Madhukant ., Subhash Chandra, Rohit Kateliya, P. Kumari, C. Sinha, J. Kaur
Comparative Evaluation of Clonidine and Fentanyl as Adjuvants with Levobupivacaine for Postoperative Epidural Analgesia after Total Knee Replacement Surgery - A Randomised Double Blind Study. Anesthesia and Critical Care Abstract Background and Aims Epidural anaesthesia commonly used for inducing anaesthesia and postoperative analgesia in patients undergoing lower limb surgeries. Fentanyl as an adjuvant to epidural local anesthetic has been for long time. Clonidine is a potent and selective α-2-adrenoceptor agonist with analgesic potency. The aim of the study was to compare the effect of clonidine and fentanyl as an adjuvant to epidural levobupivacaine in total knee replacement surgery. total knee randomly divided into two groups. Patients were allocated to one of the two groups by computer generated random selection. Group I (n=35) patients received postoperative continuous epidural infusion of levobupivacaine (1.25mg/ml) with fentanyl (2 μg/ml) whereas Group II (n=35) patients received epidural infusion of Levobupivacaine (1.25mg/ml) with Clonidine (1μg/ml) in the range of 3-7 ml/hr.
{"title":"Comparative Evaluation of Clonidine and Fentanyl as Adjuvants with Levobupivacaine for Postoperative Epidural Analgesia after Total Knee Replacement Surgery - A Randomised Double Blind Study","authors":"Madhukant ., Subhash Chandra, Rohit Kateliya, P. Kumari, C. Sinha, J. Kaur","doi":"10.26502/acc.032","DOIUrl":"https://doi.org/10.26502/acc.032","url":null,"abstract":"Comparative Evaluation of Clonidine and Fentanyl as Adjuvants with Levobupivacaine for Postoperative Epidural Analgesia after Total Knee Replacement Surgery - A Randomised Double Blind Study. Anesthesia and Critical Care Abstract Background and Aims Epidural anaesthesia commonly used for inducing anaesthesia and postoperative analgesia in patients undergoing lower limb surgeries. Fentanyl as an adjuvant to epidural local anesthetic has been for long time. Clonidine is a potent and selective α-2-adrenoceptor agonist with analgesic potency. The aim of the study was to compare the effect of clonidine and fentanyl as an adjuvant to epidural levobupivacaine in total knee replacement surgery. total knee randomly divided into two groups. Patients were allocated to one of the two groups by computer generated random selection. Group I (n=35) patients received postoperative continuous epidural infusion of levobupivacaine (1.25mg/ml) with fentanyl (2 μg/ml) whereas Group II (n=35) patients received epidural infusion of Levobupivacaine (1.25mg/ml) with Clonidine (1μg/ml) in the range of 3-7 ml/hr.","PeriodicalId":41147,"journal":{"name":"Pediatric Anesthesia and Critical Care Journal","volume":"50 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80874859","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}
Simon Moormann, Marie Luise Rüebsam, Eva Warnking, A. Gottschalk, K. Hahnenkamp, H. Van Aken, D. Doll, O. Hagemann, C. Hönemann
Introduction : Colorectal cancer is a major cause of death in the industrial world. The mortality and morbidity rates depend on postoperative complications and cancer recurrence. Research suggests that regional anesthesia reduces perioperative stress levels, potentially lowering the risk of complications. Patients with perioperative epidural analgesia might have longer survival times compared with patients without perioperative epidural analgesia. Methods: We compared short and long-term outcome data from 215 patients who underwent open colon cancer surgery by the same surgeon and the same oncologist. Eighty-three patients received general anesthesia plus thoracic epidural analgesia (EPI group), and 132 patients received general anesthesia alone (GA group). Oncological data from a state-wide follow-up database were included. The effects of different perioperative anesthetic techniques on patients’ short and long-term outcomes over 36 months were statistically analyzed (Pearson’s chi-squared test, Student’s t-test, Wilcoxon rank-sum test) as appropriate. A Kaplan-Meier analysis for survival was performed and analyzed by the Wilcoxon rank-sum test. Results: With the exception of a significantly higher prevalence of arterial hypertension in the EPI group in comparison with the GA group, there were no differences in demographics, tumor staging data, and cancer recurrence rates between the groups. However, mortality rates were significantly different between the groups. Thirty-seven of 132 GA patients comparison with 14 of benefited significantly patients Discussion: 36-month postoperative mortality rate. This effect may be due to the systemic effects of local anesthetics or to a reduced stress response caused by the thoracic epidural analgesia itself. Conclusions: Patients with colon cancer over the age of 70 years in particular significantly benefited from perioperative epidural analgesia and had longer survival times compared with patients without perioperative epidural analgesia.
{"title":"Beneficial Effects of Thoracic Epidural Anesthesia on Mortality Rate in Geriatric Patients after Elective Surgery for Colon Cancer: A Study of 215 Consecutive Patients","authors":"Simon Moormann, Marie Luise Rüebsam, Eva Warnking, A. Gottschalk, K. Hahnenkamp, H. Van Aken, D. Doll, O. Hagemann, C. Hönemann","doi":"10.26502/acc.044","DOIUrl":"https://doi.org/10.26502/acc.044","url":null,"abstract":"Introduction : Colorectal cancer is a major cause of death in the industrial world. The mortality and morbidity rates depend on postoperative complications and cancer recurrence. Research suggests that regional anesthesia reduces perioperative stress levels, potentially lowering the risk of complications. Patients with perioperative epidural analgesia might have longer survival times compared with patients without perioperative epidural analgesia. Methods: We compared short and long-term outcome data from 215 patients who underwent open colon cancer surgery by the same surgeon and the same oncologist. Eighty-three patients received general anesthesia plus thoracic epidural analgesia (EPI group), and 132 patients received general anesthesia alone (GA group). Oncological data from a state-wide follow-up database were included. The effects of different perioperative anesthetic techniques on patients’ short and long-term outcomes over 36 months were statistically analyzed (Pearson’s chi-squared test, Student’s t-test, Wilcoxon rank-sum test) as appropriate. A Kaplan-Meier analysis for survival was performed and analyzed by the Wilcoxon rank-sum test. Results: With the exception of a significantly higher prevalence of arterial hypertension in the EPI group in comparison with the GA group, there were no differences in demographics, tumor staging data, and cancer recurrence rates between the groups. However, mortality rates were significantly different between the groups. Thirty-seven of 132 GA patients comparison with 14 of benefited significantly patients Discussion: 36-month postoperative mortality rate. This effect may be due to the systemic effects of local anesthetics or to a reduced stress response caused by the thoracic epidural analgesia itself. Conclusions: Patients with colon cancer over the age of 70 years in particular significantly benefited from perioperative epidural analgesia and had longer survival times compared with patients without perioperative epidural analgesia.","PeriodicalId":41147,"journal":{"name":"Pediatric Anesthesia and Critical Care Journal","volume":"332 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77625624","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}
Saracoglu A, Tanirgan Çabakli G, K. y, Bilgili B, Yegen C, Umuroglu T
The ischemia-reperfusion injury that occurs in both the donor and the recipient during liver transplantation and the hemodynamic changes that may occur in graft afterward significantly affect the graft, sometimes triggering graft failure by causing hepatocyte damage. It is known that inhalation anesthetics provide ischemic preconditioning that prevents ischemia-reperfusion injury, but their effect on graft dysfunction caused by post-reperfusion syndrome has not yet been clarified. Our study aimed to reveal the effects of desflurane and sevoflurane used during liver transplantation on graft survival. This retrospective study was conducted following the and included 60 donors and recipients of liver transplantation procedures performed between 2015 and 2021. The patients were divided into two groups depending on the agent administered for anesthesia maintenance after patient data included age, gender, body mass index, smoking status, comorbidities, presence of renal disease, total liver volume, graft volume, remaining liver volume, total ischemic time, and duration of anesthesia and surgery, graft survival, hospital stay, diastolic blood pressure measured at the beginning and the end of the procedure, systolic blood pressure; and the values of aspartate aminotransferase (AST), alanine aminotransferase (ALT), international normalized ratio albumin, total bilirubin, platelet count, and hemoglobin at the postoperative 1, 7, and 30 days.
{"title":"The Impact of the Analgesic Agents Administered in Recipients of Liver Transplants on Graft Results","authors":"Saracoglu A, Tanirgan Çabakli G, K. y, Bilgili B, Yegen C, Umuroglu T","doi":"10.26502/acc.037","DOIUrl":"https://doi.org/10.26502/acc.037","url":null,"abstract":"The ischemia-reperfusion injury that occurs in both the donor and the recipient during liver transplantation and the hemodynamic changes that may occur in graft afterward significantly affect the graft, sometimes triggering graft failure by causing hepatocyte damage. It is known that inhalation anesthetics provide ischemic preconditioning that prevents ischemia-reperfusion injury, but their effect on graft dysfunction caused by post-reperfusion syndrome has not yet been clarified. Our study aimed to reveal the effects of desflurane and sevoflurane used during liver transplantation on graft survival. This retrospective study was conducted following the and included 60 donors and recipients of liver transplantation procedures performed between 2015 and 2021. The patients were divided into two groups depending on the agent administered for anesthesia maintenance after patient data included age, gender, body mass index, smoking status, comorbidities, presence of renal disease, total liver volume, graft volume, remaining liver volume, total ischemic time, and duration of anesthesia and surgery, graft survival, hospital stay, diastolic blood pressure measured at the beginning and the end of the procedure, systolic blood pressure; and the values of aspartate aminotransferase (AST), alanine aminotransferase (ALT), international normalized ratio albumin, total bilirubin, platelet count, and hemoglobin at the postoperative 1, 7, and 30 days.","PeriodicalId":41147,"journal":{"name":"Pediatric Anesthesia and Critical Care Journal","volume":"9 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75592946","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":"Communication in the Time of Coronavirus: Three Tips for Enhancing Communication with Families in the Intensive Care Unit that are here to stay","authors":"Kashika G Goyal, Tyler J Trahan, Margaret M Hayes","doi":"10.26502/acc.033","DOIUrl":"https://doi.org/10.26502/acc.033","url":null,"abstract":"","PeriodicalId":41147,"journal":{"name":"Pediatric Anesthesia and Critical Care Journal","volume":"17 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77747270","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}
Objective To evaluate and compare the suprascapular nerve block and glenohumeral intraarticular joint injection in treatment of chronic shoulder pain Study design The present prospective randomized study was conducted in the Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma PGIMS, Rohtak. Fifty patients of either sex, between 40-80 yrs of age, with chronic shoulder pain. The patients were randomly divided in two groups of 25 patients each. Patients received either suprascapular nerve block under ultrasound guidance or intraarticular injection using anterior approach.
{"title":"Suprascapular Nerve Block versus Glenohumeral Intraarticular Injection for Treatment of Chronic Shoulder Pain - A Comparative Study","authors":"S. K, S. S, S. S, A. Ks","doi":"10.26502/acc.045","DOIUrl":"https://doi.org/10.26502/acc.045","url":null,"abstract":"Objective To evaluate and compare the suprascapular nerve block and glenohumeral intraarticular joint injection in treatment of chronic shoulder pain Study design The present prospective randomized study was conducted in the Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma PGIMS, Rohtak. Fifty patients of either sex, between 40-80 yrs of age, with chronic shoulder pain. The patients were randomly divided in two groups of 25 patients each. Patients received either suprascapular nerve block under ultrasound guidance or intraarticular injection using anterior approach.","PeriodicalId":41147,"journal":{"name":"Pediatric Anesthesia and Critical Care Journal","volume":"139 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73749828","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}
M. Amadou, Boukari Mahamane Bawa, Maikassoua Mamane, H. Oumarou, Rabiou Maman Sani
Introduction Anaesthesia is a field procedure. Paediatric anaesthesia requires vigilance and rigour at all stages. It must be carried out in an adapted structure by a team accustomed and updating its knowledge. What Anesth Crit Care 2022; 4 (1): 14-22 DOI: 10.26502/acc.034 Anesthesia and Critical Care 15 complications of paediatric anaesthesia in outpatient surgery? Objective Evaluation of immediate postoperative complications of paediatric anaesthesia in outpatient surgery. Patients and method Prospective, descriptive and analytical study of 160 cases of outpatient surgery performed at the national hospital of Zinder over six months from 1 January to 30 June 2018. Included were children aged 01 month to 05 years operated during outpatient surgery. The variables were epidemiological data, ASA class, type of anaesthesia, operative indications and patient outcome. Results During the study period 160 anaesthesias were performed. The mean age of the patients was 27.44 months with extremes from 01 month to 60 months. The sex ratio was 3.8 in favour of boys. ASA I class represented 80% of the patients. General anaesthesia with intubation was the technique of choice in 82.50%. The drugs frequently used were ketamine, propofol, halothane and fentanyl. The main operative indication was hernia in 63.12% of cases. The complications observed were bursal haematoma (06.87%), respiratory complications (03.12%) and hyperthermia (01.25%) of cases. The evolution was favourable for all patients and no deaths were recorded. Conclusion Paediatric anaesthesia for outpatient surgery generates fewer complications if it is carried out in a suitable structure and by staff who are used to it and have updated their knowledge. This practice should be popularised as it allows us to relieve congestion in our departments with limited beds.
{"title":"naesthetic Complications in Immediate Postoperative Period during Ambulatory Paediatric Surgery at the National Hospital of Zinder in Children aged 0 to 5 years","authors":"M. Amadou, Boukari Mahamane Bawa, Maikassoua Mamane, H. Oumarou, Rabiou Maman Sani","doi":"10.26502/acc.034","DOIUrl":"https://doi.org/10.26502/acc.034","url":null,"abstract":"Introduction Anaesthesia is a field procedure. Paediatric anaesthesia requires vigilance and rigour at all stages. It must be carried out in an adapted structure by a team accustomed and updating its knowledge. What Anesth Crit Care 2022; 4 (1): 14-22 DOI: 10.26502/acc.034 Anesthesia and Critical Care 15 complications of paediatric anaesthesia in outpatient surgery? Objective Evaluation of immediate postoperative complications of paediatric anaesthesia in outpatient surgery. Patients and method Prospective, descriptive and analytical study of 160 cases of outpatient surgery performed at the national hospital of Zinder over six months from 1 January to 30 June 2018. Included were children aged 01 month to 05 years operated during outpatient surgery. The variables were epidemiological data, ASA class, type of anaesthesia, operative indications and patient outcome. Results During the study period 160 anaesthesias were performed. The mean age of the patients was 27.44 months with extremes from 01 month to 60 months. The sex ratio was 3.8 in favour of boys. ASA I class represented 80% of the patients. General anaesthesia with intubation was the technique of choice in 82.50%. The drugs frequently used were ketamine, propofol, halothane and fentanyl. The main operative indication was hernia in 63.12% of cases. The complications observed were bursal haematoma (06.87%), respiratory complications (03.12%) and hyperthermia (01.25%) of cases. The evolution was favourable for all patients and no deaths were recorded. Conclusion Paediatric anaesthesia for outpatient surgery generates fewer complications if it is carried out in a suitable structure and by staff who are used to it and have updated their knowledge. This practice should be popularised as it allows us to relieve congestion in our departments with limited beds.","PeriodicalId":41147,"journal":{"name":"Pediatric Anesthesia and Critical Care Journal","volume":"02 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86385837","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}
J. B, Nga Nomo S, I. C, Djomo Tamchom D, C. G, Mouafo B, N. S, Ze Minkande J, B. F
Background Residual curarization is dangerous, it promotes postoperative pneumonia. The objective of this study was to assess the relevance of clinical extubation criteria in the prevention of residual curarization. This was a prospective and descriptive study carried out over a period of 3 months in the anesthesia department of the Yaounde-Essos hospital center. It included all adult patients operated on under general anesthesia for elective surgery, and who received vecuronium bromide administration during the anesthetic procedure. Results A total of 80 patients were collected from 150 acts of anesthesia performed during the study period. The average age was 44 years old, the sex ratio of 1.10 in favor of men. The patient's extubation was based in the majority of cases (82.6%) on the combination of the following clinical criteria: the presence of spontaneous ventilation and swallowing reflex, the positive head lift test and the level of correct consciousness. The incidence of postoperative residual was main complications were hypoventilation associated with hypoxia (40%), diplopia (35%) and apnea (25%). the essos hospital Reliable detection of curarization only be done with a measuring
{"title":"Postoperative Residual Curarization in Difficult Environment for the Practice of General Anesthesia: Inventory of the Yaounde/Essos Hospital Center","authors":"J. B, Nga Nomo S, I. C, Djomo Tamchom D, C. G, Mouafo B, N. S, Ze Minkande J, B. F","doi":"10.26502/acc.039","DOIUrl":"https://doi.org/10.26502/acc.039","url":null,"abstract":"Background Residual curarization is dangerous, it promotes postoperative pneumonia. The objective of this study was to assess the relevance of clinical extubation criteria in the prevention of residual curarization. This was a prospective and descriptive study carried out over a period of 3 months in the anesthesia department of the Yaounde-Essos hospital center. It included all adult patients operated on under general anesthesia for elective surgery, and who received vecuronium bromide administration during the anesthetic procedure. Results A total of 80 patients were collected from 150 acts of anesthesia performed during the study period. The average age was 44 years old, the sex ratio of 1.10 in favor of men. The patient's extubation was based in the majority of cases (82.6%) on the combination of the following clinical criteria: the presence of spontaneous ventilation and swallowing reflex, the positive head lift test and the level of correct consciousness. The incidence of postoperative residual was main complications were hypoventilation associated with hypoxia (40%), diplopia (35%) and apnea (25%). the essos hospital Reliable detection of curarization only be done with a measuring","PeriodicalId":41147,"journal":{"name":"Pediatric Anesthesia and Critical Care Journal","volume":"38 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86013469","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}
The Importance of Timing in the Application of Mesenchymal Stem Cells in Critically Ill Patients with COVID-19 infection (Retrospective study). Abstract Background: The aim of this study is to control the disease by administering MSC treatment to COVID-19 patients who are taken into intensive care unit, and to assess at what time period the MSC transplant has a more positive curative effect on COVID-19 infection. Methods: Group 1 (n=32): the first administration of MSCs was started within 1-4 days, Group 2 (n=36): the first administration of MSCs was started within 4-8 days, Group 3 (n=36): the first administration of MSCs was started within 8-12 days. The main parameters investigated: COVID-19 inflammation markers, length of hospital stay, and mortality rates. Results: In our study, 54 (52%) of 104 patients died and 50 patients (48%) were discharged with recovery. When we evaluated the mortality rates between the groups, 10 patients (31%) in group-, 20 patients (56%) in group-2 and 24 patients (67%) in group-3 died, respectively. The groups were compared statistically, the mortality rate was significant in favor of group-1 (p<0,05). When the groups were compared in terms of COVID-19 inflammation markers, CRP and D-dimer levels of group-1 were found to be lower than the other groups (p<0.05). Conclusions: Administration of MSCs in the early time period reduces mortality in critically ill patients with COVID-19.
{"title":"The Importance of Timing in the Application of Mesenchymal Stem Cells in Critically Ill Patients with COVID-19 infection (Retrospective study)","authors":"Rabia Yılmaz, Z. Çukurova, Gülsüm Oya Hergünsel,","doi":"10.26502/acc.050","DOIUrl":"https://doi.org/10.26502/acc.050","url":null,"abstract":"The Importance of Timing in the Application of Mesenchymal Stem Cells in Critically Ill Patients with COVID-19 infection (Retrospective study). Abstract Background: The aim of this study is to control the disease by administering MSC treatment to COVID-19 patients who are taken into intensive care unit, and to assess at what time period the MSC transplant has a more positive curative effect on COVID-19 infection. Methods: Group 1 (n=32): the first administration of MSCs was started within 1-4 days, Group 2 (n=36): the first administration of MSCs was started within 4-8 days, Group 3 (n=36): the first administration of MSCs was started within 8-12 days. The main parameters investigated: COVID-19 inflammation markers, length of hospital stay, and mortality rates. Results: In our study, 54 (52%) of 104 patients died and 50 patients (48%) were discharged with recovery. When we evaluated the mortality rates between the groups, 10 patients (31%) in group-, 20 patients (56%) in group-2 and 24 patients (67%) in group-3 died, respectively. The groups were compared statistically, the mortality rate was significant in favor of group-1 (p<0,05). When the groups were compared in terms of COVID-19 inflammation markers, CRP and D-dimer levels of group-1 were found to be lower than the other groups (p<0.05). Conclusions: Administration of MSCs in the early time period reduces mortality in critically ill patients with COVID-19.","PeriodicalId":41147,"journal":{"name":"Pediatric Anesthesia and Critical Care Journal","volume":"9 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88205038","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}
Boukari Bm, Maikassoua M, Rabiu Mb, M. A., Abdoulaye Mb, A. O, Niandou Ma, Moussa Mr
Introduction: In otolaryngology and maxillofacial surgery, the main anesthetic problem is the management of the upper airways. The aim of this work is to take stock of anesthesiological activities in the ENT and CMF departments of the Niamey National Hospital. Methodology: This was a prospective cross-sectional and descriptive study running from January 1 to June 30, 2020. Our study included all patients operated on in ENT and stomatology during the study period. The parameters studied were socio-demographic, the practice of anesthesia, per- and postoperative incidents and accidents, anesthesia team and equipment. Result: During our study, 147 patients were included out of 2082 admitted to the Niamey National Hospital, accounted for 7.06% of toatal patients admitted during the study period. ENT accounted for 93 patients and CMF 54. The mean age of our patients was 22.29 years with extremes of 11 months and 85 years. The sex ratio was 0.67. Surgery was urgent in 14.29% of cases. 46.26% of the patients came from outside Niamey. Tonsillectomy was the most common indication. All patients admitted for completed surgery received CPA. Difficult intubation criteria were detected in 34 patients. The ASA 1 class was in the majority (70.07%). The mean wait time for the entire study population was 5 weeks and 5 days with extremes of 0 days and 486 days. Premedication was necessary in 38 patients. Diazepam was the drug administered. All patients had received antibiotic prophylaxis. Rocéphine was the molecule used. AG + IOT was 89.80% the anesthetic technique used. The hypnotics used were propofol, thiopental, ketamine, and halothane. Fentanyl was the only opioid drug. All our patients were extubated on a table with an average duration of anesthesia of 106 minutes with extremes of 20 minutes and 600 minutes. The incident reported intraoperatively was 11 cases of bleeding. The postoperative period was marked by the occurrence of bronchospasm during extubation in 11 patients and arterial hypotension in 3 others. No deaths have been recorded. In 97.96% of cases, the anesthetic team was made up of Senior Technicians in Anesthesia and Resuscitation alone, under the supervision of a resuscitator anesthetist. Conclusion: This study demostrated that safe anaesthesia can be administered for ENT and maxillofacial surgeries in limited resource setting and surgical mortality and morbidity can be reduced, through judicious use of available resources, team work and vigillance.
{"title":"Review of Anesthesia for ENT, Oral and Maxillofacial Surgery at the National Hospital of Niamey: Situational Analysis in Limited Resource Setting","authors":"Boukari Bm, Maikassoua M, Rabiu Mb, M. A., Abdoulaye Mb, A. O, Niandou Ma, Moussa Mr","doi":"10.26502/acc.035","DOIUrl":"https://doi.org/10.26502/acc.035","url":null,"abstract":"Introduction: In otolaryngology and maxillofacial surgery, the main anesthetic problem is the management of the upper airways. The aim of this work is to take stock of anesthesiological activities in the ENT and CMF departments of the Niamey National Hospital. Methodology: This was a prospective cross-sectional and descriptive study running from January 1 to June 30, 2020. Our study included all patients operated on in ENT and stomatology during the study period. The parameters studied were socio-demographic, the practice of anesthesia, per- and postoperative incidents and accidents, anesthesia team and equipment. Result: During our study, 147 patients were included out of 2082 admitted to the Niamey National Hospital, accounted for 7.06% of toatal patients admitted during the study period. ENT accounted for 93 patients and CMF 54. The mean age of our patients was 22.29 years with extremes of 11 months and 85 years. The sex ratio was 0.67. Surgery was urgent in 14.29% of cases. 46.26% of the patients came from outside Niamey. Tonsillectomy was the most common indication. All patients admitted for completed surgery received CPA. Difficult intubation criteria were detected in 34 patients. The ASA 1 class was in the majority (70.07%). The mean wait time for the entire study population was 5 weeks and 5 days with extremes of 0 days and 486 days. Premedication was necessary in 38 patients. Diazepam was the drug administered. All patients had received antibiotic prophylaxis. Rocéphine was the molecule used. AG + IOT was 89.80% the anesthetic technique used. The hypnotics used were propofol, thiopental, ketamine, and halothane. Fentanyl was the only opioid drug. All our patients were extubated on a table with an average duration of anesthesia of 106 minutes with extremes of 20 minutes and 600 minutes. The incident reported intraoperatively was 11 cases of bleeding. The postoperative period was marked by the occurrence of bronchospasm during extubation in 11 patients and arterial hypotension in 3 others. No deaths have been recorded. In 97.96% of cases, the anesthetic team was made up of Senior Technicians in Anesthesia and Resuscitation alone, under the supervision of a resuscitator anesthetist. Conclusion: This study demostrated that safe anaesthesia can be administered for ENT and maxillofacial surgeries in limited resource setting and surgical mortality and morbidity can be reduced, through judicious use of available resources, team work and vigillance.","PeriodicalId":41147,"journal":{"name":"Pediatric Anesthesia and Critical Care Journal","volume":"26 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79081592","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 : 2021-11-09DOI: 10.1101/2021.11.05.21265969
M. Croce, E. Chiappa, A. Moiso, M. Rabassa
Background: In Argentina, the burden of COVID-19 on health systems and physicians was substantial with difficulties on daily triage decisions which have to be made in the context of grave shortages of basic equipment and consumables. Purpose: this study was performed to understand what physicians were experiencing during the COVID-19 pandemic in La Plata (capital city of Buenos Aires province, Argentina). Methods: A cross-sectional study was performed; a questionnaire was sent by e-mail to physicians who work in this city during November 2020. The questionnaire was made based on Medscape US and International Physicians COVID-19 Experience Report: Risk, Burnout, Loneliness. Statistical analysis: test for normality was performed employing the Kolmogorov-Smirnov test while Chi-square test of independence to examine the relationship between sex and workplace with nominal variables. For categorical variables, Kendall tau correlation was performed to test for independence. ANOVA was developed to examine differences between physician age. Statistical significance was set to p < 0.05 in all cases. All statistical analysis was done employing SPSS Statistics, Version 24 (IBM, USA). Results: 203 physicians answered the questionnaire; the majority of physicians (96%) considered stressful their experience during pandemic and reported distress episodes being for more than 60% the most stressful of their practices, 30% presented depression and were medically treated, while 32.7% felt loneliness with 4 physicians with suicidal thoughts. Conclusion: The results highlight the need to protect the psychological well-being of the healthcare community, and to invest resources to significantly promote the mental health of professionals.
背景:在阿根廷，2019冠状病毒病给卫生系统和医生带来了沉重负担，在基本设备和耗材严重短缺的情况下，必须做出日常分诊决定。目的:本研究旨在了解拉普拉塔(阿根廷布宜诺斯艾利斯省首府)的医生在COVID-19大流行期间的经历。方法:横断面研究;2020年11月，通过电子邮件向在该市工作的医生发送了一份调查问卷。问卷是根据Medscape美国和国际医生COVID-19经验报告:风险，倦怠，孤独制作的。统计分析:使用Kolmogorov-Smirnov检验进行正态性检验，使用名义变量进行独立性卡方检验检验性别与工作场所的关系。对于分类变量，采用肯德尔tau相关来检验独立性。采用方差分析来检验医生年龄之间的差异。所有病例的差异均有统计学意义p < 0.05。所有统计分析采用SPSS Statistics, Version 24 (IBM, USA)。结果:203名医生参与问卷调查;大多数医生(96%)认为他们在大流行期间的经历压力很大，60%以上的医生报告说，痛苦发作是他们实践中压力最大的一次，30%的医生表现出抑郁并接受了治疗，而32.7%的医生感到孤独，有4名医生有自杀念头。结论:本研究结果表明，应切实保护医务工作者的心理健康，投入资源，大力促进医务人员的心理健康。
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