Spinal anesthesia is the most preferred method for lower extremity surgery owing to rapid onset, predictable and reliable block, and excellent postoperative analgesia. Pethidine is the only opioid that can be used as a sole anesthetic agent in spinal anesthesia, because of its local anesthetic activity which is unique. As there are scant articles about pethidine as a sole anesthetic agent in spinal anesthesia, this encouraged us to report intrathecal pethidine used for two old patents for their femoral fractures repair. Spinal anesthesia was carried out using 1.6 mL pethidine (50 mg/mL) in the sitting position in the midline approach by a 24-gauge, Quincke point needle. The patients were successfully managed with this method. This report emphasizes that in some situations, intrathecal pethidine technique is a safe, and good alternative inexpensive technique over spinal anesthesia with local anesthetics.
脊髓麻醉是下肢手术的首选方法，因为它起效迅速、阻滞效果可预测且可靠，术后镇痛效果极佳。哌替啶是脊髓麻醉中唯一可用作唯一麻醉剂的阿片类药物，因为它具有独特的局部麻醉活性。由于有关哌替啶作为脊髓麻醉中唯一麻醉剂的文章很少，这促使我们报告了鞘内哌替啶用于两项老专利的股骨骨折修复术的情况。脊髓麻醉采用 1.6 mL 哌替啶（50 mg/mL），患者取坐位，用 24 号昆克点针头从中线入路。采用这种方法成功地对患者进行了管理。本报告强调，在某些情况下，鞘内哌替啶技术是一种安全、廉价的好技术，可替代局麻药脊髓麻醉。
{"title":"Intrathecal pethidine as a sole anesthetic agent for lower limb surgery: a case report","authors":"Masoud Tarbiat MD, PHD, Sayed Ahmad Reza Salimbahrami MD, PHD, Gholamreza Ghorbani Amjad MD, PHD, Mahmoud Rezaei MD, PHD","doi":"10.15406/jaccoa.2024.16.00583","DOIUrl":"https://doi.org/10.15406/jaccoa.2024.16.00583","url":null,"abstract":"Spinal anesthesia is the most preferred method for lower extremity surgery owing to rapid onset, predictable and reliable block, and excellent postoperative analgesia. Pethidine is the only opioid that can be used as a sole anesthetic agent in spinal anesthesia, because of its local anesthetic activity which is unique. As there are scant articles about pethidine as a sole anesthetic agent in spinal anesthesia, this encouraged us to report intrathecal pethidine used for two old patents for their femoral fractures repair. Spinal anesthesia was carried out using 1.6 mL pethidine (50 mg/mL) in the sitting position in the midline approach by a 24-gauge, Quincke point needle. The patients were successfully managed with this method. This report emphasizes that in some situations, intrathecal pethidine technique is a safe, and good alternative inexpensive technique over spinal anesthesia with local anesthetics.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"21 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140248943","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}
Pub Date : 2024-02-29DOI: 10.15406/jaccoa.2024.16.00582
Yuliel Varona Rodríguez, Liliam Maria Castle Manresa, Ariane Sainz Cut, Julius Michel Arias, Loved White
Foundation: The Postoperative pain is considered time-limited pain, often poorly controlled. Its management requires a great challenge, since postoperative analgesia must provide the mother with adequate control and at the same time facilitate care for the baby. Objective: To evaluate the effectiveness of postoperative analgesia with the use of intrathecal morphine. Method: Observational, descriptive and cross-sectional study carried out at the Martín Chang Puga General Teaching Hospital in the Nuevitas municipality, province of Camagüey, between January 2021 and December 2022. The sample was made up of 36 patients to whom subarachnoid anesthesia was applied with Hyperbaric lidocaine plus morphine for cesarean section. Results: The age between 27-31 years predominated, 63.9% of those who underwent cesarean section did not report postoperative pain. Almost half of the sample (47.2%) studied presented side effects with the use of intrathecal morphine, with pruritus predominating. 80.5% of patients were satisfied with postoperative analgesia. Conclusion: The majority of patients found satisfaction with the analgesic treatment despite the presence of adverse effects, so it can be stated that the use of intrathecal morphine is effective in the management of post-cesarean pain.
{"title":"Effectiveness of subarachnoid anesthesia with morphine as treatment of postoperative pain in cesarean section","authors":"Yuliel Varona Rodríguez, Liliam Maria Castle Manresa, Ariane Sainz Cut, Julius Michel Arias, Loved White","doi":"10.15406/jaccoa.2024.16.00582","DOIUrl":"https://doi.org/10.15406/jaccoa.2024.16.00582","url":null,"abstract":"Foundation: The Postoperative pain is considered time-limited pain, often poorly controlled. Its management requires a great challenge, since postoperative analgesia must provide the mother with adequate control and at the same time facilitate care for the baby. Objective: To evaluate the effectiveness of postoperative analgesia with the use of intrathecal morphine. Method: Observational, descriptive and cross-sectional study carried out at the Martín Chang Puga General Teaching Hospital in the Nuevitas municipality, province of Camagüey, between January 2021 and December 2022. The sample was made up of 36 patients to whom subarachnoid anesthesia was applied with Hyperbaric lidocaine plus morphine for cesarean section. Results: The age between 27-31 years predominated, 63.9% of those who underwent cesarean section did not report postoperative pain. Almost half of the sample (47.2%) studied presented side effects with the use of intrathecal morphine, with pruritus predominating. 80.5% of patients were satisfied with postoperative analgesia. Conclusion: The majority of patients found satisfaction with the analgesic treatment despite the presence of adverse effects, so it can be stated that the use of intrathecal morphine is effective in the management of post-cesarean pain.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"26 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140411859","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}
Pub Date : 2024-01-17DOI: 10.15406/jaccoa.2024.16.00580
Luiz Eduardo Lmbelloni, MD, PhD, Eneida Maria Vieira, MD, PhD, Anna Lúcia Calaça Rivoli, MD, Sylvio Valença de Lemos Neto, MD, PhD, Patrícia L Procópio Lara, MD, Ana Cristina Pinho, MD
Background: Patient with a history of dissatisfaction during spinal anesthesia for orthopedic surgery, due to the unpleasant long duration of motor blockade of the lower limbs. During the pre-anesthetic consultation, she requested another type of anesthesia for the surgical treatment of varicose veins in the lower limbs. Case report: A 58-year-old female patient presented with varicose veins, for surgical treatment without removing the saphenous vein, only the collaterals. Patient with a history of controlled hypertension, normal blood tests, normal ECG, and chest X-ray. Abbreviation for fasting with 200 ml CHO. Venous access with #20G extract and monitoring with continuous ECG, NIBP, SpO2, and EtCO2 through a nasal catheter. Cleaning the skin with chlorhexidine and local anesthesia with 3 ml of 1% lidocaine. The spinal puncture was performed with the patient in the ventral position, by the median line in the L3-L4 interspaces using a 27G Quincke needle, after the appearance of CSF 7.5 mg of 0.15% hypobaric bupivacaine was administered at a speed of 1 mL/15s. Immediate latency, superior level T10 analgesia, without any degree of motor block. The surgical procedure posterior lasted 1:40 hours, and anterior lasted 1:20 hours, both without any degree of motor blockade and without cardiocirculatory and respiratory changes. The patient mobilized alone on the surgical table, without assistance from the prone position to the supine position. At PACU she received 200 ml of CHO and was discharged to her room. At the end of the day, she was released to her residence. Conclusion: The practice of prone positioning for performing posterior dorsal anesthesia remains relatively unfamiliar to many anesthetists. The use of a low dose of 0.15% hypobaric bupivacaine, the low cephalic dispersion of the analgesia, and the predominance of sensory roots allow the surgery to be performed without any degree of motor blockade, and proprioception remains. The use of posterior spinal anesthesia and the abbreviation of fasting before and immediately after surgery allowed excellent patient satisfaction.
{"title":"Posterior anesthesia for lower limb varicose veins: a case report with video","authors":"Luiz Eduardo Lmbelloni, MD, PhD, Eneida Maria Vieira, MD, PhD, Anna Lúcia Calaça Rivoli, MD, Sylvio Valença de Lemos Neto, MD, PhD, Patrícia L Procópio Lara, MD, Ana Cristina Pinho, MD","doi":"10.15406/jaccoa.2024.16.00580","DOIUrl":"https://doi.org/10.15406/jaccoa.2024.16.00580","url":null,"abstract":"Background: Patient with a history of dissatisfaction during spinal anesthesia for orthopedic surgery, due to the unpleasant long duration of motor blockade of the lower limbs. During the pre-anesthetic consultation, she requested another type of anesthesia for the surgical treatment of varicose veins in the lower limbs. Case report: A 58-year-old female patient presented with varicose veins, for surgical treatment without removing the saphenous vein, only the collaterals. Patient with a history of controlled hypertension, normal blood tests, normal ECG, and chest X-ray. Abbreviation for fasting with 200 ml CHO. Venous access with #20G extract and monitoring with continuous ECG, NIBP, SpO2, and EtCO2 through a nasal catheter. Cleaning the skin with chlorhexidine and local anesthesia with 3 ml of 1% lidocaine. The spinal puncture was performed with the patient in the ventral position, by the median line in the L3-L4 interspaces using a 27G Quincke needle, after the appearance of CSF 7.5 mg of 0.15% hypobaric bupivacaine was administered at a speed of 1 mL/15s. Immediate latency, superior level T10 analgesia, without any degree of motor block. The surgical procedure posterior lasted 1:40 hours, and anterior lasted 1:20 hours, both without any degree of motor blockade and without cardiocirculatory and respiratory changes. The patient mobilized alone on the surgical table, without assistance from the prone position to the supine position. At PACU she received 200 ml of CHO and was discharged to her room. At the end of the day, she was released to her residence. Conclusion: The practice of prone positioning for performing posterior dorsal anesthesia remains relatively unfamiliar to many anesthetists. The use of a low dose of 0.15% hypobaric bupivacaine, the low cephalic dispersion of the analgesia, and the predominance of sensory roots allow the surgery to be performed without any degree of motor blockade, and proprioception remains. The use of posterior spinal anesthesia and the abbreviation of fasting before and immediately after surgery allowed excellent patient satisfaction.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140505268","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}
Pub Date : 2024-01-12DOI: 10.15406/jaccoa.2024.16.00579
M. Jm, Matsanga A, Obame R, N. Pc, Ifoudji Makao A, S. Lv, Sima Zué A
Spinal anesthesia is a commonly used technique in cesarean section. This technique causes frequent maternal hypotension responsible for a reduction in placental perfusion rate causing fetal acidosis. Prophylactic vasopressor treatment is systematically recommended. Noradrenaline is today a molecule of choice. The objective of this work was to describe the benefit of using baby norepinephrine in the prevention of arterial hypotension in the context of cesarean section under spinal anesthesia. Methodology: Through a prospective observational study, parturients undergoing a planned or relative emergency cesarean section under spinal anesthesia during this period were included. Norepinephrine was administered by slow venous infusion at a rate of 0.028 to 0.057, or 4 to 10 drops/minute. Results: During the study period, 28 women were included. Their mean age was 30.1 ± 5.6. Scarred uterus (32%) and narrowed pelvis (25%) were the main indications. Parturients were classified according to the American Society of Anesthesia (ASA) as ASA1 in 82.1%. The systolic blood pressure recorded after the start of the baby norepinephrine infusion at the 1st minute, between the 5th and 15th minutes and between the 15th and 30th respectively between 100 and 140 mmHg in 71.4%, 85.7 % and 96.4% cases. Heart rate remained normal throughout norepinephrine administration. Conclusion: Low-dose norepinephrine ensures good hemodynamic stability perioperatively for cesarean section under spinal anesthesia.
{"title":"Prevention of arterial hypotension during cesarean section under spinal anesthesia: trial of a baby norepinephrine protocol at the Owendo University Hospital Center (Gabon)","authors":"M. Jm, Matsanga A, Obame R, N. Pc, Ifoudji Makao A, S. Lv, Sima Zué A","doi":"10.15406/jaccoa.2024.16.00579","DOIUrl":"https://doi.org/10.15406/jaccoa.2024.16.00579","url":null,"abstract":"Spinal anesthesia is a commonly used technique in cesarean section. This technique causes frequent maternal hypotension responsible for a reduction in placental perfusion rate causing fetal acidosis. Prophylactic vasopressor treatment is systematically recommended. Noradrenaline is today a molecule of choice. The objective of this work was to describe the benefit of using baby norepinephrine in the prevention of arterial hypotension in the context of cesarean section under spinal anesthesia. Methodology: Through a prospective observational study, parturients undergoing a planned or relative emergency cesarean section under spinal anesthesia during this period were included. Norepinephrine was administered by slow venous infusion at a rate of 0.028 to 0.057, or 4 to 10 drops/minute. Results: During the study period, 28 women were included. Their mean age was 30.1 ± 5.6. Scarred uterus (32%) and narrowed pelvis (25%) were the main indications. Parturients were classified according to the American Society of Anesthesia (ASA) as ASA1 in 82.1%. The systolic blood pressure recorded after the start of the baby norepinephrine infusion at the 1st minute, between the 5th and 15th minutes and between the 15th and 30th respectively between 100 and 140 mmHg in 71.4%, 85.7 % and 96.4% cases. Heart rate remained normal throughout norepinephrine administration. Conclusion: Low-dose norepinephrine ensures good hemodynamic stability perioperatively for cesarean section under spinal anesthesia.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139625116","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}
Pub Date : 2023-08-18DOI: 10.15406/jaccoa.2023.15.00565
Víctor M. Whizar-Lugo MD
{"title":"My patients; my books, my mentors. A tribute to them","authors":"Víctor M. Whizar-Lugo MD","doi":"10.15406/jaccoa.2023.15.00565","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00565","url":null,"abstract":"","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125046502","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}
Pub Date : 2023-08-10DOI: 10.15406/jaccoa.2023.15.00564
S. Topaloğlu, M. Eroğlu, B. Çekiç, A. Eroğlu
Objective: Patients undergoing total hip arthroplasty surgery are usually older and have limited cardiac and pulmonary reserves. Effective postoperative pain control with patient-controlled analgesia (PCA) may contribute to recovery in these patients. In this study, we aimed to compare the effectiveness of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) for pain control after hip arthroplasty. Methods: Our study was carried out in the orthopedic operating room of our hospital on 50 patients undergoing elective hip arthroplasty. At the end of the operation, the patients (n=50) were randomly divided into two groups: Group epidural (Group E) and Group intravenous (Group IV)] using a double-blind selection method, and PCA protocol was started. During the determined follow-up periods, the patients were evaluated regarding hemodynamic data, pain and sedation levels, and possible side effects. Results: In our study, no difference was observed between demographic data, heart rate, respiratory rate and mean blood pressure values in comparisons between two groups. In Group IV compared to Group E, visual analog scale (VAS) values (P<0.001), additional analgesic consumption (P<0.05) and undesirable effects such as nausea-vomiting and sedation (P<0.05) which were observed in postoperative pain follow-up were statistically significantly higher. Conclusion: Our study concluded that for postoperative pain management, the PCEA method has better analgesic performance, improves pain control and reduces the occurrence of side effects in hip arthroplasty compared to the PCIA method.
{"title":"Comparison of patient-controlled epidural and intravenous analgesia methods for postoperative pain control in patients after hip surgery","authors":"S. Topaloğlu, M. Eroğlu, B. Çekiç, A. Eroğlu","doi":"10.15406/jaccoa.2023.15.00564","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00564","url":null,"abstract":"Objective: Patients undergoing total hip arthroplasty surgery are usually older and have limited cardiac and pulmonary reserves. Effective postoperative pain control with patient-controlled analgesia (PCA) may contribute to recovery in these patients. In this study, we aimed to compare the effectiveness of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) for pain control after hip arthroplasty. Methods: Our study was carried out in the orthopedic operating room of our hospital on 50 patients undergoing elective hip arthroplasty. At the end of the operation, the patients (n=50) were randomly divided into two groups: Group epidural (Group E) and Group intravenous (Group IV)] using a double-blind selection method, and PCA protocol was started. During the determined follow-up periods, the patients were evaluated regarding hemodynamic data, pain and sedation levels, and possible side effects. Results: In our study, no difference was observed between demographic data, heart rate, respiratory rate and mean blood pressure values in comparisons between two groups. In Group IV compared to Group E, visual analog scale (VAS) values (P<0.001), additional analgesic consumption (P<0.05) and undesirable effects such as nausea-vomiting and sedation (P<0.05) which were observed in postoperative pain follow-up were statistically significantly higher. Conclusion: Our study concluded that for postoperative pain management, the PCEA method has better analgesic performance, improves pain control and reduces the occurrence of side effects in hip arthroplasty compared to the PCIA method.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127749669","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}
Pub Date : 2023-07-23DOI: 10.15406/jaccoa.2023.15.00563
Nuñez-Rueda Mayra M, Moreno Ana, Mondragón Villanueva Mabel E
Endovascular procedures are becoming increasingly common in the management of various medical conditions. However, like any invasive procedure, there are potential complications that can arise, including femoral hematoma. Femoral hematoma is a rare but potentially serious complication that can occur during endovascular procedures, and prompt recognition and management are essential to minimize the risk of adverse outcomes.
{"title":"Case report: Femoral hematoma a complication in a young patient with hypothyroidism and Eagle syndrome who underwent embolization bilobed paraclinoid aneurysm","authors":"Nuñez-Rueda Mayra M, Moreno Ana, Mondragón Villanueva Mabel E","doi":"10.15406/jaccoa.2023.15.00563","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00563","url":null,"abstract":"Endovascular procedures are becoming increasingly common in the management of various medical conditions. However, like any invasive procedure, there are potential complications that can arise, including femoral hematoma. Femoral hematoma is a rare but potentially serious complication that can occur during endovascular procedures, and prompt recognition and management are essential to minimize the risk of adverse outcomes.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132091345","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}
Pub Date : 2023-07-04DOI: 10.15406/jaccoa.2023.15.00562
Víctor M. Whizar-Lugo MD, Alberto López- Bascope MD
{"title":"Paulo Pelosi MD, FERS - A Professor of excellence in Anesthesiology and Critical Medicine","authors":"Víctor M. Whizar-Lugo MD, Alberto López- Bascope MD","doi":"10.15406/jaccoa.2023.15.00562","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00562","url":null,"abstract":"","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132739360","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}
Pub Date : 2023-06-30DOI: 10.15406/jaccoa.2023.15.00561
Vilchis-Valentin David, García-Maldonado Merith, Larrazolo-Ochoa Arturo, Gutiérrez-Montes Laura Angélica, Camacho-Ramos Cesar Esteban, Norma Cuéllar-Garduño, R. López
Introduction: Postoperative nausea and vomiting (PONV) is the most common adverse effect, after postoperative pain, with an incidence of 31.1% to 80%, which increases pain, favors broncho aspiration, wound dehiscence, and hematoma formation. Methodology: Systematized search keywords, postoperative nausea and vomiting, Incidence, therapeutics, Apfel score and risk score for postoperative nausea and vomiting, in PubMed database, the Cochrane central register of controlled trials and in http://www.clinicaltrials.gov. Results: A total of 2750 articles were obtained, and 62 articles were chosen for inclusion. Discussion: The drugs used as monotherapy to mitigate PONV such as palonosetron, fosaprepitant and aprepitant, show better results than the rest of the drugs. Conclusion: Currently, NK1 receptor antagonist drugs and 5-HT3 antagonists have been shown to have the best results in preventing PONV, however, the management of PONV should be multimodal and individualized.
{"title":"Systematized review of the literature on postoperative nausea and vomiting","authors":"Vilchis-Valentin David, García-Maldonado Merith, Larrazolo-Ochoa Arturo, Gutiérrez-Montes Laura Angélica, Camacho-Ramos Cesar Esteban, Norma Cuéllar-Garduño, R. López","doi":"10.15406/jaccoa.2023.15.00561","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00561","url":null,"abstract":"Introduction: Postoperative nausea and vomiting (PONV) is the most common adverse effect, after postoperative pain, with an incidence of 31.1% to 80%, which increases pain, favors broncho aspiration, wound dehiscence, and hematoma formation. Methodology: Systematized search keywords, postoperative nausea and vomiting, Incidence, therapeutics, Apfel score and risk score for postoperative nausea and vomiting, in PubMed database, the Cochrane central register of controlled trials and in http://www.clinicaltrials.gov. Results: A total of 2750 articles were obtained, and 62 articles were chosen for inclusion. Discussion: The drugs used as monotherapy to mitigate PONV such as palonosetron, fosaprepitant and aprepitant, show better results than the rest of the drugs. Conclusion: Currently, NK1 receptor antagonist drugs and 5-HT3 antagonists have been shown to have the best results in preventing PONV, however, the management of PONV should be multimodal and individualized.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122781875","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}
Pub Date : 2023-06-27DOI: 10.15406/jaccoa.2023.15.00560
F. Ariza, Gustavo Cruz, D. Castaño, I. Quintero, Laura Suárez, Mauricio Burbano, Einar Burbano Burbano
Purpose: To evaluate the impact of three different effect-site concentrations of remifentanil [1.0, 2.0 and 2.5 ng.ml-1] on cough, heart rate and systolic blood pressure during extubation after balanced anesthesia with desflurane or sevoflurane. Design: Double-blinded controlled trial. Setting: Operating room. Patients: ASA I-II adults (n=451) who underwent elective procedures. Interventions: Subjects were randomly assigned to maintain remifentanil effect-site concentrations at 1.0, 2.0 and 2.5 ng.ml-1 by a target control infusion system after receiving balanced general anesthesia with remifentanil and sevoflurane vs. desflurane. Measurements: Cough severity (using a four-point intensity scale), heart rate and systolic blood pressure were registered during eye opening, tracheal extubation and 2.5 minutes after. Main Results: Cough was significantly reduced in all groups of remifentanil at 2.0 and 2.5 ng.ml-1 during eye opening, tracheal extubation and 2.5 minutes after, when compared with 1.0 ng.ml-1 [Risk ratio (95% CI) at tracheal extubation 0.35 (0.23-0.53) and 0.33 (0.21-0.52) for desflurane; 0.50 (0.35-0.73) and 0.45 (0.30-0.73) for sevoflurane, respectively. P < 0.001]. There were no significant differences on heart rate or systolic blood pressure values at these time points for any of the studied groups. Conclusion: In adult patients of elective procedures under balanced general anesthesia with sevoflurane or desflurane, maintaining a remifentanil effect-site concentration at 2.0-2.5ng.ml-1 significantly reduce the risk of cough but not hemodynamic responses during tracheal extubation.
{"title":"https://medcraveonline.com/JACCOA/anesthetic-and-hemodynamic-management-in-patients-with-different-approaches-for-multiple-neurological-pathologies-case-report.html","authors":"F. Ariza, Gustavo Cruz, D. Castaño, I. Quintero, Laura Suárez, Mauricio Burbano, Einar Burbano Burbano","doi":"10.15406/jaccoa.2023.15.00560","DOIUrl":"https://doi.org/10.15406/jaccoa.2023.15.00560","url":null,"abstract":"Purpose: To evaluate the impact of three different effect-site concentrations of remifentanil [1.0, 2.0 and 2.5 ng.ml-1] on cough, heart rate and systolic blood pressure during extubation after balanced anesthesia with desflurane or sevoflurane. Design: Double-blinded controlled trial. Setting: Operating room. Patients: ASA I-II adults (n=451) who underwent elective procedures. Interventions: Subjects were randomly assigned to maintain remifentanil effect-site concentrations at 1.0, 2.0 and 2.5 ng.ml-1 by a target control infusion system after receiving balanced general anesthesia with remifentanil and sevoflurane vs. desflurane. Measurements: Cough severity (using a four-point intensity scale), heart rate and systolic blood pressure were registered during eye opening, tracheal extubation and 2.5 minutes after. Main Results: Cough was significantly reduced in all groups of remifentanil at 2.0 and 2.5 ng.ml-1 during eye opening, tracheal extubation and 2.5 minutes after, when compared with 1.0 ng.ml-1 [Risk ratio (95% CI) at tracheal extubation 0.35 (0.23-0.53) and 0.33 (0.21-0.52) for desflurane; 0.50 (0.35-0.73) and 0.45 (0.30-0.73) for sevoflurane, respectively. P < 0.001]. There were no significant differences on heart rate or systolic blood pressure values at these time points for any of the studied groups. Conclusion: In adult patients of elective procedures under balanced general anesthesia with sevoflurane or desflurane, maintaining a remifentanil effect-site concentration at 2.0-2.5ng.ml-1 significantly reduce the risk of cough but not hemodynamic responses during tracheal extubation.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"143 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124893623","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}
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