Does the Laminar Airflow System Affect the Development of Perioperative Hypothermia? A Randomized Clinical Trial

2021 ◽  
pp. 193758672098585
Author(s):  
Recai Dagli ◽  
Fatma Çelik ◽  
Hüseyin Özden ◽  
Serdar Şahin
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
Tympanic Membrane ◽  
Randomized Study ◽  
Hvac Systems ◽  
Anesthesia Induction ◽  
Temperature Changes ◽  
Perioperative Hypothermia ◽  
Surgical Evaluation ◽  
Turbulent Airflow

Objectives: We aimed to compare tympanic membrane temperature changes and the incidence of inadvertent perioperative hypothermia (IPH) in patients undergoing laparoscopic cholecystectomy under general anesthesia in laminar airflow systems (LAS-OR) and conventional turbulent airflow systems (CAS-OR). Background: Different heating, ventilation, and air-conditioning (HVAC) systems are used in the operating room (OR), such as LAS and CAS. Laminar airflow is directed directly to the patient in LAS-OR. Does laminar airflow in ORs cause faster heat loss by convection? Methods: This is a prospective, randomized study. We divided 200 patients with simple randomization (1:1), as group LAS and group CAS, and took the patients into the LAS-OR or CAS-OR for the operation. Clinical trial number: IRCT20180324039145N3. The tympanic membrane temperatures of patients were measured (°C) before anesthesia induction ( T 0) and then every 15 min during surgery ( Tn). Changes (Δ n) between T 0 and Tn were measured. Results: In the first 30 min, there was a temperature decrease of approximately 0.8 °C (1.44 °F) in both groups. Temperature decreases at 45 min were higher in group LAS than in group CAS but not statistically significant, Δ45, respectively, 0.89 (95% confidence interval [CI] [0.77, 1.02]) versus 0.77 (95% CI [0.69, 0.84]; p = .09). IPH occurred in a total of 60.9% (112 of 184) of patients in the entire surgical evaluation period in group LAS and group CAS (58.9% vs. 62.8%, p = . 59). Conclusions: IPH is seen frequently in both HVAC systems. Clinically, the advantage of HVAC systems relative to each other has not been demonstrated during laparoscopic cholecystectomy.

scholarly journals Self-produced audio-visual animation introduction alleviates preoperative anxiety in pediatric strabismus surgery: a randomized controlled study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuexi Jin ◽  
Aifen Jiang ◽  
Wanna Jiang ◽  
Wenxin Wu ◽  
Lisha Ye ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Study ◽  
Strabismus Surgery ◽  
Preoperative Anxiety ◽  
Controlled Study ◽  
Average Score ◽  
Anesthesia Induction ◽  
Emergence Agitation ◽  
Clinical Trial Registry ◽  
Group A

Abstract Background Hospital anxiety caused by strabismus surgery has an unpleasant and disturbing feeling for both children and their parents. This study aimed to determine the effect of viewing a self-produced audio-visual animation introduction on preoperative anxiety and emergence agitation of pediatric patients undergoing strabismus surgery. Methods In this prospective randomized study, 1 hundred children scheduled for strabismus surgery with aged 3 ~ 6 years. The children were randomly divided into 2 groups (n = 50 for each), Group A: using a self-produced audio-visual animation introduction; Group C: controlled group without audio-visual animation introduction. Children’s preoperative anxiety was determined by the modified Yale Preoperative Anxiety Scale (mYPAS) at different time points: the night before surgery(T1), at pre-anesthetic holding room(T2), and just before anesthesia induction(T3). The Spielberger State-Trait Anxiety Inventory (STAI) was used to record the anxiety of parents at T1,T2 and T3. The incidence and the degree of emergence agitation were recorded. Results The mYPAS scores at T2 and T3 were higher than T1(p < 0.05) in both groups. The average score of mYPAS in Group A was significantly lower than in Group C at T2 and T3(p < 0.05). The STAI scores in Group A at T2 and T3 were significantly lower than in Group C(p < 0.05). The incidence of agitation in Group A was lower than that in Group C(p < 0.05). Conclusions Based on the findings, viewing a self-produced audio-visual animation can effectively alleviate the preoperative anxiety for both children and their parents in pediatric strabismus surgery, and it was effective for reducing emergence agitation as well. Trial registration The trial was prospectively registered before patient enrollment at Chinese Clinical Trial Registry (Clinical Trial Number: ChiCTR1900025116, Date: 08/12/2019).

Prospective Randomized Study of Mode Switching in a Clinical Trial of Pacemaker Therapy for Sinus Node Dysfunction

2004 ◽  
Vol 15 (2) ◽  
pp. 153-160 ◽  
Author(s):  
MICHAEL O. SWEENEY ◽  
ANNE S. HELLKAMP ◽  
KENNETH A. ELLENBOGEN ◽  
TAYA V. GLOTZER ◽  
RUSSELL SILVERMAN ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Sinus Node ◽  
Randomized Study ◽  
Sinus Node Dysfunction ◽  
Prospective Randomized Study ◽  
Mode Switching ◽  
Pacemaker Therapy

scholarly journals Comparative Evaluation of Effectiveness of Intravenous Paracetamol and Intravenous Diclofenac as Post-operative Analgesia in Laparoscopic Cholecystectomy

2018 ◽  
Vol 6 (2) ◽  
pp. 6
Author(s):  
Kalpana Kharbuja ◽  
Mahesh Sharma ◽  
Nil Raj Sharma
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
P Value ◽  
Anesthesia Induction ◽  
Chi Square ◽  
Rescue Analgesia ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Intravenous Paracetamol

Introduction: Though the development of minimally invasive surgery  has revolutionized the field of surgery,  post-operative pain is still a significant issue. Unlike in the past, concerns about adverse effects have limited the role of opioids in post-operative pain management. This study aims to compare the effectiveness of intravenous paracetamol and  diclofenac as postoperative analgesia in laparoscopic cholecystectomy. Methods:One hundred and twenty eight patients of American Society of Anesthesiologists (ASA) categories I and II  included in this study  were divided into two groups. Anesthesia induction and maintenance were standardized. The first group received 15mg/kg (maximum 1gm) intravenous paracetamol and the second group received 2mg/kg (maximum 75mg) intravenous diclofenac 30 minutes prior to ending of surgery. A questionnaire was responded by patients and chart was maintained by visual analogue scale. Mann Whitney U test was used to analyze quantitative data and Chi-square test for categorical data. P value <0.05 was considered statistically significant. Results:  Profiles of hemodynamic changes were almost similar in both groups with respect to heart rate and blood pressure. However, paracetamol infusion provided hemodynamic stability in post-operative period. We observed statistically significant differences  in visual analogue scale between the two groups. Most of the patients in paracetamol group had low mean pain scores in post-operative period and provided an extended analgesia compared to diclofenac. No serious postoperative complication was observed in  paracetamol group.   Conclusion: Administration of intravenous paracetamol has better and prolonged analgesic effect  with low mean pain score and less requirement for rescue analgesia compared to diclofenac.

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