Nigerian Journal of Clinical Practice最新文献

Background: Studies have been conducted to evaluate changes in hemodynamics, postoperative bleeding, and pain in pediatric dental patients receiving general anesthesia (GA). However, a limited number of studies have evaluated the effects of local anesthetics (LA) on tooth extraction procedures during GA. There is no consensus in the literature regarding LA application in the perioperative period for dental treatments performed within the scope of GA.

Aim: This study aimed to determine the retrospective physiologic effects of fluctuations in vital signs and postoperative bleeding in children who did or did not receive LA for tooth extraction under GA.

Methods: A retrospective evaluation of 77 patients aged 5.16 ± 1.85 years who had the extraction of primary posterior teeth with or without LA under GA were reviewed in the post-anaesthesia care unit (PACU) for postoperative bleeding and the effects of intraoperative LA on fluctuations in postoperative parameters such as mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (SpO2), respiratory rate (RR), and the end-tidal carbon dioxide (EtCO2). These were compiled from the patient records of the procedures.

Results: Significant differences between the baseline and peak MAP (P < 0.001), HR (P = 0.011), and EtCO2 (P = 0.002) were noted in children without LA compared to those who had LA. In addition, substantial variations were observed between the baseline and peak values for MAP (P < 0.001) and HR (P = 0.037) in children who had tooth extraction in the mandibular region. Statistically significant differences were noted between the baseline and peak values for patients who did not receive LA before the extraction of the first primary molar in terms of MAP (P < 0.02) and EtCO2 (P = 0.032). Similarly, significant differences in MAP (P < 0.02) and EtCO2 (P = 0.034) were noted in the extraction of the second primary molar. In addition, there was a significant difference in bleeding based on the number of tooth extractions in those who did not receive LA (P = 0.020).

Conclusion: This study showed that in children who underwent tooth extraction under GA, additional LA application minimized changes in HR, MAP, and EtCO2, whereas a lack of LA application produced significant fluctuations from baseline to peak values of HR, MAP, and EtCO2. In addition, LA application reduced postoperative bleeding.

Background: Kidney transplantation is one of the life-saving therapies for patients with end-stage renal disease, which affects a person's psychological, social, and physical well-being. How transplanted patients perceive their illness and their body can affect their physical and psychological recovery.

Aim: This qualitative study was designed to evaluate self-esteem and body image in kidney transplant patients.

Methods: The study involved 16 female renal transplanted patients. Data were collected using a two-part interview form developed by the investigators in accordance with the literature. We used Lundman's method to transcribe the interviews and coded the data from the interviews. The results of the study were discussed using the themes. The first three interviews were entered into MAXQDA, and then, additional interviews were analyzed.

Results: Six main themes and 15 subthemes were generated based on the thematic analysis of the interviews with participants about body image and self-esteem. Themes included body acceptance, changes in body image, deterioration of social relationships, changes in self-esteem, spousal concerns, and organ perceptions. This study collected detailed data on body image, self-esteem, social relationships, and spouse/partner relationships after kidney transplantation.

Conclusion: The change in participants' body image and self-esteem after kidney transplantation caused having negative feelings regarding sexual life, relationships, and social life and feeling unfamiliar with the transplanted organ.