Significantly higher values of cardiac biomarkers were observed in SAH patients complicated with NPE. Elevated values of cardiac biomarkers appear to play an active role in prediction of NPE, although white blood cell count may be involved in the prediction of NPE. There is an influence of SAH therapy on predictors of NPE.

The duration of anesthesia, the sitting position of the patient, and the presence of comorbidities significantly increase the risk of anesthesia complications in pediatric neurosurgery.

The prevalence of allergic reactions in general opulation shows a constant rise. It has been estimated that up to 40% of surgical patients have a positive history of some kind of allergy. These patients represent a challenge during perioperative evaluation, since they can be exposed to a large variety of drugs and substances during surgery and anesthesia. A lot of adverse drug reactions show similar clinical presentation with allergic reactions. The latter are usually poorly explored since preoperative allergology testing is performed in a limited number of patients. Management of patients with history of allergy is impeded by the fact that most of allergens cross-react in a manner that is not always easy to predict. Allergies can manifest themselves with a broad spectrum of clinical symptoms, ranging from mild skin symptoms such as itch and urticaria, to a life-threatening anaphylactic reactions followed by hypotension, bronchospasm and cardiovascular collapse. Prevention of allergic reactions during perioperative period requires detailed history taking in order to identify patients at risk, optimization of anesthesia strategy, pharmacological premedication and further allergology diagnostic work-up in selected cases.

Background Globalization and profitable health (cost/benefit) requires pharmacoeconomic evaluation of the costs in relation to effectiveness of the methods of treatment. The objective of this study was to analyze the cumulative costs of anesthesia in all surgical disciplines using the Activity-Based Costing (ABC) analysis. Methods This work is a part of Phase IV clinical study. Retrospectively, for 2006, direct costs of anesthesia services were calculated: (1) personnel costs (salaries), (2) drugs and supplies, (3) other costs (analysis and apparatus) in the Institute of Anesthesiology and Resuscitation, Clinical Center of Serbia. The research group included all anesthetized patients of both genders and ofall ages. Summary data documented in the anesthesia department and databases of the Clinical Center of Serbia and the Republic Institute of Health Insurance were used. Numerical data were calculated and analyzed by computer programs Microsoft Office Excel 2003 and SPSS for Windows. Results The results of direct costs showed that personnel costs accounted for 40%, medicines and supplies-31.80% and other costs-28.20% of the funds. Anesthesia costs accounted for 10% (ABC analysis) of direct costs. Methodological dilemmas were related to the inaccuracy of anesthetic and surgical protocols, the classification of anesthetic and surgical services and the imperfection of computer data entry software. Basic hospital activities information should be more specific and precise. Clinical protocols of the anesthetized patients should be connected better with the Admission department, Intensive care units, Day surgical hospital and other departments. Database of the clinical drug pathway, Clinical protocols, Accounting Information Systems, and Hospital Management Information Systems should be precise, specific and managed in a better way. Conclusions The costs of local and general anesthesia procedures are objectively low and numerous, what may be objectified by this pharmacoeconomic analysis. Those insufficiently informed call for "rationalization". The costs of drugs and supplies are real while all other costs are agreed upon, and accordingly, there is no possibility of cutting down the expenses within so small and restrictive health budget. The change of budget dynamics and education of control staff could be helpful.