Journal of Anesthesiology and Clinical Research

Analysis of Risk Factors for Postoperative Delirium in Geriatric Patients at Skopje Macedonia Hospital: An Observational Study

Konstantina Pekovska, Igor Mitevska — Thu, 29 Feb 2024 08:34:05 +0000

Introduction: Postoperative delirium (DPO) is a complication that often occurs in geriatric patients and can increase morbidity and mortality. Risk factors for DPO in geriatric patients are multifactorial, including advanced age, history of DPO, dementia, comorbidities, and use of certain medications.

Methods: This study was carried out prospectively on 100 geriatric patients undergoing surgery at Skopje Macedonia Hospital. Patient data was collected using questionnaires, interviews, and physical examinations. DPO is defined using the confusion assessment method (CAM).

Results: Of 100 patients, 20 (20%) experienced DPO. Risk factors for DPO identified in this study were elderly (OR = 2.5; 95% CI 1.2-5.1), history of DPO (OR = 3.0; 95% CI 1.4-6.2), dementia (OR = 4.0; 95% CI 1.8-8.8), and use of anticholinergic drugs (OR = 2.2; 95% CI 1.1-4.4).

Conclusion: Elderly, history of DPO, dementia, and use of anticholinergic drugs are risk factors for DPO in geriatric patients. Efforts to prevent DPO in geriatric patients should focus on modifying these risk factors.

Effectiveness of Dexmedetomidine vs Propofol in Post-Open Heart Surgery Patients: A Prospective, Randomized, Double-Blind Study at the PLA Army Central Hospital in Beijing, China

Li Shen — Fri, 01 Mar 2024 03:34:57 +0000

Introduction: Dexmedetomidine and propofol are sedation drugs commonly used in patients after open heart surgery. The aim of this study was to compare the effectiveness of dexmedetomidine and propofol in patients after open heart surgery in terms of sleep quality, delirium, and hemodynamics.

Methods: A prospective, randomized, double-blind study was conducted on 120 patients after open heart surgery at the PLA Army Central Hospital in Beijing, China. Patients were randomized to receive dexmedetomidine (n = 60) or propofol (n = 60). Sleep quality was measured using the Pittsburgh Sleep Quality Scale (PSQI), delirium was measured using the confusion assessment method for the intensive care unit (CAM-ICU), and hemodynamics were monitored continuously.

Results: Patients receiving dexmedetomidine had lower PSQI scores (p < 0.05) and a lower incidence of delirium (p < 0.05) compared with patients receiving propofol. There were no significant differences in hemodynamic parameters between the two groups.

Conclusion: Dexmedetomidine is more effective than propofol in improving sleep quality and reducing delirium in patients after open heart surgery.

The Effect of Implementing the Sepsis Early Goal-Directed Therapy (EGDT) Protocol on Patient Mortality in the Hospital ICU in Cairo, Egypt

Mohammed Abdel Gabbar, Amr Hassan — Fri, 01 Mar 2024 06:39:36 +0000

Introduction: Sepsis is a life-threatening systemic inflammatory syndrome with a high mortality rate. Early goal-directed therapy (EGDT) is a structured therapy protocol that aims to improve tissue perfusion and oxygenation in sepsis patients.

Methods: This retrospective observational study analyzed data on sepsis patients in the ICU of a Cairo hospital, Egypt (2020-2023). Patient mortality was compared before and after the implementation of the EGDT protocol.

Results: Of the 220 sepsis patients, 120 were treated before and 100 after EGDT implementation. Patient mortality in the EGDT group was significantly lower (12% vs 25%, p<0.05).

Conclusion: Implementation of the EGDT protocol can reduce the mortality of sepsis patients in the hospital ICU in Cairo, Egypt.

Intravenous Lidocaine Efficacy in Preventing Succinylcholine-Induced Postoperative Myalgia in Surgical Adult Patients at Tikur Anbessa Specialized Hospital

Mon, 04 Mar 2024 04:26:37 +0000

Introduction: Medical professionals exclusively utilize succinylcholine as a depolarizing muscle relaxant. Some of the negative symptoms include fasciculation, myalgia, muscle spasms, and hyperkalemia. The study aimed to evaluate the efficacy of intravenous lidocaine in preventing succinylcholine-induced postoperative myalgia.

Methods: A prospective cohort study was undertaken on 80 elective surgery patients. Participants were categorized into two groups: one group received intravenous lidocaine (the exposed group), and the other did not receive lidocaine (the control group). The study participant was chosen using a rigorous random sampling procedure. Data collectors monitored patients for post-operative myalgia at 12, 24, and 48 hours following the procedure. We analyzed the data using SPSS version 26. A P-value below 0.05 indicated statistical significance.

Results: Demographic and clinical data in both groups are similar, with a p-value greater than 0.05. The total incidence rate of succinylcholine-induced postoperative myalgia was 39.3%. 22.5% of the group that received lidocaine experienced postoperative myalgia, compared to 60% of the group that did not receive lidocaine. The group that received lidocaine had lower postoperative myalgia severity generated by succinylcholine compared to the group that did not receive lidocaine, with percentages of 42.9% against 53.3% for mild myalgia, and 15.8% versus 84.3% for moderate myalgia, respectively, with a p-value of 0.001.

Conclusion: Administering lidocaine intravenously prior to surgery effectively reduced the occurrence and intensity of succinylcholine-induced muscle pain after the operation.

Comparison of the Effectiveness of Total Intravenous Anesthesia (TIVA) vs Inhalation Techniques in Patients with Morbid Obesity at Dr. M. Djamil General Hospital, Padang, Indonesia

Abdul Mutholib, Zuriatinah — Wed, 06 Mar 2024 05:38:24 +0000

Introduction: Morbidly obese patients (BMI ≥ 40 kg/m²) present unique challenges in anesthesia. Total intravenous anesthesia (TIVA) and inhalation techniques have their respective advantages and disadvantages in this group of patients. This study aims to compare the effectiveness and safety of TIVA and inhalation anesthesia in morbidly obese patients at Dr. M. Djamil General Hospital Padang.

Methods: A prospective, randomized study was conducted on 80 morbidly obese patients undergoing elective surgery. Patients were randomized to receive TIVA with propofol and remifentanil or inhalation anesthesia with sevoflurane and desflurane.

Results: The TIVA group demonstrated faster recovery time (p = 0.02) and less postoperative opioid requirements (p = 0.01) than the inhalation group. There was no significant difference in the incidence of intraoperative or postoperative complications.

Conclusion: TIVA is an effective and safe option for morbidly obese patients undergoing elective surgery. TIVA offers faster recovery and fewer postoperative opioid requirements than inhalation anesthesia.