Optimal Site for Precordial Stethoscope Placement in Pediatric Patients Younger than Two Years: A Preliminary Cross-sectional Study

Background: The precordial stethoscope is a traditional and non-invasive monitoring method during pediatric general anesthesia. In this preliminary cross-sectional study, we aimed to investigate the characteristics of lung and heart sounds via precordial stethoscope and determine the optimal site for auscultation in children below 2 years of age. Methods: This study involved 68 patients who underwent general anesthesia with tracheal intubation. Auscultation sounds via precordial stethoscope were recorded in MP3 format at the following three sites: Site A-region between the clavicle and nipple on the left midclavicular line; Site B-region between the nipple and costal arch on the left midclavicular line; and Site C-point on the left midaxillary line that was horizontally leveled with Site B. Eight blinded evaluators individually and randomly scored lung and heart sounds on a 10-point scale (0: cannot hear at all and 10: can hear clearly). Results: Lung sound scores at Sites A, B, and C were 8.0 (7.0–9.0), 4.5 (2.9–6.0), and 7.0 (5.5–8.5), respectively, while heart sound scores at Sites A, B, and C were 3.5 (2.0–6.0), 6.5 (4.0–8.0), and 1.0 (0.4–2.0), respectively. Statistically significant differences were found in all pairs of sites. Conclusion: We suggest that Site A, where anesthesiologists can hear both the lung and heart sounds, is the optimal site of precordial stethoscope attachment during general anesthesia for intubated children below 2 years of age.

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Skin-to-skin contact and breastfeeding of newborns in a university hospital

Revista Gaúcha de Enfermagem ◽

10.1590/1983-1447.2020.20190154 ◽

2020 ◽

Vol 41 (spe) ◽

Author(s):

Paola Melo Campos ◽

Helga Geremias Gouveia ◽

Juliana Karine Rodrigues Strada ◽

Bruna Alibio Moraes

Keyword(s):

Descriptive Analysis ◽

Cross Sectional Study ◽

University Hospital ◽

Patient Records ◽

Sectional Study ◽

Cross Sectional ◽

Monitoring Method ◽

Skin Contact ◽

Clinical Conditions ◽

Skin To Skin

ABSTRACT Objective: To determine the prevalence of skin-to-skin contact (STSC) and breastfeeding (BF) stimulation, as well as the reasons for these practices not to be performed; to identify whether women were given information on these practices along the pre-natal monitoring. Method: A cross-sectional study carried out in a university hospital with 586 women. Data collection was from February to September 2016. Data was collected from patient records and from a questionnaire. A descriptive analysis was performed. Results: Immediately after birth, 60.1% of the newborns (NBs) had STSC, and 44.9% were stimulated to suck at the breast. After primary care, 24.1% had STSC, and 69.3% were stimulated to suck at the breast; 47.7% of the newborns did not have STSC due to their unfavorable clinical conditions; 79.2% of the women were not able to inform the reason why BF was not stimulated; 58.5% of the women had pre-natal guidance about STSC, and 90.8% about BF. Conclusion: Both STSC and BF rates could be improved, in view of the benefits provided by these practices.

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Sensitivity and Specificity Comparison Between APFEL, KOIVURANTA, and SINCLAIR Score As PONV Predictor In Post General Anesthesia Patient

Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya ◽

10.30651/jqm.v4i1.2826 ◽

2020 ◽

Vol 4 (1) ◽

pp. 69

Author(s):

M Yusuf Gunawan ◽

Arie Utariani ◽

Maulydia Maulydia ◽

Anna Surgean Veterini

Keyword(s):

High Risk ◽

General Anesthesia ◽

Elective Surgery ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Prophylactic Administration ◽

Risk Patients ◽

Auc Value ◽

Post Operative Nausea

ABSTRACTBackground: Post Operative Nausea Vomiting (PONV) are the two most common and unpleasant side effects after anesthesia and surgery. Without proper prophylactic administration, the PONV incidence is currently around 20% -30% in normal patients and 70% in high-risk patients (Butterworth et al., 2013). Recently, many PONV predictor scores have been used to determine the PONV severity and prophylactic administration. Objective: To compare the scores of Apfel, Koivuranta, and Sinclair as predictors of PONV in adult patients after general anesthesia at RSUD Dr. Soetomo. Methods: A cross-sectional study design conducted in 100 patients who underwent elective surgery under general anesthesia at RSUD Dr. Soetomo Surabaya. Patients who meet the criteria will be recorded in the clinical research form and being followed to evaluate the assessment using Apfel, Koivuranta, and Sinclair scores when the patient is in the recovery room and the ward. A diagnostic test is performed to assess the accuracy between these scores. Results: In this study, the prevalence of PONV after general anesthesia in elective surgery at GBPT RSUD Dr Soetomo Surabaya is 26%. The Apfel score obtained has a sensitivity value of 79.5%, a specificity of 45.9% with an AUC value of 0.701. The Koivuranta score has a sensitivity value of 96.2%, a specificity of 27% with an AUC value of 0.628. The Sinclair score has a sensitivity value of 73.1%, a specificity of 48.6% with an AUC value of 0.619. Conclusion: Apfel's score is more accurate PONV prediction score and has a simpler score determination variable. Keywords : PONV, predictor score, apfel score, koivuranta score, sinclair score, general anesthesia.

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Hemodynamic Response to Laryngoscopy and Intubation Using McCoy Laryngoscope: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6752 ◽

2021 ◽

Vol 59 (238) ◽

Author(s):

Gajal Lakhe ◽

Suresh Pradhan ◽

Santosh Dhakal

Keyword(s):

Blood Pressure ◽

General Anesthesia ◽

Pressor Response ◽

Hemodynamic Response ◽

Cross Sectional Study ◽

Adult Patients ◽

Mean Blood Pressure ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional

Introduction: Laryngoscopy and intubation are stressful as they lead to a rise in heart rate and blood pressure. Though transient, it may be detrimental to the cardiac and neurosurgical patients. There is a need to explore the possibility of obtunding the pressor response to laryngoscopy and intubation with the use of McCoy blade laryngoscope. We aimed to find out the hemodynamic response to laryngoscopy and intubation using McCoy laryngoscope in adult patients undergoing general anesthesia. Methods: The descriptive cross-sectional study was conducted in 37 American Society of Anesthesiologists' Physical Status I/IIpatients, with normal airway from December 2019- May 2020 in a tertiary care hospital. Ethical approval was obtained from Institutional Research Committee (reference number.: MEMG/IRC/290/GA). Convenience sampling method was used. The mean systolic and diastolic blood pressures were measured at baseline, one, three and five minutes after laryngoscopy and intubation. Data were analyzed using the Statistical Package for the Social Sciences Version 21.0. Results: In the first minute after laryngoscopy and intubation, the rise in mean blood pressure was noted in 14 (37.83%) cases. The peak rise in mean blood pressure was 3%, note done minute after laryngoscopy and intubation. Conclusions: We noted better attenuation of pressor response to laryngoscopy and intubation using McCoy blade laryngoscope in adult patients undergoing general anesthesia.

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Risk Indicators and Treatment Needs of Children 2–5 Years of Age Receiving Dental Treatment under General Anesthesia in Saskatchewan

Dentistry Journal ◽

10.3390/dj10010008 ◽

2022 ◽

Vol 10 (1) ◽

pp. 8

Author(s):

Alyssa Weninger ◽

Erica Seebach ◽

Jordyn Broz ◽

Carol Nagle ◽

Jessica Lieffers ◽

...

Keyword(s):

General Anesthesia ◽

Oral Hygiene ◽

Dental Treatment ◽

Cross Sectional Study ◽

Risk Indicators ◽

Sectional Study ◽

Treatment Needs ◽

Cross Sectional ◽

Dental Home ◽

The Mean

Background: When compared to national averages in Canada, Saskatchewan has one of the highest rates of dental treatment under general anesthesia (GA) and average costs per child. Thus, the purpose of this cross-sectional study is to explore the risk indicators and treatment needs of children receiving dental treatment under GA in Saskatchewan. Methods: In this cross-sectional study, we recruited caregivers of children between 24 and 71 months of age in Saskatoon, Canada. Caregivers completed a 40-item questionnaire, which was supplemented with clinical data and then subject to statistical analysis (independent t-tests and one-way ANOVA). Results: A total of 90 caregiver/child dyads were enrolled with the mean age for children being 49.5 ± 12.3 months. The mean age of a child’s first dental visit was 34.7 ± 15.3 months with only 37.9% of children having a dental home. The mean deft index was 11.7 ± 3.4, with an average of 10.9 ± 3.5 teeth receiving treatment. Additionally, location of primary residence (p = 0.03), family income (p = 0.04), family size (p = 0.01), parental education (p = 0.03), dental home (p = 0.04), and body mass index (p = 0.04) had a statistically significant association with a higher mean deft. Conclusions: Our cross-sectional study confirms that children who require dental treatment under GA have a high burden of disease. While individual risk indicators such as diet and oral hygiene play a role in the progression of early childhood caries (ECC), we also demonstrate that children who do not have access to early preventive visits or a dental home are at a higher risk. In addition to improving motivation for oral hygiene at home and nutritional education, improving access to oral health care should be addressed in strategies to reduce ECC.

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Fear of going under general anesthesia: A cross-sectional study

Saudi Journal of Anaesthesia ◽

10.4103/1658-354x.179094 ◽

2016 ◽

Vol 10 (3) ◽

pp. 317 ◽

Cited By ~ 11

Author(s):

AA Alshehri ◽

ME Ruhaiyem ◽

M Saade ◽

TA Shoabi ◽

H Zahoor ◽

...

Keyword(s):

General Anesthesia ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Acromioaxillosuprasternal Notch Index and Old Head and Anatomic Neck Criteria in Predicting Difficult Laryngoscopy in Tracheal Intubation in Children under General Anesthesia

Internal Medicine And Medical Investigation Journal ◽

10.24200/imminv.v4i1.207 ◽

2019 ◽

Vol 4 (2) ◽

Author(s):

Nedasadat Mansouritehrani

Keyword(s):

General Anesthesia ◽

Cross Sectional Study ◽

Neck Circumference ◽

Difficult Laryngoscopy ◽

Sectional Study ◽

Upper Lip ◽

Cross Sectional ◽

Significant Difference ◽

Grade 3 ◽

Better Than

Introduction: Currently, various methods are being used for determining difficult laryngoscopy. The present study aimed to compare the acromioaxillosuprasternal notch index function with the old head and neck anatomic criteria in predicting difficult laryngoscopy with respect to trachea intubation under general anesthesia in children. Materials and Methods: In this cross-sectional study, 379 children under intubation with general anesthesia entered the study. Patients were divided into two groups: easy laryngoscopy (grades 1 and 2) and difficult laryngoscopy (grades 3 and 4) based on Cormack-Lehane score. The thyromental distance systems, height to thyromental distance, Upper-Lip-Bite test, neck circumference, and acromioaxillosuprasternal notch index were studied and compared. Results: Laryngoscopy was difficult in 48 subjects (38 were grade 3 and 10 were grade 4). Interestingly, no significant difference was detected between easy and difficult laryngoscopies based on the thyromental distance, neck circumference, height to thyromental distance, and acromioaxillosuprasternal notch index (P>0.05). height to thyromental distance , acromioaxillosuprasternal notch index , and neck circumference have a sensitivity of 32.2%, 47.9%, 51.1%, respectively, and the specificity was 52.7%, 45.6%, and 48.9%, respectively. Conclusion: Neck circumference and acromioaxillosuprasternal notch index outperform the height to thyromental distance. On the other hand, Modified Mallampati test is better than Upper-Lip-Bite test in determining difficult laryngoscopy in children.

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Cesarean Sections under General Anesthesia at a Tertiary Care Center in Western Nepal: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.4724 ◽

2019 ◽

Vol 57 (220) ◽

Author(s):

Krishna Murari Adhikari ◽

Gajal Lakhe ◽

Anjali Subedi Adhikari

Keyword(s):

Confidence Interval ◽

General Anesthesia ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Caesarian Section ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional ◽

Emergency Caesarean

Introduction: General anesthesia is feared to have adverse feto-maternal outcomes compared to neuraxial anesthesia. It is recommended to keep rate of caesarean sections under general anesthesia below 5% and 15% for elective and emergency caesarean sections respectively. This study was conducted to find out the prevalence of caesarean sections under general anesthesia at a tertiary care center in western Nepal.Methods: A descriptive cross-sectional study was conducted among caesarean sections conducted at Manipal Teaching Hospital, Pokhara, Nepal from January 2014 to December 2017. Ethical approval was taken from the Institutional Review Committee with reference number MEMG/IRC/GA/122. All the caesarean sections conducted during this study period were included in the study using whole sampling method. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Data for each patient was subsequently entered into an Excel spreadsheet and analyzed using Statistical Package for Social Sciences version 20.Results: Among 3613 cases, caesarean sections under general anesthesia was observed in 175 (4.84%) in our center over a period of four years at 95% Confidence Interval (4.13-5.55%). The yearly variations ranges from 2.83% to 8.99%. The rate of general anesthesia was found slightly higher in elective 31 (5.82%) as compared to emergency caesarean section 144 (4.67%).Conclusions: The four year medical records of our institution showed fluctuating trend of caesarian sections under general anesthesia. The rate of general anesthesia for emergency caesarian section was within the recommended rate while it was slightly higher in elective caesarian section.

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