Difference of cooling use during sleep between elderly and young people

In Japan, nearly 80% of heatstroke occurrences in recent years have involved people older than 65 years old. This study surveyed the actual use of cooling by elderly people at sleep time compared to those found for younger people. Results revealed the followings. 1) Ratios of cooling use at sleep time were 30.8% for elderly people and 57.4% for younger people. The respective ratios of natural ventilation use at sleep time were 39.9% and 32.4%. 2) Average wet bulb globe temperatures (WBGTs) of bed rooms during sleep were 26.9°C for elderly people and 26.4°C for younger people. 3) Elderly people feel warmer than younger people but they feel more thermally comfortable. 4) Sleep scores were 49.7 for elderly people and 48.5 for younger people. No difference was found for the frequency of night waking or the Sleep maintenance score, but the Fatigue recovery score showed the greatest difference between elderly and younger people.

Comparison of the Effect of Ketamine, Ketamine-Midazolam and Ketamine-Propofol on Post-Tonsillectomy Agitation in Children

Background: Emergence agitation (EA) in children is one of the most common complications following anaesthesia. We aimed to compare the effect of ketamine, ketaminemidazolam and ketamine-propofol on EA after tonsillectomy. Methods: This study was a randomised, double-blind clinical trial conducted on 162 children undergoing adenotonsillectomy surgery. The participants were randomly divided into three groups of receiving ketamine (0.5 mg/kg) (N = 54), ketamine (0.5 mg/kg) + propofol (1 mg/kg) (N = 54) and ketamine (0.5 mg/kg) + midazolam (0.01 mg/kg) (N = 54) 10 min before the end of the operation. At the time of the patients’ entry into the post-anaesthesia care unit (PACU) and at intervals of 5 min, 10 min and 20 min after that, consciousness, mobility, breathing, circulation and SpO2 were recorded. Modified Aldrete recovery score (MARS), the objective pain score (OPS) and Richmond agitation-sedation scale (RASS) were also evaluated. Results: At the time of entrance to the PACU and 5 min later, the ketamine-midazolam and ketamine-propofol groups had lower RASS scores than the ketamine group (P < 0.001); after 10 min and 20 min, the ketamine-propofol group showed the lowest RASS score (P < 0.001). Ketamine-propofol group had a significantly lower MARS score at all-time points (P < 0.001). Recovery time was the longest for the ketamine-propofol group (P = 0.008). Conclusion: The ketamine-midazolam group had lower RASS, greater haemodynamic stability and MARS values without delayed awakening.

Comparison of Recovery Quality Following Medetomidine versus Xylazine Balanced Isoflurane Anaesthesia in Horses: A Retrospective Analysis

Medetomidine partial intravenous anaesthesia (PIVA) has not been compared to xylazine PIVA regarding quality of recovery. This clinical retrospective study compared recoveries following isoflurane anaesthesia balanced with medetomidine or xylazine. The following standard protocol was used: sedation with 7 µg·kg−1 medetomidine or 1.1 mg·kg−1 xylazine, anaesthesia induction with ketamine/diazepam, maintenance with isoflurane and 3.5 µg·kg−1·h−1 medetomidine or 0.7 mg·kg−1·h−1 xylazine, and sedation after anaesthesia with 2 µg·kg−1 medetomidine or 0.3 mg·kg−1 xylazine. Recovery was timed and, using video recordings, numerically scored by two blinded observers. Influence of demographics, procedure, peri-anaesthetic drugs, and intraoperative complications (hypotension, hypoxemia, and tachycardia) on recovery were analysed using regression analysis (p < 0.05). A total of 470 recoveries (medetomidine 279, xylazine 191) were finally included. Following medetomidine, recoveries were significantly longer (median (interquartile range): 57 (43–71) min) than xylazine (43 (32–59) min) (p < 0.001). However, the number of attempts to stand was similar (medetomidine and xylazine: 2 (1–3)). Poorer scores were seen with increased pre-anaesthetic dose of xylazine, intraoperative tetrastarch, or salbutamol. However, use of medetomidine or xylazine did not influence recovery score, concluding that, following medetomidine–isoflurane PIVA, recovery is longer, but of similar quality compared to xylazine.

Lung Ultrasound Assisted Comparison of Volume Effects of Fluid Replacement Regimens in Pediatric Patients Undergoing Penile Hypospadias Repair: A Randomized Controlled Trial

Background: Effective perioperative fluid therapy is a great consideration. Objectives: Using lung ultrasound (LUS), this study evaluated the preference of the conventional and restrictive fluid replacement regimens for their volume impact in pediatric patients undergoing a relatively long procedure with limited volume loss (hypospadias repair). Methods: Eighty pediatric patients scheduled for hypospadias repair surgery were enrolled for conventional (CG) or restrictive fluid management groups (RG). The CG obtained Ringer's lactate at the conventional calculated doses, while the RG obtained infusion of Ringer's lactate at a rate of 3 mL/kg/h. B-line numbers in the LUS, recovery score, urine output, blood pressure (BP), heart rate HR, and oxygen saturation (SpO2) were recorded. Results: As evidenced by the LUS, RG showed a higher incidence of normal lung morphology with a mean and SD of 1.3 ± 2.2 for B-line numbers, whereas, in CG, they were 3.1 ± 2.2 with a P-value < 0.001. Urine output was 3.2 ± 0.8 and 2.9 ± 0.7 for CG and RG, respectively, with a P-value equal to 0.07. HR, BP, and SpO2 differences between groups were statistically insignificant. The recovery score was higher in RG (5.8 ± 0.4) than in CG (5.1 ± 0.8) at the first postoperative 20 minutes, with a P-value < 0.001. Conclusions: In lengthy procedures with limited volume loss, using a moderately restrictive regimen is preferred over the conventional intraoperative fluid regimen considering both respiratory dysfunctions and recovery score.

Effect of temperament on recovery in isoflurane-anaesthetised horses

Background: Recovery is a crucial phase of equine anaesthesia and factors influencing recovery quality are an active area of research. Aim: To investigate the effect of temperament on recovery score after isoflurane-anaesthesia in 30 adult horses undergoing elective surgery. Methods: Two veterinarians used a numerical rating scale to score each horse's response to five tests as a gauge of temperament. Owners used a numerical rating scale to score their horse's temperament according to seven behaviour-related questions. Horses underwent elective surgery under general anaesthesia using a standardised protocol. Recovery was recorded and scored by a blinded assessor using the simple descriptive scale for scoring recovery (R1) and the Edinburgh system (R2). Findings: There was no correlation between veterinarian or owner-assessed temperament and recovery score. Veterinary-assessed temperament score was negatively correlated with pre-induction romifidine and total romifidine dose. Both recovery scores were negatively correlated with anaesthetic duration and R1 was positively correlated with time to first movement in recovery. Conclusions: Temperament did not influence recovery score in our population of horses.

An Analysis for the application of rapid rehabilitation surgery concept in the nursing satisfaction of the perioperative period of the elderly’s hip arthroplasty

Objective To explore the application of rapid rehabilitation surgery concept in the nursing satisfaction of the perioperative period of the elderly’s hip arthroplasty. Methods To select 58 cases of elderly patients undergoing hip arthroplasty in our hospital from March 2017 to February 2018 as the research subjects. The patients were randomly divided into the experimental group and the control group by number table method and there were 29 cases per group. The patients in the experimental group were in the nurse of the concept model of rapid rehabilitation surgery, while the patients in the control group were in the routine nurse of perioperative period. Results After the comparison of hip joint function recovery score, operation time and hospitalization time between the two groups of patients, the advantages of hip function recovery score, operation time, and hospitalization time in the experimental group were obvious statistically significant(P<UNK> 0.05). Compared with the patients in the control group, the nursing satisfaction of the patients in the experimental group was higher and statistically significant(P<UNK> 0.05). Conclusion The concept of rapid rehabilitation surgery is effective for the elderly patients with hip arthroplasty, which can promote the rehabilitation of patients and improve the nursing satisfaction of patients. It is of great significance to improve the relationship between nursing patients.