Asian journal of anesthesiology最新文献

Background: Adductor canal block (ACB) is a motor sparing block providing analgesia for surgeries involving anterior part of the knee. The aim of our study was to evaluate the analgesic efficacy of ACB to reduce pain in arthroscopic knee surgeries done under spinal anesthesia. Our primary objective was to evaluate the 24 hours postoperative morphine consumption. The secondary objectives were to evaluate the visual analog scale (VAS) scores at rest and during knee flexion, hemodynamics and side effects of the block.

Methods: In this prospective randomised controlled trial, 70 patients who underwent arthroscopic knee surgeries were randomly divided into two groups, A and C. Surgeries were done under spinal anesthesia. Group A patients received ACB with 20 mL of 0.5 % ropivacaine using ultrasound postoperatively. Block was not performed in group C. The amount of morphine consumption in PCA pump, duration of analgesia, mean VAS scores at rest and flexion, hemodynamics and adverse effects were monitored.

Results: The average morphine consumption was significantly lesser with a P-value ＜ 0.001 in group A (8.628 ± 2.001 mg) when compared to group C (21.914 ± 5.118 mg). The duration of analgesia was longer in group A (365.71 ± 53.648 min vs. 150.429 ± 22.537 min) with highly significant P-value of ＜ 0.001. Group A patients had significantly decreased VAS scores at rest and knee flexion and better haemodynamic stability.

Conclusions: We conclude that ultrasound-guided ACB resulted in significantly lesser morphine consumption after arthroscopic knee surgeries. ACB prolonged the duration of analgesia with better hemodynamics, lesser VAS pain scores and with no complications.

Introduction: Decisions on appropriate time of extubation after pediatric neurosurgery are often challenging for anesthesiologists. The primary goal was to investigate the incidence of delayed extubation after pediatric neurosurgery. The secondary goal was to identify the factors affecting delayed extubation in these patients.

Methods: This retrospective study was done in pediatric patients who underwent neurosurgery at a university hospital in a 5-year period from April 2015 to March 2020. Delayed extubation was that the patients who were not extubated at the end of procedure before leaving the operating room. Demographic data, preoperative and intraoperative factors associated with delayed extubation were collected and analyzed.

Results: A total of 539 pediatric patients were included in our study. There were 56 children in delayed extubation group with the incidence of 10.4%. In the multivariate analysis, the factors associated with delayed extubation were including neonates (adjusted odds ratio [aOR], 3.743; 95% confidence interval [CI], 1.076-13.028), American Society of Anesthesiologists physical status III-IV (aOR, 3.010; 95% CI, 1.057-8.573), preoperative oxygen supplement (aOR, 6.033; 95% CI, 1.713-21.243), intracranial surgery (aOR, 4.494; 95% CI, 1.458-13.847), estimated blood loss (EBL) ≥ 40% of total blood volume (TBV) (aOR, 5.465; 95% CI, 1.640-18.210), and finishing operation after official hours (aOR, 3.810; 95% CI, 1.633-8.889).

Conclusions: There were the preoperative and intraoperative factors associated with delayed extubation such as preoperative oxygen supplement, intracranial surgery, or EBL ≥ 40% of TBV. These might be useful for anesthesiologists in making decisions about the planning of extubation after neurosurgery in children.

Background: In previous literature, reference values for cerebrospinal fluid (CSF) may be based on patients who were not truly healthy, other species, or outdated information. In the present study, we performed a lumbar puncture in patients requiring spinal anesthesia by a reasonable indication to evaluate CSF parameters in healthy adults.

Methods: All patients between the ages of 20 and 70 years scheduled for elective orthopedic or urologic surgery requiring spinal anesthesia were enrolled in this study. We measured electrolytes and gas tension analysis in CSF and whole blood samples in adult humans.

Results: A total of 28 patients were included with an average age of 44.2 years. The concentration of Na^+ in blood was slightly lower when compared with that in CSF. There were significantly higher levels of K^+ and Ca^(2+) in the blood when we compared with CSF. Significantly lower levels of Cl^- and Mg^(2+) in the blood were observed when compared with CSF. The glucose level of CSF was about half of that in blood.

Conclusions: We provided updated reference values for various solutes in blood and CSF in adults. Analysis of CSF parameters and relevant paired blood samples is highly informative, helping clinicians diagnose a variety of central nervous system diseases.

Background: With the increase in the number of people exposed to anesthetic gases, there is a critical need to examine the prevalence of neurotoxic symptoms in these individuals using reliable tools. The aim of this study was to evaluate the psychometric characteristics of EUROQUEST questionnaire and to measure the rate of neurotoxic symptoms in the anesthesiology personnel.

Methods: This research was a cross-sectional study. This study was a cross-sectional one. Participants included 404 personnel of the operating room in western Iran. EUROQUEST questionnaire was translated into Persian and used to measure the rate of neurotoxic symptoms. Reliability of the questionnaire was examined by Cronbach's alpha, while face and construct validities were evaluated using SPSS 16 (SPSS Inc., Chicago, IL, USA) and AMOS 18 (IBM, Chicago, IL, USA) software.

Results: The results indicated that EUROQUEST questionnaire had acceptable reliability and validity. The most prevalent symptoms were observed in memory and concentration, fatigue, and sleepiness. The prevalence of fatigue was higher than other dimensions, with 28% of participants in the third and fourth quartiles. Also, there was no relationship between symptoms and work experience.

Conclusions: EUROQUEST questionnaire can be applied in studies of the neurotoxic symptoms. The study of the prevalence of symptoms also indicated that most participants complained about memory and concentration, fatigue, and sleepiness, and these symptoms were observed in all individuals regardless of their work experience.