BMC anesthesiology
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Emergence delirium (ED) is a mental disturbance in children during recovery from general anaesthesia. The Pediatric Anesthesia Emergence Delirium (PAED) scale is the only validated scale that assesses ED in paediatric patients undergoing general anaesthesia. The aim of this study was the translation and cross-cultural adaptation of the PAED scale into Spanish (Chile). METHODS: A five-stage translation and cross-cultural adaptation process was carried out. The reliability of the Spanish version of the PAED scale was evaluated in paediatric patients independently by a set of two raters (anaesthesiologists or postanaesthesia care unit nurses) in the postanaesthetic period after major outpatient surgery. ED was defined by a cut-off level of ≥ 10 points on the PAED scale. RESULTS: The PAED scale was evaluated in 353 consecutive children. Patients had a mean age of 7.4 ± 3.22 years. The preoperative ASA Physical Status class was 62%, 37%, and 1% (ASA class I, II and III, respectively). The distribution of patients by service was as follows: 45% of patients underwent paediatric surgery; 33% underwent otorhinolaryngological surgery; 11% underwent orthopaedic surgery; 10% underwent ophthalmological surgery; and 1% underwent other types of surgery. The interrater agreement ranged from 96.9% to 97.9%, with Kappa values ranging from 0.59 to 0.79. The Cronbach's alpha value was 0.91. The ED global incidence was 9.1% and was higher in the younger age groups (3-10 years). ⋯ The translated and cross-culturally adapted Spanish version of the PAED scale is a reliable instrument to measure ED in the postanaesthetic period in Chilean children.
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Weaning from mechanical ventilation (MV) is an essential issue in critically ill patients, and we used an explainable machine learning (ML) approach to establish an extubation prediction model. ⋯ We developed an extubation prediction model with high accuracy and visualised explanations aligned with clinical workflow, and the model may serve as an autonomous screen tool for timely weaning.
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Randomized Controlled Trial
Effect of positive end-expiratory pressure on pulmonary compliance and pulmonary complications in patients undergoing robot-assisted laparoscopic radical prostatectomy: a randomized control trial.
To observe the effects of different positive end-expiratory pressure (PEEP) ventilation strategies on pulmonary compliance and complications in patients undergoing robotic-assisted laparoscopic prostate surgery. ⋯ The use of PEEP at 5cmH2O during RARP increases lung compliance, improves intraoperative oxygenation index and reduces postoperative atelectasis.
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Randomized Controlled Trial
Sedative effect and safety of different doses of S-ketamine in combination with propofol during gastro-duodenoscopy in school-aged children: a prospective, randomized study.
Propofol combined with opioids can reduce the dosage of propofol and improve the safety of endoscopy. However, there are few studies on propofol combined with S-ketamine in children undergoing gastro-duodenoscopy. We aim to determine the sedative effect and safety of different doses of S-ketamine in combination with propofol in school-aged children undergoing gastro-duodenoscopy. ⋯ S-ketamine (0.7 mg.kg-1) in combination with propofol can provide satisfactory sedative effect and reduce the dosage of propofol in school-aged children undergoing gastro-duodenoscopy, but there are higher incidence of postoperative dizziness and longer PACU stay.
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Randomized Controlled Trial
Dexamethasone in preventive analgesia alleviates pain and complications after jaw cyst enucleation: a randomized controlled trial.
Dexamethasone is widely used in the prevention of postoperative complications in oral surgery and strengthening the analgesic effect after anesthesia, but the efficacy is controversial, and the relationship between postoperative complications and pain is still unclear. The purpose of this study was to evaluate the analgesic effect of dexamethasone in the treatment of jaw cyst and to explore the relationship between postoperative complications and pain. ⋯ Dexamethasone can reduce the degree of facial swelling and trismus after jaw cyst surgery by inhibiting the production of inflammation, which alleviated the postoperative pain of patients significantly. In addition, it did not increase the risk of hyperglycemia.