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1.
Med Gas Res ; 13(1): 10-14, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35946217

RESUMO

The intubating laryngeal mask airway (ILMA) can be used for ventilation and oxygenation between intubation attempts, but there is a varied success rate ranging from 33% to 96%. Air Q is a relatively new entrant. Parker flex tube aids in atraumatic intubation. The primary aim of this study was to compare Air Q intubating laryngeal airway with ILMA as intubation conduits in patients with simulated fixed cervical spine using a Parker flex tube. It was a single-blinded, randomized, prospective, and comparative study conducted on 91 patients aged between 18 to 60 years of either sex, scheduled to undergo elective surgery under general anesthesia belonging to the American Society of Anesthesiologists physical status I and II. Out of 45 patients in each group, Air Q was successfully placed in 43 patients and ILMA was successfully placed in 44 patients. 35.56% of the patients required maneuvers for placing the Air Q, whereas, for placing the ILMA, only 15.56% of the patients required maneuvers. Intubation through the AIR Q was successful in 39 patients and through the ILMA in 44 patients, but there was no significant difference between the two groups. The number of attempts and the time of device insertion were comparable. There were a similar number of attempts, maneuvers required, and time is taken for endotracheal intubation. The incidence of cough and sore throat was comparable in both groups. We conclude that ILMA has a higher success rate than Air Q for tracheal intubation with Parker Flex tube in patients with simulated fixed cervical spine. More optimized maneuvers were required for the placement of Air Q.


Assuntos
Máscaras Laríngeas , Adolescente , Adulto , Anestesia Geral , Vértebras Cervicais , Humanos , Intubação Intratraqueal , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
2.
Medicine (Baltimore) ; 101(35): e30336, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36107590

RESUMO

BACKGROUND: Although midazolam is widely administered as an anxiolytic premedication, it may cause over-sedation and hypoxia in geriatric patients. Cranial electrotherapy stimulation (CES) is a nonpharmacological device with anxiolytic effect. This study compared the effects of CES and midazolam as a preoperative treatment in geriatric patients. METHODS: Eighty patients, under the age of 65 to 79 years, undergoing general anesthesia were randomly assigned into midazolam premedication group (M group, n = 40) or CES pretreatment group (CES group, n = 40). The patients in the M group were intramuscularly injected with midazolam (0.07 mg/kg) 30 minutes before receiving general anesthesia. The patients in the CES group received 20 minutes of CES pretreatment on the day before and on the morning of the surgery. RESULTS: In the preoperative holding area, the anxiety score (P = .02) and the sedation score (P < .001) were significantly lower in the CES group compared with those in the M group. The oxygen saturations at the preoperative holding area and the operating room were significantly higher in the CES group than those in the M group (P < .001). CONCLUSION: CES pretreatment relieved preoperative anxiety with less risk of over-sedation and respiratory depression than midazolam premedication in geriatric patients.


Assuntos
Ansiolíticos , Terapia por Estimulação Elétrica , Idoso , Anestesia Geral , Ansiolíticos/uso terapêutico , Humanos , Midazolam , Oxigênio
3.
BMC Anesthesiol ; 22(1): 286, 2022 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-36088298

RESUMO

OBJECTIVE: This study aimed to investigate the effects of morning and afternoon surgeries on the early postoperative sleep function in patients undergoing general anesthesia. METHODS: Fifty nine patients, aged 18-60 years, American society of anaesthesiologists (ASA) grade I or II, Body mass index of 18.5-28 kg/m2, undergoing laparoscopic myomectomy under total intravenous anesthesia, were included in the study. These patients were divided into two groups according to the start time of anesthesia: morning surgery group (group A, 8:00-12:00) and afternoon surgery group (group P, 14:00-18:00). The sleep conditions of the two groups of patients were evaluated by the Athens Insomnia Scale (AIS) one day before and one day after the operation. A total score of > 6 was regarded as postoperative sleep disturbance. The incidences of sleep disturbance one day after the operation in two groups were compared. The bispectral Index assessed the patient's total sleep duration, sleep efficiency, and overall quality of sleep from 21:00 to 6:00 on the first night after surgery. Plasma concentrations of melatonin and cortisol at 6:00 am 1 day before surgery, 1 day after surgery were measured by ELISA, and rapid random blood glucose was measured. RESULTS: The total AIS score, overall quality of sleep, total sleep duration, and final awakening earlier than desired scores of the two groups of patients on the first night after surgery were significantly increased compared with preoperative scores (P < 0.01). In group P, the sleep induction and the physical and mental functioning during the day scores increased significantly after surgery compared with preoperative scores (P < 0.05). The postoperative AIS scores in group P increased significantly compared with those in group A (P < 0.01). The incidence of postoperative sleep disturbances (70.0%) in group P was significantly higher than that in group A (37.9%) (P < 0.05). Compared with group A, the total sleep duration under BIS monitoring in group P was significantly shorter, the sleep efficiency and the overall quality of sleep was significantly reduced (P < 0.01). Compared with those in group A, the level of melatonin on 1 d after surgery in group P was significantly decreased, and the level of cortisol in group P was significantly increased. There were no significant differences between the two groups in the levels of postoperative blood glucose and pain. CONCLUSION: Both morning and afternoon surgeries have significant impacts on the sleep function in patients undergoing general anesthesia, while afternoon surgery has a more serious impact on sleep function. TRIAL REGISTRATION: ClinicalTrials, NCT04103528. Registered 24 September 2019-Retrospectively registered, http://www. CLINICALTRIALS: gov/ NCT04103528.


Assuntos
Melatonina , Transtornos do Sono-Vigília , Anestesia Geral , Glicemia , Humanos , Hidrocortisona , Período Pós-Operatório , Qualidade do Sono , Transtornos do Sono-Vigília/epidemiologia
4.
Anesth Analg ; 135(4): 787-797, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36108191

RESUMO

BACKGROUND: Some studies have found surgery and anesthesia in children to be associated with neurodevelopmental deficits, but specific reasons for this association have not been fully explored. This study evaluates intraoperative mean arterial pressure (MAP) during a single ambulatory procedure in children and subsequent mental disorder diagnoses. METHODS: A retrospective observational study was performed including children ≥28 days and <18 years of age with intraoperative electronic anesthetic records between January 1, 2009, and April 30, 2017, at our institution. Eligible children were categorized based on their mean intraoperative MAP relative to other children of the same sex and similar age: category 1 (very low): children with mean intraoperative MAP values below the 10th percentile, category 2 (low): mean MAP value ≥10th and <25th percentiles, category 3 (reference): mean MAP value ≥25th and <75th percentiles, category 4 (high): mean MAP value ≥75th and <90th percentile, and category 5 (very high): mean MAP value ≥90th percentile. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9) and ICD, Tenth Revision, Clinical Modification (ICD-10)-coded mental disorders were identified in hospital and outpatient claims, with a median duration of follow-up after surgery of 120 days (interquartile range [IQR], 8-774.5 days). Cox proportional hazards models evaluated the hazard ratio (HR) of time to first mental disorder diagnosis associated with intraoperative blood pressure category between the end of surgery and censoring, with the primary analysis adjusting for demographic, anesthetic, comorbidity, and procedure-type variables as potential confounders. RESULTS: A total of 14,724 eligible children who received general anesthesia for a single ambulatory surgical procedure were identified. After adjusting for all available potential confounders, when compared to the reference, there were no statistically significant differences in mental disorder diagnosis risk based on intraoperative mean MAP category. Compared to reference, children in the very low and low blood pressure categories reported HRs of 1.00 (95% confidence interval [CI], 0.74-1.35) and 1.10 (95% CI, 0.87-1.41) for a mental disorder diagnosis, respectively, and children in the high and very high categories reported HRs of 0.87 (95% CI, 0.68-1.12) and 0.76 (95% CI, 0.57-1.03), respectively. CONCLUSIONS: Presence in a predefined mean intraoperative MAP category was not associated with subsequent mental disorder diagnoses within our follow-up period. However, the limitations of this study, including uncertainty regarding what constitutes an adequate blood pressure in children, may limit the ability to form definitive conclusions.


Assuntos
Procedimentos Cirúrgicos Ambulatórios , Anestésicos , Procedimentos Cirúrgicos Ambulatórios/efeitos adversos , Anestesia Geral , Pressão Arterial , Pressão Sanguínea , Criança , Humanos
5.
BMC Anesthesiol ; 22(1): 292, 2022 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-36109691

RESUMO

PURPOSE: To observe the effect of different antiemetic drugs for the prevention of postoperative nausea and vomiting (PONV) after gynaecological day surgery under remimazolam general anesthesia. METHODS: One hundred ninety-two patients were selected for gynaecological day surgery and randomly divided into three groups: droperidol group (DD group), tropisetron group (DT group) and control group (DC group). Flurbiprofen axetil 50 mg and dexamethasone 5 mg were given intravenously before induction of anesthesia, and 2 min later droperidol 1 mg was given intravenously to the DD group, tropisetron 5 mg to the DT group and saline (5 ml) to the DC group. Induction of anesthesia: remimazolam 6 mg/kg/h was continuously infused until sleep, mivacurium 0.2 mg/kg and alfentanil 20ug/kg were slowly pushed, 3 min later intubation was performed to control breathing. Maintenance of anesthesia: 40ug/kg/h of alfentanil, 1 mg/kg/h of remimazolam continuous infusion. After awakening and extubation, the patient was transferred to the PACU. PONV were recorded in the PACU and an electronic questionnaire was pushed 24 h after surgery. RESULTS: The incidence of PONV within the PACU was significantly lower in the DD (14.5%)and DT(26.7%) groups than in the DC(50%) group (p < 0.01), there was no significantly difference between the DT and DD groups. There were no significant difference in the incidence of PONV in 24 h after surgery between the three groups(DD:DT:DC = 44.5%:45.1%:63.8%,p > 0.05). CONCLUSIONS: Droperidol or tropisetron combined with dexamethasone is superior to dexamethasone alone for the prevention of PONV in the PACU after remimazolam combined with alfentanil anesthesia, with no significant difference in the incidence of PONV in 24 h after surgery.


Assuntos
Antieméticos , Náusea e Vômito Pós-Operatórios , Alfentanil , Procedimentos Cirúrgicos Ambulatórios , Anestesia Geral/efeitos adversos , Antieméticos/uso terapêutico , Benzodiazepinas , Dexametasona/uso terapêutico , Droperidol/uso terapêutico , Feminino , Humanos , Mivacúrio , Náusea e Vômito Pós-Operatórios/tratamento farmacológico , Náusea e Vômito Pós-Operatórios/epidemiologia , Náusea e Vômito Pós-Operatórios/prevenção & controle , Tropizetrona
6.
Eur Rev Med Pharmacol Sci ; 26(17): 6208-6214, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36111921

RESUMO

OBJECTIVE: The term THRIVE refers to the delivery of 100% heated and humidified oxygen via a nasal cannula to maintain viable gas exchange during prolonged apnea. There are no reports of its application for Operative Hysteroscopy (OH) under general anesthesia (GA). The aim of the study is to investigate the success rate of THRIVE as unique airway management technique in this setting. The results will support the development of a randomized controlled trial (RCT) to demonstrate the non-inferiority of THRIVE compared to traditional techniques. PATIENTS AND METHODS: Twenty consecutive ASA I-II women presenting for OH were enrolled. Standard anesthesia, as well as transcutaneous carbon dioxide (tcCO2) monitoring, was performed. After preoxygenation with 30 L∙min-1, GA was induced with propofol and fentanyl, then oxygen flow was increased to 70 L∙min-1 and anesthesia maintained with propofol infusion. The primary outcome was success rate of THRIVE defined as SpO2 > 94%, tcCO2 < 60 mmHg and no need for rescue airway intervention. RESULTS: Mean age was 47 ± 12 years. Mean duration of the procedure was 25 ± 9 minutes, and the success rate of the technique was 100%. Median SpO2 during the procedure was 100 (IQR 99-100) %. Mean maximum tcCO2 level was 51 ± 7 mmHg while mean tcCO2 level during the procedure was 45 ± 7 mmHg. At the end of the procedure, mean tcCO2 was 44 ± 5 mmHg. CONCLUSIONS: THRIVE allowed adequate gas exchange during OH under GA, without additional rescue airway interventions. The application of THRIVE in this setting may allow minimal airway manipulation and optimal comfort for the patient with low failure rate. We calculated the sample size for the planned non-inferiority RCT investigating the effectiveness of THRIVE versus laryngeal mask ventilation in OH: 82 is the minimal number of patients per group to test a non-inferiority limit of 10%.


Assuntos
Insuflação , Propofol , Adulto , Manuseio das Vias Aéreas , Anestesia Geral , Dióxido de Carbono , Estudos de Coortes , Estudos de Viabilidade , Feminino , Fentanila , Humanos , Histeroscopia , Pessoa de Meia-Idade , Gravidez
8.
Br Dent J ; 233(5): 407-412, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36085476

RESUMO

Aims The aims were to determine the profile of patients referred for treatment with dental general anaesthetic (DGA) and identify patient-related factors that contributed to a child requiring a DGA.Design setting In total, 42 patients were recruited from new patient assessment clinics at the Edinburgh Dental Institute, Scotland. Prospective questionnaires were given to the patients' caregivers with questions regarding their child's dental anxiety level, ethnicity, level of English spoken and languages spoken at home. Height and weight (BMI) measurements were taken and other information (age, sex, medical history status and postcode for level of social deprivation) were collected from their medical records.Results Compared to the local population, children referred for treatment with DGA had a significantly decreased level of English (p = 0.0001) with an increase in non-English languages at home (p = 0.0004). Patients from minority ethnic groups (p = 0.008) and children from socially deprived areas (p = 0.0001) were significantly overrepresented. Self-reported dental anxiety was high and more common in primary than secondary school-aged children (p = 0.039).Conclusions This study highlighted several patient-related variables that may increase the likelihood of DGA treatment. Further work is required to confirm these associations and develop interventions to reduce the number of children requiring DGAs.


Assuntos
Anestésicos Gerais , Anestesia Geral/efeitos adversos , Criança , Etnicidade , Humanos , Grupos Minoritários , Estudos Prospectivos
11.
J Clin Anesth ; 82: 110949, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36049381

RESUMO

STUDY OBJECTIVE: Postoperative neurocognitive disorders (PND) are common complications after surgery under general anesthesia. In our aging society the incidence of PND will increase. Hence, interdisciplinary efforts should be taken to minimize the occurrence of PND. Electroencephalographic (EEG) monitoring of brain activity during anesthesia or emergence from anesthesia is a promising tool to identify patients at risk. We therefore investigated whether we could identify specific EEG signatures during emergence of anesthesia that are associated with the occurrence of PND. DESIGN AND PATIENTS: We performed a prospective observational investigation on 116 patients to evaluate the EEG features during emergence from general anesthesia dominated by slow delta waves in patients with and without delirium in the postoperative care unit (PACU-D) as assessed by the CAM-ICU and the RASS. MAIN RESULTS: During emergence both the frontal and global EEG of patients with PACU-D were significantly different from patients without PACU-D. PACU-D patients had lower relative alpha power and reduced fronto-parietal alpha coherence. CONCLUSIONS: With our analysis we show differences in EEG features associated with anesthesia emergence in patients with and without PACU-D. Frontal and global EEG alpha-band features could help to identify patients with PACU-D. CLINICAL TRIAL NUMBER: NCT03287401.


Assuntos
Período de Recuperação da Anestesia , Delírio do Despertar , Envelhecimento , Anestesia Geral/efeitos adversos , Eletroencefalografia , Delírio do Despertar/diagnóstico , Delírio do Despertar/etiologia , Humanos , Cuidados Pós-Operatórios
12.
Biomed Res Int ; 2022: 9160145, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36046452

RESUMO

Objective: This work is aimed at evaluating the efficacy and safety of general anesthesia (GA) combined with spinal anesthesia (SA) (GA+SA) in elderly patients with chronic obstructive pulmonary disease (COPD). Methods and Material. 50 elderly COPD patients were rolled randomly into a control group (simple GA) and observation group (GA+SA). The differences in operation time, postoperative recovery time (PRT), language expression time (LET), anesthetic dosage (AD), catheter extubation time (CET), respiratory circulation indicators (mean arterial pressure (MAP), heart rate (HR), SaO2, and PaO2), postoperative VRS score, pulmonary function (forced vital capacity (FVC)), forced expiratory volume in 1 s (FEV1)/FVC and forced expiratory flow (FEF 25%~75%), serum inflammatory factors (IL-6, IL-8, and TNF-α), Short Portable Mental Status Questionnaire (SPMSQ) score, and the incidence of respiratory system events were analyzed. Results: The results showed that the PRT, LET, AD, and CET of the observation group were all shorter (P < 0.05). The postoperative MAP, HR, SaO2, and PaO2 levels of patients who received GA+SA were much higher than those who received simple GA (P < 0.05). The postoperative VRS score of the observation group was better than that of the controls (P < 0.05). The postoperative pulmonary function of patients in the observation group was better compared with that in the control group (P < 0.05). The postoperative serum inflammatory factors in the observation group were lower in contrast to the patients who received simple GA (P < 0.05). The postoperative cognitive function SPMSQ score of patients who received GA+SA was lower compared with the score of patients who received simple GA (P < 0.05). However, the probability of respiratory system events in the observation group was lower (P < 0.05). Conclusion: In conclusion, GA+SA could significantly shorten the PRT and improve the recovery quality of elderly COPD patients. It can also reduce the postoperative inflammatory response and strengthen the pulmonary function and cognitive function. It also enhances the analgesic which is beneficial to patients' postoperative recovery. Therefore, GA+SA was a highly effective and safe anesthesia method for elderly patients with COPD, and it was worthy of clinical application.


Assuntos
Anestesia Geral , Doença Pulmonar Obstrutiva Crônica , Idoso , Anestesia Geral/efeitos adversos , Anestesia Geral/métodos , Raquianestesia , Volume Expiratório Forçado , Humanos , Período Pós-Operatório , Doença Pulmonar Obstrutiva Crônica/cirurgia
13.
Zhonghua Yi Xue Za Zhi ; 102(33): 2614-2618, 2022 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-36058687

RESUMO

Objective: To investigate the effect of rotigotine on the quality of emergence from general anesthesia in patients undergoing deep brain stimulation (DBS). Methods: A total of 42 patients (31 males and 11 females, aged 55-85 years) undergoing DBS surgery under general anesthesia in the First Affiliated Hospital of Zhengzhou University from March 2020 to October 2021 were selected. The patients were divided into non-rotigotine group (n=21) and rotigotine group (n=21) by using a random number table according to whether rotigotine patch was used. Postoperative recovery time, extubation time, length of postanesthesia care unit (PACU) stay, and grades of muscle tension, swallowing function and salivary secretion during recovery were compared between the two groups. Meanwhile, the incidence of adverse events during extubation was also compared. Results: The postoperative recovery time, extubation time and length of PACU stay in rotigotine group were (20.3±2.6) min, (30.6±3.1) min and (46.4±3.9) min, respectively, which were shorter than those of non-rotigotine group [(29.0±5.8) min, (42.6±10.0) min and (63.0±18.9) min, respectively] (all P<0.05). The grades of postoperative muscle tension, swallowing function and salivary secretion in rotigotine group [M(Q1, Q3)] were 1(1, 2), 1(1, 2) and 1(1, 1), respectively, which were lower than those of non-rotigotine group [2(2, 3), 2(2, 2) and 2(1, 2), respectively] (P=0.001, 0.002 and 0.011). The incidence of adverse events during anesthesia extubation in rotigotine group was 14.3% (3/21), which was lower than that of non-rotigotine group [42.9% (9/21), P=0.040]. Conclusion: Rotigotin patch is helpful to improve the quality of emergence from general anesthesia in patients undergoing DBS and reduce the occurrence of adverse events during extubation.


Assuntos
Período de Recuperação da Anestesia , Estimulação Encefálica Profunda , Extubação , Anestesia Geral/efeitos adversos , Feminino , Humanos , Masculino
14.
Eur Rev Med Pharmacol Sci ; 26(16): 5890-5901, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36066164

RESUMO

OBJECTIVE: Propofol (2,6-diisopropylphenol) is a broadly used anaesthetic in total intravenous anaesthesia (TIVA) that might alter course of disease in patients who underwent oncology surgery. High inter-individual variability of the propofol dose needed for the same level of consciousness during surgical tumour removal is influenced by many factors. PATIENTS AND METHODS: This is a retrospective observational cohort study of prospectively collected patients data over 20 month's period. The main endpoint of the study was to compare propofol consumption needed for cancer and no cancer surgical interventions. The secondary endpoints were to find out whether there is a difference in recovery time between the two groups of patients and to reveal potential correlations between propofol consumption and age, duration of anaesthesia, body weight and Charlson co-morbidity index (CCI) in cancer and no cancer surgery. RESULTS: There were 103 patients with cancer (mean age 59.3 yr ± 10.7) and 109 patients operated due to other reasons (mean age 47.6 yr ± 17.52). Female sex predominated in both groups (70.9% in cancer and 67.9% in no cancer patients). They differed regarding CCI, 4.48 (±2.1) in cancer in contrast to 1.49 (±1.83) in no cancer patients, and anaesthesia time, 92.67 minutes ± 46.15 vs. 75.24 ± 37.28, respectively (p = 0.0012). Propofol induction dose did not differ significantly between the two groups (p = 0.193), while total propofol consumption was 85.86 mcg/kgBW/min (± 25.98) in cancer and 95.77 (± 31.48) in no cancer patients (p = 0.01). Propofol consumption negatively correlated with duration of anaesthesia and body weight in cancer group. However, in no cancer patients there was very strong negative association with age, duration of anaesthesia and CCI, and significant but weaker negative association with body weight. The time to awakening did not differ significantly between the groups (p = 0.219). CONCLUSIONS: Propofol dose differed in cancer comparing to no cancer patients under general anaesthesia. There was no need for dose adjustment regarding the age and sex in patients with cancer in contrast to no cancer surgery.


Assuntos
Neoplasias , Propofol , Anestesia Geral , Anestesia Intravenosa/efeitos adversos , Anestésicos Intravenosos , Peso Corporal , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias/induzido quimicamente , Neoplasias/cirurgia
15.
Br J Hosp Med (Lond) ; 83(8): 1-3, 2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-36066302

RESUMO

This article discusses the place of routine use of depth of anaesthesia monitoring in patients receiving volatile anaesthesia. Benefits include reducing the probability of accidental awareness or excessive depth of anaesthesia, and creating training opportunities to improve familiarity with its use, but these must be weighed against the costs, as it may not be advantageous from a cost-benefit perspective.


Assuntos
Anestesia , Anestesiologia , Anestesia Geral/efeitos adversos , Análise Custo-Benefício , Monitoramento de Medicamentos , Humanos
16.
Acta Med Okayama ; 76(4): 429-437, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36123158

RESUMO

Blood pressure (BP) often rises before surgery. This study investigated whether BP elevation immediately before surgery was associated with adverse outcomes. Medical records of 11,732 patients (average age: 61 years; male: 47.4%) who underwent non-cardiac elective inpatient surgery under general anesthesia at Kagawa University Hospital between January 2011 and June 2019 were reviewed. Differences between the first BP values measured on the day before surgery and the first BP values in the operating room were defined as Δ systolic BP (ΔSBP) and Δ diastolic BP (ΔDBP). The relationships between ΔSBP/ΔDBP and 30-day mortality, 30-day readmission, and over-the-standard length of hospital stay (OSLOS) were assessed. OSLOS was defined as a hospital stay longer than mean+2 standard deviations and was calculated using the Japanese Diagnosis Procedure Combination data. In univariate analysis, the differences in ΔSBP and ΔDBP between the OSLOS and standard LOS groups were both 2 mmHg. In multivariate logistic regression analysis, only ΔDBP was associated with OSLOS. The adjusted odds ratio (95% confidence interval) for the largest quartile was 1.31 (1.02-1.69) (p<0.05). ΔDBP was associated with OSLOS; however, there may be little need to worry about large ΔSBPs and ΔDBPs in clinical practice.


Assuntos
Anestesia Geral , Anestesia Geral/efeitos adversos , Pressão Sanguínea , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Retrospectivos
17.
Comput Math Methods Med ; 2022: 4259499, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36124166

RESUMO

Purpose: This research mainly discussed the impacts of epidural anesthesia (EA) and general anesthesia (GA) on perioperative cognitive function (CF) and deep vein thrombosis (DVT) in patients undergoing total knee arthroplasty (TKA). Methods: One hundred and twenty-four patients undergoing TKA in our hospital between July 2015 and October 2021 were selected, of which 74 patients received EA (research group) and the other 50 patients received GA (control group). Perioperative CF, DVT, stress response indicators (norepinephrine, NE; cortisol, Cor), and heart rate (HR) levels were observed and compared. Risk factors affecting DVT of TKA patients were analyzed by logistic regression. Results: The research group had statistically better CF than the control group, with notably lower NE, Cor, and HR levels and incidence of DVT. Logistic regression analysis showed that the type of anesthesia and MoCA were risk factors for DVT in TKA patients. Conclusion: EA is more feasible for patients undergoing TKA, which is conducive to improving their CF, relieving stress responses, and reducing the incidence of DVT, with a certain sedative effect.


Assuntos
Anestesia Epidural , Artroplastia do Joelho , Trombose Venosa , Anestesia Epidural/efeitos adversos , Anestesia Geral/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Cognição , Humanos , Hidrocortisona , Hipnóticos e Sedativos , Norepinefrina , Trombose Venosa/epidemiologia , Trombose Venosa/etiologia , Trombose Venosa/prevenção & controle
18.
J Drugs Dermatol ; 21(9): 997-1000, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36074505

RESUMO

Dermatologists have been pioneers in the development and refinement of liposuction using local anesthesia. Although other specialties routinely use general anesthesia for liposuction, the safety profile of liposuction using local anesthesia is impressive. This article traces the history and development of liposuction by dermatologists in the United States. J Drugs Dermatol. 2022;21(9):997-1000. doi:10.36849/JDD.6952.


Assuntos
Lipectomia , Anestesia Geral , Anestesia Local , Dermatologistas , Humanos , Lipectomia/efeitos adversos , Estados Unidos
19.
Prim Dent J ; 11(3): 98-103, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36073049

RESUMO

Dental practitioners are well versed in informing patients of the risks and benefits associated with dental extractions. The purpose of this service evaluation was to determine whether patients understood and recalled information relevant to their planned oral surgery procedure, prior to second stage consent.A questionnaire was distributed to patients who were attending for their elective treatment appointment. This explored their ability to recall the planned intervention, the modality of treatment (local anaesthetic, intravenous sedation, or general anaesthetic), understanding of alternative treatment options and the risks associated with the procedure. Completed responses were received from 29 of the distributed questionnaires (response rate=58%). The majority of patients were not aware of the following risks with their procedure: pain, bleeding, bruising, swelling, infection, damage to adjacent structures.Despite a well-documented consent form and comprehensive discussion, we identified that patients may not comprehend or recollect the risks associated with their dental extraction. As dental professionals we have a duty to seek ways to facilitate patient understanding and maximise their autonomy.


Assuntos
Odontólogos , Papel Profissional , Anestesia Geral/efeitos adversos , Humanos , Consentimento Livre e Esclarecido , Extração Dentária
20.
PLoS One ; 17(9): e0273410, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36084154

RESUMO

BACKGROUND: The incidence of atelectasis is high in patients undergoing general anesthesia. This may cause oxygenation impairment and further contribute to postoperative pulmonary complications (PPCs). As important airway management devices for general anesthesia, few studies have compared the effects of laryngeal mask airway (LMA) and endotracheal tube (ETT) on atelectasis. Additionally, lung ultrasound has been increasingly used for bedside atelectasis diagnosis. For the above considerations, this trial is designed to compare the effects of LMA and ETT on atelectasis assessed by lung ultrasound scores, further providing more powerful clinical evidence for perioperative respiratory management of non-laparoscopic elective lower abdominal surgery under general anesthesia. METHODS: This is a prospective, single-center, single-blind, randomized controlled trial. From July 2021 to July 2022, 180 patients undergoing elective non-laparoscopic lower abdominal surgery under general anesthesia will be recruited and randomly divided into the ETT and LMA groups at a ratio of 1:1. The primary outcome is the total atelectasis LUS of 12 lung regions 15 min after the establishment of the artificial airway. The total atelectasis LUS at the end of surgery and 30 min after extubation, oxygenation index, postoperative airway complications, PPCs, and length of stay will be analyzed as secondary indicators. TRIAL REGISTRATION: ClinicalTrials.gov identifier: ChiCTR1900020818. Registered on January 20, 2019. Registered with the name of "Laryngeal mask airway versus endotracheal tube for atelectasis." URL: https://www.chictr.org.cn/showproj.aspx?proj=35143.


Assuntos
Máscaras Laríngeas , Atelectasia Pulmonar , Anestesia Geral/efeitos adversos , Humanos , Intubação Intratraqueal/efeitos adversos , Máscaras Laríngeas/efeitos adversos , Pulmão , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Atelectasia Pulmonar/diagnóstico por imagem , Atelectasia Pulmonar/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego
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