ASSESSMENT OF CHANGES OF SKIN MOISTURE IN PATIENTS SUBJECT TO GENERAL ANESTHESIA WITH NEUROLOGICAL DISEASES IN AN INTERVIEW

Introduction: General anaesthesia is carried out using anaesthetic agents that among others depress the circulatory system and CNS. Central and peripheral thermoregulation occurs, which is due to mild hypothermia as well as changes in skin moisture. An important element of therapy in the perioperative period is adequate intravenous fluid therapy, which affects the final effects of treatment. The aim: Evaluation of skin moisture as a result of changes in central and peripheral thermoregulation during general anaesthesia and evaluation of the hydration status of patients. Material and methods: The study included 180 patients undergoing general anaesthesia for elective surgery, aged 20-85 years of age. Before general anaesthesia, patients were evaluated for ASA-related risk of anaesthesia (ASA 1 - healthy patients, ASA 2 and 3 - patients with neurological and circulatory disorders). Patients were divided into 2 groups, the study group (90 people) were patients who were given no intravenous fluids before the surgery and the control group (90 patients) were those receiving doses of 500 ml crystalline intravenously one hour before anaesthesia. The research was carried out at the Operational Block of the Provincial Hospital in Tarnobrzeg, from November 2013 to November 2014. Skin moisture was measured using a CM 825 Corneometer: before general anaesthesia, after induction for anaesthesia, 15 min after surgical incision of the skin and after awakening the patient. Results: Both in the test and control groups, statistically significant differences were found in subsequent skin moisture measurements. Pairwise comparisons indicate statistically significant differences between each pair of measurements. In both groups of patients, there is a clear decrease in skin moisture after induction of anaesthesia compared to the measurement performed before general anaesthesia. The skin moisture values are reduced in subsequent measurements, however the difference is much lower. Conclusions: 1 Measurement of skin moisture can be used as one of the parameters to assess perioperative stress and changes in body temperature during general anaesthesia, which indirectly determines the functioning of the hypothalamus. 2 By measuring the skin moisture it is possible to indirectly assess the hydration status of patients as well as the decrease of the metabolism during general anaesthesia. 3 The decrease in skin moisture during general anaesthesia is the effect of changes in central and peripheral thermoregulation.

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Unusual association between spinal cord tumour and perioperative arrhythmia

Journal of Neuroanaesthesiology and Critical Care ◽

10.4103/2348-0548.154237 ◽

2015 ◽

Vol 02 (02) ◽

pp. 127-129

Author(s):

Vikas Chauhan ◽

Ashish Bindra ◽

Parmod Bithal

Keyword(s):

Elective Surgery ◽

Perioperative Period ◽

Spinal Cord Tumour ◽

Anaesthetic Agents ◽

Catecholamine Excess ◽

Intraoperative Period ◽

Systemic Pathology ◽

Preoperative Work Up ◽

Work Up ◽

Ventricular Ectopics

AbstractThere are multiple causes of perioperative arrhythmias. Some have underlying cardiac disease while others accompany systemic pathology. Use of anaesthetic agents in the intraoperative period is also a known cause of rhythm abnormalities. Preoperative benign arrhythmias may progress to serious ones in intraoperative period. The trigger may be a transient insult such as hypoxemia, cardiac ischaemia, catecholamine excess or electrolyte abnormality. Thus, presence of arrthymia in the preoperative period adds to preoperative work-up and especially in the elective surgery settings, they call for additional opinion and patient evaluation. However, not all arryhthmias are amenable to drug treatment and modalities like pacing, some require just careful watch in the perioperative period. We report a patient with thoracic intramedullary space occupying lesion who presented to us with multiple ventricular ectopics on electrocardiography, which eventually disappeared with tumour removal. The case highlights the association of multiple ectopics with spinal tumour and their management.

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Gastric pH in patients premedicated with Esomeprazole or Famotidine undergoing routine surgery under general anaesthesia

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v1i2.8141 ◽

2013 ◽

Vol 1 (2) ◽

pp. 71-76

Author(s):

BR Shrestha ◽

S Shrestha ◽

S Moktan ◽

OS Shrestha

Keyword(s):

General Anaesthesia ◽

Ph Value ◽

Elective Surgery ◽

Gastric Ph ◽

Control Group ◽

Ph Indicator ◽

Double Blind ◽

Group Iii ◽

Group I ◽

American Society

Background: Stress and anxiety in patients planned for surgery under anaesthesia may change pH of gastric secretion. Premedication of surgical patients with pH altering drugs may modify the pH favourably. With the advent of newer agents, premedication has been carried out with different agents. Most of the time choice of drug is made by the perioperative physician on his/her own. Objective: To study gastric pH in patients premedicated either with Esomeprazole or Famotidine. Methods: This is a randomized controlled double blind prospective study conducted in 150 patients of American Society of Anesthesiologists grade I and II posted for elective surgery under general anaesthesia. The patients enrolled in the study were randomly assigned to three groups having 50 patients in each. Group I (control group) did not receive any pH altering drug, Group II (Famotidine Group) received 40 mg of Famotidine and Group III (Esomeprazole Group) received 40 mg of Esomeprazole the night before surgery. The observer was totally blind about the groups or drugs given to the patients. On the day of surgery, after induction of anaesthesia gastric juice was obtained via nasogastric tube and was checked for pH using pH indicator paper. Results: The pH raised by Esomeprazole was statistically significant (p<0.001) when compared to that of control group or Famotidine group. The mean pH value in control group was less than 2.5 whereas the pH value was higher than 2.5 in patients premedicated with either Famotidine or Esomeprazole. Conclusions: Gastric pH is raised by Famotidine or Esomeprazole premedication prior to routine surgery, Esomeprazole being superior to Famotidine, p<0.001. Patients (84%) not premedicated with either of the drugs had pH less than 2.5. DOI: http://dx.doi.org/10.3126/jkmc.v1i2.8141 Journal of Kathmandu Medical College, Vol. 1, No. 2, Oct.-Dec., 2012: 71-76

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Methadone or Butorphanol as Pre-Anaesthetic Agents Combined with Romifidine in Horses Undergoing Elective Surgery: Qualitative Assessment of Sedation and Induction

Animals ◽

10.3390/ani11092572 ◽

2021 ◽

Vol 11 (9) ◽

pp. 2572

Author(s):

Sara Nannarone ◽

Giacomo Giannettoni ◽

Chiara Laurenza ◽

Andrea Giontella ◽

Giulia Moretti

Keyword(s):

General Anaesthesia ◽

Intravenous Injection ◽

Patient Population ◽

Elective Surgery ◽

Physiological Parameters ◽

Qualitative Assessment ◽

Anaesthetic Agents ◽

Analgesic Potency

While butorphanol is the most commonly used opioid in horses, methadone is not licensed in most countries. Our aim was to compare the effects of both drugs, combined with romifidine, regarding the quality of sedation and induction in horses undergoing elective surgery. Results indicate the suitability of both methadone and butorphanol in this patient population. Animals were scored 10 min after intravenous injection of sedatives. Despite lower overall sedation (OS) score in horses receiving methadone (p = 0.002), the quality and time of induction and intubation remained unchanged. None of the horses had the lowest OS score (no sedation), nor the highest score for ataxia (horse falling). Methadone induced a tendency for minor noise reaction yet minor head lowering scores, the latter being probably the most influencing parameter when scoring OS. Measured physiological parameters decreased in both groups, with greater bradycardia recorded after methadone (p = 0.017), including a higher incidence of atrioventricular blocks that resolved during general anaesthesia. The quality of induction was good–excellent in most of the animals. While comparisons between the degree of antinociception were beyond the scope of this study, analgesic potency might influence the choice when considering opioids as pre-anaesthetic drugs in combination with romifidine before surgery in equines.

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Effects of 10-min of pre-warming on inadvertent perioperative hypothermia in intraoperative warming patients: a randomized controlled trial

Anesthesia and Pain Medicine ◽

10.17085/apm.20027 ◽

2020 ◽

Vol 15 (3) ◽

pp. 356-364

Author(s):

Jae Hwa Yoo ◽

Si Young Ok ◽

Sang Ho Kim ◽

Ji Won Chung ◽

Sun Young Park ◽

...

Keyword(s):

Body Temperature ◽

Thermal Comfort ◽

Elective Surgery ◽

Controlled Trial ◽

Randomized Study ◽

Perioperative Period ◽

Control Group ◽

Perioperative Hypothermia ◽

Randomized Controlled ◽

Forced Air

Background: This study aimed to evaluate the efficacy of 10-min pre-warming in preventing inadvertent perioperative hypothermia, which is defined as a reduction in body temperature to less than 36.0℃ during the perioperative period in intraoperative warming patients. Methods: In this prospective randomized study, 60 patients scheduled for elective surgery under general anesthesia lasting less than 120 min were divided into two groups: the 10-min pre-warming group (n = 30) and the control group (n = 30). Patients in the 10-min pre-warming group were pre-warmed for 10 min in the pre-anesthetic area using a forced-air warmer set at 47ºC. Intraoperatively, we warmed all patients with a forced-air warmer. Body temperature was measured using a tympanic membrane thermometer pre- or postoperatively and a nasopharyngeal temperature probe intraoperatively. Patients were evaluated on the shivering and thermal comfort scale in the pre-anesthetic area and post-anesthesia care unit. Results: The incidences of intraoperative hypothermia and postoperative hypothermia were similar in both groups (10.7% vs. 28.6%, P = 0.177; 10.7% vs. 10.7%, P = 1.000 respectively). Body temperature was higher in the 10-min pre-warming group (P = 0.003). Thermal comfort during the pre-warming period was higher in the 10-min pre-warming group (P < 0.001). However, postoperative thermal comfort and shivering grades of both groups were similar.Conclusions: Ten minutes of pre-warming has no additional effect on the prevention of inadvertent perioperative hypothermia in intraoperative warming patients.

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A randomized controlled study of intravenous esmolol to attenuate the cardiovascular responses to laryngoscopy and endotracheal intubation

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20200788 ◽

2020 ◽

Vol 8 (3) ◽

pp. 1103

Author(s):

Ninad Deepak Chodankar ◽

Bhagyashree Shivde

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

General Anaesthesia ◽

Endotracheal Intubation ◽

Elective Surgery ◽

Cardiovascular Responses ◽

Controlled Study ◽

Control Group ◽

Significant Difference ◽

Control Group Group

Background: Objective is to compare the efficacy of intravenous Esmolol to attenuate the cardiovascular responses to laryngoscopy and endotracheal intubation with control group.Methods: Study was done on 60 adults, ASA grade I or II normotensive patients, undergoing elective surgery under general anaesthesia and willing to participate. These patients where be randomly allocated in to either group C (Control) or E (Esmolol). Group ‘C’ Control group. Group ‘E’, patients were given intravenous Esmolol 1.5 mg/kg 2 minutes before start of laryngoscopy. All patients were premedicated, induced and intubated using Thiopentone and Succinyl Choline as per the protocol. Heart Rate (HR), SBP, DBP and MAP were recorded at baseline (taken half an hour prior to anaesthesia), Before sedation, After induction but before intubation, Immediately after endotracheal intubation and Thereafter at 1, 2, 3, 4, 5 and 10 minutes.Results: Heart rate was lower in Group E as compared to Group C, and there was statistically significant difference immediately after intubation till 4 minutes after intubation. While Blood pressure was lower in Group E as compared to Group C, and there was statistically significant difference only immediately after intubation.Conclusions: In Normotensive patients requiring general anaesthesia with laryngoscopy and intubation, authors conclude that intravenous Esmolol 1.5 mg/kg attenuated Heart rate response but fails to satisfactorily prevent rise in blood pressure.

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Extrinsic Pathway Inhibitor in Elective Surgery: A Comparison with other Coagulation Inhibitors

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651017 ◽

1989 ◽

Vol 62 (03) ◽

pp. 856-860 ◽

Cited By ~ 28

Author(s):

P M Sandset ◽

H E Høgevold ◽

T Lyberg ◽

T R Andersson ◽

U Abildgaard

Keyword(s):

Vascular Surgery ◽

Protein C ◽

Elective Surgery ◽

Perioperative Period ◽

Acute Phase Reactant ◽

Hip Surgery ◽

Albumin Concentration ◽

Extrinsic Pathway ◽

Heparin Cofactor Ii ◽

Coagulation Inhibitors

SummaryExtrinsic coagulation pathway inhibitor may be an important regulator of haemostasis to prevent thrombosis after tissue damage. The functional activity of this inhibitor was determined using a chromogenic substrate assay, and compared to the activities of anti thrombin, heparin cofactor II and protein C during the perioperative period of elective hip replacement (n = 28), cholecystectomy (n = 11), and vascular surgery (n = 5). Peroperatively, all the inhibitors decreased rather similarly and to the same degree as the decrease in albumin concentration. The decreases during hip surgery were about 2-fold the decreases observed during cholecystectomy. A significant peroperative increase in extrinsic pathway inhibitor activity was observed in vascular surgery, probably due to a bolus injection of heparin. Antithrombin, heparin cofactor II and protein C levels normalized on days 3-5 postoperatively in all three patient groups. Sustained low levels of extrinsic pathway inhibitor were observed on postoperative days 1 to 7 in hip surgery patients. Apparently, extrinsic pathway inhibitor is not an acute phase reactant. In uncomplicated surgery, the decreases of the coagulation inhibitor levels are mainly due to hemodilution.

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Preoperative preparation of alcohol and psychoactive substances-addicted patients

Acta chirurgica iugoslavica ◽

10.2298/aci1102151d ◽

2011 ◽

Vol 58 (2) ◽

pp. 151-155

Author(s):

Ivan Dimitrijevic ◽

Zoran Zoricic ◽

Miodrag Milenovic ◽

Ivan Palibrk ◽

Draga Dimitrijevic ◽

...

Keyword(s):

Substance Abuse ◽

Postoperative Care ◽

Surgical Intervention ◽

Elective Surgery ◽

Perioperative Period ◽

Psychoactive Substance ◽

Preoperative Preparation ◽

Psychoactive Substances ◽

Key Issues ◽

Proper Diagnosis

Proper diagnosis of psychoactive substance abuse and addiction, as well as acute intoxication, withdrawal syndrome and overdosing are of great importance in patients who are preparing for surgical intervention. There are some specific details in their preoperative preparation whether they underwent emergency or elective surgery. Good knowledge of the characteristics of psychoactive substance abuse and addiction, interaction of psychoactive substances and anesthetics and any other drugs that could be used in the perioperative period is important especially for anastesiologist. In this work we present key issues for recognizing theese patients as well as some guidelines for adequate preoperative preparation and postoperative care.

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Clinical effect of application of nursing concept of rehabilitation surgery for improvement of quality of postoperative recovery in orthopedics

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02610-3 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Hong Lv ◽

Ning Yang

Keyword(s):

Tract Infection ◽

Perioperative Period ◽

Postoperative Recovery ◽

Control Group ◽

Observation Group ◽

Activity Time ◽

Joint Function ◽

Vein Thrombosis ◽

Accelerated Rehabilitation

Abstract Objective To analyze the application of concept nursing of accelerated rehabilitation surgery in orthopedic postoperative recovery. Methods A total of 120 patients who received orthopedic surgery were divided into the control group undergoing routine orthopedic nursing and the observation group undergoing the concept of accelerated rehabilitation surgery nursing. Results Patients in the observation group had shorter in-bed activity time and out-of-bed activity time, average time of hospital stay, and lower total treatment costs. The incidence of incision infection, respiratory system infection, digestive tract infection, urinary tract infection, deep vein thrombosis, and other complications in the observation group was much lower. The recovery scores of joint function in the observation group at 1, 3, 6, and 12 months after the operation were all better, and the recovery rate of joint function within 1 year after the operation was higher. Conclusion Following the concept of accelerated rehabilitation surgery nursing during the perioperative period can improve the quality of postoperative orthopedic recovery.

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The effect of opioid-free anesthesia on the quality of recovery after gynecological laparoscopy: study protocol for a prospective randomized controlled trial

Trials ◽

10.1186/s13063-021-05166-z ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jae Yen Song ◽

Hoon Choi ◽

Minsuk Chae ◽

Jemin Ko ◽

Young Eun Moon

Keyword(s):

General Anesthesia ◽

Assessment Tool ◽

Controlled Trial ◽

Perioperative Period ◽

Postoperative Outcomes ◽

Control Group ◽

Quality Of Recovery ◽

Gynecological Laparoscopy ◽

Prospective Randomized Controlled Trial

Abstract Background Because of the indiscriminate use of opioids during the perioperative period, opioid-free anesthesia (OFA) has been increasingly required. Nevertheless, the studies on the detailed techniques and effects of OFA are not sufficient. The Quality of Recovery-40 (QoR-40) questionnaire is a validated assessment tool for measuring recovery from general anesthesia. However, no study has used the QoR-40 to determine if OFA leads to better recovery than standard general anesthesia. Therefore, we aim to perform this study to determine the effects of OFA using dexmedetomidine and lidocaine on the quality of recovery as well as the various postoperative outcomes. Methods The participants (n = 78) will be allocated to one of the two groups; the study group will receive bolus and infusion of dexmedetomidine and lidocaine, and the control group will receive remifentanil infusion during general anesthesia for gynecological laparoscopy. The other processes including anesthetic and postoperative care will be performed similarly in the two groups. Intraoperative hemodynamic, anesthetic, and nociceptive variables will be recorded. Postoperative outcomes such as QoR-40, pain severity, and opioid-related side effects will be assessed. Additionally, an ancillary cytokine study (inflammatory cytokine, stress hormone, and reactive oxygen species) will be performed during the study period. Discussion This will be the first study to determine the effect of OFA, using the combination of dexmedetomidine and lidocaine, on the quality of recovery after gynecological laparoscopy compared with standard general anesthesia using remifentanil. The findings from this study will provide scientific and clinical evidence on the efficacy of OFA. Trial registration ClinicalTrials.gov NCT04409964. Registered on 28 May 2020

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Effect of Whole-Body Cryotherapy on Morphological, Rheological and Biochemical Indices of Blood in People with Multiple Sclerosis

Journal of Clinical Medicine ◽

10.3390/jcm10132833 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2833

Author(s):

Bartłomiej Ptaszek ◽

Aneta Teległów ◽

Justyna Adamiak ◽

Jacek Głodzik ◽

Szymon Podsiadło ◽

...

Keyword(s):

Multiple Sclerosis ◽

Neurological Diseases ◽

Venous Blood ◽

Whole Body ◽

Controlled Study ◽

Control Group ◽

Blood Indices ◽

Rheological Indices ◽

Whole Body Cryotherapy ◽

The Impact

The aim of this study was to examine and assess the impact of a series of 20 whole-body cryotherapy (WBC) treatments on the biochemical and rheological indices of blood in people with multiple sclerosis. In this prospective controlled study, the experimental group consisted of 15 women aged 34–55 (mean age, 41.53 ± 6.98 years) with diagnosed multiple sclerosis who underwent a series of whole-body cryotherapy treatments. The first control group consisted of 20 women with diagnosed multiple sclerosis. This group had no intervention in the form of whole-body cryotherapy. The second control group consisted of 15 women aged 30–49 years (mean age, 38.47 ± 6.0 years) without neurological diseases and other chronic diseases who also underwent the whole-body cryotherapy treatment. For the analysis of the blood indices, venous blood was taken twice (first, on the day of initiation of whole-body cryotherapy treatments and, second, after a series of 20 cryotherapy treatments). The blood counts were determined using an ABX MICROS 60 hematological analyzer (USA). The LORCA analyzer (Laser–Optical Rotational Cell Analyzer, RR Mechatronics, the Netherlands) was used to study the aggregation and deformability of erythrocytes. The total protein serum measurement was performed using a Cobas 6000 analyzer, Roche and a Proteinogram-Minicap Sebia analyzer. Fibrinogen determinations were made using a Bio-Ksel, Chrom-7 camera. Statistically significant differences and changes after WBC in the levels of red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), elongation index, total extend of aggregation (AMP), and proteins (including fibrinogen) were observed. However, there was no significant effect of a series of 20 WBC treatments on changes in blood counts, rheology, and biochemistry in women with multiple sclerosis. Our results show that the use of WBC has a positive effect on the rheological properties of the blood of healthy women.

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