Risk Factors for Acute Postoperative Sort Throat (POST) After Supraglottic Device Use 

2021 ◽  
Author(s):  
Yanzhe Huang ◽  
Kaizheng Chen ◽  
Xia Shen
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Medical Records ◽  
Multivariate Logistic Regression Analysis ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Postanesthesia Care Unit ◽  
Intracuff Pressure ◽  
Duration Of Surgery ◽  
Pacu Stay

Abstract Background. To identify risk factors for acute postoperative sort throat (POST) after general anesthesia using a supraglottic airway device (SAD) in adults undergoing elective tympanoplasty.Methods. The medical records of 1424 adults who underwent elective tympanoplasty under general anesthesia using an SAD were reviewed retrospectively. Patients received one of four SADs at the discretion of the anesthesiologists: flexible reinforced LMA (FLMA), Ambu AuraFlex FLMA, or two local brand devices (Tuoren FLMA or Tuoren Esophageal Drainage LMA). POST upon discharge from the postanesthesia care unit (PACU) was measured using a visual analog sale (VAS) and categorized as no pain, mild pain, and moderate to severe pain. Data regarding potential risk factors for POST were collected from the medical records. Results. The mean patient age was 43.24 years; 622 patients were male and 802 were female. The overall incidence of POST during the PACU stay was 38.1%. Female sex, certain types of SAD, higher intracuff pressure, and longer duration of surgery were independent risk factors for POST on multivariate logistic regression analysis. Compared to FLMA, both the Tuoren FLMA and the Tuoren Esophageal Drainage LMA were risk factors for POST. The Tuoren Esophageal Drainage LMA was the strongest independent risk factor for moderate to severe POST.Conclusions. Use of local brand SADs contributed to the development of POST after elective tympanoplasty under general anesthesia. The Tuoren Esophageal Drainage LMA was the strongest predictor of moderate to severe POST.

Massive Engorgement of a Hemangioma of the Tongue After General Anesthesia Using a Supraglottic Airway Device: A Case Report

2020 ◽  
Vol 14 (9) ◽  
pp. e01256 ◽  
Author(s):  
Sushan Gupta ◽  
Saratchandra Majety ◽  
Jeson R. Doctor ◽  
Jigeeshu V. Divatia
Keyword(s):  
Case Report ◽  
General Anesthesia ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Supraglottic Airway Device

scholarly journals Risk Factors of Postoperative Shivering at Post Anesthesia Care Unit in Normothermic Patients Underwent General Anesthesia

2021 ◽  
Author(s):  
Laortip Rattanapittayaporn ◽  
Maliwan Oofuvong
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Core Temperature ◽  
Conditional Logistic Regression ◽  
Control Group ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Emergency Case ◽  
Increased Risk ◽  
Duration Of Surgery

Objective: The aim of study was to identify risk factors that can be modified to reduce incidence of postoperative shivering in normothermic patient who underwent general anesthesia.Material and Methods: A retrospective case control study was conducted between January 2017 and August 2018 by assessing the anesthetic records of normothermic patients at a post anesthesia care unit who underwent general anesthesia. A control group of 201 patients was randomly matched with 201 cases by age (±5 years) and site of surgery. Medical records were reviewed for data including patient demographics, operative time, anesthetic medication, type of fluid, core temperature at the end of surgery and occurrence of postoperative shivering. Conditional logistic regression analysis was performed to assess the association between potential risk factors and postoperative shivering.Results: Higher body mass index (BMI) [odds ratio (OR) 0.91, 95% confidence interval (CI) 0.87-0.96] and higher core temperature at end of surgery (OR 0.33 95% CI 0.18-0.63) are associated with reduced risk of postoperative shivering. Whereas emergency case compared with elective case (OR 3.06 95% CI 1.63-5.72) and longer duration every 10 minutes (OR 1.05 95% CI 1.03-1.08) are associated with an increased risk of postoperative shivering.Conclusion: Emergency case, longer duration of surgery, lower BMI and lower core temperature at end of surgery were significantly associated with postoperative shivering.

scholarly journals Risk Factors for Moderate-to-severe Postoperative Pain After Percutaneous Nephrolithotomy:A Retrospective Study

2021 ◽  
Author(s):  
Hao-Tian Wu ◽  
Tian-fu Ding ◽  
Huan Zhang
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Postoperative Pain ◽  
Severe Pain ◽  
Multivariate Logistic Regression Analysis ◽  
Renal Calculus ◽  
Multivariate Logistic Regression ◽  
Pain Group ◽  
Duration Of Surgery ◽  
Severe Postoperative Pain

Abstract Backgroud and Objectives: Percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure for removing renal calculus ,but a large number of patients experience acute moderate-to-severe pain despite the analgesia provided.The aim of this study is to explore the risk factors for postoperative pain after percutaneous nephrolithotomy (PCNL), and provides a reference for clinical prevention of postoperative pain after PCNL.Methods: According to the inclusion and exclusion criteria, the clinical data of 331 patients who underwent PCNL in our hospital from September 2019 to February 2021 were retrospectively collected. General anesthesia was induced with propofol, sufentanil and rocuronium and maintained with sevoflurane, remifentanil and rocuronium.Depending on whether the patient had moderate-to-severe postoperative pain, they were divided into mild or no pain group and moderate-to-severe pain group. We collected and analyzed data on age,gender, body mass index (BMI),ASA grading,co-morbidities,number of renal calculus,renal calculus size,degree of hydronephrosis,preoperative urine culture,preoperative creatinine,stone burdens,expansion method,tract diameter,nephrostomy tube,calculi residual,operative position ,puncture time ,number of expanded channels,expanded channel time, duration of surgery,vital signs and VAS pain score.The indicators with statistically significant differences were selected and multivariate logistic regression analysis was carried out to determine the risk factors for postoperative pain. Results: Among 331 patients, 221 had moderate-to-severe pain and the incidence rate was 66.77%. Univariate analysis and multivariate logistic regression analysis showed that independent risk factors for moderate-to-severe pain after PCNL were:number of renal calculus(OR=5.303，P=0.001),stone burdens (OR=7.623，P=0.001),calculi residual(OR=0.2377，P=0.001),duration of surgery (min)(OR=1.024， P=0.001). Conclusions: The main risk factors for pain after PCNL are number of renal calculus,stone burdens ,calculi residual and duration of surgery.

scholarly journals Comparative Efficacy of the Air-Q Intubating Laryngeal Airway during General Anesthesia in Pediatric Patients: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Eun Jin Ahn ◽  
Geun Joo Choi ◽  
Hyun Kang ◽  
Chong Wha Baek ◽  
Yong Hun Jung ◽  
...  
Keyword(s):  
Systematic Review ◽  
General Anesthesia ◽  
Pediatric Patients ◽  
Meta Analysis ◽  
Final Analysis ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Comparative Efficacy ◽  
Supraglottic Airway Devices ◽  
Airway Devices

Air-Q® (air-Q) is a supraglottic airway device which can be used as a guidance of intubation in pediatric as well as in adult patients. We evaluated the efficacy and safety of air-Q compared to other airway devices during general anesthesia in pediatric patients by conducting a systematic review and meta-analysis. A total of 10 studies including 789 patients were included in the final analysis. Compared with other supraglottic airway devices, air-Q showed no evidence for a difference in leakage pressure and insertion time. The ease of insertion was significantly lower than other supraglottic airway devices. The success rate of intubation was significantly lower than other airway devices. However, fiberoptic view was better through the air-Q than other supraglottic airway devices. Therefore, air-Q could be a safe substitute for other airway devices and may provide better fiberoptic bronchoscopic view.

scholarly journals Aggressive Prophylactic Treatments for Postoperative Nausea and Vomiting Improve Outcomes in Pediatric Adenotonsillectomy Procedure

2020 ◽  
Vol 25 (4) ◽  
pp. 303-308
Author(s):  
Tatyana Demidovich ◽  
Orlando Perez-Franco ◽  
Marco Silvestrini-Suarez ◽  
Pin Yue
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
General Anesthesia ◽  
Postoperative Nausea ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Antiemetic Drugs ◽  
Pacu Stay

OBJECTIVE Postoperative nausea and vomiting (PONV) is an extremely common side effect of general anesthesia that is difficult to manage. We tested a hypothesis that an aggressive prophylactic intervention with additional antiemetic drugs will reduce the incidence of PONV in a high-risk pediatric population undergoing adenotonsillectomy. METHODS In this retrospective study, pediatric patients undergoing adenotonsillectomy were screened for their risk factors for PONV. Patients who had 3 or more risk factors were identified as high risk and received either scopolamine patch preoperatively (for patients over 40 kg body weight) or diphenhydramine immediately postextubation in addition to ondansetron and dexamethasone, which are given routinely. Incidences of PONV within the first 60 minutes of a postanesthesia care unit (PACU) stay were collected and analyzed. RESULTS Overall postoperative vomiting rates during the first hour of a PACU stay were 4.3% for the group that was treated with dexamethasone and ondansetron only and 3.9% for the group that was treated with additional antiemetic drugs. Aggressive prophylactic management of PONV did reduce the rate of nausea and vomiting in a group of high-risk patients (p < 0.0001). The postoperative antiemetic drug usage was also decreased during the first 60 minutes of a PACU stay. However, the approach did not reduce the overall rate of PONV for the entire study population (p = 0.1612 for nausea and p = 0.0678 for vomiting). CONCLUSION Aggressive intraoperative management of PONV with additional antiemetic drugs are beneficial in high-risk pediatric population. Intraoperative diphenhydramine usage decreased the rate of PONV. However, preoperative scopolamine patch prevention did not improve PONV, which may be related to the drug's longer onset of action. Our result suggests that current clinical practice is undertreating PONV in pediatric patients receiving general anesthesia.

scholarly journals Identification of risk factors associated with oral 5-aminolevulinic acid-induced hypotension in photodynamic diagnosis for non-muscle invasive bladder cancer: a multicenter retrospective study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hideo Fukuhara ◽  
Takahiro Nohara ◽  
Koshiro Nishimoto ◽  
Yutaka Hatakeyama ◽  
Yuki Hyodo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bladder Cancer ◽  
General Anesthesia ◽  
Aminolevulinic Acid ◽  
Multivariate Logistic Regression Analysis ◽  
Photodynamic Diagnosis ◽  
Decision Tree Analysis ◽  
Multivariate Logistic Regression ◽  
Induced Hypotension ◽  
Tree Analysis

Abstract Background To investigate risk factors for orally administered 5-aminolevulinic acid (ALA)-induced hypotension for bladder cancer patients receiving photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT). Methods Patients were categorized into two groups intraoperatively: a hypotensive group (minimum systolic blood pressure (SBP) ≤80 mmHg) and a non-hypotensive group (minimum SBP > 80 mmHg). We examined differences between the hypotensive group and non-hypotensive groups to identify clinical risk of ALA-induced hypotension using multivariate logistic regression analysis and decision tree analysis. Results Among 282 cases with ALA-PDD-assisted TURBT from three institutions who were screened, 245 patients were included in the final analysis. In total, 156 patients (63.7%) showed any grade of hypotension during ALA-PDD-assisted TURBT. General anesthesia and spinal anesthesia were induced intraoperatively in 113 patients (46.1%) and 132 patients (53.9%), respectively. Median SBP at baseline (before taking ALA) and at the beginning of anesthesia was 127 mmHg (range, 69–186 mmHg) and 124 mmHg (range, 69–186 mmHg), respectively. Median minimum SBP during ALA-PDD-assisted TURBT was 75 mmHg (range, 43–140 mmHg). Multivariate logistic regression analysis revealed that history of hypertension (odds ratio (OR) 7.568, p < 0.05) and general anesthesia (OR 14.435, p < 0.05) as significantly associated with an increased risk of hypotension incidence. Use of calcium antagonist showed significant negative associations with hypotension (OR 0.183, p < 0.05). Decision tree analysis showed presence of general anesthesia, age ≥ 74 years and American Society of Anesthesiologists physical status (ASA-PS) ≥2 as the most important discriminators. Conclusions General anesthesia and hypertension were independent risk factors related to ALA-induced hypotension. In contrast, use of calcium antagonists was identified as a factor associated with reduced risk of ALA-induced hypotension.

scholarly journals The Influencing Factors of Postoperative Delirium in Elderly Hip Fracture Patients: What Should Treatment Focus On

2021 ◽  
Author(s):  
Chunwen Yan ◽  
Min Yang ◽  
Nasha Niu ◽  
Linmei Li ◽  
Li Pan
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Blood Loss ◽  
Elderly Patients ◽  
Influencing Factors ◽  
Postoperative Delirium ◽  
Multivariate Logistic Regression Analysis ◽  
Estimated Blood Loss ◽  
Duration Of Surgery ◽  
History Of

Abstract Background: The postoperative delirium is a common yet serious complication in elderly patients with hip fracture, it’s necessary to evaluate the potential risk factors of delirium in patients with hip fracture, to provide reliable evidence to the clinical management of hip fracture.Methods: Elderly patients who underwent hip fracture surgery in our hospital from June 1, 2019 to May 31, 2021 were selected. The characteristics and treatment data of delirium and no delirium patients were collected and compared. Multivariate logistic regression analysis was conducted to analyze the influencing factors affecting postoperative delirium in elderly patients with hip fracture.Results: A total of 245 patients with hip fracture were included, the incidence of postoperative delirium in patients with hip fracture was 13.06%. There were significant differences in the age, BMI, history of delirium, estimated blood loss and duration of surgery (all p<0.05). There were significant differences in the albumin and TSH between delirium and no delirium group(all p<0.05), Logistics analyses indicated that ge≥75y(OR3.112,95%CI1.527~5.742), BMI ≥24 kg/m2(OR2.127,95%CI1.144~3.598), history of delirium(OR1.754,95%CI1.173~2.347), estimated blood loss≥400ml(OR1.698,95%CI1.427~1.946), duration of surgery≥120min(OR2.138,95%CI1.126~3.085), preoperative albumin≤40g/L(OR1.845,95%CI1.102~2.835) and TSH≤2mU/L(OR2.226, 95%CI1.329~4.011) were the independent risk factors of postoperative delirium in patients with hip fracture(all p<0.05).Conclusions: Postoperative delirium is very common in elderly patients with hip fracture, and it was associated with many risk factors, clinical preventions targeted on those risk factors are needed to reduce the postoperative delirium.

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