Background:
Spinal anesthesia induced hypotension and bradycardia are common and hazardous in elderly patients. Many techniques are being tried to prevent and treat these problems even if there is a controversy. The effects of prophylactic atropine on prevention of spinal anesthesia induced hypotension and bradycardia in geriatrics for urologic surgeries are not well-established.
Objective:
To assess the effects of prophylactic atropine in prevention of spinal anesthesia induced hypotension and bradycardia in geriatrics undergoing urological surgeries at a resource limited setting in Central Ethiopia from December 1, 2017 to February 28, 2018 G C.
Methods:
This is a prospective cohort study that recruits 76 patients who underwent elective urological surgeries. Independent t-test and Manny Whitney tests were used for numeric data while Chi-Square or Fisher exact test was used for categorical variables. P-values < 0.05 were considered as statistically significant.
Results:
There was no significant difference in baseline heart rate, mean arterial pressure, type & duration of surgery and total fluid administrations. There was a statistically significant difference in mean heart rate and mean arterial pressure at different times of measurement between the exposed and un-exposed groups. Total 1 h vasopressor consumption was minimal in the exposed group (P = 0.038).
Conclusion:
Prophylactic atropine with in 1 min of induction of spinal anesthesia in elderly patients undergoing urological surgery might reduce the incidence of hypotension and bradycardia.
Highlights:
Background:
Caudal epidural analgesia is one of the most popular reliable, safe and commonly performed regional blocks in pediatric patients undergoing lower abdominal and lower limb surgery. Various adjuvants such as opioids or α2 agonists are being used to improve the quality and duration of caudal analgesia. Addition of Tramadol to local anesthetics has been noted to prolong the duration of analgesia after surgery.
Objective:
To assess the efficacy of adding caudal tramadol to bupivacine for post operative analgesia in pediatric infraumblical surgery.
Method:
Hospital based prospective cohort study design was employed. Comparison of two mean with equal sample size formula for two independent cohort was used to get sample size of 56 children's whose age is 1–14 years' old that undergone elective Infraumbilical surgery received caudal block with bupivacaine alone or with tramadol added. A systemic random sampling technique was used to select study participants. Postoperatively severity of pain either by FLACC/NRS, time to analgesic request and analgesic consumption were evaluated at 1st, 2nd,4th,8th,12th and 24th hrs. Pain severity, first analgesia request time and analgesic consumption were assessed using Mann–Whitney U test for 24 h. Chi-square test was used to assess homogenous categorical independent variables between the two groups and a p-value less than 0.05 was considered to be statically significant.
Result:
Tramadol with bupivacaine has prolonged postoperative analgesia with a median duration of 14 h compared to 5 h in bupivacaine alone. Moreover, total Paracetamol analgesic consumption was lower in tramadol group with a median total dose of 250 mg compared with 437.5 mg in bupivacaine group with statistically significant difference within 24 h (p < 0.018). Also, reduced the pain score in tramadol group, being statically significant at 4th, 8th and12th hours.
Conclusion:
Caudal tramadol with bupivacaine decrease postoperative pain severity, total analgesic consumption and prolong the duration of analgesia. Based on our finding we recommend the use of caudal tramadol with bupivacaine is effective for postoperative analgesia.
Highlights:
Background: Spinal anesthesia induced hypotension and bradycardia are common and hazardous in elderly patients. Many techniques are being tried to prevent and treat these problems even if there is a controversy. The effects of prophylactic atropine on prevention of spinal anesthesia induced hypotension and bradycardia in geriatrics for urologic surgeries are not well-established. Objective: To assess the effects of prophylactic atropine in prevention of spinal anesthesia induced hypotension and bradycardia in geriatrics undergoing urological surgeries at a resource limited setting in Central Ethiopia from December 1, 2017 to February 28, 2018 G.C. Methods: This is a prospective cohort study that recruits 76 patients who underwent elective urological surgeries. Independent t-test and Manny Whitney tests were used for numeric data while Chi-Square or Fisher exact test was used for categorical variables. P-values < 0.05 were considered as statistically significant. Results: There was no significant difference in baseline heart rate, mean arterial pressure, type & duration of surgery and total fluid administrations. There was a statistically significant difference in mean heart rate and mean arterial pressure at different times of measurement between the exposed and un-exposed groups. Total one hour vasopressor consumption was minimal in the exposed group (P = 0.038). Conclusion: Prophylactic atropine with in one minute of induction of spinal anesthesia in elderly patients undergoing urological surgery might reduce the incidence of hypotension and bradycardia.
Background
Fasting of children before anesthesia is mandatory with the aim of to reduce the complications of due to regurgitation, vomiting, aspiration during anesthesia and surgery. Prolonged fasting times have several negative implications in children due to high fluid turnover quickly leads to dehydration, hypotension, metabolic disturbances and hypoglycemia which lead to poor anesthetic outcomes.
Aims
The aim of this study was to assess adherence to preoperative fasting guidelines and associated factors among pediatrics patients undergoing elective surgery in Addis Ababa selected Public Hospitals, Ethiopia, 2020.
Methods
A cross-sectional survey was conducted in Addis Ababa selected Public hospitals, Ethiopia, 2020. A total sample of 279 pediatric patients with age up to 17 years scheduled for elective surgery included in the data collection. The data analysis was done with SPSS V.21 and the value of the variables and its associated factors was checked its association with logistic regression. Significance was determined at P -value < 0.05. The result was presented by using text, tables, charts, and graphs.
Results
A total of 279 pediatric patients were responded in the analysis, with a 98.6% response rate. Majority of the participants 251(89.96%) were not followed the guidelines of preoperative fasting. The mean fasting time for clear liquids was 10 ± 4.03 (2–18 hrs.), for breast milk 7.18 ± 2.26 (3.5–12 hrs.), and for solid foods 13.5 ± 2.76 (8–19 hrs.). The reasons for which the preoperative fasting delayed was due to incorrect order 35.1%, prior cases procedures took longer times 34.1%, and changing sequence of schedule was 20.8%.
Conclusion
The majority of children were still having prolonged fasting practice. The staff’s instructions and sequences of schedules are challenged to follow the international fasting guidelines protocol.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.