Effects of Anticholinergics on Postoperative Vomiting, Recovery, and Hospital Stay in Children Undergoing Tonsillectomy with or without Adenoidectomy 

1999 ◽  
Vol 90 (3) ◽  
pp. 697-700 ◽  
Author(s):  
Ashwani K. Chhibber ◽  
Stewart J. Lustik ◽  
Rajbala Thakur ◽  
David R. Francisco ◽  
Kenneth B. Fickling
Keyword(s):  
Nitrous Oxide ◽  
Hospital Stay ◽  
Neuromuscular Blockade ◽  
Oxygen Mixture ◽  
Postanesthesia Care Unit ◽  
Postoperative Vomiting ◽  
Inhalation Induction ◽  
Number Of Patients ◽  
Significant Difference ◽  
Nitrous Oxide Oxygen

Background Nausea and vomiting are the most frequent problems after minor ambulatory surgical procedures. The agents used to induce and maintain anesthesia may modify the incidence of emesis. When neuromuscular blockade is antagonized with anticholinesterases, atropine or glycopyrrolate is used commonly to prevent bradycardia and excessive oral secretions. This study was designed to evaluate the effect of atropine and glycopyrrolate on postoperative vomiting in children. Methods Ninety-three patients undergoing tonsillectomy with or without adenoidectomy were studied. After inhalation induction of anesthesia with nitrous oxide, oxygen, and halothane, anesthesia was maintained with a nitrous oxide-oxygen mixture, halothane, morphine, and atracurium. Patients were randomized to receive, in a double-blinded manner, either 15 microg/kg atropine or 10 microg/kg glycopyrrolate with 60 microg/kg neostigmine to reverse neuromuscular blockade. Patient recovery, the incidence of postoperative emesis, antiemetic therapy, and the duration of postoperative hospital stay were assessed. Results There were no significant differences in age, gender, weight, or discharge time from the postanesthesia care unit or the hospital between the groups. Twenty-four hours after operation, the incidence of vomiting in the atropine group (56%) was significantly less than in the glycopyrrolate group (81%; P<0.05). There was no significant difference between the atropine and glycopyrrolate groups in the number of patients who required antiemetics or additional analgesics. Conclusions In children undergoing tonsillectomy with or without adenoidectomy, reversal of neuromuscular blockade with atropine and neostigmine is associated with a lesser incidence of postoperative emesis compared with glycopyrrolate and neostigmine.

scholarly journals Is Obesity a Risk Factor for Spinal Surgeries? A Retrospective Study in a Specialized Orthopedic Spine Center

2021 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Hasan Ghandhari ◽  
◽  
Ebrahim Ameri ◽  
Mohsen Motalebi ◽  
Mohamad-Mahdi Azizi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Obese Group ◽  
Obese Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Various studies have shown the effects of morbid obesity on the adverse consequences of various surgeries, especially postoperative infections. However, some studies have shown that the complications of spinal surgery in obese and non-obese patients are not significantly different. Objectives: This study investigated and compared the duration of surgery, length of hospital stay, and complications after common spinal surgeries by orthopedic spine fellowship in obese and non-obese patients in a specialized spine center in Iran. Methods: All patients who underwent decompression with or without lumbar fusion were included in this retrospective study. These patients were classified into two groups: non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). The data related to type and levels of surgery, 30-day hospital complications, length of hospital stay, rate of postoperative wound infection, blood loss, and need for transfusion were all extracted and compared between the two groups. Results: A total of 148 patients (74%) were in the non-obese group and 52 patients (26%) in the obese group. The number of patients that need packed cells was significantly higher in the obese group (51.8% vs 32.6%) (P=0.01). Otherwise, there were not a significant difference between type of treatment (fusion or only decompression) (P=0.78), interbody fusion (P=0.26), osteotomy (P=0.56), duration of surgery (P=0.25), length of hospital stay (P=0.72), mean amount of blood loss (P=0.09), and postoperative complications (P=0.68) between the two groups. Conclusion: Our results suggest that duration of surgery, length of hospital stay, and postoperative complications are not associated with the BMI of the patients.

scholarly journals Increases in Cuff Volume and Pressure in Red Rubber Endotracheal Tubes during Anaesthesia

1979 ◽  
Vol 7 (2) ◽  
pp. 152-157 ◽  
Author(s):  
W. R. Thompson ◽  
T. E. Oh
Keyword(s):  
Nitrous Oxide ◽  
Cuff Pressure ◽  
Intermittent Positive Pressure Ventilation ◽  
Spontaneous Respiration ◽  
Oxygen Mixture ◽  
Positive Pressure ◽  
Cuff Volume ◽  
Endotracheal Tubes ◽  
Nitrous Oxide Oxygen ◽  
Pressure Changes

Increases in endotracheal tube cuff volume and pressure during anaesthesia have been reported to be due to the diffusion of nitrous oxide into the cuff. This study compared cuff volume and pressure changes in anaesthetized intubated patients who were ventilated with those allowed to breath spontaneously. The cuffs of Magill red rubber endotracheal tubes were inflated with either air or a nitrous oxide-oxygen mixture. Serial pressure and volume recordings confirmed that both parameters increased when the cuff was inflated with air. The increase in cuff pressure was however, greater during intermittent positive pressure ventilation than for spontaneous respiration. There were no significant changes when the cuff was inflated with the nitrous oxide-oxygen mixture.

scholarly journals Nondrainage after Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis Does Not Increase the Postoperative Morbidity

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jianguo Qiu ◽  
Ming Li
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Postoperative Recovery ◽  
End Points ◽  
Acute Calculous Cholecystitis ◽  
Vas Score ◽  
Estimated Blood Loss ◽  
Number Of Patients ◽  
Significant Difference ◽  
Calculous Cholecystitis

Background. It is now established that prophylactic drainage is not needed after laparoscopic cholecystectomy (LC) for chronic calculous cholecystitis. However, the benefit of drains versus their potential harm for acute calculous cholecystitis (ACC) following laparoscopic LC has been questioned. Therefore, we conducted a comparative study to assess the need for drainage.Methods. Between January 2014 and October 2016, 212 patients with ACC undergoing LC undergo either drainage (n= 106) or no drainage (n= 106). The primary end points were the number of patients with postoperative drain-related complications, early and late Visual Analogue Scale (VAS) score, and hospital stay. Secondary end points included estimated blood loss, postoperative recovery, analgesia requirement, and cosmetic satisfaction result.Results. There was no bile duct injury and mortality in both groups. The overall complication rate was 12.5% with no significant difference between those with or without drainage (P=0.16). Normal activity resumption was significantly faster and the postoperative hospital stay was slightly shorter in the nondrainage group (P=0.03 andP= 0.04, respectively). The early VAS score in the drainage group was significantly higher (p<0.05). There were no significant differences between the two groups in postoperative hematology test, late VAS score, and patient satisfaction of cosmetic outcome.Conclusion. Routine drainage for patients with ACC after LC may not be justified with similar drain-related complications compared with nondrainage group.

Apneic Oxygenation Following Respiration with Air or Nitrous Oxide-Oxygen Mixture

1964 ◽  
Vol 25 (1) ◽  
pp. 102-102
Author(s):  
M. L. HELLER ◽  
T. R. Watson ◽  
D. S. IMREDY
Keyword(s):  
Nitrous Oxide ◽  
Oxygen Mixture ◽  
Apneic Oxygenation ◽  
Nitrous Oxide Oxygen

scholarly journals Quantitative Relationships between Pulmonary Function and Residual Neuromuscular Blockade

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
ShuYing Fu ◽  
WenDong Lin ◽  
XiNing Zhao ◽  
ShengJin Ge ◽  
ZhangGang Xue
Keyword(s):  
Pulmonary Function ◽  
Neuromuscular Blockade ◽  
Demographic Data ◽  
Preoperative Evaluation ◽  
Tracheal Extubation ◽  
Postanesthesia Care Unit ◽  
Predictive Values ◽  
Residual Neuromuscular Blockade ◽  
Significant Difference ◽  
Train Of Four

Background. Neuromuscular blockade is a risk factor for postoperative respiratory weakness during the immediate postoperative period. The quantitative relationships between postoperative pulmonary-function impairment and residual neuromuscular blockade are unknown. Methods. 113 patients who underwent elective laparoscopic cholecystectomy were enrolled in this study. They all had a pulmonary-function test (PFT) during the preoperative evaluation. Predictive values based on demographic data were also recorded. The train-of-four ratio (TOFR) was recorded at the same time as the PFT and at every 5 minutes in the qualified 98 patients in the postanesthesia care unit (PACU). We analyzed the degree of PFT recovery when the TOFR had recovered to different degrees. Results. There was a significant difference (P<0.05) between the preoperative baseline value and the postoperative forced vital capacity at each TOFR point, except at a TOFR value of 1.1. There was also a significant difference (P<0.05) between the preoperative baseline value and the postoperative peak expiratory flow at each TOFR point. Conclusions. Postoperative residual neuromuscular blockade was common (75.51%) after tracheal extubation, and pulmonary function could not recover to an acceptable level (85% of baseline value), even if TOFR had recovered to 0.90. Trial Registration. Chinese Clinical Trial Register is ChiCTR-OOC-15005838.

Effectiveness of fixed 50% nitrous oxide oxygen mixture and EMLA cream for insertion of central venous catheters in children

2004 ◽  
Vol 43 (7) ◽  
pp. 777-779 ◽  
Author(s):  
Abderrahman Abdelkefi ◽  
Yosr Ben Abdennebi ◽  
Fethi Mellouli ◽  
Tarek Ben Othman ◽  
Lamia Torjman ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Central Venous Catheters ◽  
Oxygen Mixture ◽  
Central Venous ◽  
Emla Cream ◽  
Nitrous Oxide Oxygen

scholarly journals Evaluation of idiopathic scoliosis by anterior and posterior arthrodesis

2015 ◽  
Vol 14 (2) ◽  
pp. 88-92 ◽  
Author(s):  
Jean Carlo Frigotto Queruz ◽  
Allan Kato ◽  
Carlos Abreu de Aguiar ◽  
Luiz Muller Avila ◽  
Luis Eduardo Munhoz da Rocha
Keyword(s):  
Idiopathic Scoliosis ◽  
Hospital Stay ◽  
Posterior Approach ◽  
Thoracolumbar Spine ◽  
Average Hospital ◽  
Icu Stay ◽  
Group I ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group Ii

<sec><title>OBJECTIVE:</title><p> To evaluate comparatively surgical treatment of adolescent idiopathic scoliosis type 5CN by anterior and posterior approach.</p></sec><sec><title>METHODS:</title><p> The study consists of a comparative retrospective study of two groups of patients with the thoracolumbar spine arthrodesis technique by anterior and posterior approach. Twenty and two patients were sequentially selected, 11 operated by anterior approach - called Group I - and 11 by posterior approach - Group II. Anamnesis and physical examination were performed, as well as length of hospital stay and ICU stay, degree of correction, comorbidities and pre and postoperative radiographic images data were gathered.</p></sec><sec><title>RESULTS:</title><p> The mean age was 13.7 years in Group I and 14 years in Group II. The average hospital stay was 5.81 days for Group I and 5 for Group II. The average ICU stay was 2.81 and 2 days, respectively. Considering the operated levels, Group I presented an average of 4.81 vertebrae (4-6 levels), and Group II presented an average of 6.36 vertebrae (5-11 levels). Complications did not show statistically significant difference.</p></sec><sec><title>CONCLUSION:</title><p> Despite the limited number of patients in groups, it was demonstrated that the posterior approach reduces the number of days of hospitalization and ICU stay. However, it was found increased levels included in the arthrodesis.</p></sec>

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