A prospective observational study comparing criteria-based discharge method with traditional time-based discharge method for discharging patients from post-anaesthesia care unit undergoing ambulatory or outpatient minor surgeries under general anaesthesia

Abstracts Background Patient outcomes are influenced by intraoperative temperature management. Oesophageal/pharyngeal temperature monitoring is the standard of care at our institute but is not well tolerated in awake patients. Many non-invasive temperature monitors have been studied. Only the TraxIt® Wearable Children’s Underarm Thermometer which contains liquid crystals that undergo phase changes according to temperature is available at our institution. We tested these non-invasive monitors against our standard of care which is the oesophageal/pharyngeal temperature monitor. Methods We conducted a prospective observational study of 100 patients receiving general anaesthesia for elective surgery. Patients were eligible for inclusion if they were ≥ 18 years old, were planned to have a general anaesthetic > 60 min during which no body cavity (chest or abdomen) would be opened. Patient temperature was measured with an oesophageal/pharyngeal thermistor probe and skin surface temperature monitors placed over the forehead, in the axilla, over the sternum, and behind the ear (over major vessels to the brain). Temperatures were recorded and then analysed using Altman-Bland plots. Pre-determined clinically relevant limits of agreement were set at −/+ 0.5 °C. Results From the 100 patients we collected 500 data points for each monitor with an average monitoring time of 102 min (30–300 min) across a range of surgical procedures. None of the skin surface temperature monitors achieved the pre-determined limits of agreement and results were impacted by the use of a forced air warmer. Conclusion The TraxIt® Wearable Children’s Underarm Thermometers are not suitable for temperature monitoring during general anaesthesia.

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Gastric content assessed with gastric ultrasound in paediatric patients prescribed a light breakfast prior to general anaesthesia: A prospective observational study

Pediatric Anesthesia ◽

10.1111/pan.13755 ◽

2019 ◽

Vol 29 (12) ◽

pp. 1173-1178 ◽

Cited By ~ 2

Author(s):

Hanna Andersson ◽

Peter Frykholm

Keyword(s):

Observational Study ◽

General Anaesthesia ◽

Gastric Content ◽

Prospective Observational Study ◽

Paediatric Patients

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Multicentre prospective observational study of sodium-glucose cotransporter-2 inhibitor-associated postoperative ketoacidosis: the SAPKA study protocol

BMJ Open ◽

10.1136/bmjopen-2021-049592 ◽

2021 ◽

Vol 11 (11) ◽

pp. e049592

Author(s):

Hiroyuki Seki ◽

Norifumi Kuratani ◽

Toshiya Shiga ◽

Yudai Iwasaki ◽

Kanae Karita ◽

...

Keyword(s):

Observational Study ◽

General Anaesthesia ◽

Study Protocol ◽

Prospective Observational Study ◽

Surgical Stress ◽

Sglt2 Inhibitor ◽

Sglt2 Inhibitors ◽

Sodium Glucose Cotransporter ◽

Urinary Glucose ◽

Tract Infections

IntroductionSodium-glucose cotransporter 2 (SGLT2) inhibitors are a new class of antihyperglycaemic agents that promote urinary glucose excretion in the renal proximal tubule and have cardio-protective and renal-protective properties. However, there are several safety concerns related to increased risks of hypoglycaemic, urinary tract infections and ketoacidosis. Ketoacidosis is a potentially fatal complication that often presents as euglycaemic ketoacidosis during SGLT2 inhibitor treatment. Furthermore, invasive treatment and related surgical stress may increase the risk of ketogenesis. Therefore, this study aims to clarify the incidence of SGLT2 inhibitor-associated postoperative ketoacidosis (SAPKA) among patients who are receiving SGLT2 inhibitors and undergoing surgery under general anaesthesia.Methods and analysisThis multicentre, prospective, observational study will recruit 750 adult Japanese patients with diabetes who are receiving SGLT2 inhibitors and undergoing surgery under general anaesthesia. Urine samples will be collected on postoperative days 0, 1, 2 and 3. Blood gas analysis will be performed when urine ketone positivity is detected. The incidence of postoperative ketoacidosis will be identified based on urine ketone positivity and a blood pH of ≤7.3. The study will also collect data to identify risk factors for SAPKA.Ethics and disseminationThe study protocol has been approved by the ethics committee of Kyorin University (approval number: 785, 26 October 2020) and local ethical approval will be required at each participating centre. Study findings will be submitted to peer-reviewed journals and abstracts will be submitted to relevant national and international meetings.Trial registration numberUMIN000042795

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A possible future for anaesthesia in breast surgery: thoracic paravertebral block and awake surgery. A prospective observational study

Tumori Journal ◽

10.1177/0300891620951626 ◽

2020 ◽

pp. 030089162095162

Author(s):

Domenico P. Santonastaso ◽

Annabella de Chiara ◽

Emanuele Russo ◽

Emiliano Gamberini ◽

Leonardo Lucchi ◽

...

Keyword(s):

Observational Study ◽

General Anaesthesia ◽

Prospective Observational Study ◽

Rating Scale ◽

Breast Surgery ◽

Numeric Rating Scale ◽

Paravertebral Block ◽

Awake Surgery ◽

Thoracic Paravertebral Block ◽

Numeric Rating

Introduction: Quadrantectomy is a surgical procedure traditionally performed under general anaesthesia with intraoperative and postoperative opioid-based analgesia. The use of locoregional anaesthesia techniques in breast surgery has become widespread and allows excellent management of intraoperative and postoperative pain with reduced opioid consumption. We chose thoracic paravertebral block as regional anaesthesia technique in breast surgery to investigate the possibility of carrying out this surgery with the patient awake. Methods: A prospective observational study on 50 patients was designed. The primary outcome for this study was the possibility to carry out the surgery with only the paravertebral block associated with mild sedation without general anaesthesia. Forty minutes before the start of the surgery, an ultrasound-guided thoracic paravertebral block was performed at two thoracic levels, and for each level, 7 mL of ropivacaine 0.7% was injected. Sedation was obtained with target-controlled infusion of propofol. Results: Forty-nine patients underwent the operation awake; in one case, we had to place an I-gel and perform general anaesthesia. No patient needed intraoperative or postoperative opioids. The numeric rating scale, recorded at 0, 2, 6, 12, 24, and 36 hours, was greater than 3 in only five patients. Conclusions: We believe that if in the future we try to make quadrantectomy an intervention in which the anaesthesia is exclusively regional, therefore with a patient awake and collaborating, it will not be possible to ignore the use of thoracic paravertebral block.

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Comparison of peribulbar block and general anaesthesia in mechanical vitrectomy: A prospective observational study

Revista Española de Anestesiología y Reanimación (English Edition) ◽

10.1016/j.redare.2019.09.006 ◽

2020 ◽

Vol 67 (2) ◽

pp. 63-67

Author(s):

B. Carvalho ◽

C. Jantarada ◽

J. Azevedo ◽

P. Maia ◽

L. Guimarães

Keyword(s):

Observational Study ◽

General Anaesthesia ◽

Prospective Observational Study ◽

Peribulbar Block

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Comparison of Effects of Propofol and Sevoflurane Used in Maintenance of General Anaesthesia on Post-Operative Nausea and Vomiting - A Prospective Observational Study

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/317 ◽

2021 ◽

Vol 10 (20) ◽

pp. 1515-1518

Author(s):

Siri Kandavar ◽

Sampathila Padmanabha

Keyword(s):

Observational Study ◽

General Anaesthesia ◽

Prospective Observational Study ◽

Nausea And Vomiting ◽

P Value ◽

Sevoflurane Group ◽

Anaesthetic Agents ◽

Operative Care ◽

The Difference ◽

Post Operative Nausea

BACKGROUND Post-operative nausea and vomiting is a complication of general anaesthesia but can also be seen less commonly in regional anaesthesia. The uneasiness and discomfort associated with it can make the post-operative period eventful. We conducted this study to evaluate if sevoflurane and propofol used in maintenance of anaesthesia have any influence on post-operative nausea and vomiting. METHODS We included 64 patients in this prospective observational study who were undergoing elective otorhinolaryngology surgery belonging to American Society of Anaesthesiologist (ASA) PS I and II. After induction of general anaesthesia and endotracheal intubation, Group P received propofol at 100 - 200 mcg / kg / hr and group S received sevoflurane as maintenance anaesthetics agent at 1.5 - 2 %. All the patients were given ondansetron intravenously in the intra-operative period. Anaesthetic agents used for maintenance was stopped at the end of the surgery and patients were extubated and shifted to post-operative care unit. Patients were assessed for any occurrence of post-operative nausea and vomiting after extubation for 24 hours. RESULTS There were 2 (6.25 %) patients in the propofol group and 12 (37.5 %) patients in the sevoflurane group who had post-operative nausea and vomiting in the first hour. The difference in the nausea and vomiting between the groups was statistically significant with (P value of 0.0046) higher incidence in sevoflurane group. All the patients who had nausea and vomiting were treated with dexamethasone. When the patients were reassessed after four hours, five patients had nausea in sevoflurane group after four hours, which was treated with metoclopramide or Ondansetron. After six hours, none of the patients had nausea or vomiting. CONCLUSIONS The incidence of post-operative nausea and vomiting was lesser in the propofol group compared to sevoflurane group. KEY WORDS Post-Operative Nausea and Vomiting, Propofol, Sevoflurane, General Anaesthesia

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EFFECT OF DEXAMETHASONE GARGLE AND MgSO4 GARGLE ON INCIDENCE AND SEVERITY OF POST OPERATIVE SORE THROAT IN PATIENTS UNDERGOING SURGERY UNDER GA : A RANDOMISED COMPARATIVE STUDY

10.36106/ijar/4501618 ◽

2021 ◽

pp. 40-42

Author(s):

Tamanna Baktier ◽

Akash Gupta ◽

Neeharika Arora ◽

Ankur Garg ◽

Ekta Singh ◽

...

Keyword(s):

Comparative Study ◽

General Anaesthesia ◽

Sore Throat ◽

Magnesium Sulphate ◽

Lower Incidence ◽

Post Anaesthesia Care Unit ◽

Duration Of Surgery ◽

The Mean ◽

Anaesthesia Care ◽

To Receive

BACKGROUND: Post operative sore throat (POST) is an unpleasant and troublesome sequelae after endotracheal intubation . The present study compares the efcacy of dexamethasone gargle versus magnesium sulphate gargle on incidence and severity of post operative sore throat in patients under General Anaesthesia. METHODS : 60 patients were randomly allocated to receive either magnesium sulphate gargle or dexamethasone gargle . 15 mins prior to induction of GA , the dexamethasone gargle group (n=30) received 8mg dexamethasone dissolved in 20ml of 5% dextrose whereas the magnesium sulphate gargle group received 1 gm of MgSO4 dissolved in 20ml of 5% of dextrose. Patients were assessed for incidence and severity of post operative sore throat , cough and hoarseness of voice in post anaesthesia care unit at 0hr, 2hrs, 4hrs, 6hrs and 24 hrs . RESULTS : Our study revealed that there was signicant (p<0.01) difference in the severity of sore throat between the groups at 0 hr, 2 hrs, 4 hrs , 6 hrs with patients receiving MgSO4 gargles showing decreased severity than gargling with dexamethasone. The two groups were found to be demographically comparable . In our current study , the mean duration of surgery in both groups was 2-2.5 hours and difference was statistically insignicant . SUMMARY : Among patients who gargled with 1gm of MgSO4 exhibited lower incidence and severity of POST as compared to patients who gargled with 8mg of dexamethasone

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