Anesthesiology Research and Practice最新文献

{"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":"Strategy for Calculating Magnesium Sulfate Dose in Obese Patients: A Randomized Blinded Trial.","authors":"Sebastião E Silva Filho,&nbsp;Omar S Klinsky,&nbsp;Miguel A M C Gonzalez,&nbsp;Sandro Dainez,&nbsp;Flavio Angelis,&nbsp;Joaquim E Vieira","doi":"10.1155/2022/8424670","DOIUrl":"https://doi.org/10.1155/2022/8424670","url":null,"abstract":"<p><strong>Background: </strong>Magnesium sulfate has analgesic properties during the postoperative period. However, there is a knowledge gap in pharmacology related to the use of the real, ideal, or corrected ideal body weight to calculate its dose in obese patients. This trial compared postoperative analgesia using actual and corrected ideal body weight.</p><p><strong>Methods: </strong>Seventy-five obese patients scheduled to undergo laparoscopic gastroplasty or cholecystectomy under general anesthesia were randomly assigned to three groups. The patients in the control group did not receive magnesium sulfate; the other two groups received magnesium sulfate at 40 mg·kg^-1 of actual body weight or corrected ideal body weight.</p><p><strong>Results: </strong>In patients with body mass index >30 mg·kg^-2 (mean body mass index ranging from 32.964 kg·m^-2 to 33.985 kg·m^-2, according to the groups) scheduled for video laparoscopic cholecystectomy, there were no differences in the blood magnesium concentrations in the groups receiving magnesium sulfate throughout the study, regardless of whether the strategy to calculate its dose was based on total or corrected ideal body weight. Patients in the groups receiving magnesium sulfate showed a significant reduction in morphine consumption (<i>p</i> ≤ 0.001) and pain scores (<i>p</i>=0.006) in the postoperative period compared to those in the control group. There were no significant differences in morphine consumption (<i>p</i>=0.323) or pain scores (<i>p</i>=0.082) between the two groups receiving magnesium sulfate. There were no differences in the total duration of neuromuscular block induced by cisatracurium among the three groups (<i>p</i>=0.181).</p><p><strong>Conclusions: </strong>Magnesium sulfate decreased postoperative pain and morphine consumption without affecting the recovery time of cisatracurium in obese patients undergoing laparoscopic cholecystectomy. Strategies to calculate the dose based on the actual or corrected ideal body weight had similar outcomes related to analgesia and the resulting blood magnesium concentration. However, as the sample in this trial presented body mass indices ranging from 30.11 kg·m^-2 to 47.11 kg/m^-2, further studies are needed to confirm these findings in more obese patients, easily found in centers specialized.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":"8424670"},"PeriodicalIF":1.4,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9666020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40712297","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":"Intraoperative Analgesia with Magnesium Sulfate versus Remifentanil Guided by Plethysmographic Stress Index in Post-Bariatric Dermolipectomy: A Randomized Study.","authors":"S E Silva Filho,&nbsp;S Dainez,&nbsp;M A M C Gonzalez,&nbsp;F Angelis,&nbsp;J E Vieira,&nbsp;C S Sandes","doi":"10.1155/2022/2642488","DOIUrl":"https://doi.org/10.1155/2022/2642488","url":null,"abstract":"<p><strong>Background: </strong>Magnesium sulfate reduces pain scores and analgesic consumption. Its use as an analgesic resource in opioid-free or opioid-sparing techniques have also been tested. The evaluation of the antinociceptive potency of drugs and doses indirectly, through hemodynamic oscillations has been questioned. A relatively new algorithm called the plethysmographic stress index has been considered sensitive and relatively specific as a parameter for assessing the need for intraoperative analgesia.</p><p><strong>Objectives: </strong>The aim of this trial was to assess the intraoperative analgesic capacity of magnesium sulfate compared to remifentanil. The secondary objectives were propofol consumption and its latency, the consumption of opioids, ephedrine, and cisatracurium. <i>Patients and Methods</i>. Forty patients scheduled for post-bariatric dermolipectomy were randomly assigned to two groups to receive total intravenous anesthesia with target-controlled hypnosis induced with propofol. Analgesia was obtained in the remifentanil group with remifentanil at an initial dose of 0.2 <i>μ</i>g·kg^-1·min^-1 and in the magnesium sulfate group with magnesium sulfate 40 mg·kg^-1 + 10 mg·kg^-1·h^-1.</p><p><strong>Results: </strong>There was no statistical hemodynamic difference between the groups before and after orotracheal intubation (<i>p</i> = 0.062) and before and after the surgical incision (<i>p</i> = 0.656). There was also no statistical difference in the variation of mean arterial pressure before and after intubation (<i>p</i> = 0.656) and before and after the surgical incision (<i>p</i> = 0.911). There was similar consumption of cisatracurium, ephedrine, and postoperative opioids between the groups. Some patients in the magnesium sulfate group needed more intraoperative fentanyl and propofol, although the latency of propofol was similar in both the groups.</p><p><strong>Conclusion: </strong>We conclude that using magnesium sulfate in intravenous general anesthesia for post-bariatric dermolipectomy is related to a significant reduction in opioid consumption without compromising hemodynamic stability. Overall, PSI monitoring was helpful in driving the analgesic strategy. The use of magnesium sulfate proved to be an important adjunct in the scenario presented, allowing the use of opioids to be avoided in certain cases. We found no statistical differences in the consumption of neuromuscular blocker and vasoconstrictor. Substituting opioids for magnesium sulfate leads to an increase in propofol consumption in the scenario presented. Studies with a larger sample are needed to corroborate the results presented and evaluate other potential advantages in reducing opioid consumption.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":"2642488"},"PeriodicalIF":1.4,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40458242","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 Prophylactic Bolus Ephedrine Versus Norepinephrine for Management of Postspinal Hypotension during Elective Caesarean Section in Resource Limited Setting: A Prospective Cohort Study.","authors":"Mitiku Desalegn,&nbsp;Tewoderos Shitemaw,&nbsp;Habtamu Tamrat","doi":"10.1155/2022/7170301","DOIUrl":"https://doi.org/10.1155/2022/7170301","url":null,"abstract":"<p><strong>Background: </strong>Spinal anaesthesia for caesarean section is the preferred technique since it provides better maternal safety and neonatal outcome compared to general anaesthesia. Hypotension is the most common complication after spinal anaesthesia. The study aims to determine the effectiveness of a prophylactic bolus dose of norepinephrine and ephedrine on the management of postspinal hypotension during caesarean section.</p><p><strong>Method: </strong>An institutional-based prospective cohort study was conducted on 84 pregnant women undergoing elective caesarean section. Based on the responsible anaesthetist's postspinal hypotension management plan, patients were divided into two groups. Those patients who received ephedrine are grouped into the ephedrine (EPH, <i>n</i> = 42) group, and patients who received norepinephrine are grouped under the norepinephrine group (NE, <i>n</i> = 42) by data collectors. After aseptic technique, spinal anaesthesia was administered with 0.5% (3 ml) bupivacaine using a 23G spinal needle. During spinal anaesthesia, a prophylactic bolus dose of 10 mg (2 ml) EPH or 16 g (2 ml) NE was given based on management plan of the shift anaesthetist. Mean arterial pressure (MAP), the heart rate (HR), number of boluses of vasopressor used, incidence of nausea and vomiting, and the Apgar score of babies at 1 and 5 min between the groups were recorded.</p><p><strong>Results: </strong>The norepinephrine group had a statistically significant higher MAP compared to the ephedrine group in the first 10 and 15 min (<i>p</i> < 0.05) of the study period. Thereafter, there was no statistically significant difference in MAP between the groups until the end of the study period (<i>p</i> > 0.05). The ephedrine group had a statistically significant higher heart rate throughout the procedure compared to the norepinephrine group (<i>p</i> < 0.05). The norepinephrine group required a lower bolus number of vasopressors compared to the ephedrine group to maintain blood pressure. The Apgar scores of all babies at 1 and 5 min were above seven. Significant differences regarding maternal complications (nausea and vomiting) between the groups were not detected (nausea, <i>p</i>=0.21 and vomiting, <i>p</i>=0.092).</p><p><strong>Conclusion: </strong>Norepinephrine can be used instead of ephedrine to keep a pregnant mother's blood pressure stable during a caesarean section under spinal anaesthesia without causing harm to the mother or baby. Trial registration. ClinicalTrials.gov Identifier: NCT05522088 (Date of registration: 30/08/22).</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":"7170301"},"PeriodicalIF":1.4,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33526644","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":"Lumbar Erector Spinae Plane Block for Total Hip Arthroplasty Comparing 24-Hour Opioid Requirements: A Randomized Controlled Study.","authors":"Dahlia Townsend,&nbsp;Nasir Siddique,&nbsp;Atsumi Kimura,&nbsp;Yaacov Chein,&nbsp;Eli Kamara,&nbsp;John Pope,&nbsp;Mitchell Weiser,&nbsp;Singh Nair,&nbsp;Iyabo Muse","doi":"10.1155/2022/9826638","DOIUrl":"https://doi.org/10.1155/2022/9826638","url":null,"abstract":"<p><strong>Design: </strong>Prospective, randomized, controlled trial. <i>Patients</i>. Sixty-three adult patients with an American Society of Anesthesiologists Status I-III who are undergoing elective primary total hip arthroplasty. <i>Interventions.</i> Patients were randomized to the control group (no block) or the ESPB group (preoperative ultrasound-guided lumbar ESPB). Intraoperatively, all patients received spinal anesthesia with moderate sedation. Postoperatively, patients received a standardized multimodal analgesia protocol. <i>Measurements</i>. The primary outcome was cumulative opioid consumption at 24 hours postoperatively. Secondary outcomes included cumulative opioid consumption at 8 hours and through 48 hours postoperatively and pain scores at 24 and 48 hours post surgery. <i>Main Results.</i> Thirty-one patients were randomized to the control group (spinal alone) and 32 patients to the ESPB group. The median opioid requirement in the first 8 hours after surgery was higher in the control group (28 mg of oral morphine equivalents (OME) versus 5 mg of OME in the ESPB group) (<i>p</i> = 0.013). There was no statistically significant difference in opioid consumption between the groups at 24 hours (<i>p</i> = 0.153) or 48 hours (<i>p</i> = 0.357) postoperatively. There was no statistically significant difference in pain scores between the two groups through 24 hours (<i>p</i> = 0.143) or 48 hours (<i>p</i> = 0.617) after surgery.</p><p><strong>Conclusion: </strong>Lumbar ESPB reduces opioid utilization during the first 8 hours postoperatively after total hip arthroplasty but not thereafter. Evaluating the use of either adding a local anesthetic adjunct to the ESPB or using longer-acting local anesthetic warrants further investigation.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":"9826638"},"PeriodicalIF":1.4,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33526645","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":"Prevalence of Emergence Delirium in Children Undergoing Tonsillectomy and Adenoidectomy.","authors":"Katie Liu,&nbsp;Christopher Liu,&nbsp;Seckin O Ulualp","doi":"10.1155/2022/1465999","DOIUrl":"https://doi.org/10.1155/2022/1465999","url":null,"abstract":"<p><strong>Objective: </strong>Emergence delirium (ED) is associated with behavioral disturbances and psychomotor agitation, increased risk of selfinjury, delayed discharge, and parental dissatisfaction with quality of care. Otolaryngology procedures are associated with an increased risk of ED. The aims of this study were to determine the prevalence of ED in children who had tonsillectomy and adenoidectomy (T&A), assess the characteristics of children who had ED, and ascertain the recovery times of patients with ED.</p><p><strong>Methods: </strong>Charts of patients who had tonsillectomy and adenoidectomy between Jan 1, 2018 and March 26, 2020 at a tertiary children's hospital were reviewed. Data collection included demographics, body mass index, indication for T&A, Pediatric Anesthesia Emergence Delirium (PAED) score, American Society of Anesthesiologists (ASA) physical status classification, total anesthesia time, postanesthesia care phase I time, and postanesthesia care phase II time.</p><p><strong>Results: </strong>Of the 4974 patients who underwent T&A, ED occurred in 1.3% of patients. Toddlers (2.9%) and male children (1.6%) had a significantly higher prevalence of ED. Prevalence of ED was similar amongst patients with recurrent tonsillitis, patients with obstructive sleep disordered breathing, and patients with both obstructive sleep apnea (OSA) and recurrent tonsillitis. The prevalence of ED was not different amongst ASA I, ASA II, and ASA III. Males with ED had longer total anesthesia times (41 <i>v</i>. 34 minutes, <i>p</i>=0.02) and ASA I patients with ED had longer phase I times (<i>p</i>=0.04) in the postanesthesia care unit (PACU). There was no significant difference in total anesthesia time, phase I time, or phase II time when compared across the subgroups of gender, age, indication for T&A, severity of obstructive sleep apnea (OSA), and ASA score.</p><p><strong>Conclusions: </strong>Males, toddlers, and preschool-age children were more likely to have ED. Males with ED had longer total anesthesia times. ED was associated with longer phase I times in ASA I patients.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":"1465999"},"PeriodicalIF":1.4,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33517184","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":"Contributing Factors to Operating Room Delays Identified from an Electronic Health Record: A Retrospective Study.","authors":"Scott M Pappada,&nbsp;Thomas J Papadimos,&nbsp;Sadik Khuder,&nbsp;Sean T Mack,&nbsp;Peyton Z Beachy,&nbsp;Andrew B Casabianca","doi":"10.1155/2022/8635454","DOIUrl":"https://doi.org/10.1155/2022/8635454","url":null,"abstract":"<p><p>The operating room (OR) is considered a major cost center and revenue generator for hospitals. Multiple factors contribute to OR delays and impact patient safety, patient satisfaction scores, and hospital financial performance. Reducing OR delays allows better utilization of OR resources and staffing and improves patient satisfaction while decreasing operating costs. Accurate scheduling can be the basis to achieve these goals. The objective of this initial study was to identify factors not normally documented in the electronic health record (EHR) that may contribute to or be indicators of OR delays. <i>Materials and Methods</i>. A retrospective data analysis was performed analyzing 67,812 OR cases from 12 surgical specialties at a small university medical center from 2010 through the first quarter of 2017. Data from the hospital's EHR were exported and subjected to statistical analysis using Statistical Analysis System (SAS) software (SAS Institute, Cary, NC). <i>Results</i>. Statistical analysis of the extracted EHR data revealed factors that were associated with OR delays including, surgical specialty, preoperative assessment testing, patient body mass index, American Society of Anesthesiologists (ASA) physical status classification, daily procedure count, and calendar year. <i>Conclusions</i>. Delays hurt OR efficiency on many levels. Identifying those factors may reduce delays and better accommodate the needs of surgeons, staff, and patients thereby leading to improved patient's outcomes and patient satisfaction. Reducing delays can decrease operating costs and improve the financial position of the operating theater as well as that of the hospital. Anesthesiology teams can play a key role in identifying factors that cause delays and implementing mitigating efficiencies.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":"8635454"},"PeriodicalIF":1.4,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9489409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33488745","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}