scholarly journals A retrospective examination of the effects of regional anesthesia methods applied for postoperative pain control on analgesic consumption after lower extremity surgery

2020 ◽  
Vol 7 (10) ◽  
pp. 659-662
Author(s):  
Mehmet Kenan Erol
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Postoperative Pain ◽  
Lower Extremity ◽  
Peripheral Nerve ◽  
Regional Anesthesia ◽  
Intensive Care Stay ◽  
Significant Difference ◽  
The Difference ◽  
Group 1

Objective: If preferable, the regional anesthesia is a more preferred method than general anesthesia. The preference for regional anesthesia increases as postoperative recovery is quicker, hospitalization is less and hospital costs are low. Material and methods: We retrospectively evaluated the hemodynamic findings, postoperative pain, hospital, and intensive care stay in patients aged 18-80 who underwent lower extremity surgery with regional anesthesia in the last 1 year. We divided the cases into 3 groups; Group 1 (n =114) patients with a peripheral nerve block, Group 2 (n =104) spinal anesthesia, and Group 3 (n =81) epidural anesthesia. Results: The difference between group 1 and 2, age hospitalization, and time of stay in intensive care was statistically significant. (P=0.021) (P=0.000). The difference between group 1 and 3 Intensive care unit stay was statistically significant (P = 0.003). The difference between the length of stay in the intensive care unit between groups 2 and 3 was found as statistically significant (P = 0.000). There was no significant difference in terms of hospital stay. Group 1 was found to have the shortest duration of intensive care stay. Conclusion: In lower extremity surgeries, peripheral nerve blocks may have provided more hemodynamic stability and longer analgesic effect compared to central blocks.

scholarly journals Comparison between Dexmedetomidine and Midazolam for Sedation in Patients with Intubation after Oral and Maxillofacial Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Li Wang ◽  
Tiejun Zhang ◽  
Lili Huang ◽  
Wei Peng
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Maxillofacial Surgery ◽  
Pain Scale ◽  
Oral And Maxillofacial Surgery ◽  
Midazolam Group ◽  
Significant Difference ◽  
Behavioral Pain Scale ◽  
Random Number Table ◽  
The Difference

The aim of the investigation is to clarify the beneficial sedative effects for patients with postoperative intubation in the intensive care unit (ICU) after oral and maxillofacial surgery. Forty patients with postoperative intubation were divided into two groups in method of random number table: midazolam group and dexmedetomidine group. The Ramsay score, the behavioral pain scale (BPS) score, SpO2, HR, MAP, and RR were recorded before sedation (T0), 30 minutes (T1), 1 hour (T2), 2 hours (T3), 6 hours (T4), and 12 hours (T5) after dexmedetomidine or midazolam initiation in intensive care unit, and 10 minutes after extubation (T6). The rate of incidences of side effects was calculated. Sedation with midazolam was as good as standard sedation with dexmedetomidine in maintaining target sedation level. The BPS score in the midazolam group was higher than that in the dexmedetomidine group. The time of tracheal catheter extraction in the dexmedetomidine group was shorter than that in the midazolam group (p≤0.001). The incidence of bradycardia in the dexmedetomidine group was higher than that in the midazolam group (p=0.028). There was no statistically significant difference in the incidence of hypotension between the two groups (p=0.732). The incidence of respiratory depression of group midazolam was higher than that of group dexmedetomidine (p=0.018). The incidence of delirium in the dexmedetomidine group was significantly lower than that in the midazolam group, and the difference was statistically significant (p=0.003). Dexmedetomidine and midazolam can meet the needs for sedation in ICU patients. And dexmedetomidine can improve patients’ ability to communicate pain compared with midazolam.

scholarly journals The Use of Eosinophil Count in Predicting the Need of Coronavirus Disease 2019 Patient for Treatment in Intensive Care Unit

2021 ◽  
Vol 9 (B) ◽  
pp. 631-635
Author(s):  
Ngakan Ketut Wira Suastika ◽  
Ketut Suega
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Eosinophil Count ◽  
Early Stage ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Receiver Operating Curve ◽  
Significant Difference ◽  
The Difference ◽  
Eosinophil Counts

BACKGROUND: Identification of coronavirus disease 2019 (COVID-19) patients who have the potential to become critical cases at an early stage and providing aggressive therapy can reduce the mortality rate. AIM: This study aims to determine the diagnostic value and differences of eosinophil counts in patients with COVID-19 who require treatment in intensive care unit (ICU) and non-ICU. METHOD: The prospective study was conducted on 382 patients with confirmed COVID-19 who were hospitalized from May to September 2020. Samples were obtained through consecutive sampling techniques. Mann–Whitney analysis was used to determine the difference of eosinophil counts in COVID-19 patients who require treatment in ICU and non-ICU. Receiver operating curve analysis was used to determine the diagnostic value of eosinophil count to predict the need of COVID-19 patients for treatment in ICU. RESULTS: There is a significant difference in the absolute and percentage eosinophil count in COVID-19 patients who need treatment in ICU and non-ICU. The area under the curve of absolute and percentage eosinophil count to predict the need of COVID-19 patients for treatment in ICU is 0.659 and 0.738, respectively. The best cutoff value, sensitivity and specificity of absolute and percentage eosinophil count is <0.025 × 103 μL and <0.25%; 77.7% and 78.3%; and 50.0% and 57.1%, respectively. CONCLUSIONS: The eosinophil count can be used as a biomarker to predict the need of COVID-19 patients for treatment in ICU.

scholarly journals Comparison Of Different Anesthetic Techniques Used For Geriatric Patients Who Underwent TUR-P Operation: Single Center Experience

2020 ◽  
Author(s):  
Ozge Gozcu ◽  
Elzem Sen ◽  
Haluk Sen ◽  
Omer Bayrak
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Anesthetic Techniques ◽  
Asa Score ◽  
Intensive Care Stay ◽  
Significant Difference ◽  
Operation Duration ◽  
The Cost

Abstract Objectives To investigate impacts that effect entrance to intensive care unit, mortality, and cost; according to demographical and clinical parameters of patients, and different anesthetic techniques performed on patients who underwent TUR-P operation. Methods Data of 234 patients aged 60 years and older who underwent TUR-P operations was evaluated retrospectively. The patients were examined in two groups as neuroaxial and general anesthesia groups. Charlson Comorbidity Index, preoperative laboratory parameters, presence of comorbidity, preoperative intensive care requirement, operation duration were obtained from hospital records. The cost calculation was based on the length of the patient's stay in hospital and intensive care unit. Results According to ASA score, no significant difference was observed among operation duration, length of hospital stay and intensive care unit stay. According to the CCI score, there was no significant difference among the operation time; however, when the patient's CCI was 3 and above 3, the duration of intensive care stay and hospital stay were significantly longer. The cost was increased significantly when CCI was 3 and above 3, but did not change according to the ASA score. Conclusions In our study, it was observed that the type of anesthesia did not affect the duration of surgery, rate of entrance to intensive care unit, length of intensive care stay, length of hospital stay, mortality and the cost. However, it was observed that the duration of hospitalization and rate of intensive care unit entrance increased in patients with CCI 3 and above, therefore the cost was increased.

scholarly journals Safety and efficacy of routine diagnostic test reduction interventions in patients admitted to the intensive care unit: A systematic review and meta-analysis

2021 ◽  
Vol 49 (1) ◽  
pp. 23-34
Author(s):  
Katherine P Hooper ◽  
Matthew H Anstey ◽  
Edward Litton
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Meta Analysis ◽  
Diagnostic Testing ◽  
Intervention Group ◽  
Cochrane Central Register ◽  
Safety And Efficacy ◽  
Significant Difference

Reducing unnecessary routine diagnostic testing has been identified as a strategy to curb wasteful healthcare. However, the safety and efficacy of targeted diagnostic testing strategies are uncertain. The aim of this study was to systematically review interventions designed to reduce pathology and chest radiograph testing in patients admitted to the intensive care unit (ICU). A predetermined protocol and search strategy included OVID MEDLINE, OVID EMBASE and the Cochrane Central Register of Controlled Trials from inception until 20 November 2019. Eligible publications included interventional studies of patients admitted to an ICU. There were no language restrictions. The primary outcomes were in-hospital mortality and test reduction. Key secondary outcomes included ICU mortality, length of stay, costs and adverse events. This systematic review analysed 26 studies (with more than 44,00 patients) reporting an intervention to reduce one or more diagnostic tests. No studies were at low risk of bias. In-hospital mortality, reported in seven studies, was not significantly different in the post-implementation group (829 of 9815 patients, 8.4%) compared with the pre-intervention group (1007 of 9848 patients, 10.2%), (relative risk 0.89, 95% confidence intervals 0.79 to 1.01, P = 0.06, I2 39%). Of the 18 studies reporting a difference in testing rates, all reported a decrease associated with targeted testing (range 6%–72%), with 14 (82%) studies reporting >20% reduction in one or more tests. Studies of ICU targeted test interventions are generally of low quality. The majority report substantial decreases in testing without evidence of a significant difference in hospital mortality.

scholarly journals Comparison of three fixation methods for orotracheal intubation in 95 adults

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Ye Sun ◽  
Hua Fan ◽  
Xiao-Xia Song ◽  
Hua Zhang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tracheal Intubation ◽  
Older People ◽  
Endotracheal Intubation ◽  
Orotracheal Intubation ◽  
The Other ◽  
Fixation Methods ◽  
The Difference

Abstract Background The present study aimed to compare three fixation methods for orotracheal intubation. Methods Through literature retrieval, the effects of the adhesive/twill tape method, fixator method, and adhesive/twill tape–fixator alternation method on patients with tracheal intubation in the intensive care unit (ICU) were compared. Results The fixator and alternation methods were more effective in protecting the tongue mucosa and teeth. The alternation method was superior to the other two methods in maintaining the position of the endotracheal intubation. However, the difference in facial and lip injuries between the three methods was not statistically significant. Conclusion The fixator method can significantly reduce intraoral injury and is more suitable for older people with weak tongue mucosa and loose teeth. These are worth popularizing among a wider group.

A volumetric three-dimensional evaluation of invasiveness of an endoscopic and microscopic approach for transmeatal visualisation of the middle ear

2021 ◽  
pp. 1-5
Author(s):  
A H A Baazil ◽  
J G G Dobbe ◽  
E van Spronsen ◽  
F A Ebbens ◽  
F G Dikkers ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Middle Ear ◽  
Three Dimensional ◽  
Endoscopic Approach ◽  
Microscopic Approach ◽  
Significant Difference ◽  
Computed Tomography Scans ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Abstract Objective This study aimed to compare the necessary scutum defect for transmeatal visualisation of middle-ear landmarks between an endoscopic and microscopic approach. Method Human cadaveric heads were used. In group 1, middle-ear landmarks were visualised by endoscope (group 1 endoscopic approach) and subsequently by microscope (group 1 microscopic approach following endoscopy). In group 2, landmarks were visualised solely microscopically (group 2 microscopic approach). The amount of resected bone was evaluated via computed tomography scans. Results In the group 1 endoscopic approach, a median of 6.84 mm3 bone was resected. No statistically significant difference (Mann–Whitney U test, p = 0.163, U = 49.000) was found between the group 1 microscopic approach following endoscopy (median 17.84 mm3) and the group 2 microscopic approach (median 20.08 mm3), so these were combined. The difference between the group 1 endoscopic approach and the group 1 microscopic approach following endoscopy plus group 2 microscopic approach (median 18.16 mm3) was statistically significant (Mann–Whitney U test, p < 0.001, U = 18.000). Conclusion This study showed that endoscopic transmeatal visualisation of middle-ear landmarks preserves more of the bony scutum than a microscopic transmeatal approach.

Sibling Visiting in a Neonatal Intensive Care Unit

PEDIATRICS ◽  
1983 ◽  
Vol 71 (5) ◽  
pp. 835-838
Author(s):  
Fred Schwab ◽  
Brenda Tolbert ◽  
Stephen Bagnato ◽  
M. Jeffrey Maisels
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Direct Observation ◽  
Neonatal Intensive Care ◽  
Behavioral Patterns ◽  
Control Intervention ◽  
Significant Difference

The effect of sibling visiting in a neonatal intensive care unit was studied. Sixteen siblings of 13 infants were randomly assigned to a visiting or nonvisiting group. Behavioral patterns were measured by questionnaires administered to the parents and by direct observation and interviews with the children. There were no significant changes in the behavior of the children following the birth of their sibling, and there was no significant difference between the behavior scores of the two groups 1 week after the experimental (or control) intervention. The visiting children did not show signs of fear or anxiety during the visit. These data suggest that sibling visiting to a neonatal intensive care unit is not likely to be harmful and might be beneficial to the siblings and their families.

Comparative study between noninvasive positive pressure ventilation and invasive mechanical ventilation in patients with respiratory failure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed N Al Shafi'i ◽  
Doaa M. Kamal El-din ◽  
Mohammed A. Abdulnaiem Ismaiel ◽  
Hesham M Abotiba
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Significant Difference

Abstract Background Noninvasive positive pressure ventilation (NIPPV) has been increasingly used in the management of respiratory failure in intensive care unit (ICU). Aim of the Work is to compare the efficacy and resource consumption of NIPPMV delivered through face mask against invasive mechanical ventilation (IMV) delivered by endotracheal tube in the management of patients with acute respiratory failure (ARF). Patients and Methods This prospective randomized controlled study included 78 adults with acute respiratory failure who were admitted to the intensive care unit. The enrolled patients were randomly allocated to receive either noninvasive ventilation or conventional mechanical ventilation (CMV). Results Severity of illness, measured by the simplified acute physiologic score 3 (SAPS 3), were comparable between the two patient groups with no significant difference between them. Both study groups showed a comparable steady improvement in PaO2:FiO2 values, indicating that NIPPV is as effective as CMV in improving the oxygenation of patients with ARF. The PaCO2 and pH values gradually improved in both groups during the 48 hours of ventilation. 12 hours after ventilation, NIPPMV group showed significantly more improvement in PaCO2 and pH than the CMV group. The respiratory acidosis was corrected in the NIPPV group after 24 hours of ventilation compared with 36 hours in the CMV group. NIPPV in this study was associated with a lower frequency of complications than CMV, including ventilator acquired pneumonia (VAP), sepsis, renal failure, pulmonary embolism, and pancreatitis. However, only VAP showed a statistically significant difference. Patients who underwent NIPPV in this study had lower mortality, and lower ventilation time and length of ICU stay, compared with patients on CMV. Intubation was required for less than a third of patients who initially underwent NIV. Conclusion Based on our study findings, NIPPV appears to be a potentially effective and safe therapeutic modality for managing patients with ARF.

scholarly journals The difference in outcome of patients with open inguinal hernia repair by using delayed absorbable sutures instead of non-absorbable sutures for mesh fixation

2020 ◽  
Vol 8 (1) ◽  
pp. 24
Author(s):  
Ali G. Mohammed Redha ◽  
Adil A. Jaber ◽  
Aqeel M. Nasser
Keyword(s):  
Hernia Repair ◽  
Mesh Fixation ◽  
Good Alternative ◽  
P Value ◽  
Absorbable Sutures ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
One Year ◽  
Group 1

Background: Different methods are found for mesh fixation in inguinal hernioplasty both open and laparoscopic. In open technique, sutures have been the method of choice for their reduced costs and surgeons’ habits. Whether absorbable instead of non-absorbable sutures can be used still a matter of debate in view of hernia recurrence and post-operative complications.Methods: This is a prospective done on 158 male patients with uncomplicated unilateral inguinal hernias. Two groups of 69 patients were evaluated after periods up to 1 year after open hernioplasty by using delayed absorbable sutures in one group (group 1) and non-absorbable sutures in the other group (group 2) for fixation of mesh.Results: In spite of a noticeable reduction in complication in the group 1 in term of number and percentage when compared with group 2 mainly chronic pain, there is no significant difference (p value>0.05). However, these results are associated with zero recurrence in both groups during a period of one year follow up.Conclusions: Delayed absorbable sutures are good alternative of non-absorbable sutures in open mesh hernia repair associated with less complications and almost no increase in chance of recurrence.  

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