Anesthesiology Research and Practice最新文献

{"title":"Sublingual Sufentanil vs. Intravenous Fentanyl for the Treatment of Acute Postoperative Pain in the Ambulatory Surgery Center: A Randomized Clinical Trial.","authors":"Aaron Berg,&nbsp;Jason Habeck,&nbsp;Michael Strigenz,&nbsp;Jonah Pearson,&nbsp;Alexander Kaizer,&nbsp;Jacob Hutchins","doi":"10.1155/2022/5237877","DOIUrl":"https://doi.org/10.1155/2022/5237877","url":null,"abstract":"<p><strong>Objectives: </strong>Sublingual sufentanil is a novel opioid medication to treat moderate to severe pain postoperatively. This study's aim was to determine if a single dose of a sublingual sufentanil tablet (SST) is as efficacious as a single dose of intravenous (IV) fentanyl in readiness to discharge from ambulatory surgery.</p><p><strong>Methods: </strong>This was a two-arm, parallel group, randomized prospective outcomes study conducted at a single, free-standing ambulatory surgery center. Patients aged 18-80 undergoing general anesthesia who developed a postoperative pain score of ≥ 4 were enrolled and randomized to receive either 30 mcg SST or 50 mcg IV fentanyl. After their initial randomized dose, rescue IV fentanyl followed by oral oxycodone if needed. Recovery length of stay from arrival in the postanesthesia care unit until readiness to discharge criteria was met based on phase 2 discharge criteria.</p><p><strong>Results: </strong>75 patients were analyzed. Readiness to discharge from the recovery room was not significantly different between either group (IV fentanyl median 65 minutes; IQR 56-89; SST 73 min, IQR 58-89; <i>p</i>=0.903). There was no significant difference in the amount of morphine equivalents (MME) of rescue opioids needed (IV fentanyl median rescue MME of 22.5, IQR 13.1-23.4; SST median rescue MME of 15.0, IQR 7.5-30.0; <i>p</i>=0.742). The change in pain from PACU initially, and on discharge was not significantly different (IV fentanyl initial pain minus pain on discharge median 3, IQR 2-4; SST initial pain minus pain on discharge median 4, IQR 2-5.5; <i>p</i>=0.079). There was no difference in the six-item screener and the Overall Benefit of Analgesic Survey Score. <i>Discussion</i>. In conclusion, patients who received a sublingual sufentanil 30 mcg tablet had no significant differences in PACU length of stay or rescue analgesic usage when compared to intravenous fentanyl 50 mcg.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":"5237877"},"PeriodicalIF":1.4,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40622913","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":"Incidence and Associated Factors of Postoperative Pulmonary Complications after Abdominal Surgery in the Public Hospital, Addis Ababa, Ethiopia.","authors":"Geresu Gebeyehu,&nbsp;Ashenafi Eshetu,&nbsp;Senait Aweke","doi":"10.1155/2022/8223903","DOIUrl":"https://doi.org/10.1155/2022/8223903","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pulmonary complications are a wide variety of disorders that affect normal respiratory functions, which in turn lead to morbidity and mortality. The extent to which it occurs is not yet studied in most clinical settings. This study assessed the incidence and risk factors of postoperative pulmonary complications in patients undergoing abdominal surgery under general anesthesia.</p><p><strong>Methods: </strong>A multicenter, prospective cross-sectional study was conducted at Menelik II, Tikur Anbessa Specialized, Zewditu Memorial, and Yekatit 12 Memorial hospitals after obtaining ethical clearance from each hospital. The study recruited a total of 287 participants using systematic random sampling. The data collection tool included sociodemographic, surgical, and anesthetic factors. Participants were followed for 7 days postoperatively, and any respiratory problems were recorded once identified. The collected data were entered and analyzed using SPSS version 26. Both bivariate and multivariate logistic regressions were used for analysis. A <i>p</i> value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>About 33% of the participants that underwent abdominal surgery developed postoperative pulmonary complications. Age > 65 years (AOR = 12.091, 95% CI = 3.310-44.169), duration of surgery >3 hours (AOR = 11.737, 95% CI = 3.621-38.039), preoperative oxygen saturation <94% (AOR = 10.671, 95% CI = 3.794-30.016), and postoperative serum albumin level <3.5 g/dl (<i>p</i> value <0.001) were associated with postoperative pulmonary complications significantly. <i>Conclusion and Recommendations.</i> The incidence of postoperative pulmonary complications after abdominal surgeries was high. Age >65years, duration of surgery >3 hours, preoperative SpO2% <94%, cigarette smoking, and postoperative serum albumin level <3.5 g/dl were factors strongly associated with postoperative pulmonary complications. We recommend special care for elderly patients, limit the surgical duration to less than 3 hours, treat the underlying cause of desaturation, and correct postoperative serum albumin to prevent the occurrence of postoperative pulmonary complications.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":"8223903"},"PeriodicalIF":1.4,"publicationDate":"2022-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9279106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40601219","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":"Simulation-Based Neonatal Resuscitation Education for Undergraduate Anesthesia Students: A Pre- and Post-Evaluation of Knowledge and Clinical Skills.","authors":"Debas Yaregal Melesse,&nbsp;Henos Enyew Ashagrie","doi":"10.1155/2022/7628220","DOIUrl":"https://doi.org/10.1155/2022/7628220","url":null,"abstract":"<p><strong>Background: </strong>Nearly one in five hundred babies unexpectedly need resuscitation at birth, and the need for resuscitation is often unpredictable. A large majority of these deaths occur in low-resource settings and are preventable. Appropriate resuscitation techniques are crucial to the survival of newborn infants. Therefore, producing skilled health professionals in teaching institutions is mandatory to perform this activity.</p><p><strong>Objective: </strong>The study aimed a pre- and post-evaluation of knowledge and clinical skills performance of anesthesia students completing simulation-based neonatal resuscitation training at a Teaching Referral Hospital.</p><p><strong>Methods: </strong>A pre-post-intervention study was conducted on undergraduate final-year anesthesia students at Comprehensive and Specialized Teaching Referral Hospital, Ethiopia. We used a validated checklist to follow the students' performance (American Heart Association, 2005, and Ogunlesi et al., 2012). The data were collected through this checklist. The collected data were analyzed with statistical package for social sciences (SPSS) version 20. Categorical variables were analyzed with chi-square test, and a <i>p</i>-value <0.05 was considered as statistically significant.</p><p><strong>Results: </strong>A total of 51 students participated in the study. Twenty of them were females. The pre-intervention knowledge of the respondents about aspects of evaluation for neonatal resuscitation was 90.2%, and post-intervention was 94.1%; the knowledge of the respondents about aspects of appropriate actions at pre- and post-interventions was 73.4% and 83.1%, respectively. <i>Conclusions and recommendations</i>: This study showed that there was improvement of post-interventions knowledge and clinical skills of undergraduate anesthesia students for both aspects of evaluation and appropriate actions for neonatal resuscitation. We recommend that students who attached clinical anesthesia practice should take at least simulation-based training at skill laboratories timely.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":"7628220"},"PeriodicalIF":1.4,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40476992","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":"Awareness among Pregnant Women about Epidural Analgesia: A Cross-Sectional Study.","authors":"Waad M Almuntashiri,&nbsp;Aseel S Mutawakkil,&nbsp;Amjad S Alghamdi,&nbsp;Razan D Alqarni,&nbsp;Alaa M Althubaiti,&nbsp;Haifaa S Kayal","doi":"10.1155/2022/7388833","DOIUrl":"https://doi.org/10.1155/2022/7388833","url":null,"abstract":"<p><strong>Background: </strong>Epidural analgesia (EPA) is an effective anesthetic technique to overcome pain during labor. This study aimed to evaluate the current awareness of EPA among pregnant women.</p><p><strong>Methods: </strong>We carried out a cross-sectional study using a questionnaire to measure awareness about EPA among pregnant women visiting the obstetrics and gynaecology clinic in King Abdulaziz Medical City in Jeddah. Following the results, a group of women was selected and educated by trained medical students.</p><p><strong>Results: </strong>This study comprised 105 women. We found that 25 (23.8%) respondents revealed a complete lack of knowledge regarding EPA, 63 (60%) showed minimal awareness, and 17 (16.2%) were aware of EPA from various sources. The gravidity and history of EPA administration were significantly associated with knowledge. Multigravida women and those who had received EPA showed higher level of knowledge (<i>p</i>=0.048 and <i>p</i> < 0.001, respectively). In addition, there was a significant association between the level of education and request for EPA (<i>p</i>=0.027). Forty-one participants were enrolled in an educational program that explained the importance of EPA. Twenty (48.8%) women decided to undergo EPA during delivery; however, 7 (17.7%) refused and 14 (34.1%) were not sure about their decision.</p><p><strong>Conclusion: </strong>This study revealed a lack of awareness about EPA among pregnant women. Educational programs were effective as many participants chose EPA following the educational session as a form of pain relief during labor. We recommend the implementation of routine education on EPA in vaginal delivery during antenatal visits for all pregnant women.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":"7388833"},"PeriodicalIF":1.4,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40601221","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":"A Randomized Controlled Trial for Prevention of Postspinal Anesthesia Shivering in Gynecological Surgeries: Mirtazapine vs. Dexamethasone.","authors":"Ibrahim M Esmat,&nbsp;Ahmed M Elsayed,&nbsp;Hazem M El-Hariri,&nbsp;Tarek M Ashoor","doi":"10.1155/2022/5061803","DOIUrl":"https://doi.org/10.1155/2022/5061803","url":null,"abstract":"<p><strong>Background: </strong>The frequency of shivering regarding regional anesthesia is 55%. Newer effective and tolerable options for postspinal anesthesia shivering (PSAS) prophylaxis are necessary to improve patients' quality of care. This research assessed the impact of preemptive mirtazapine versus preemptive dexamethasone to decrease frequency and severity of PSAS in gynecological procedures.</p><p><strong>Methods: </strong>300 patients booked for gynecological procedures under spinal anesthesia (SA) were randomly apportioned into three groups (100 each) to get one preemptive dose of 30 mg mirtazapine tablet (M group), 8 mg dexamethasone diluted in 100 ml of saline infusion (D group) or placebo (C group) two hours before surgery. Incidence of clinically significant PSAS was the primary outcome. Core temperature, shivering score, hemodynamics changes, adverse events, and patient satisfaction score were documented as secondary outcomes.</p><p><strong>Results: </strong>Compared with C group, mirtazapine and dexamethasone decreased incidence of clinically significant shivering (74% vs. 16% and 31%, respectively; <i>P</i> < 0.001). M and D groups had less hypotensive episodes during 5-25 min after intrathecal injection (<i>P</i> < 0.001). 90 min after SA, tympanic temperatures were lower than baseline values in the three groups (<i>P</i> < 0.001). Pruritus, nausea, and vomiting were more often in C group (<i>P</i> < 0.001), whereas sedation was more frequent in M group (<i>P</i> < 0.001). C group had the lowest satisfaction scores (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Prophylactic administration of mirtazapine or dexamethasone attenuated shivering with minimal hazards in patients scheduled for gynecological surgeries under spinal anesthesia with priority to mirtazapine. The trial is registered with NCT03675555.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":"5061803"},"PeriodicalIF":1.4,"publicationDate":"2022-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8926546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40308130","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":"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":"Reduced Effective Oxygen Delivery and Ventilation with a Surgical Facemask Placed under Compared to over an Oxygen Mask: A Comparative Study.","authors":"Marvin G Chang,&nbsp;Takashi Sakano,&nbsp;Benjamin S Levin,&nbsp;David Convissar,&nbsp;Edward A Bittner","doi":"10.1155/2022/4798993","DOIUrl":"https://doi.org/10.1155/2022/4798993","url":null,"abstract":"<p><strong>Objectives: </strong>Consensus guidelines for perioperative anesthesia management during the COVID-19 pandemic recommend that patients wear a facemask in addition to their oxygen mask or nasal cannulae following tracheal extubation, where this is practical. The effects on effective oxygen delivery and ventilation of a surgical facemask under compared to over an oxygen (O₂) mask are unclear.</p><p><strong>Design: </strong>Single-center, comparative pilot study. <i>Setting</i>. Endoscopy procedure room at a major academic hospital.</p><p><strong>Subjects: </strong>Five healthy anesthesiologists. <i>Interventions</i>. Using a carbon dioxide (CO₂) sampling line positioned at the lips, the fraction of inspired O₂ (FiO₂), fraction of expiratory O₂ (FeO₂), expiratory end-tidal CO₂ (EtCO₂), and respiratory rate (RR) were measured under the following conditions: (1) a surgical facemask only, (2) a surgical facemask under an O₂ mask, (3) an O₂ mask only, and (4) a surgical facemask over an O₂ mask. <i>Measurements and Main Results</i>. The sampled fractional expired oxygen (FeO₂) at the lips was significantly lower when the surgical facemask was under compared to when over the O₂ mask (27.9± 1.68 vs. 49.9 ± 6.27, <i>p</i> = 0.001), while there was no significant difference in inspired oxygen (FiO₂). The sampled expiratory EtCO₂ was significantly higher when the surgical facemask was under the O₂ mask compared to when over the O₂ mask (28.3 ± 8.5 vs. 23.5 ± 7.6, <i>p</i> = 0.026). The RR was not significantly different when the surgical facemask was under compared to over the O₂ mask.</p><p><strong>Conclusions: </strong>Effective oxygen delivery and ventilation was reduced (lower FeO₂ and increased EtCO₂) when a surgical facemask was placed under compared to over an O₂ mask.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":" ","pages":"4798993"},"PeriodicalIF":1.4,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8777390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39713985","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}