BMC anesthesiology
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The epidemiology and risk factors for postoperative complications related to free flap reconstruction in head and neck cancer patients admitted to the Intensive Care Unit (ICU) are unknown. ⋯ Postoperative complications related to free flap reconstruction were common in this ICU population. Careful fluid management and monitoring of CRP and hemoglobin levels may reduce complications.
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Post-operative sore throat is the common complaint and uncomfortable side effect in patients receiving general anesthesia with endotracheal intubation. Drugs with analgesic and anti-inflammatory properties, like steroids and local anesthetics, are the best options for postoperative sore throat prophylaxis. Therefore, this study aimed to compare the effects of intravenous lidocaine and dexamethasone in reducing postoperative sore throat following endotracheal extubation at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, from January 1 to March 30, 2023 G.C. ⋯ The incidence of POST was 40%, 32%, and 57.1% in the lidocaine, dexamethasone, and control groups, respectively (P = .0356). Dexamethasone reduced the incidence of POST during the first 24 h (AOR: 0.374, 95% CI: 0.149-0.939). However, no difference was observed in the severity of POST at 3 h (p = 0.130), 6 h (p = 0.096), 12 h (p = 0.313), and 24 h (p = 0.525) of the post-extubation period among the three groups. IV lidocaine did not effectively reduce the incidence and severity of postoperative sore throat at different time intervals. CONCLUSION AND RECOMMENDATION: Intravenous dexamethasone is more effective than intravenous lidocaine in reducing the incidence of postoperative sore throat among the groups. Based on these findings, intravenous dexamethasone is recommended to decrease the incidence of postoperative sore throat.
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Observational Study
A retrospective study of the effects of a vasopressor bolus on systolic slope (dP/dt) and dynamic arterial elastance (Eadyn).
To enhance the utility of functional hemodynamic monitoring, the variables systolic slope (dP/dt) and dynamic arterial elastance (Eadyn) are calculated by the Hypotension Prediction Index (HPI) Acumen® Software. This study was designed to characterize the effects of phenylephrine and ephedrine on dP/dt and Eadyn. ⋯ Bolus administration of phenylephrine or ephedrine increases dP/dt but does not change Eadyn. dP/dt demonstrates potential for predicting the inotropic response to phenylephrine or ephedrine, providing guidance for the most efficacious vasopressor when treating hypotension.
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Observational Study
Opioid free analgesia after return home in ambulatory colonic surgery patients: a single-center observational study.
Because of the adverse effects of morphine and its derivatives, non-opioid analgesia procedures are proposed after outpatient surgery. Without opioids, the ability to provide quality analgesia after the patient returns home may be questioned. We examined whether an opioid-free strategy could ensure satisfactory analgesia after ambulatory laparoscopic colectomy. ⋯ Non-opioid analgesia after ambulatory laparoscopic colectomy seems efficient to ensure adequate analgesia. This therapeutic strategy makes it possible to avoid the adverse effects of opioids.
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Checklists are a common tool used in order to mitigate risks caused by human factors and can facilitate the safe induction of anesthesia as well as handovers. SBAR (Situation, Background, Assessment, Recommendation) is a checklist recommended by the WHO and DGAI for handovers, while SOAP-M (Suction, Oxygen, Airway, Pharmaceuticals, Monitoring) is a checklist for the induction of anesthesia. This study investigates the implementation and adoption of these two checklists. ⋯ SOAP-M and SBAR are perceived as useful checklists for patient handovers and anesthesia induction by tertiary referral hospital's employees with high score in general safety attitude and were therefore commonly used one year after their introduction. No significant difference in checklist adoption between occupations as well as groups divided according to work experience could be found. Perceived usefulness is significantly higher among users of the checklist, who feel using the checklists provides more support.