IntroductionOur aim was to study the outcomes and predictors of in-hospital cardiopulmonary resuscitation (CPR) among adult patients at a tertiary care centre in Pakistan.MethodsWe conducted a retrospective chart review of all adult patients (age ≥14 years), who underwent CPR following cardiac arrest, in a tertiary care hospital during a 5-year study period (June 1998 to June 2003). We excluded patients aged 14 years or less, those who were declared dead on arrival and patients with a “do not resuscitate” order. The 1- and 6-month follow-ups of discharged patients were also recorded.ResultsWe found 383 cases of adult in-hospital cardiac arrest that underwent CPR. Pulseless electrical activity was the most common initial rhythm (50%), followed by asystole (30%) and ventricular tachycardia/fibrillation (19%). Return of spontaneous circulation was achieved in 72% of patients with 42% surviving more than 24 h, and 19% survived to discharge from hospital. On follow-up, 14% and 12% were found to be alive at 1 and 6 months, respectively. Multivariable logistic regression identified three independent predictors of better outcome (survival >24 h): non-intubated status [adjusted odds ratio (aOR):3.1, 95% confidence interval (CI):1.6–6.0], location of cardiac arrest in emergency department (aOR: 18.9, 95% CI:7.0–51.0) and shorter duration of CPR (aOR:3.3, 95% CI:1.9–5.5).ConclusionOutcome of CPR following in-hospital cardiac arrest in our setting is better than described in other series. Non-intubated status before arrest, cardiac arrest in the emergency department and shorter duration of CPR were independent predictors of good outcome.

Pericapsular nerve group (PENG) block has been successfully utilized as an optional regional anesthesia approach to manage the pain for hip surgeries without affecting motor function. During recent years, the applications of PENG block are expanding. There is one previous review on PENG block for hip surgeries in the scientific literature and it is limited to case series and case reports only. We found few randomized controlled trials related to the role of PENG block in recent literature. So, a meta-analysis was done to evaluate the role of PENG block in managing postoperative pain after hip surgeries. We followed PRISMA guidelines to perform this meta-analysis. Online databases including Medline and ScienceDirect were used. This review was registered with the PROSPERO database (CRD42022297694) in January 2022. The included studies in this review reported opioid use, pain control after surgery, and side effects associated with PENG block among patients undergoing hip surgeries. The Review Manager software, i.e. RevMan for Mac 5.4 (Cochrane Collaboration, Oxford, UK) was utilized to conduct a meta-analysis. During this meta-analysis, six randomized trials were included. Our results demonstrated that PENG block usage for patients undergoing hip surgery is correlated with a significant reduction in opioids in the first 24 h after surgery (p=0.05). It also resulted in significant prolongation of time to first request analgesia with mean difference as 3.82 h (0.05-7.60), (p=0.05). Our results showed that PENG block is associated with better patient satisfaction as well. The PENG block resulted in less motor block in the postoperative period (p=0.0002). In conclusion, PENG block can significantly reduce 24-h opioids consumption after hip surgery. This block also resulted in prolonged time to first request of analgesia postoperatively. There is less risk of motor block and hence the potential for better physiotherapy.

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Context: The process of stratifying patient risk preoperatively helps in the decision about the best-possible postoperative care for patients. There have been many scoring systems that are used in anesthesia practice. Aims: To find out whether there is any difference between the mortality predicted from SORT scoring and the observed mortality among Saudi patients. Settings and Design: This was a prospective, observational study in which we included patients underoing nonemergency surgical procedures at the Security Forces Hospital, Riyadh. Methods and Material: We calculated the SORT scores for all the included patients. We then collected the 30-day mortality data of all the patients having nonemergency surgical procedures. Statistical Analysis Used: We calculated the expected mortality ratio. A P value of less than 0.05 was considered significant. Results: The mean SORT mortality risk score (%) for the whole sample was 0.30. The expected number of deaths was 1.638 while the observed deaths were 2, which yields an O/E ratio of 0.819 (p-value: 0.006). The O/E mortality ratios for patients in each individual ASA class were found to be statistically insignificant which means that SORT score can reliably predict mortality for each ASA class. Conclusions: SORT scores can be used to predict 30-day mortality after nonemergency surgeries in Saudi population.