scholarly journals Incidence and Causes of Failed Spinal Anesthesia

2020 ◽  
Vol 3 (2) ◽  
pp. 50-54
Author(s):  
Ahmet Yüksek ◽  
Ökkeş Hakan Miniksar ◽  
Mehtap Honca ◽  
Hakan Öz
Keyword(s):  
Spinal Anesthesia ◽  
Failure Rate ◽  
Sensory Block ◽  
Obstetric Anesthesia ◽  
University Hospital ◽  
High Rate ◽  
Failure Rates ◽  
Cause Of Failure ◽  
Technical Operation ◽  
Definition Of

Introduction: Spinal anesthesia (SA) is one of the most frequently applied anesthesia procedures today. However, SA failure rate varies between 1 and 17%. The age of the patient, the position at which the procedure is performed, or the characteristics of the technical operation can affect success. In this study, we aimed to compare the most frequent SA failures according to the types of surgery and causes of failure. The results of SA procedures performed in a university hospital were compare to those published in the current literature. Materials and Methods: After obtaining ethics committee ­approval for our study, the hospital archives were examined retrospectively for 1 year with respect to SA procedures. SA application and failure rates were examined. Three or more SA attempts, failed dural puncture, or unsuccessful injection, and anesthesia applications that did not provide sufficient sensory block for surgery despite successful drug treatment were defined as failure. Results: Of all anesthesia procedures, SA was applied at a rate of 23.5%. Our SA failure rate was calculated as 16.6%. Considering a single surgical procedure, obstetric anesthesia was the most common surgery with failed SA (28.7%). The most common cause of failure was insufficient analgesia (32.9%). Discussion: SA failure rates were observed to be in a variable distribution range in the literature, and in some studies, SA failure was defined as a block that did not occur despite a full dose and successful injection, and this rate was found to be 3.9%. The high rate in our study group may be explained by differences in the definition of SA: blocks performed with several trials and any block that could not be applied were also recorded as SA failure. The reasons for failing to apply this procedure is an issue that is worth examining also in terms of patient satisfaction and safety, which is an important issue. Conclusion: Although the definition of unsuccessful SA is confusing, SA failure rates are worth examining and improving for each hospital.

scholarly journals Evaluation of Sensory Mapping of Erector Spinae Plane Block

2020 ◽  
Vol 3;23 (6;3) ◽  
pp. E285-E295
Author(s):  
Adriana Cadavid
Keyword(s):  
Patient Satisfaction ◽  
Myofascial Pain ◽  
Sensory Block ◽  
Likert Scale ◽  
Erector Spinae ◽  
University Hospital ◽  
High Rate ◽  
Ultrasound Guided ◽  
Thoracic Pain ◽  
Rescue Analgesia

Background: Erector spinae plane (ESP) block is an effective regional analgesic technique for thoracic and abdominal pain. The volume of local anesthetic (LA) needed to produce sensory block in the spinal segment is unknown. Objectives: The aim of the present study was to examine the extent of dermatomal spread following ultrasound-guided administration of ESP block, with a fixed-volume dose of a LA at the midthoracic area for analgesia in acute thoracic pain patients. Secondary objectives were postprocedure analgesia and patient satisfaction. Study Design: This research used a prospective unicentric exploratory cohort design. Setting: The study was conducted at an academic university hospital. Methods: A total of 18 patients with acute severe chest pain including rib fractures, thoracic postoperative rescue analgesia, zoster herpetic neuritis, and myofascial pain syndrome received ESP block under ultrasound guidance at the T5-T7 levels. Twenty mL of 0.5% plain bupivacaine was injected. Evaluation of the sensory block was carried out 60 minutes following the completion of the ESP block via a change in sensation to pinprick and cold methods. The Visual Analog Scale (VAS) for pain was recorded one hour after the procedure. Patient satisfaction was reported using a 4-point Likert scale. This study was registered with the clinicaltrials.gov database (identifier: NCT03831581). Results: Sixteen patients had a successful ESP block; 2 patients were excluded for a failed block. The mean dermatomal spread was 9 (range, 8-11). VAS scores improved by at least 50% from baseline (P < .05), one hour after the ESP block. The degree of satisfaction reported by all patients on the Likert scale was 4 points. No major complications were observed. Limitations: This study was limited by its sample size. Conclusions: An ultrasound-guided ESP block with a single injection at the midthoracic level with 20 mL of 0.5% plain bupivacaine provides a mean dermatomal spread of 9 dermatomes (range, 8-11) with a high rate of analgesic efficacy and low incidence of adverse effects. Key words: Acute pain, dermatomal spread, erector spine plane nerve block, thoracic pain, thoracic postoperative analgesia

scholarly journals Analytical formulas of PFD and PFH calculation for systems with nonconstant failure rates

2017 ◽  
Vol 231 (4) ◽  
pp. 373-382 ◽  
Author(s):  
Elena Rogova ◽  
Gabriel Lodewijks ◽  
Mary Ann Lundteigen
Keyword(s):  
Failure Rate ◽  
Rate Function ◽  
Distribution Functions ◽  
Cumulative Distribution ◽  
Failure Rates ◽  
Failure Rate Function ◽  
Analytical Formulas ◽  
Exact Calculations ◽  
Definition Of

Most analytical formulas developed for the PFD and PFH calculation assume a constant failure rate. This assumption does not necessarily hold for system components that are affected by wear. This article presents methods of analytical calculations of PFD and PFH for an M-out-of-N redundancy architecture with nonconstant failure rates and demonstrates its application in a simple case study. The method for PFD calculation is based on the ratio between cumulative distribution functions and includes forecasting of PFD values with a possibility of update of failure rate function. The approach for the PFH calculation is based on simplified formulas and the definition of PFH. In both methods, a Weibull distribution is used for characteristics of the system behavior. The PFD and PFH values are obtained for low, moderate and high degradation effects and compared with the results of exact calculations. Presented analytical formulas are a useful contribution to the reliability assessment of M-out-of-N systems.

Acute reduction of cerebrospinal fluid volume prior to spinal anesthesia: implications for sensory block extent

2020 ◽  
Vol 86 (6) ◽  
Author(s):  
Martin F. Bjurström ◽  
Niklas Mattsson ◽  
Andreas Harsten ◽  
Nicholas Dietz ◽  
Mikael Bodelsson
Keyword(s):  
Cerebrospinal Fluid ◽  
Spinal Anesthesia ◽  
Sensory Block ◽  
Fluid Volume ◽  
Cerebrospinal Fluid Volume

Electromigration and Electrochemical Reaction Mixed Failure Mechanism in Gold Interconnection System

1999 ◽  
Author(s):  
Hide Murayama ◽  
Makoto Yamazaki ◽  
Shigeru Nakajima
Keyword(s):  
Failure Mechanism ◽  
Failure Rate ◽  
Electrochemical Reaction ◽  
Dielectric Films ◽  
Failure Rates ◽  
Interlayer Dielectric ◽  
Bipolar Devices ◽  
Gold Metallization

Abstract Power bipolar devices with gold metallization experience high failure rates. The failures are characterized as shorts, detected during LSI testing at burn-in. Many of these shorted locations are the same for the failed devices. From a statistical lot analysis, it is found that the short failure rate is higher for devices with thinner interlayer dielectric films. Based upon these results, a new electromigration and electrochemical reaction mixed failure mechanism is proposed for the failure.

STUDY ON CLINICAL CHARACTERISTICS AND RESULT OF TREATMENT BENIGN VOCAL CORD TUMOR WITH RIGID LARYNGEAL ENDOSCOPIC SURGERY

2012 ◽  
pp. 58-65
Author(s):  
Duy Thai Truong ◽  
Van Dung Phan ◽  
Tu The Nguyen
Keyword(s):  
Vocal Cord ◽  
Endoscopic Surgery ◽  
Clinical Characteristics ◽  
University Hospital ◽  
High Rate ◽  
Treatment Rate ◽  
Reinke’S Edema ◽  
Vocal Nodules ◽  
A Prospective Study

Objective: Study on clinical characteristics and result of treatment benign vocal cord tumor with suspensive laryngeal endoscopic surgery. Materials and Methods: A prospective study was undertaken in 43 patients who had benign vocal cord tumor and performed a suspensive laryngeal endoscopic surgery at ENT Dept. of Hue University Hospital, from 3/2010 to 5/2011. Results: The most common was group was 31 - 45 (44.2%). There was no difference of gender. Moderate hoarness was 67.4%. Classification of benign laryngeal tumor: vocal nodules (13 cases), vocal cyst (18 cases), vocal polyp (10 cases) and Reinke’s edema (2 cases). The successful treatment rate of vocal benign tumor was 88.4%. Conclusions: Suspensive laryngeal endoscopic surgery was the best method to cure benign vocal cord tumor. The surgeon had a clear operative field, easy manoeuver, high rate of cure and less complication.

INTESTINAL PARASITE INFECTION IN HUE UNIVERSITY HOSPITAL IN 2013-2014 BY DIRECT EXAMINATION AND IMMUNOLOGICAL DIAGNOSTICS

2016 ◽  
pp. 105-111
Author(s):  
Nu Phuong Anh Ton ◽  
Thi Minh Chau Ngo
Keyword(s):  
Intestinal Parasite ◽  
Intestinal Parasites ◽  
Clonorchis Sinensis ◽  
Taenia Solium ◽  
University Hospital ◽  
High Rate ◽  
Intestinal Helminth ◽  
Direct Examination ◽  
Life Condition ◽  
Parasite Infections

Introduction: Intestinalparasite infections still are very common in tropical country such as Vietnam. Therefore evaluation of the prevalence of them should be done. Materials and methods: A crosssectional descriptivestudy were carried out to use the wet mount direct examination, Kato and ELISA technique for evaluation the rate of intestinal parasite infections, interviewed them to reveal their life’s hygenic condition, knowledge and risk behaviour of intestinal parasite infections in 640 patients attending to the in Hue University of hospital. Result: The rate of soiltransmitted intestinal helminth were lower than the foodborne infection of cestode and trematode such as: Taenia solium/saginata 3.64%, Clonorchis sinensis 2.73%. The rate of positive antibody of rare intestinal parasite were Fasciola gigantica 40.68%, E. histolytica/dispar 43.75%, Toxocara canis 32.43%, Gnasthostoma spinigerum 37.5%, Taenia solium 51.43%, Strongyloidesstercoralis 16.67%. Most of people has hygenic life condition with hygenic water available. The popular knowledge of intestinal parasite diseases of transmission, pathology, prevention and treatment were concentrate on oiltransmittedintestinal helminth.There were high rate of platyhelminths infectious behaviourssuch as: eating raw water plant 75.6%, eating raw beef 80.6%, eating raw pork 72.2%, eating raw fish 11.8%, bare foot 34.2%. Conclusions: The result of our study showed that the higher rate of foodborne cestode and trematode than soiltransmittedhelminth correspond tothe hygenic life condition, the knowledge of the diseases and risk behavior of intestinal parasites infection. Key words: Helminth, cestode, trematode

Changes in the rate of prophylactic vena cava filter insertion at a university hospital

2015 ◽  
Vol 31 (6) ◽  
pp. 403-408
Author(s):  
Andrew Smith ◽  
Demetri Adrahtas ◽  
Doreen Elitharp ◽  
Antonios Gasparis ◽  
Nicos Labropoulos ◽  
...  
Keyword(s):  
Vena Cava ◽  
Vena Cava Filter ◽  
University Hospital ◽  
High Rate ◽  
Inappropriate Use ◽  
Surgical Critical Care ◽  
Change In Practice ◽  
Filter Insertion ◽  
Level I ◽  
Second Period

Objective We previously demonstrated a high rate of prophylactic vena cava filter (VCF) insertion at our institution. We have since attempted to restrict the use of VCF to indications supported by Level-I evidence. This study was designed to evaluate the success of our interventions. Methods All patients receiving VCF between 2007–2009 and 2012–2014 at a university hospital were reviewed. After assessing the use of VCF in the first period, a meeting was convened among the Departments of Radiology, Vascular Surgery and Trauma. Policy was implemented to avoid the inappropriate use of VCF. Data were prospectively collected in the second period to assess the effect of our intervention. Results There were 156 VCF placed from 2012 to 2014. VCF was absolutely indicated in 84% of cases, relatively indicated in 9% and prophylactic in 7%. These data contrast our previous experience from 2007 to 2009. In the earlier series, a total of 244 filters were placed, in which 54% of patients had an absolute indication, 14% relative, and 32% prophylactic. There was a significant decrease in filters placed for pure prophylaxis: whereas 76 prophylactic filters were placed between 2007 and 2009, only 11 were placed between 2012 and 2014 ( p < 0.0001). No significant differences existed for relatively indicated filters. The department of trauma and surgical critical care (TSCC) observed the most dramatic change in practice. TSCC placed 61 prophylactic VCF between 2007 and 2009 (57% of all filters placed by the department), and 4 prophylactic VCF from 2012 to 2014 (15% of filters placed by TSCC) ( p < 0.0001). Conclusion These findings demonstrate a significant change in the attitudes regarding prophylactic VCF insertion between the two periods of study. Further investigations must be performed to assess changes in clinical outcomes that may result from the altered practice at our university.

Outcomes of Inside-out Meniscal Repair in the Setting of Multiligament Reconstruction in the Knee

2017 ◽  
Vol 45 (9) ◽  
pp. 2098-2104 ◽  
Author(s):  
Jorge Chahla ◽  
Chase S. Dean ◽  
Lauren M. Matheny ◽  
Justin J. Mitchell ◽  
Mark E. Cinque ◽  
...  
Keyword(s):  
Failure Rate ◽  
Meniscal Repair ◽  
Postoperative Outcome ◽  
Control Group ◽  
Failure Rates ◽  
Significant Difference ◽  
Outcome Scores ◽  
Inside Out ◽  
Repair Group

Background: Limited evidence exists for meniscal repair outcomes in a multiligament reconstruction setting. Purpose/Hypothesis: The purpose of this study was to assess outcomes and failure rates of meniscal repair in patients who underwent multiligament reconstruction compared with patients who underwent multiligament reconstruction but lacked meniscal tears. The authors hypothesized that the outcomes of meniscal repair associated with concomitant multiligament reconstruction would significantly improve from preoperatively to postoperatively at a minimum of 2 years after the index surgery. Secondarily, they hypothesized that this cohort would demonstrate similar outcomes and failure rates compared with the cohort that did not have meniscal lesions at the time of multiligament reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: Inclusion criteria for the study included radiographically confirmed skeletally mature patients of at least 16 years of age who underwent multiligamentous reconstruction of the knee without previous ipsilateral osteotomy, intra-articular infections, or intra-articular fractures. Patients were included in the experimental group if they underwent inside-out meniscal suture repair with concurrent multiligament reconstruction. Those included in the control group (multiligament reconstruction without a meniscal tear) underwent multiligament reconstruction but did not undergo any type of meniscal surgery. Lysholm, Western Ontario and McMaster Universities Osteoarthritis Index, Short Form–12 physical component summary and mental component summary, Tegner activity scale, and patient satisfaction scores were recorded preoperatively and postoperatively. The failure of meniscal repair was defined as a retear of the meniscus that was confirmed arthroscopically. Results: There were 43 patients (16 female, 27 male) in the meniscal repair group and 62 patients (25 female, 37 male) in the control group. Follow-up was obtained in 93% of patients with a mean of 3.0 years (range, 2.0-4.7 years). There was a significant improvement between all preoperative and postoperative outcome scores ( P < .05) for both groups. The meniscal repair group had significantly lower preoperative Lysholm and Tegner scores ( P = .009 and P = .02, respectively). There were no significant differences between any other outcome scores preoperatively. The failure rate of the meniscal repair group was 2.7%, consisting of 1 symptomatic meniscal retear. There was no significant difference in any postoperative outcome score at a minimum 2-year follow-up between the 2 groups. Conclusion: Good to excellent patient-reported outcomes were reported for both groups with no significant differences in outcomes between the cohorts. Additionally, the failure rate for inside-out meniscal repair with concomitant multiligament reconstruction was low, regardless of meniscus laterality and tear characteristics. The use of multiple vertical mattress sutures and the biological augmentation resulting from intra-articular cruciate ligament reconstruction tunnel reaming may be partially responsible for the stability of the meniscal repair construct and thereby contribute to the overall improved outcomes and the low failure rate of meniscal repair, despite lower preoperative Lysholm and Tegner scores in the meniscal repair group.

scholarly journals Clinical Evaluation of Bracket Bonding Using Two Different Polymerization Sources

2008 ◽  
Vol 78 (5) ◽  
pp. 922-925 ◽  
Author(s):  
Nikolaos S. Koupis ◽  
Theodore Eliades ◽  
Athanasios E. Athanasiou
Keyword(s):  
Failure Rate ◽  
Orthodontic Treatment ◽  
Light Emitting Diode ◽  
Rank Test ◽  
Dental Arch ◽  
Halogen Lamp ◽  
Failure Rates ◽  
Bond Failure ◽  
Significant Difference ◽  
The Right

Abstract Objective: To comparatively assess clinical failure rate of brackets cured with two different photopolymerization sources after nine months of orthodontic treatment. Materials and Methods: The sample of this study comprised 30 patients who received comprehensive orthodontic treatment by means of fixed appliances. Using the same adhesive, 600 stainless steel brackets were directly bonded and light cured for 10 seconds with the light-emitting diode (LED) lamp or for 20 seconds with the conventional halogen lamp. A split-mouth design randomly alternated from patient to patient was applied. Failure rates were recorded for nine months and analyzed with Pearson χ2 test, and log-rank test at α = .05 level of significance. Results: The overall failure rate recorded with the halogen unit (3.33%) was not significantly different from the failure rate for the LED lamp (5.00%). Significantly more failures were found in boys compared with girls, in the mandibular dental arch compared with the maxillary arch, and in posterior segments compared with anterior segments. However, no significant difference was found between the right and left segments. Conclusion: Both light-curing units showed sufficiently low bond failure rates. LED curing units are an advantageous alternative to conventional halogen sources in orthodontics because they enable a reduced chair-time bonding procedure without significantly affecting bond failure rate.

Perceptions, Attitudes and Use of Pharmacy Customers to Medicine Labels

2021 ◽  
pp. 58-70
Author(s):  
Eman Elmahjoubi ◽  
Mufida Yamane
Keyword(s):  
Structured Interview ◽  
University Hospital ◽  
High Rate ◽  
Foreign Languages ◽  
Local Study ◽  
The Public ◽  
Interview Technique ◽  
Written Information ◽  
Awareness Programs ◽  
The University

Background. The safe use of medicines largely relies on consumers reading the labeling and packaging carefully and accurately, and being able to comprehend and act on the information presented. We aimed to conduct local study on consumers’ perceptions, attitudes and use of written drug information. Methods. A survey included 200 adults of the public in 13 community pharmacies and one main hospital (the University Hospital) in Tripoli city of Libya, using a structured interview technique. Results. The results showed that 73% of participants read drug labels with variation from always (39.72 %) to rarely (10.95%). About 42.46% of pharmacy customers read the Patients Package Inserts (PPIs) routinely, however; 53.42% of them faced difficulties in understanding the labelling. Foreign languages and small font sizes of written information were the most barriers to participants` comprehensibility (44.69 %, 34%) respectively. The findings indicated that 59 % of the respondents were used to obtain information from pharmacists. Despite the relatively high rate of reading to drug labels among pharmacy customers; more than half of them were unable to interpret information correctly. Conclusion. The study demonstrated the need for the implementation of educational and awareness programs for patients by pharmacists to improve the health literacy of medication labels. Steps must be taken to ensure that medicines in Libyan market are supplied with bilingual and non-technical language labels.

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