scholarly journals Evaluation Of Anxiety During Nasal Pack Removal In Patients Operated Under Local Versus General Anesthesia

2018 ◽  
Vol 08 (04) ◽  
pp. 226-230
Author(s):  
Amer Sabih Hydri ◽  
Muhammad Junaid Alam ◽  
Iqbal Hussain Udaipurwala ◽  
Furqan Mirza
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Rating Scale ◽  
Military Hospital ◽  
General Anesthesia Group ◽  
Nasal Pack ◽  
Assessment Scores ◽  
Anesthesia Group ◽  
Group B ◽  
Hamilton Anxiety

Objective: To evaluate the anxiety experienced before, during and after conventional paraffin gauze nasal pack removal in patients operated under local versus general anesthesia. Study design: Comparative study. Place and duration of study: Department of ENT, Combined Military Hospital Sialkot and PAF Hospital Shorkot from July 2017 to June 2018. Material and methods: A total of 120 patients planned for Septoplasty were enrolled and divided into two groups. Sixty patients were to be operated under local anesthesia (Group A) while the other 60 were undergoing the same procedure under general anesthesia (Group B). Conventional paraffin gauze nasal packing was done for 24 hours in all 120 patients. Hamilton Anxiety Rating Scale (HAM-A) was used to determine the patients’ anxiety in both groups, 1 hour pre-operatively, immediately before and 1 hour after nasal pack removal. Results: The mean Hamilton Anxiety Scale assessment scores in both groups were of ‘mild’ category. The highest scores in both groups were observed immediately before nasal pack removal, with a range of 15-18, while the lowest scores in both groups were documented one hour after pack removal with a range of 13-16. Anxiety level in patients operated under general anesthesia was slightly lower than patients administered local anesthesia mean score of 16.40 ± 0.763 vs 17.21 ± 0.666 (p<0.001). Conclusion: Anxiety during nasal pack removal is mainly associated with prior pain experienced during nasal pack insertion. It is recommended that proper analgesia, adequate topical anesthesia, gentle insertion would make this process less distressing and will subsequently result in less anxiety at its removal.

scholarly journals The Effect of Sevoflurane Anesthesia for Dental Procedure on Neurodevelopment in Children: A Prospective, Equivalence, Controlled Trial

2020 ◽  
Author(s):  
Pinping Zhou ◽  
Chao Zhang ◽  
Guijin Huang ◽  
Yuan Hu ◽  
Wenzhu Ma ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Age Groups ◽  
Outcome Data ◽  
Clinical Trial Registry ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
Significant Difference

Abstract Background: Dental procedures under general anesthesia (DGA) was found to improve the oral health-related quality of children's life. However, some parents and pediatricians expressed concern about the neurotoxicity of general anesthesia. The purpose of this trial was to investigate whether DGA in children has an adverse effect on neurodevelopment.Methods: In this prospective, assessor-masked, controlled, equivalence trial, we recruited 340 children younger than 7 years who were undergoing caries treatment between Feb 1, 2019, and Aug 31, 2019, without factors affecting neurodevelopment. They received either sevoflurane-based general anesthesia or awake-local anesthesia. The Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition was used to evaluate the neurodevelopment of children at six months after surgery, and the Full-Scale IQ (FSIQ) was selected as the primary outcome. Predefine the 95% CI of a difference in means within five (1/3 SD) as the equivalence margin.Results: The outcome data were obtained from 129 children in the general anesthesia group and 144 in the local anesthesia group. The median length of general anesthesia was 130 min (IQR 110 – 160). There was equivalence in means of FSIQ score between the general anesthesia group and the local anesthesia group (local minus general anesthesia 0.46, 95% CI -2.35 to 1.61). There was no significant difference in FSIQ scores between different age groups and different anesthesia durations. Only the mother's education could affect the primary outcome.Conclusions: In this trial, prolonged DGA with a sevoflurane-only anesthetic in preschool children, does not adversely affect neurodevelopment at six months after surgery compared with awake-local anesthesia. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800015216. Registered Mar 15 2018, http://www.chictr.org.cn/showproj.aspx?proj=24830.

scholarly journals Clinical, Surgical Characteristics and Long-Term Outcomes of Lumbar Hernia.

2020 ◽  
Author(s):  
Chaoyong Shen ◽  
Guixiang Zhang ◽  
Sen Zhang ◽  
Yuan Yin ◽  
Bo Zhang ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Lumbar Hernia ◽  
Consecutive Series ◽  
Long Term Outcomes ◽  
Anesthesia Group ◽  
History Of ◽  
Group A ◽  
Group B

Abstract Background/AimLumbar hernia is extremely rare which resulting from a defect in the abdominal wall. Due to its rarity, there is no established optimal treatment available for lumbar hernia yet. Thus, we here investigated the clinical, surgical characteristics and outcomes of lumbar hernia by collecting 28 such patients in our hospital. MethodsPatients diagnosed with lumbar hernia from our institution between April 2011 and August 2020 were retrospectively collected in this study. Demographics, clinical characteristics and surgical information were recorded. ResultsA consecutive series of 28 patients with lumbar hernia were retrospectively collected, including 13 males (46.4%) and 15 females (53.6%). The ages of the patients ranged from 5 to 79 years (median: 55 years), with a mean age of 55.6±14.9 years. A total of 7 cases had a history of previous lumbar trauma or surgery. There were 11 (39.3%), 15 (53.6%) and 2 (7.1%) cases had right, left and bilateral lumbar hernia, respectively. Superior and inferior lumbar hernia were found in 25 (89.3%) and 3 (10.7%) patients. General anesthesia was applied in 16 cases (group A), whereas 12 patients received local anesthesia (group B). Patients in the group B had a shorter hospital stay than that of the group A (3.5±1.3 days vs. 7.1±3.2 days, p=0.001), as well as total hospitalization expenses between the two groups (8309.3±1467.1 CNY vs. 19117.3±8116.1 CNY, p<0.001). ConclusionsLumbar hernia is a relatively rare entity, and inferior lumbar hernia is rarer. It is feasible to repair lumbar hernia under local anesthesia, and it may be more suitable than general anesthesia in some selected cases.

scholarly journals The effect of sevoflurane anesthesia for dental procedure on neurodevelopment in children: a prospective, equivalence, controlled trial

2020 ◽  
Author(s):  
Pinping Zhou ◽  
Chao Zhang ◽  
Guijin Huang ◽  
Yuan Hu ◽  
Wenzhu Ma ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Age Groups ◽  
Outcome Data ◽  
Clinical Trial Registry ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
Significant Difference

Abstract Background Dental procedures under general anesthesia (DGA) was found to improve the oral health-related quality of children's life. However, some parents and pediatricians expressed concern about the neurotoxicity of general anesthesia. The purpose of this trial was to investigate whether DGA in children has an adverse effect on neurodevelopment. Methods In this prospective, assessor-masked, controlled, equivalence trial, we recruited 340 children younger than 7 years who were undergoing caries treatment between Feb 1, 2019, and Aug 31, 2019, without factors affecting neurodevelopment. They received either sevoflurane-based general anesthesia or awake-local anesthesia. The Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition Chinese version was used to evaluate the neurodevelopment of children at six months after surgery, and the Full-Scale IQ (FSIQ) was selected as the primary outcome. Predefine the 95% CI of a difference in means within five (1/3 SD) as the equivalence margin. Results The outcome data were obtained from 129 children in the general anesthesia group and 144 in the local anesthesia group. The median length of general anesthesia was 130 min (IQR 110–160). There was equivalence in means of FSIQ score between the general anesthesia group and the local anesthesia group (local minus general anesthesia 0.46, 95% CI -2.35 to 1.61). There was no significant difference in FSIQ scores between different age groups and different anesthesia durations. Just the mother's education could affect the primary outcome. Conclusions In this trial, prolonged DGA with a sevoflurane-only anesthetic in preschool children, does not adversely affect neurodevelopment at six months after surgery compared with awake-local anesthesia. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800015216. Registered Mar 15 2018, http://www.chictr.org.cn/showproj.aspx?proj=24830.

scholarly journals Anesthetic Management and Outcome in Patients during Endovascular Therapy for Acute Stroke

2012 ◽  
Vol 116 (2) ◽  
pp. 396-405 ◽  
Author(s):  
Melinda J. Davis ◽  
Bijoy K. Menon ◽  
Leyla B. Baghirzada ◽  
Cynthia R. Campos-Herrera ◽  
Mayank Goyal ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Neurologic Outcome ◽  
Stroke Severity ◽  
General Anesthesia Group ◽  
Poor Outcome ◽  
Anesthesia Group ◽  
Modifiable Factors

Background Studies of endovascular treatment for acute ischemic stroke have identified general anesthesia as a predictor for poor outcome in comparison with local anesthesia/sedation. This retrospective study attempts to identify modifiable factors associated with poor outcome, while adjusting for baseline stroke severity, in patients receiving general anesthesia. Methods We reviewed charts of 129 patients treated between January 2003 and September 2009. The primary outcome was the modified Rankin Score of 0-2 for 3 months poststroke. Predictors of neurologic outcome included baseline National Institutes of Health Stroke Scale score, blood glucose concentration, and age. Additional risk factors evaluated were prolonged stroke onset-treatment interval and systolic blood pressure less than 140 mmHg. Choice of local anesthesia or general anesthesia was recorded. Results The study group was 96 out of 129 patients for whom modified Rankin Scale scores were available; 48 patients received general anesthesia and 48 local anesthesia. The proportion of patients with "good" outcomes were 15% and 60% in the general anesthesia group and local anesthesia group, respectively (P &lt; 0.001). Lowest systolic blood pressure and general anesthesia were correlated (r = -0.7, P &lt; 0.001). Independent predictors for good neurologic outcome were local anesthesia, systolic blood pressure greater than 140 mmHg, and low baseline stroke scores. Conclusions Adjusted for stroke severity, patients who received general anesthesia for treatment are less likely to have a good outcome than those managed with local anesthesia. This may be due to preintervention risk not included in the stroke severity measures. Hypotension, more frequent in the general anesthesia patients, may also contribute.

scholarly journals SUCCESS OF PERCUTANEOUS NEPHROLITHOTOMY: COMPARING SPINAL ANESTHESIA WITH GENERAL ANESTHESIA

2015 ◽  
Vol 22 (2) ◽  
Author(s):  
Ari Astram ◽  
Ponco Birowo ◽  
Nur Rasyid ◽  
P Pryambodho ◽  
C Susilo
Keyword(s):  
Hospital Stay ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
Group A ◽  
Group B ◽  
Surgery Duration

Objective: The purpose of this study compared the outcome of PCNL under general and spinal anesthesia for the outcome. Material & Methods: PCNL had been performed from 2000 until 2011 with total 760 PCNL divided into 220 PCNL using general anesthesia (Group A) and the remaining 540 PCNL using spinal anesthesia (Group B) The data of both groups were evaluated with Chi square test, and Mann-Whitney test. Result: Stone free rate in Group A was 71.37% similar with Group B 72.97% (p > 0.05). Spinal anesthesia was used more often in patient who had previous surgery 65.5% compared with general anesthesia 36.82% (p < 0.05). The average surgery duration in Group A was longer than group B (77.10 ± 35.59 minutes vs 68.42 ± 30.55 minutes) (p < 0.05). The average length of hospital stay in Group B was shorter than Group A (3.90 ± 2.72 days vs 5.47 ± 4.25 days) (p < 0.05). There was no difference between Group A and Group B in complication and the needs of tranfusion. Conclusion: PCNL under spinal anesthsia was feasible and safe even better in the shorter surgery duration and the length of hospital stay.

scholarly journals The effect of sevoflurane anesthesia for dental procedure on neurodevelopment in children: a prospective, equivalence, controlled trial

2020 ◽  
Author(s):  
Pinping Zhou ◽  
Chao Zhang ◽  
Guijin Huang ◽  
Yuan Hu ◽  
Wenzhu Ma ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Age Groups ◽  
Outcome Data ◽  
Factors Affecting ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
Significant Difference

Abstract Background Dental procedures under general anesthesia (DGA) was found to improve the oral health-related quality of children's life. However, some parents and pediatricians expressed concern about the neurotoxicity of general anesthesia. The purpose of this trial was to investigate whether DGA in children has an adverse effect on neurodevelopment. Methods In this prospective, assessor-masked, controlled, equivalence trial, we recruited 340 children younger than 7 years who were undergoing caries treatment between Feb 1, 2019, and Aug 31, 2019, without factors affecting neurodevelopment. They received either sevoflurane-based general anesthesia or awake-local anesthesia. The Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition Chinese version was used to evaluate the neurodevelopment of children at six months after surgery, and the Full-Scale IQ (FSIQ) was selected as the primary outcome. Predefine the 95% CI of a difference in means within five (1/3 SD) as the equivalence margin. Results The outcome data were obtained from 129 children in the general anesthesia group and 144 in the local anesthesia group. The median length of general anesthesia was 130 min (IQR 110 – 160). There was equivalence in means of FSIQ score between the general anesthesia group and the local anesthesia group (local minus general anesthesia 0.46, 95% CI -2.35 to 1.61). There was no significant difference in FSIQ scores between different age groups and different anesthesia durations. Just the mother's education could affect the primary outcome. Conclusions In this trial, prolonged DGA with a sevoflurane-only anesthetic in preschool children, does not adversely affect neurodevelopment at six months after surgery compared with awake-local anesthesia.

scholarly journals Pilonidal Sinus Operations Performed Under Local Anesthesia versus the General Anesthesia: Clinical Trial Study

2016 ◽  
Vol 8 (9) ◽  
pp. 200 ◽  
Author(s):  
Nasrin Rahmani ◽  
Afshin Gholipour Baradari ◽  
Seyed Mohammad-Javad Heydari Yazdi ◽  
Abolfazl Firouzian ◽  
Seyyed Abbas Hashemi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Pilonidal Sinus ◽  
Recovery Time ◽  
Sinus Surgery ◽  
Pilonidal Sinus Disease ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
The Mean

<p><strong>BACKGROUNDS:</strong> Various methods were defined to prepare patients for the pilonidal sinus surgery including local, spinal, and general anesthesia. But there is no powerful evidence to differ these procedures. Therefore, in the current study, we compared local and general anesthesia in the pilonidal sinus surgery.</p><p><strong>METHODS &amp; MATERIAL:</strong> in this clinical trial (IRCT201312031786N5) study 60 patients with the pilonidal sinus disease divided to two groups of local anesthesia versus general anesthesia. For local anesthesia we used 6ml of 2% lidocaine with an epinephrine (1:200,000), 6ml of 0.5% bupivacaine, 1ml fentanyl (50μg/ml), 1ml clonidine (75μg/ml) and for general anesthesia fentanyl 1.5 μg.kg-1, thiopental 3-5 mg.kg-1, followed by the trachea intubation facilitated by atracurim 0.5 mg.kg-1 with maintenance of isoflurane 1-3% in nitrous oxygen 70% and oxygen 30%. The student t-test and Chi-square test were applied to evaluate the differences.</p><p><strong>RESULTS:</strong> there were 30 patients with the mean age of 27.43±8.42 years in local anesthesia group and 30 cases with the mean age of 27.5±8.44 years underwent general anesthesia. The recovery time was significantly lower in the local anesthesia group (P=0.000). The oxygen saturation of the general anesthesia group was significantly higher at 1 and 20 minutes after the operation. The average of pain score was significantly higher in general anesthesia group at 3h and 6h after surgery (P&lt;0.001). There were no significant differences in post-operative complications and hospital length of stay.</p><p><strong>CONCLUSION: </strong>this investigation revealed that local anesthesia has decreased pain during 48 hours after the surgery, shorter recovery time, and the less consumption of painkillers. So, we concluded that we can consider local anesthesia as a good alternative for the general anesthesia in the pilonidal sinus surgery.</p>

scholarly journals The effect of sevoflurane anesthesia for dental procedure on neurocognition in children: a prospective, equivalence, controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pinping Zhou ◽  
Chao Zhang ◽  
Guijin Huang ◽  
Yuan Hu ◽  
Wenzhu Ma ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Neurocognitive Function ◽  
Clinical Trial Registry ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
Significant Difference ◽  
The Mean

Abstract Background Dental procedures under general anesthesia (DGA) was found to improve the oral health-related quality of children’s life. However, some parents and pediatricians expressed concern about the neurotoxicity of general anesthesia. The purpose of this trial was to whether DGA in children has an adverse effect on neurocognition. Methods In this prospective, assessor-masked, controlled, equivalence trial, we recruited 340 children younger than 7 years who were undergoing caries treatment between Feb 1, 2019, and Aug 31, 2019, without factors affecting neurodevelopment. They received either sevoflurane-based general anesthesia or awake-local anesthesia. The Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition was used to evaluate the neurocognitive function of children at 6 months after surgery, and the Full-Scale IQ (FSIQ) was selected as the primary outcome. The predefined clinical equivalence margin was 5 (1/3 SD of FSIQ score). If the 95% CI of the difference between the average FSIQ score of the two groups is within − 5 to + 5, then the two groups are equivalent. Results The outcome data were obtained from 129 children in the general anesthesia group and 144 in the local anesthesia group. The median length of general anesthesia was 130 min (IQR 110–160). The mean FSIQ score in the general anesthesia group was 103·12 (SD 8.94), and the mean of the local anesthesia group was 103·58 (SD 8.40). There was equivalence in means of FSIQ score between the two groups (local minus general anesthesia 0.46, 95% CI − 2.35 to 1.61). There was no significant difference in FSIQ scores between different age groups and different anesthesia durations. Only the mother’s education could affect the primary outcome. Conclusions In this trial, prolonged DGA with a sevoflurane-only anesthetic in preschool children, does not adversely affect neurocognitive function at 6 months after surgery compared with awake-local anesthesia. Trial registration Chinese Clinical Trial Registry, ChiCTR1800015216. Registered Mar 15 2018.

scholarly journals Analysis  of  Percutaneous Kyphoplasty under Different Types of Anesthesia for the Treatment of Multiple Osteoporotic Vertebral Fractures

2020 ◽  
Author(s):  
Shuai Zhang ◽  
Shuang Xu ◽  
Jin Yang ◽  
Song Wang ◽  
Qing Wang
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Operative Time ◽  
Vital Signs ◽  
General Situation ◽  
General Anesthesia Group ◽  
Vas Score ◽  
Anesthesia Group ◽  
Osteoporotic Vertebral Fractures ◽  
Significant Difference

Abstract Background Surgeons believe that the advantage of PKP under local anesthesia for the treatment of OVF in preventing interference with the general situation of elderly patients with multiple organ dysfunction. Surgeons can directly assess whether a spinal cord nerve injury occurs while the patient is awake. However, when patients with m-OVFs receive local anesthesia, fluoroscopy time often has to be increased,the operative time has to be extended, or the operation has to be terminated because of body posture-related discomfort, the toxic reaction of bone cement, and abrupt fluctuation of vital signs. No relevant study has thus far been conducted on the choice of the type of anesthesia to administer to patients undergoing PKP for m-OVFs.This study aimed to determine which of the two types of anesthesia is more suitable for PKP for m-OVFs. Methods A retrospective study was conducted for 159 patients who underwent PKP for m-OVFs from January 2016 to January 2020; 81 patients underwent PKP under general anesthesia(Group G), and 78 patients underwent PKP under local anesthesia(Group L). Clinical and adverse events were compared between the two groups. Results No difference in baseline information was found between the two groups. The intraoperative mean arterial pressure, average heart rate, average fluoroscopy times of each vertebral body, and operative time were less in Group G than in Group L. The VAS score was significantly lower than that before operation. The AVH, MVH, and the KA were significantly improved in both groups postoperation. The improvement in VAS score, AVH, MVH, and KA in Group G were higher than those in Group L. No significant difference in the incidence of complications was observed between the two groups. Conclusion PKP under either general anesthesia or local anesthesia was reliable. Compared with PKP under local anesthesia, that under general anesthesia could more reliably maintain the stability of vital signs, alleviate preoperative pain in patients, and attain a better orthopedic effect. Moreover, the latter does not increase the complications of patients with m-OVFs. However, the high medical expense of PKP under general anesthesia is a factor to consider when choosing the type of anesthesia.

scholarly journals Spinal block and delirium in oncologic patients after laparoscopic surgery in the Trendelenburg position: A randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0249808
Author(s):  
Jorge Kiyoshi Mitsunaga ◽  
Vinicius Fernando Calsavara ◽  
Elton Shinji Onari ◽  
Vinicius Monteiro Arantes ◽  
Carolina Paiva Akamine ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Laparoscopic Surgery ◽  
General Anesthesia ◽  
Controlled Trial ◽  
Spinal Block ◽  
Trendelenburg Position ◽  
General Anesthesia Group ◽  
Randomized Controlled ◽  
Anesthesia Group ◽  
Oncologic Patients

Delirium is the most common postsurgical neurological complication and has a variable incidence rate. Laparoscopic surgery, when associated with the Trendelenburg position, can cause innumerable physiological changes and increase the risk of neurocognitive changes. The association of general anesthesia with a spinal block allows the use of lower doses of anesthetic agents for anesthesia maintenance and facilitates better control over postoperative pain. Our primary outcome was to assess whether a spinal block influences the incidence of delirium in oncologic patients following laparoscopic surgery in the Trendelenburg position. Our secondary outcome was to analyze whether there were other associated factors. A total of 150 oncologic patients who underwent elective laparoscopic surgeries in the Trendelenburg position were included in this randomized controlled trial. The patients were randomized into 2 groups: the general anesthesia group and the general anesthesia plus spinal block group. Patients were immediately evaluated during the postoperative period and monitored until they were discharged, to rule out the presence of delirium. Delirium occurred in 29 patients in total (22.3%) (general anesthesia group: 30.8%; general anesthesia plus spinal block: 13.8% p = 0.035). Patients who received general anesthesia had a higher risk of delirium than patients who received general anesthesia associated with a spinal block (odds ratio = 3.4; 95% confidence interval: 1.2–9.6; p = 0.020). Spinal block was associated with reduced delirium incidence in oncologic patients who underwent elective laparoscopic surgeries in the Trendelenburg position.

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