketamine at a dose of 0.7 mg/kg at the end of surgery effectively reduced the incidence of EA in septoplasty and OSRP surgery.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2023 ","pages":"2286451"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9988369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9075303","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":"A Randomized Controlled Trial for Prevention of Postoperative Nausea and Vomiting after Laparoscopic Sleeve Gastrectomy: Aprepitant/Dexamethasone vs. Mirtazapine/Dexamethasone.","authors":"Tarek M Ashoor, Dina Y Kassim, Ibrahim M Esmat","doi":"10.1155/2022/3541073","DOIUrl":"10.1155/2022/3541073","url":null,"abstract":"<p><strong>Background: </strong>Coadministration of different antiemetics proved to decrease postoperative nausea and vomiting (PONV) after laparoscopic sleeve gastrectomy (LSG). This trial compared aprepitant/dexamethasone (A/D) combination vs mirtazapine/dexamethasone (M/D) combination vs dexamethasone (<i>D</i>) alone for prevention of PONV in morbidly obese patients undergoing LSG.</p><p><strong>Methods: </strong>Ninety patients scheduled for LSG were randomly allocated to receive 8 mg dexamethasone intravenous infusion (IVI) only in the <i>D</i> group or in addition to 80 mg aprepitant capsule in the A/D group or in addition to 30 mg mirtazapine tablet in the M/D group. Assessment of PONV was carried out at 0-2 h (early) and 2-24 h (late). The primary outcome was the complete response 0-24 h after surgery. Collective PONV, postoperative pain, side effects and patient satisfaction score were considered as secondary outcomes.</p><p><strong>Results: </strong>The A/D and M/D groups were superior to the <i>D</i> group for a complete response within 0-24 h after surgery (79.3% for the A/D group, 78.6% for the M/D group, and 20.7% for the <i>D</i> group). The <i>D</i> group was inferior to the A/D and M/D groups regarding collective PONV and use of rescue antiemetic 0-24 h after surgery (<i>P</i> < 0.001, <i>P</i> < 0.001, respectively). The peak nausea scores (2-24 h) were significantly reduced in the M/D group in comparison to the <i>D</i> group (<i>P</i>=0.005). Patients in the M/D group showed high sedation scores, while those in the A/D group showed low pain scores (2-24 h) and less analgesic requirements (<i>P</i> < 0.001, <i>P</i> < 0.001, <i>P</i> < 0.001, respectively). The A/D and M/D groups were superior to the <i>D</i> group with regard to the patient satisfaction score (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Aprepitant/dexamethasone combination and mirtazapine/dexamethasone combination were superior to dexamethasone alone in alleviating postoperative nausea and vomiting in morbidly obese patients scheduled to undergo laparoscopic sleeve gastrectomy. Trial Registration: ClinicalTrials.gov identifier: NCT04013386.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2022 1","pages":"3541073"},"PeriodicalIF":1.6,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9078838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44534915","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":"Anesthetic Approach in Ambulatory Vitrectomy: Peribulbar Block vs. Balanced General Anesthesia","authors":"Bárbara Gouveia, L. Ferreira, P. Maia","doi":"10.1155/2022/3838222","DOIUrl":"https://doi.org/10.1155/2022/3838222","url":null,"abstract":"Background Vitrectomy is one of the most common outpatient ophthalmic surgeries. The anesthetic technique used in outpatient surgery should contribute to a faster functional recovery, better pain control, and fewer complications. The aim of this study was to compare peribulbar block and balanced general anesthesia, in patients undergoing outpatient vitrectomy. Methods A prospective cohort study was carried out, including adult patients undergoing ambulatory vitrectomy, between January and February 2018. Peribulbar block or balanced general anesthesia was the independent variable analyzed. Clinical and perioperative variables were evaluated, namely, postoperative pain, nausea, and vomiting in the postoperative period, intraoperative hypotension, patient satisfaction with the anesthetic technique, time to oral diet introduction and to hospital discharge, operating room occupancy time, and pharmacological costs. SPSS® 27 was used for statistical analyses. Results Twenty-one patients were evaluated, 11 of whom underwent peribulbar block and 10 underwent balanced general anesthesia. Patients undergoing peribulbar block did not experience postoperative pain when compared to patients undergoing balanced general anesthesia (p=0.001). Intraoperative hypotension occurred in 18.2% of patients undergoing peribulbar block and in 70% of those undergoing balanced general anesthesia (p=0.03). Time to oral diet introduction (<1 hour vs. > 2 hours; p < 0.05), operating room occupancy time (70 vs. 90 minutes; p=0.027), time to hospital discharge (17 vs. 22.5 hours; p=0.004), and pharmacological costs (4.65 vs. 12.09 euros; p < 0.05) were lower in patients undergoing peribulbar block versus balanced general. Conclusions Peribulbar block seems to meet the criteria of an ideal anesthetic technique in outpatient vitrectomy surgery.","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49364364","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":"Lateral Quadratus Lumborum Block versus Transversus Abdominis Plane Block in Laparoscopic Surgery: A Randomized Controlled Study","authors":"Omar Sayed Fargaly, M. Boules, M. Hamed, Mohammed Abdel Aleem Abbas, M. Shawky","doi":"10.1155/2022/9201795","DOIUrl":"https://doi.org/10.1155/2022/9201795","url":null,"abstract":"Background After laparoscopic abdominal surgery, we aim to evaluate the analgesic efficiency of US-directed bilateral transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB). Methods 50 patients aged 18–60 years listed for elective laparoscopic abdomen operation were registered in this study. Cases were randomly allocated into two similar groups: TAPB and QLB groups. The first outcome was the growing morphine consumption on the 1st day postoperatively. The second outcome involved VAS score, first analgesic necessities, and any postoperative complications. Statistical analysis was done with the 2-sample t-test, and Mann–Whitney U testing was utilized to compare medians for skewed end points. Qualitative data were introduced as numbers and percentages, and chi-squared testing was utilized to determine the significance. Results The median cumulative morphine consumptions on the 1st day were high significantly in the TAPB group than in the QLB group (6 mg [6, 9] vs. 3 mg [3, 6], p value ≤0.0001]). The QLB group showed an increase in the median of the time to the first analgesic request in comparison with the TAPB group (17 hours [12, 24] vs. 8 hours [6, 24], p ≤ 0.001). In addition, on the 1st day, the mean VAS scoring at rest was lower in the QLB group. Conclusion In comparison to the TAPB, the QL block delivers more successful pain relief, has an extended period of analgesic actions, extends interval to the 1st analgesic necessity, is accompanied with lesser morphine consumptions, and may be utilized in multimodal analgesia and opioid-sparing regimens after that laparoscopic operation. This trial is registered with NCT04553991.","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49585657","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":"Hemodynamic Effects of Methamphetamine and General Anesthesia","authors":"Keyvan M. Safdari, Curtis Converse, F. Dong, Nickolas MacDougall, K. Hyer, Alec C. Runyon, Haley Ahlering, M. Comunale","doi":"10.1155/2022/7542311","DOIUrl":"https://doi.org/10.1155/2022/7542311","url":null,"abstract":"Design A retrospective analysis of all anesthetic records at our institution over a two-year period was performed. Setting. Operating room cases under balanced anesthesia. Patients. All patients with ASA class I or II, who did not have trauma or were initially admitted to ICU, aged 18–65, without preexisting cardiac, renal, or pulmonary disease. Patients were divided into three groups: those acutely positive for methamphetamine within 48 hours of surgery (n = 137), those positive for methamphetamine between 48 hours and 7 days of surgery (n = 69), and randomly selected controls who were negative for methamphetamine within 7 days of surgery (n = 159). Measurements. Intraoperative hemodynamic instability was defined as either a drop of more than 40% in MAP for greater than 5 minutes or requirement for significant amount of vasopressors. Main Results. Among the patients who were acutely positive for methamphetamine within 24 hours, 31.4% met the criteria for hemodynamic instability within the first hour of general anesthesia, compared to 26.1% of the subacutely positive patients and 6.3% of controls (p < 0.0001). This was despite lower doses of anesthetic medications in the acutely and subacutely positive groups. Conclusion Patients who present to the operating room with a positive urine drug screen for amphetamines within 2 days of surgery are at increased risk of hemodynamic instability. Postponing surgery up to 7 days somewhat decreases this risk, but not to the levels of patients who do not use methamphetamines.","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49535762","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 Postoperative Analgesia of Fascia Iliaca Compartment Block and Anterior Quadratus Lumborum Block in Proximal Femur Fracture.","authors":"O S M Abd Elmaksoud,&nbsp;S E M Elansary,&nbsp;N G Fahmy,&nbsp;R M Hussien","doi":"10.1155/2022/3465537","DOIUrl":"https://doi.org/10.1155/2022/3465537","url":null,"abstract":"<p><p>Elderly patients with various comorbidities are more likely to suffer from proximal femur fractures. It is also a painful fracture, and poor pain management can have serious physiological and psychological consequences, such as acute delirium. <i>Purpose</i>. The aim of this study is to compare the efficacy of ultrasound-guided transmuscular (anterior) quadratus lumborum block (QLB) versus infrainguinal fascia iliaca compartment block (FICB) in proximal femur fractures for postoperative analgesia. Patient-reported pain on the visual analogue scale (VAS), analgesic demand, and ambulation were the key factors. <i>Patients and Methods</i>. This prospective, randomised trial was done after receiving approval from the institute' study ethical committee. In this study, ultrasound-guided infrainguinal fascia iliaca compartment block was compared to ultrasound-guided anterior quadratus lumborum block using 50 ml of bupivacaine 0.25%, with a maximum dose of 2.5 mg/kg at the end of surgery after spinal anaesthesia in 128 patients (64 patients in each group). Nalbuphine was given as rescue analgesia if VAS >3. Our 1^st outcome was the first rescue analgesia and total analgesic consumption in the 1^st 24 hours; the 2^nd outcome was the time patients started to ambulate. <i>Results</i>. Postoperative pain perception was substantially greater in the FICB group starting from 30 min (<i>P</i> value 0.022) till 24 hours (<i>P</i> value <0.001), and they received a considerably larger total narcotic dose (14.1 ± 3.5) than patients in the QLB group (7.9 ± 3.4), <i>P</i> value (<0.001 ^<i>∗</i> ). The time required to achieve first rescue analgesia was much less in the FICB group (8.5 ± 2.2) compared to the QLB group (14.1 ± 4.5), <i>P</i> value (<0.001 ^<i>∗</i> ), and they took much longer to ambulate (22.3 ± 4.8) when compared to the QLB group (20.1 ± 4.6), <i>P</i> value (0.011 ^<i>∗</i> ). Hypotension (1.6%) was detected mainly in the QLB group, whereas poor fascial separation (1.6%) was observed only in the FICB group. There were no significant differences in complications between both the FICB and QLB groups. <i>Conclusion</i>. Patients receiving postoperative anterior QL block for proximal femur fracture demonstrated delayed first rescue analgesia and lower total nalbuphine consumption with early ambulation than patients who received FICB.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2022 ","pages":"3465537"},"PeriodicalIF":1.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9130016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10251647","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}