BMC anesthesiology
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Neuraxial anesthesia is the gold standard for cesarean sections, but general anesthesia is sometimes necessary, especially in emergency cases. Anaphylactic shock due to succinylcholine, a commonly used neuromuscular blocking agent, is rare but life-threatening. ⋯ This case highlights the need for rapid identification and management of anaphylactic shock during emergency cesarean sections under general anesthesia, especially in high-risk patients with complex medical histories.
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Hemodynamic changes are independent risk factors for long-term patient morbidity and duration of hospital stay. According to the statistics, the three most prevalent complications in the postanaesthesia care unit were airway events, haemodynamic instability, and postoperative nausea and vomiting. Hemodynamic instability in the postanaesthesia care unit can result in serious complications, such as long-term patient morbidity and prolonged hospital stays. This study aimed to determine the incidence and factors associated with haemodynamic changes among adult surgical patients in the postanaesthetic care unit. ⋯ In general, 93 study subjects (22.7%) experienced advanced haemodynamic instability during the intraoperative period. This implies that the incidence of hemodynamic instability was high. Intraoperative haemodynamic instability, American Society of Anaesthesiology class III, postoperative respiratory adverse events, neurologic and gynaecological procedures, use of neuraxial anaesthesia, and prolonged duration of procedures were predictors of haemodynamic instability in the postanaesthesia care unit.
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Major abdominal surgery is a kind of high-risk surgery type for postoperative acute kidney injury (AKI) among non-cardiac surgeries. Despite dexmedetomidine exerts significant renal protective effects in cardiac surgeries and animal studies, whether it is associated with a lower incidence of AKI in major abdominal surgeries remains unclear. ⋯ In this single-center retrospective propensity-matched study, we did not detect a significant overall difference in post-operative AKI rates between patients treated with or without dexmedetomidine during major abdominal surgery. However, though additional prospective data are needed, our study found that administering dexmedetomidine with a loading dose may be associated with lower rates of AKI, potentially indicating a renoprotective effect of loading-dose dexmedetomidine in this setting.
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The study aimed to develop a predictive model with machine learning (ML) algorithm, to predict and manage the need for red blood cell (RBC) transfusion during hip fracture surgery. ⋯ Our study firstly demonstrated that the RF model with 10 common variables might predict intraoperative RBC transfusion in hip fracture patients.
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Randomized Controlled Trial
Endoscopic assessment of gastric emptying in older adults after preoperative administration of 5% glucose solution: a randomized controlled study.
Delayed gastric emptying of liquids may heighten the risk of aspiration reflux in elderly individuals. To investigate the gastric emptying of an oral supplement containing 5% dextrose solutions before sedation for gastroscopy. ⋯ In elderly patients, drinking 5 ml/kg of a 5 % glucose solution two hours prior to gastroscopy does not significantly increase gastric volume compared to midnight fasting.