首页 > 最新文献

Archives of Anesthesia and Critical Care最新文献

英文 中文
Intraoperative Administration of Diphenhydramine Attenuates Postoperative Catheter Related Bladder Discomfort in Patient Following Percutaneous Nephrolithotomy 术中服用苯海拉明可减轻经皮肾镜碎石术患者术后导尿管相关的膀胱不适感
Pub Date : 2024-06-15 DOI: 10.18502/aacc.v10i3.15693
M. Khajavi, Mohammad Maroofia, Hamed Akhavizadegan
Background: We intend to evaluate the effect of intraoperative diphenhydramine administration on incidence and severity of catheter related bladder discomfort (CRBD) and pain after percutaneous nephrolithotomy. Methods: In a double blind randomized clinical trial, adult male patients undergoing percutaneous nephrolithotomy were enrolled. They were randomized into two groups by a computerized digital random allocation method. Before anesthesia induction, group D (Diphenhydramine group) (n = 48) received 5 ml normal saline containing 0.5 mg/kg of diphenhydramine intravenously. In group C (Control group) (n = 48), 5 ml of normal saline was injected in the same manner. Induction and maintenance of anesthesia were identical in both groups. The incidence and severity of CRBD and postoperative pain were assessed at recovery room. Results: The incidence of CRBD was significantly lower in group D than in group C (14% vs. 63%, P=0.001). The severity of CRBD was milder in group D in comparison to group C (P<0.05). Postoperative pain score was significantly lower in group D (P<0.05). Conclusion: Intraoperative administration of diphenhydramine is an effective practice for the prevention of CRBD after percutaneous nephrolithotomy in male patients and can reduce postoperative pain as well.
背景:我们打算评估术中使用苯海拉明对经皮肾镜碎石术后导尿管相关膀胱不适(CRBD)和疼痛的发生率和严重程度的影响。方法:双盲随机临床试验:在一项双盲随机临床试验中,对接受经皮肾镜取石术的成年男性患者进行了登记。他们通过计算机数字随机分配法被随机分为两组。麻醉诱导前,D 组(苯海拉明组)(48 人)静脉注射 5 毫升生理盐水,其中含有 0.5 毫克/千克苯海拉明。C组(对照组)(n = 48)以同样的方式注射 5 毫升生理盐水。两组的麻醉诱导和维持相同。在恢复室对 CRBD 的发生率和严重程度以及术后疼痛进行评估。结果D 组的 CRBD 发生率明显低于 C 组(14% 对 63%,P=0.001)。与 C 组相比,D 组 CRBD 的严重程度较轻(P<0.05)。D 组的术后疼痛评分明显较低(P<0.05)。结论术中使用苯海拉明可有效预防男性患者经皮肾镜碎石术后的 CRBD,并可减轻术后疼痛。
{"title":"Intraoperative Administration of Diphenhydramine Attenuates Postoperative Catheter Related Bladder Discomfort in Patient Following Percutaneous Nephrolithotomy","authors":"M. Khajavi, Mohammad Maroofia, Hamed Akhavizadegan","doi":"10.18502/aacc.v10i3.15693","DOIUrl":"https://doi.org/10.18502/aacc.v10i3.15693","url":null,"abstract":"Background: We intend to evaluate the effect of intraoperative diphenhydramine administration on incidence and severity of catheter related bladder discomfort (CRBD) and pain after percutaneous nephrolithotomy. \u0000Methods: In a double blind randomized clinical trial, adult male patients undergoing percutaneous nephrolithotomy were enrolled. They were randomized into two groups by a computerized digital random allocation method. Before anesthesia induction, group D (Diphenhydramine group) (n = 48) received 5 ml normal saline containing 0.5 mg/kg of diphenhydramine intravenously. In group C (Control group) (n = 48), 5 ml of normal saline was injected in the same manner. Induction and maintenance of anesthesia were identical in both groups. The incidence and severity of CRBD and postoperative pain were assessed at recovery room. \u0000Results: The incidence of CRBD was significantly lower in group D than in group C (14% vs. 63%, P=0.001). The severity of CRBD was milder in group D in comparison to group C (P<0.05). Postoperative pain score was significantly lower in group D (P<0.05). \u0000Conclusion: Intraoperative administration of diphenhydramine is an effective practice for the prevention of CRBD after percutaneous nephrolithotomy in male patients and can reduce postoperative pain as well.","PeriodicalId":502847,"journal":{"name":"Archives of Anesthesia and Critical Care","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337159","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}
引用次数: 0
Anesthesiologist’s Perspective on a Child with Acute Lymphoblastic Leukemia undergoing Neurosurgery: Case Report 麻醉师眼中的急性淋巴细胞白血病患儿神经外科手术:病例报告
Pub Date : 2024-06-15 DOI: 10.18502/aacc.v10i3.15701
Shalvi Mahajan, Kirandeep Kaur, Priya Thappa, Aparna Deperu, Vinitha Narayanan
Acute lymphoblastic leukemia (ALL) is the most common hematological malignancy in the pediatric age group. Anesthesia in such patients necessitates special considerations, in terms of disease progression and its respective treatment as well. We present a case of a 2-year-old child, a known case of ALL posted for drainage of multifocal brain abscess under general anesthesia. Anesthetic management of children with ALL presenting for neurosurgical procedures should focus on disease and its various systemic manifestations, treatment-related side effects, and anesthetic interactions which sometimes may be disastrous
急性淋巴细胞白血病(ALL)是儿科最常见的血液恶性肿瘤。对这类患者进行麻醉需要特别考虑疾病的进展和相应的治疗。我们介绍了一例 2 岁儿童的病例,他是已知的 ALL 病例,在全身麻醉下进行多灶性脑脓肿引流术。对接受神经外科手术的 ALL 患儿的麻醉管理应重点关注疾病及其各种全身表现、与治疗相关的副作用以及有时可能造成灾难性后果的麻醉相互作用。
{"title":"Anesthesiologist’s Perspective on a Child with Acute Lymphoblastic Leukemia undergoing Neurosurgery: Case Report","authors":"Shalvi Mahajan, Kirandeep Kaur, Priya Thappa, Aparna Deperu, Vinitha Narayanan","doi":"10.18502/aacc.v10i3.15701","DOIUrl":"https://doi.org/10.18502/aacc.v10i3.15701","url":null,"abstract":"Acute lymphoblastic leukemia (ALL) is the most common hematological malignancy in the pediatric age group. Anesthesia in such patients necessitates special considerations, in terms of disease progression and its respective treatment as well. We present a case of a 2-year-old child, a known case of ALL posted for drainage of multifocal brain abscess under general anesthesia. Anesthetic management of children with ALL presenting for neurosurgical procedures should focus on disease and its various systemic manifestations, treatment-related side effects, and anesthetic interactions which sometimes may be disastrous","PeriodicalId":502847,"journal":{"name":"Archives of Anesthesia and Critical Care","volume":"79 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337994","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}
引用次数: 0
Short-Time Anesthesia Management for Duchenne Muscular Dystrophy 杜氏肌肉萎缩症的短时麻醉管理
Pub Date : 2024-06-15 DOI: 10.18502/aacc.v10i3.15704
Masoud Tarbiat, M. Bakhshaei, H. Khorshidi, Sayed Ahmadreza Salimbahrami
The Article Abstract is not available.
文章摘要不详。
{"title":"Short-Time Anesthesia Management for Duchenne Muscular Dystrophy","authors":"Masoud Tarbiat, M. Bakhshaei, H. Khorshidi, Sayed Ahmadreza Salimbahrami","doi":"10.18502/aacc.v10i3.15704","DOIUrl":"https://doi.org/10.18502/aacc.v10i3.15704","url":null,"abstract":"The Article Abstract is not available.","PeriodicalId":502847,"journal":{"name":"Archives of Anesthesia and Critical Care","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336245","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}
引用次数: 0
Investigating the Role of Dexmedetomidine and Propofol on Fertility Rate in IVF Candidate Patients 研究右美托咪定和丙泊酚对试管婴儿候选患者生育率的影响
Pub Date : 2024-06-15 DOI: 10.18502/aacc.v10i3.15690
F. Behnaz, Atiyeh Tizghadam, Gholamreza Mohseni, Leila Nazari
Background: One of the most important treatments used in women with infertility is IVF, and improving its results can affect the success of assisted reproductive techniques. It was previously shown that anesthetics can enter the follicular fluid (FF), so there is concern about the accumulation of anesthetics in the FF and their negative effects on fertilization and fetal growth under general anesthesia. The use of drugs that have both analgesic and sedative effects but do not have hemodynamic side effects is of particular importance and dexmedetomidine is one of the drugs introduced in this field. On the other hand, the use of sedatives such as midazolam and propofol may cause hemodynamic disturbances and severe hypotension in these patients, which limits the use of such drugs. Accordingly, and considering the importance of the issue, in this study, we decided to evaluate and compare the effect of propofol and dexmedetomidine on fertility in IVF candidates. Methods: In this clinical trial study, 78 infertile patients who underwent IVF were randomly examined. After dividing the patients into two groups receiving dexmedetomidine and propofol or standard recording doses, the fertility rate of the patients in the two groups was evaluated using chi-square and Fisher tests at a significance level of 0.05. Results: The use of dexmedetomidine for (P = 0.0348) Pressure_After_Dia, HR_Before (P = 0.0204), Injection_Time (P =0.000) and Recovery Time (P =0.000) indices caused a significant increase compared to the propofol group. Conclusion: The results of the present study did not show a significant difference in the use of these two drugs on fertility.
背景:试管婴儿是女性不孕症患者最重要的治疗方法之一,改善试管婴儿的效果会影响辅助生殖技术的成功率。以前的研究表明,麻醉剂可进入卵泡液(FF),因此人们担心麻醉剂在卵泡液中的蓄积及其对全身麻醉下的受精和胎儿生长的负面影响。使用既有镇痛和镇静作用又不会对血液动力学产生副作用的药物尤为重要,右美托咪定就是在这一领域引入的药物之一。另一方面,使用咪达唑仑和丙泊酚等镇静剂可能会导致这些患者出现血流动力学紊乱和严重低血压,从而限制了此类药物的使用。因此,考虑到这一问题的重要性,在本研究中,我们决定评估并比较丙泊酚和右美托咪定对试管婴儿候选人生育能力的影响。研究方法在这项临床试验研究中,我们随机抽取了 78 名接受体外受精的不孕患者。将患者分为接受右美托咪定和丙泊酚或标准记录剂量的两组后,在显著性水平为 0.05 的条件下,使用卡方检验和费雪检验对两组患者的受孕率进行评估。结果显示与异丙酚组相比,使用右美托咪定可显著增加压力(P = 0.0348)、心率(P = 0.0204)、注射时间(P = 0.000)和恢复时间(P = 0.000)指数。结论本研究结果显示,使用这两种药物对生育力的影响没有明显差异。
{"title":"Investigating the Role of Dexmedetomidine and Propofol on Fertility Rate in IVF Candidate Patients","authors":"F. Behnaz, Atiyeh Tizghadam, Gholamreza Mohseni, Leila Nazari","doi":"10.18502/aacc.v10i3.15690","DOIUrl":"https://doi.org/10.18502/aacc.v10i3.15690","url":null,"abstract":"Background: One of the most important treatments used in women with infertility is IVF, and improving its results can affect the success of assisted reproductive techniques. It was previously shown that anesthetics can enter the follicular fluid (FF), so there is concern about the accumulation of anesthetics in the FF and their negative effects on fertilization and fetal growth under general anesthesia. The use of drugs that have both analgesic and sedative effects but do not have hemodynamic side effects is of particular importance and dexmedetomidine is one of the drugs introduced in this field. On the other hand, the use of sedatives such as midazolam and propofol may cause hemodynamic disturbances and severe hypotension in these patients, which limits the use of such drugs. Accordingly, and considering the importance of the issue, in this study, we decided to evaluate and compare the effect of propofol and dexmedetomidine on fertility in IVF candidates. \u0000Methods: In this clinical trial study, 78 infertile patients who underwent IVF were randomly examined. After dividing the patients into two groups receiving dexmedetomidine and propofol or standard recording doses, the fertility rate of the patients in the two groups was evaluated using chi-square and Fisher tests at a significance level of 0.05. \u0000Results: The use of dexmedetomidine for (P = 0.0348) Pressure_After_Dia, HR_Before (P = 0.0204), Injection_Time (P =0.000) and Recovery Time (P =0.000) indices caused a significant increase compared to the propofol group. \u0000Conclusion: The results of the present study did not show a significant difference in the use of these two drugs on fertility.","PeriodicalId":502847,"journal":{"name":"Archives of Anesthesia and Critical Care","volume":"8 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337652","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}
引用次数: 0
One Way for Air, While Great Vessels in Despair! 空气只有一条路,大船却陷入绝望!
Pub Date : 2024-06-15 DOI: 10.18502/aacc.v10i3.15703
Deepika Karjigi, Prabhu Harvi, Kajal Shrestha, Deekshith D R, .. Shiwali, Murali Naik
The Article Abstract is not available.
文章摘要不详。
{"title":"One Way for Air, While Great Vessels in Despair!","authors":"Deepika Karjigi, Prabhu Harvi, Kajal Shrestha, Deekshith D R, .. Shiwali, Murali Naik","doi":"10.18502/aacc.v10i3.15703","DOIUrl":"https://doi.org/10.18502/aacc.v10i3.15703","url":null,"abstract":"The Article Abstract is not available.","PeriodicalId":502847,"journal":{"name":"Archives of Anesthesia and Critical Care","volume":"4 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337139","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}
引用次数: 0
Assessment of the Impact of Prolonged Cesarean Section on Neonatal PH 评估延长剖腹产时间对新生儿 PH 的影响
Pub Date : 2024-06-15 DOI: 10.18502/aacc.v10i3.15696
F. Rahimi‐Sharbaf, F. Golshahi, Hosseinali Ataei, Mahbobeh Shirazi, Behrokh Sahebdel, Maryam Yousefi, Majid Kaheh, Parestesh Makhzani, Akhtar Momen, Elham Feizabad, Maryam Gerayeli
Background: Prolonged predelivery time in cesarean-section (C-section) may be associated with worse neonatal outcomes such as lower umbilical cord acid-base profile. This study investigated the association between surgical and anesthetic predelivery time intervals and neonatal acidosis in pregnant women delivering via C-section under spinal anesthesia. Methods: This cross-sectional study was conducted on 70 pregnant women candidates for elective cesarean C-section, referred to Yas Hospital. Results: Umbilical artery pH<7.3 was observed in 27 (38.6%) out of 70 included participants. The study variables including maternal age, hypertension, and gestational diabetes were not associated with umbilical pH level. 1-minute Apgar scores were linearly associated with pH (β: 0.170, 0.100 to 0.239, p-value<0.001). Among all evaluated surgical and anesthetic intervals, induction of spinal anesthesia to delivery (β: -0.008, -0.012 to -0.004, p-value<0.001), and skin incision to uterine incision interval (β: -0.006, -0.009 to -0.002, p-value=0.002) interval time had a significant linear association with PH. Conclusion: The duration of induction of spinal anesthesia to delivery and skin incision to the uterine incision in non-emergent C-sections is linked to lower neonatal umbilical pH which shows the importance of optimizing the timing of elective C-section surgeries and reducing the risk of neonatal acidosis for obstetricians and anesthesiologists.
背景:剖腹产(C-section)产前时间过长可能与新生儿预后较差(如脐带酸碱度较低)有关。本研究调查了脊髓麻醉下剖腹产孕妇的手术和麻醉预产时间间隔与新生儿酸中毒之间的关系。研究方法这项横断面研究的对象是转诊至亚斯医院的 70 名择期剖腹产孕妇。结果在 70 名参与者中,有 27 人(38.6%)的脐动脉 pH 值低于 7.3。产妇年龄、高血压和妊娠糖尿病等研究变量与脐动脉 pH 值无关。1 分钟 Apgar 评分与 pH 值呈线性相关(β:0.170,0.100 至 0.239,p 值<0.001)。在所有评估的手术和麻醉间隔中,椎管内麻醉诱导至分娩(β:-0.008,-0.012 至-0.004,P值<0.001)和皮肤切口至子宫切口间隔(β:-0.006,-0.009 至-0.002,P值=0.002)与PH值呈显著线性相关。结论在非急诊剖腹产手术中,从脊髓麻醉诱导到分娩以及从皮肤切口到子宫切口的持续时间与新生儿脐部酸碱度较低有关,这表明产科医生和麻醉师优化择期剖腹产手术时间、降低新生儿酸中毒风险的重要性。
{"title":"Assessment of the Impact of Prolonged Cesarean Section on Neonatal PH","authors":"F. Rahimi‐Sharbaf, F. Golshahi, Hosseinali Ataei, Mahbobeh Shirazi, Behrokh Sahebdel, Maryam Yousefi, Majid Kaheh, Parestesh Makhzani, Akhtar Momen, Elham Feizabad, Maryam Gerayeli","doi":"10.18502/aacc.v10i3.15696","DOIUrl":"https://doi.org/10.18502/aacc.v10i3.15696","url":null,"abstract":"Background: Prolonged predelivery time in cesarean-section (C-section) may be associated with worse neonatal outcomes such as lower umbilical cord acid-base profile. This study investigated the association between surgical and anesthetic predelivery time intervals and neonatal acidosis in pregnant women delivering via C-section under spinal anesthesia. \u0000Methods: This cross-sectional study was conducted on 70 pregnant women candidates for elective cesarean C-section, referred to Yas Hospital. \u0000Results: Umbilical artery pH<7.3 was observed in 27 (38.6%) out of 70 included participants. The study variables including maternal age, hypertension, and gestational diabetes were not associated with umbilical pH level. 1-minute Apgar scores were linearly associated with pH (β: 0.170, 0.100 to 0.239, p-value<0.001). Among all evaluated surgical and anesthetic intervals, induction of spinal anesthesia to delivery (β: -0.008, -0.012 to -0.004, p-value<0.001), and skin incision to uterine incision interval (β: -0.006, -0.009 to -0.002, p-value=0.002) interval time had a significant linear association with PH. \u0000Conclusion: The duration of induction of spinal anesthesia to delivery and skin incision to the uterine incision in non-emergent C-sections is linked to lower neonatal umbilical pH which shows the importance of optimizing the timing of elective C-section surgeries and reducing the risk of neonatal acidosis for obstetricians and anesthesiologists.","PeriodicalId":502847,"journal":{"name":"Archives of Anesthesia and Critical Care","volume":"5 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337081","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}
引用次数: 0
Comparison of Analgesia Produced by preoperative Ultrasound-guided Femoral Nerve Blocks and Postoperative Intravenous Administration of Opioids in Patients Undergoing Hip Replacement Surgery 髋关节置换手术患者术前超声引导股神经阻滞与术后静脉注射阿片类药物的镇痛效果比较
Pub Date : 2024-06-15 DOI: 10.18502/aacc.v10i3.15692
Moloud Zolfaqari, Mehrdad Mokaram Dori, Seyed Hossein Khademi, M. Gilani, M. Ziaee, Tayyebe Ghanei
Background: Perioperative pain management can improve surgery results and patient outcomes. Moreover, multimodal methods for pain control have been advised so this study was conducted to assess the beneficial impact of preoperative ultrasound-guided femoral nerve blocks in hip replacement surgery. Methods: This study is a double-blinded clinical trial including 60 individuals who were candidates for joint replacement surgery. The intervention group (n = 30) received a femoral nerve block prior to general anesthesia. Results: After surgery, patients received morphine, Apotel, and morphine + Apotel, all of which were administered at lower doses in the intervention group (femoral nerve block) than in the control group. Pain intensity in first hour (P= 0.01), 4 hours (P= 0.003), 8 hours (P= 0.01), 12 hours (P= 0.001), and 24 hours (P= 0.01) after surgery and average pain 4 hours (P= 0.01), 8 hours (P = 0.01), 12 hours (P = 0.02), and 24 hours (P= 0.01) after surgery was significantly less in the intervention group (femoral nerve block) than in the control group. Conclusion: The findings of our investigation demonstrated the efficacy of ultrasound-guided femoral nerve blocks in the improvement of pain control following hip replacement surgery.
背景:围手术期疼痛控制可改善手术效果和患者预后。此外,多模式疼痛控制方法已被推荐,因此本研究旨在评估术前超声引导股神经阻滞对髋关节置换手术的有益影响。研究方法本研究是一项双盲临床试验,包括 60 名关节置换手术候选者。干预组(n = 30)在全身麻醉前接受股神经阻滞。结果手术后,患者接受吗啡、阿博特尔和吗啡+阿博特尔治疗,干预组(股神经阻滞)的给药剂量均低于对照组。干预组(股神经阻滞)术后第一小时(P= 0.01)、4 小时(P= 0.003)、8 小时(P= 0.01)、12 小时(P= 0.001)和 24 小时(P= 0.01)的疼痛强度以及术后 4 小时(P= 0.01)、8 小时(P= 0.01)、12 小时(P= 0.02)和 24 小时(P= 0.01)的平均疼痛明显低于对照组。结论我们的研究结果表明,超声引导下的股神经阻滞对改善髋关节置换手术后的疼痛控制有一定疗效。
{"title":"Comparison of Analgesia Produced by preoperative Ultrasound-guided Femoral Nerve Blocks and Postoperative Intravenous Administration of Opioids in Patients Undergoing Hip Replacement Surgery","authors":"Moloud Zolfaqari, Mehrdad Mokaram Dori, Seyed Hossein Khademi, M. Gilani, M. Ziaee, Tayyebe Ghanei","doi":"10.18502/aacc.v10i3.15692","DOIUrl":"https://doi.org/10.18502/aacc.v10i3.15692","url":null,"abstract":"Background: Perioperative pain management can improve surgery results and patient outcomes. Moreover, multimodal methods for pain control have been advised so this study was conducted to assess the beneficial impact of preoperative ultrasound-guided femoral nerve blocks in hip replacement surgery. \u0000Methods: This study is a double-blinded clinical trial including 60 individuals who were candidates for joint replacement surgery. The intervention group (n = 30) received a femoral nerve block prior to general anesthesia. \u0000Results: After surgery, patients received morphine, Apotel, and morphine + Apotel, all of which were administered at lower doses in the intervention group (femoral nerve block) than in the control group. Pain intensity in first hour (P= 0.01), 4 hours (P= 0.003), 8 hours (P= 0.01), 12 hours (P= 0.001), and 24 hours (P= 0.01) after surgery and average pain 4 hours (P= 0.01), 8 hours (P = 0.01), 12 hours (P = 0.02), and 24 hours (P= 0.01) after surgery was significantly less in the intervention group (femoral nerve block) than in the control group. \u0000Conclusion: The findings of our investigation demonstrated the efficacy of ultrasound-guided femoral nerve blocks in the improvement of pain control following hip replacement surgery.","PeriodicalId":502847,"journal":{"name":"Archives of Anesthesia and Critical Care","volume":"5 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337248","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}
引用次数: 0
Epidural Blood Patch in Subdural Hematoma Due to Spontaneous Intracranial Hypotention: A Case Report and Literature Review 自发性颅内低压所致硬膜下血肿的硬膜外血补片:病例报告和文献综述
Pub Date : 2024-06-15 DOI: 10.18502/aacc.v10i3.15702
Mahmoud Ganjifard, Ebrahim Espahbodi, Abbas Tafakhori
Spontaneous intracranial hypotension (SIH) is an orthostatic headache syndrome with variable symptoms and complications which is often misdiagnosed at initial manifestations. SIH results from spontaneous CSF leakage leading to brain sag. The typical findings on cranial MR imaging consist of subdural fluid collections, enhancement of the pachymeninges, engorgement of venous structures, pituitary hyperemia, and sagging of the brain. Subdural hematoma may occur as a result of tearing of bridging veins and usually develop into chronic subdural hematoma. The majority of patients with SDH due to SIH have chronic DSH and, therefore, rarely present with neurological deficits. Evacuation of SDH may be performed for large SDH with ME (mass effects), or when dilated or asymmetric pupil is present. However in most cases, evacuation of the hematoma is not necessary and may result in worsened outcomes. The epidural blood patch (EBP) is a treatment of choice. Fortunately, most of these subdural hematomas can be handled with treatment directed at the underlying spinal CSF leak without the need for surgery. We report the case of 42-year-old man with the chief complaint of orthostatic headache. He was admitted to neurology ward and after imaging studies, it was found that he has bilateral subdural hematoma. Due to the lack of history of trauma, underlying disease, and coagulation disorder, and considering the imaging findings, the patient was referred to the pain department to perform an epidural blood patch. After performing the epidural blood patch, the patient's pain was relieved immediately, and during a three-month follow-up period, the epidural hematoma was completely absorbed. Spontaneous intracranial hypotension (SIH) is a highly misdiagnosed and underdiagnosed disorder and requires a high index of suspicion for diagnosis. During the last decades, a much larger number of spontaneous cases are identified. Literature is a bit confusing, with some authors recommending evacuation of subdural fluid in cases of deteriorating consciousness and few others recommending EBP first even in patients with comatose state but epidural patch is often an important part of treatment.
自发性颅内压过低(SIH)是一种症状和并发症多变的正压性头痛综合征,在初期表现时常被误诊。自发性颅内低血压是由于自发性脑脊液渗漏导致脑下垂引起的。头颅磁共振成像的典型发现包括硬膜下积液、蝶窦增强、静脉结构充血、垂体充血和脑下垂。硬膜下血肿可能是桥接静脉撕裂所致,通常会发展为慢性硬膜下血肿。大多数因 SIH 而导致 SDH 的患者都有慢性 DSH,因此很少出现神经功能缺损。对于伴有 ME(肿块效应)的大面积 SDH,或出现瞳孔散大或不对称时,可进行 SDH 抽吸。但在大多数情况下,没有必要对血肿进行抽吸,否则可能导致病情恶化。硬膜外血补片(EBP)是一种首选治疗方法。幸运的是,大多数硬膜下血肿都可以通过针对脊髓CSF漏的治疗来解决,而无需手术。我们报告了一例 42 岁男子的病例,主诉为正压性头痛。他被送入神经内科病房,经过影像学检查,发现他患有双侧硬膜下血肿。由于没有外伤史、基础疾病和凝血功能障碍,考虑到影像学检查结果,患者被转到疼痛科进行硬膜外血补。进行硬膜外血补后,患者的疼痛立即得到缓解,在三个月的随访期间,硬膜外血肿完全吸收。自发性颅内低血压(SIH)是一种极易误诊和漏诊的疾病,诊断时需要高度怀疑。近几十年来,发现的自发性病例越来越多。文献报道有点混乱,一些作者建议在意识恶化的情况下抽出硬膜下积液,还有一些作者建议即使患者处于昏迷状态也应首先进行硬膜外贴敷,但硬膜外贴敷通常是治疗的重要组成部分。
{"title":"Epidural Blood Patch in Subdural Hematoma Due to Spontaneous Intracranial Hypotention: A Case Report and Literature Review","authors":"Mahmoud Ganjifard, Ebrahim Espahbodi, Abbas Tafakhori","doi":"10.18502/aacc.v10i3.15702","DOIUrl":"https://doi.org/10.18502/aacc.v10i3.15702","url":null,"abstract":"Spontaneous intracranial hypotension (SIH) is an orthostatic headache syndrome with variable symptoms and complications which is often misdiagnosed at initial manifestations. SIH results from spontaneous CSF leakage leading to brain sag. The typical findings on cranial MR imaging consist of subdural fluid collections, enhancement of the pachymeninges, engorgement of venous structures, pituitary hyperemia, and sagging of the brain. Subdural hematoma may occur as a result of tearing of bridging veins and usually develop into chronic subdural hematoma. The majority of patients with SDH due to SIH have chronic DSH and, therefore, rarely present with neurological deficits. Evacuation of SDH may be performed for large SDH with ME (mass effects), or when dilated or asymmetric pupil is present. However in most cases, evacuation of the hematoma is not necessary and may result in worsened outcomes. The epidural blood patch (EBP) is a treatment of choice. Fortunately, most of these subdural hematomas can be handled with treatment directed at the underlying spinal CSF leak without the need for surgery. \u0000We report the case of 42-year-old man with the chief complaint of orthostatic headache. He was admitted to neurology ward and after imaging studies, it was found that he has bilateral subdural hematoma. Due to the lack of history of trauma, underlying disease, and coagulation disorder, and considering the imaging findings, the patient was referred to the pain department to perform an epidural blood patch. After performing the epidural blood patch, the patient's pain was relieved immediately, and during a three-month follow-up period, the epidural hematoma was completely absorbed. \u0000Spontaneous intracranial hypotension (SIH) is a highly misdiagnosed and underdiagnosed disorder and requires a high index of suspicion for diagnosis. During the last decades, a much larger number of spontaneous cases are identified. Literature is a bit confusing, with some authors recommending evacuation of subdural fluid in cases of deteriorating consciousness and few others recommending EBP first even in patients with comatose state but epidural patch is often an important part of treatment.","PeriodicalId":502847,"journal":{"name":"Archives of Anesthesia and Critical Care","volume":"89 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337457","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}
引用次数: 0
Comparative Study of the Preemptive Dexmedetomidine Versus Ondansetron Effect in Post-Operative Nausea and Vomiting after Middle Ear Surgery 右美托咪定与昂丹司琼对中耳手术后恶心呕吐的先期疗效比较研究
Pub Date : 2024-06-15 DOI: 10.18502/aacc.v10i3.15689
M. Safavi, A. Honarmand, Behzad Nazemroaya, Negar Maleky
Background: Nausea and vomiting after operation has high prevalence and cause adverse effect. The aim of this study was to compare the effect of dexmedetomidine with ondansetron in prevention of post-operative nausea and vomiting (PONV) after middle ear surgery under general anesthesia.and saliva gas in traumatic patients under mechanical ventilation. Methods: This in this double-blinded clinical trial study, one hundred and sixty-two patients undergoing middle ear surgery under general anesthesia were randomly divided into three groups of 55 each: ondansetron (O), dexmedetomidine (D) and control (C). Group O received 0.1 mg/kg of ondansetron, Group D received 1 μg/kg/min of dexmedetomidine and Group C received 10 cc of normal saline 15 to 20 minutes before surgical incision. After that, the patients were examined in post-anesthesia care unit (PACU) and up to 24 hours after the operation in terms of PONV and other study variables. Results: The severity of nausea after operation based on VAS (visual analog scale) was significantly different between Group O (2.2±0.7) and Group D (3.9± 0.7) and Group C (5.15±1.3) (P= 0.04). The incidence of vomiting in the first 24h postoperatively was 14.8% in Group O, 46.3% in Group D and 88.8% in Group C (P= 0.003). Conclusion: Our study showed that ondansetron was better than dexmedetomidine for prevention of PONV after middle ear surgery.
背景:手术后恶心和呕吐的发生率很高,并会造成不良影响。本研究旨在比较右美托咪定与昂丹司琼对全身麻醉下中耳手术后恶心呕吐(PONV)的预防效果。方法:在这项双盲临床试验研究中,162 名在全身麻醉下接受中耳手术的患者被随机分为三组,每组 55 人:昂丹司琼组(O)、右美托咪定组(D)和对照组(C)。O 组接受 0.1 mg/kg 的昂丹司琼,D 组接受 1 μg/kg/min 的右美托咪定,C 组在手术切口前 15 至 20 分钟接受 10 cc 的生理盐水。之后,在麻醉后监护室(PACU)和手术后 24 小时内对患者的 PONV 和其他研究变量进行检查。结果根据视觉模拟量表(VAS),O 组(2.2±0.7)、D 组(3.9±0.7)和 C 组(5.15±1.3)的术后恶心严重程度有显著差异(P= 0.04)。术后 24 小时内的呕吐发生率,O 组为 14.8%,D 组为 46.3%,C 组为 88.8%(P= 0.003)。结论我们的研究表明,在预防中耳手术后 PONV 方面,昂丹司琼的效果优于右美托咪定。
{"title":"Comparative Study of the Preemptive Dexmedetomidine Versus Ondansetron Effect in Post-Operative Nausea and Vomiting after Middle Ear Surgery","authors":"M. Safavi, A. Honarmand, Behzad Nazemroaya, Negar Maleky","doi":"10.18502/aacc.v10i3.15689","DOIUrl":"https://doi.org/10.18502/aacc.v10i3.15689","url":null,"abstract":"Background: Nausea and vomiting after operation has high prevalence and cause adverse effect. The aim of this study was to compare the effect of dexmedetomidine with ondansetron in prevention of post-operative nausea and vomiting (PONV) after middle ear surgery under general anesthesia.and saliva gas in traumatic patients under mechanical ventilation. \u0000Methods: This in this double-blinded clinical trial study, one hundred and sixty-two patients undergoing middle ear surgery under general anesthesia were randomly divided into three groups of 55 each: ondansetron (O), dexmedetomidine (D) and control (C). Group O received 0.1 mg/kg of ondansetron, Group D received 1 μg/kg/min of dexmedetomidine and Group C received 10 cc of normal saline 15 to 20 minutes before surgical incision. After that, the patients were examined in post-anesthesia care unit (PACU) and up to 24 hours after the operation in terms of PONV and other study variables. \u0000Results: The severity of nausea after operation based on VAS (visual analog scale) was significantly different between Group O (2.2±0.7) and Group D (3.9± 0.7) and Group C (5.15±1.3) (P= 0.04). The incidence of vomiting in the first 24h postoperatively was 14.8% in Group O, 46.3% in Group D and 88.8% in Group C (P= 0.003). \u0000Conclusion: Our study showed that ondansetron was better than dexmedetomidine for prevention of PONV after middle ear surgery.","PeriodicalId":502847,"journal":{"name":"Archives of Anesthesia and Critical Care","volume":"3 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337327","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}
引用次数: 0
期刊
Archives of Anesthesia and Critical Care
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1