scholarly journals Risk factors of inadequate emergence following general anesthesia with an emphasis on patients with substance dependence history

2020 ◽  
Vol 73 (4) ◽  
pp. 302-310 ◽  
Author(s):  
Jalil Makarem ◽  
Amir Hossein larijani ◽  
Babak Eslami ◽  
Afshin Jafarzadeh ◽  
Kasra Karvandian ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Substance Dependence ◽  
Foley Catheter ◽  
Adult Patients ◽  
Emergence Agitation ◽  
Never Married ◽  
Neurologic Disorders ◽  
Substance Dependent ◽  
History Of

Background: This study aims to define the incidence and risk factors of both emergence agitation and hypoactive emergence in adult patients and substance-dependent patients following general anesthesia to elaborate on the risk factors and precise management of them. Methods: The study recruited 1,136 adult patients who received elective surgeries under general anesthesia for this prospective observational study. Inadequate emergence was determined according to the Richmond Agitation-Sedation Scale (RASS). Emergence agitation was defined as a RASS ≥ +1 point, and hypoactive emergence was defined as a RASS ≤ –2 points. Subgroup analyses were then conducted on patients with substance dependence.Results: Inadequate emergence in the post-anesthesia care unit (PACU) occurred in 20.3% of patients, including 13.9% with emergence agitation and 6.4% with hypoactive emergence. Ninety-five patients had a history of substance dependence. Compared to divorced patients, never-married and presently married patients, who underwent gynecological and thoracic surgeries, had a lower risk of agitation. Neurologic disorders, intraoperative blood loss, intraoperative morphine, and PACU analgesic drug administration were associated with increased agitation risk. Hypertension and psychological disorders, intraoperative opioids, and PACU Foley catheter fixation were associated with increased hypoactive emergence risk. Substance-dependent patients had higher risk for agitation (21.1%, P = 0.019) and hypoactive emergence (10.5%, P = 0.044). Conclusions: Inadequate emergence in PACU following general anesthesia is a significant problem correlated with several perioperative factors. Patients with a history of substance dependence appear to be more at risk of inadequate emergence than the general population.

scholarly journals Risk factors of emergence agitation after general anesthesia in adult patients

2016 ◽  
Vol 11 (4) ◽  
pp. 410-416 ◽  
Author(s):  
Jong Cheol Rim ◽  
Jung A Kim ◽  
Jeong In Hong ◽  
Sang Yoong Park ◽  
Jong Hwan Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Adult Patients ◽  
Emergence Agitation

scholarly journals Clinical Study of Postoperative Bleeding after Tonsillectomy in 497 Cases

2021 ◽  
Vol 4 (01) ◽  
pp. e17-e20
Author(s):  
Takeshi Tanaka ◽  
Kenji Ishii ◽  
Kyoko Matsumoto ◽  
Koushirou Miura ◽  
Ayako Kihara ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Clinical Study ◽  
General Anesthesia ◽  
Retrospective Analysis ◽  
Body Mass ◽  
Smoking Habit ◽  
Postoperative Bleeding ◽  
Operation Time ◽  
History Of

AbstractWe conducted a retrospective analysis of 497 patients who underwent tonsillectomy at Kamio Memorial Hospital from September 2015 to August 2018. A total of 35 cases (7.0%) developed postoperative bleeding and three cases (0.6%) needed a second operation under general anesthesia to stop the bleeding. Postoperative bleeding most frequently occurred between 24 hours and 6 days after the operation. The incidence of postoperative bleeding was significantly higher in males and in patients aged 20 to 39 years old. The operation time, body mass index, smoking habit, and history of hypertension were not identified as clinical risk factors for bleeding after tonsillectomy in this study.

scholarly journals Risk Factors of Emergence Agitation in Adults Undergoing General Anesthesia for Nasal Surgery

2015 ◽  
Vol 8 (1) ◽  
pp. 46 ◽  
Author(s):  
Hyo-Jin Kim ◽  
Duk-Kyung Kim ◽  
Hyo-Yeol Kim ◽  
Jin-Kyoung Kim ◽  
Seung-Won Choi
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Emergence Agitation ◽  
Nasal Surgery

A population-based twin study in women of smoking initiation and nicotine dependence

1999 ◽  
Vol 29 (2) ◽  
pp. 299-308 ◽  
Author(s):  
K. S. KENDLER ◽  
M. C. NEALE ◽  
P. SULLIVAN ◽  
L. A. COREY ◽  
C. O. GARDNER ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nicotine Dependence ◽  
Structural Equation ◽  
Substance Dependence ◽  
Smoking Initiation ◽  
Population Based ◽  
Familial Factors ◽  
Wide Range ◽  
History Of ◽  
Low Levels

Background. The development of drug dependence requires prior initiation. What is the relationship between the risk factors for initiation and dependence?Methods. Using smoking as a model addiction, we assessed smoking initiation (SI) and nicotine dependence (ND) by personal interview in 1898 female twins from the population-based Virginia Twin Registry. We developed a twin structural equation model that estimates the correlation between the liability to SI and the liability to ND, given SI.Results. The liabilities to SI and ND were substantially correlated but not identical. Heritable factors played an important aetiological role in SI and in ND. While the majority of genetic risk factors for ND were shared with SI, a distinct set of familial factors, which were probably partly genetic, solely influenced the risk for ND. SI was associated with low levels of education and religiosity, high levels of neuroticism and extroversion and a history of a wide range of psychiatric disorders. ND was associated with low levels of education, extroversion, mastery, and self-esteem, high levels of neuroticism and dependency and a history of mood and alcohol use disorders.Conclusions. The aetiological factors that influence SI and ND, while overlapping, are not perfectly correlated. One set of genetic factors plays a significant aetiological role in both SI and ND, while another set of familial factors, probably in part genetic, solely influences ND. Some risk factors for SI and ND impact similarly on both stages, some act at only one stage and others impact differently and even in opposite directions at the two stages. The pathway to substance dependence is complex and involves multiple genetic and environmental risk factors.

Prophylactic Use of a Combination of an Anticoagulant and Ursodeoxycholic Acid for Sinusoidal Obstruction Syndrome after Allogeneic Myeloablative Hematopoietic Stem Cell Transplantation

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5755-5755
Author(s):  
Hiroshi Okamura ◽  
Mitsutaka Nishimoto ◽  
Takahiko Nakane ◽  
Hideo Koh ◽  
Yasuhiro Nakashima ◽  
...  
Keyword(s):  
Risk Factors ◽  
Research Funding ◽  
Gemtuzumab Ozogamicin ◽  
Adult Patients ◽  
Allogeneic Hsct ◽  
History Of ◽  
Group 3 ◽  
Group 2 ◽  
Prophylactic Use ◽  
Group 1

Abstract Introduction: Sinusoidal obstruction syndrome (SOS) is one of the potentially fatal complications of hematopoietic stem cell transplantation (HSCT). In particular, severe SOS frequently leads to multiple organ failure, and a worse prognosis. Thus, prophylaxis against development of SOS could contribute improved survival after HSCT. Previous reports demonstrated the effectiveness of the prophylactic use of ursodeoxycholic acid (UDCA) or certain anticoagulants, including unfractionated and low-molecular-weight heparin, for SOS. In two randomized controlled trials and two meta-analyses it was reported that UDCA, a hydrophilic bile acid, was an effective and safe drug for prophylaxis against SOS. The usefulness and feasibility of prophylactic use of anticoagulants after allogeneic HSCT are however still controversial. In addition, to our knowledge no study has evaluated the feasibility of usage of UDCA combined with an anticoagulant for SOS prevention after allogeneic HSCT in adult patients. To assess the efficacy and safety of use of UDCA combined with an anticoagulant as SOS prophylaxis, we performed a retrospective cohort study to examine the occurrences of SOS and hemorrhagic events in patients who underwent myeloablative allogeneic HSCT at our institution. We examined use of any anticoagulant together with simultaneous administration of UDCA, in comparison with UDCA alone for the prevention of SOS. Patients and methods: We reviewed the charts of consecutive adult patients in whom myeloablative allogeneic HSCT was performed at our hospital from November 1994 to May 2014, and who received either unfractionated heparin or dalteparin (low-molecular-weight heparin) with UDCA (group 1), danaparoid with UDCA (group 2), or UDCA only (group 3), used for prophylaxis against SOS. Results: A total of 280 patients (group 1: n=52; group 2: n=33; and group 3: n=195) were investigated. The proportions of patients with risk factors for SOS-including non-remission at the time of HSCT, a second or subsequent HSCT, high aspartate aminotransferase (AST) levels before HSCT, high ferritin levels before HSCT, a history of receiving gemtuzumab ozogamicin, and HLA disparity-were similar across the three groups. In group 1, a conditioning regimen containing busulfan was used less frequently (P = 0.002). SOS occurred in seven patients (13.7%) in group 1, five patients (15.2%) in group 2, and 28 patients (14.4%) in group 3, all meeting the Seattle criteria. None of the patients in group 1, two (6.1%) in group 2, and nine (4.6%) in group 3 had SOS diagnosed according to the Baltimore criteria. There was no significant difference in the incidence of SOS among the three groups. In addition, with regard to the cumulative incidence of severe SOS, no statistically significant difference was present among the three groups. The incidence of hemorrhagic events within 30 and 100 days following allogeneic HSCT was not significantly different across the three groups (30 days; 5.8%, 3.0%, 5.1%, P = 0.843, 100 days; 17.6%, 15.2%, 14.4%, P=0.843, respectively). Furthermore, the probabilities of OS and NRM until day 100 after allogeneic HSCT were similar among the three groups (P = 0.733 and P = 0.637, respectively). In a univariate model, a history of gemtuzumab ozogamicin treatment, high serum ferritin levels before HSCT, an HLA mismatched donor, and non-complete remission of disease at the time of allogeneic HSCT were found to be significant risk factors for SOS. Multivariate analysis revealed that a history of gemtuzumab ozogamicin therapy, a mismatched HLA donor, and non-complete remission of disease at the time of allogeneic HSCT were significant and independent risk factors for SOS. In the multivariate as well as univariate analyses, combined administration of UDCA and any anticoagulant for SOS prophylaxis did not have a significant effect on the incidence SOS, when compared to prophylaxis with UDCA alone. Conclusion: Our study results suggest that the combined use of UDCA and an anticoagulant for SOS prophylaxis after myeloablative allogeneic HSCT in adult patients was not beneficial. Establishment of an optimal strategy for prophylaxis against SOS after HSCT is still needed. Disclosures Nakane: Mundipharma KK: Research Funding. Koh:Pfizer: Consultancy, Honoraria. Hino:Pfizer: Honoraria, Research Funding; Nippon Shinyaku: Honoraria, Speakers Bureau; Alexion: Honoraria, Research Funding. Nakamae:Mochida Pharmaceutical Co., Ltd.: Honoraria, Research Funding; Pfizer: Consultancy, Honoraria; Novartis Pharma KK: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: travel/accommodation/meeting expenses, Research Funding.

scholarly journals Depression-anxiety in Adult Population of Qatar during the First Year of COVID-19

2021 ◽  
Author(s):  
Salma Mawfek Khaled ◽  
Iman Amro ◽  
Lina Bader ◽  
Tarek Bellaj ◽  
Yousri Marzouki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Online Survey ◽  
Adult Population ◽  
First Year ◽  
Cross Sectional ◽  
Never Married ◽  
Potential Risk Factors ◽  
History Of ◽  
Adjusted Model ◽  
Arabic Speaking

There is limited data from Arabic-speaking countries on risk factors for depression and anxiety during the COVID-19 pandemic. Country-specific data is necessary given differences in culture, demographics, and COVID-19 infection and mortality rates. This study intended to identify the factors associated with symptoms of depression-anxiety in the adult population of Qatar during the first year of the COVID-19 pandemic. We conducted a cross-sectional online survey in Qatar between July and December 2020 after Qatar’s first COVID-19 wave and before the beginning of the second wave. Depression-anxiety was defined as a cut-off of 20 or higher on the PHQ-ADS scale. Of 1138 participants, 71.05% were female, 69.0% Arabs, and 70.0% Non-Qataris. 77 % were < 40 years (the median age in Qatar is 32 years). In a fully-adjusted model, six variables were significantly associated with PHQ-ADS; Arab ethnicity (OR=1.67, p=0.026), never married (OR=1.69, p < 0.015), prior psychiatric history (OR=1.80, p=0.009), Social Media induced worries (OR=1.72, p=0.003), history of COVID-19 (OR=1.76, p=0.039), loneliness (OR=1.91, p < 0.001), and lower levels of religiosity (OR=0.96, p=0.039). The potential risk factors identified may assist with anxiety and depression prevention in future COVID-19 waves, similar national events and assist with early intervention to treat sufferers.

scholarly journals Incidence of Emergence Agitation in Pediatric Patient after General Anesthesia

2021 ◽  
Vol 55 (1) ◽  
pp. 25
Author(s):  
Lucky Andriyanto ◽  
Arie Utariani ◽  
Elizeus Hanindito ◽  
Kohar Hari Santoso Hari Santoso ◽  
Hamzah Hamzah ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Pediatric Patient ◽  
Pediatric Anesthesia ◽  
Routine Care ◽  
Preoperative Anxiety ◽  
Emergence Agitation ◽  
Spss Software ◽  
Associated Risk Factors ◽  
Dissociated State

Post anesthesia agitation is common problem in pediatric post anesthesia care unit. The incidences range from 10 to 80%. EA has been described as a dissociated state of consciousness in which the child is inconsolable, irritable, and uncooperative typically thrashing, crying, moaning or incoherent. This study was done to determine the incidence of emergence agitation and associated risk factors in pediatric patients who underwent general anesthesia. This descriptive and analytic study was performed on 105 pediatric patient aged 1-12 years that underwent general anesthesia for various elective diagnostic and surgeries at Dr. Soetomo Hospital between January and February 2016. The presence of emergence agitation was recorded using Pediatric Anesthesia Emergence Delirium (PAED) scale. The factors that linked with Emergence Agitation were recorded in a questionnaire. The data were analyzed using SPSS software with logistic regression. p - values less than 0.05 were considered as significant. Forty two (40%) children had Emergence Agitation. Preoperative anxiety (p = 0.006) and Pain (p=0.035) were associated with higher rates of post anesthetic emergence agitation. This study identified preoperative anxiety and pain as risk factors, which are associated with emergence agitation in children. To minimize the incidence of post anesthetic emergence agitation, these risk factors should be considered in the routine care by anesthetist.

scholarly journals Psychosocial Characteristics and Obstetric Health of Women Attending a Specialist Substance Use Antenatal Clinic in a Large Metropolitan Hospital

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Lucy Burns ◽  
Elizabeth Conroy ◽  
Elizabeth A. Moore ◽  
Delyse Hutchinson ◽  
Paul S. Haber
Keyword(s):  
Substance Use ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Substance Dependence ◽  
Antenatal Clinic ◽  
Psychosocial Characteristics ◽  
Substance Dependent ◽  
Metropolitan Hospital ◽  
History Of ◽  
Health Complications

Objective. This paper reports the findings comparing the obstetrical health, antenatal care, and psychosocial characteristics of pregnant women with a known history of substance dependence (n=41) and a comparison group of pregnant women attending a general antenatal clinic (n=47).Method. Face-to-face interviews were used to assess obstetrical health, antenatal care, physical and mental functioning, substance use, and exposure to violence.Results. The substance-dependent group had more difficulty accessing antenatal care and reported more obstetrical health complications during pregnancy. Women in the substance-dependent group were more likely to report not wanting to become pregnant and were less likely to report using birth control at the time of conception.Conclusions. The profile of pregnant women (in specialised antenatal care for substance dependence) is one of severe disadvantage and poor health. The challenge is to develop and resource innovative and effective multisectoral systems to educate women and provide effective care for both women and infants.

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