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Search results for: general anesthesia

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</div> </div> </div> <h1 class="mt-3 mb-3 text-center" style="font-size:1.6rem;">Search results for: general anesthesia</h1> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5160</span> Neurological Complications Related to Anesthesia in Pediatric Patients Receiving Radiation Therapy under Anesthesia</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Behzad%20Sinaei">Behzad Sinaei</a>, <a href="https://publications.waset.org/abstracts/search?q=Shahryar%20Sane"> Shahryar Sane</a>, <a href="https://publications.waset.org/abstracts/search?q=Behzad%20Kazemi%20Haki"> Behzad Kazemi Haki</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Children with different malignancies usually experience potential neurologic complications when treated with radiation therapy, especially if under frequent anesthesia. The aim of this study was to evaluate the neurologic problems associated with anesthesia in pediatrics treated with radiotherapy under anesthesia. The study was a cross-sectional experiment that consisted of 133 pediatric patients with different malignancies who needed anesthesia for performing radiotherapy and were referred to Omid Charity Hospital and Imam Khomeini University Hospital from 2014 to 2020 by the census. P-values less than 0.05 were considered statistically significant (P-value < 0.05). Anesthesia complications in this study were slight and insignificant. Some were due to the effects of the tumor on other important organs or either previous radiation therapy or chemotherapy. For safe anesthesia, considering the effects of tumors on body organs and the neurological complications they cause can greatly help reduce anesthesia complications in pediatrics under radiation therapy. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=anesthesia" title="anesthesia">anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=neurologic%20complications" title=" neurologic complications"> neurologic complications</a>, <a href="https://publications.waset.org/abstracts/search?q=pediatrics" title=" pediatrics"> pediatrics</a>, <a href="https://publications.waset.org/abstracts/search?q=radiotherapy" title=" radiotherapy"> radiotherapy</a> </p> <a href="https://publications.waset.org/abstracts/150880/neurological-complications-related-to-anesthesia-in-pediatric-patients-receiving-radiation-therapy-under-anesthesia" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/150880.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">103</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5159</span> MicroRNA Differential Profiling in Hepatitis C Patients Undergoing Major Surgeries: Propofol versus Sevoflurane Anesthesia</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Hala%20Demerdash">Hala Demerdash</a>, <a href="https://publications.waset.org/abstracts/search?q=Ola%20M.%20Zanaty"> Ola M. Zanaty</a>, <a href="https://publications.waset.org/abstracts/search?q=Emad%20Eldin%20Arida"> Emad Eldin Arida</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: This study investigated the micoRNA expression changes induced by Sevoflurane and Propofol and their effects on liver functions. Patients and methods: The study was designed as randomized controlled study, carried out on 200 adult patients, scheduled for major surgeries under general anesthesia (GA). Patients were randomly divided into four groups; groups SC and PC included chronic hepatitis C (CHC) patients where SC group are patients receiving Sevoflurane, and PC group are patients receiving Propofol anesthesia. While S and P groups included non- hepatitis patients; S group are patients receiving Sevoflurane and P group are patients receiving Propofol. Anesthesia in Group S and SC patients was maintained by sevoflurane, while anesthesia in Group P and PC patients was maintained by propofol infusion. Blood samples were analyzed for PT, PTT and liver enzymes. Serum samples were analyzed for microRNA before and after surgery. Results: Results show miRNA-122 and miRNA-21 were absent in serum of S and P groups in pre-operative samples. However, they were expressed in SC and PC groups. In post-operative samples; miRNA-122 revealed an increased expression in all groups; with more exaggerated response in SC group. On the other hand miRNA-21 revealed increased expression in both SC and PC groups; a slight expression in S group with absent expression in P group. There was a post-operative negative correlation between miR-122 and ALT (r=-0.46) in SC group and (r=-0.411) in PC group and positive correlation between ALT and miR-21 (r=0.335) in SC group and (r=0.379) in PC group. The amount of blood loss was positively correlated with miR-122 (r=0.366) in SC group and (r=0.384) in PC group. Conclusion: Propofol anesthesia is safer than Sevoflurane anesthesia in patients with CHC. Sevoflurane and Propofol anesthesia affect miRNA expression in both CHC and non-hepatitis patients. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=anesthesia" title="anesthesia">anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=chronic%20hepatitis%20C" title=" chronic hepatitis C"> chronic hepatitis C</a>, <a href="https://publications.waset.org/abstracts/search?q=micoRNA" title=" micoRNA"> micoRNA</a>, <a href="https://publications.waset.org/abstracts/search?q=propofol" title=" propofol"> propofol</a>, <a href="https://publications.waset.org/abstracts/search?q=sevoflurane" title=" sevoflurane"> sevoflurane</a> </p> <a href="https://publications.waset.org/abstracts/42677/microrna-differential-profiling-in-hepatitis-c-patients-undergoing-major-surgeries-propofol-versus-sevoflurane-anesthesia" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/42677.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">341</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5158</span> First Documented Anesthesia with Use of Low Doses of Tiletamine-Zolazepam Combination in Ovoviparous Amazon Tree Boa Undergoing Emergency Coeliotomy-Case Report</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Krzysztof%20Buczak">Krzysztof Buczak</a>, <a href="https://publications.waset.org/abstracts/search?q=Sonia%20Lachowska"> Sonia Lachowska</a>, <a href="https://publications.waset.org/abstracts/search?q=Pawel%20Kucharski"> Pawel Kucharski</a>, <a href="https://publications.waset.org/abstracts/search?q=Agnieszka%20Antonczyk"> Agnieszka Antonczyk</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Tiletamine - zolazepam combination is increasingly used in veterinary anaesthesiology in wild animals, including snakes. The available literature shows a lack of information about anesthesia in this mixture in ovoviviparous snakes. The studies show the possibility of using the combination at a dose of 20 mg/kg or more for snake immobilization. This paper presents an anesthetic protocol with the use of a combination of tiletamine - zolazepam at the dose of 10 mg/kg intramuscularly and maintenance with inhalant anesthesia with isoflurane in pure oxygen. The objective of this study was to evaluate the usefulness of the anesthetic protocol to proceed with coeliotomy in Amazon Tree Boa. The patient was a five years old bicolor female Amazon Tree Boa (Corallus hortulanus) with dystocia. The clinical examination reveals significant emaciation (bodyweight 520g), high degree of dehydration, heart rate (HR = 60 / min), pale mucous membranes and poor reactivity. Meloxicam (1 mg/kg) and tramadol (10 mg/kg) were administered subcutaneously and the patient was placed in an incubator with access to fresh oxygen. Four hours later, the combination of tiletamine - zolazepam (10 mg/kg) was administered intramuscularly for induction of anesthesia. The snake was intubated and connected to inhalant anesthesia equipment. For maintenance, the anesthesia isoflurane in pure oxygen was used due to apnea, which occurs 30 minutes after the induction semi-closed system was attached and the ventilator was turned on (PCV system, four breaths per minute, 8 cm of H2O). Cardiopulmonary parameters (HR, RR, SPO2, ETCO2, ETISO) were assessed throughout the procedure. During the entire procedure, the operating room was heated to a temperature of 26 degrees Celsius. Additionally, the hose was placed on a heating mat, which maintained a temperature of 30 degrees Celsius. For 15 minutes after induction, the loss of muscle tone was observed from the head to the tail. Induction of general anesthesia was scored as good because of the possibility of intubation. During the whole procedure, the heart rate was at the rate of 58 beats per minute (bpm). Ventilation parameters were stable throughout the procedure. The recovery period lasts for about 4 hours after the end of general anesthesia. The muscle tension returned from tail to head. The snake started to breathe spontaneously within 1,5 hours after the end of general anesthesia. The protocol of general anesthesia with the combination of tiletamine- zolazepam with a dose of 10 mg/kg is useful for proceeding with the emergency coeliotomy in maintenance with isoflurane in oxygen. Further study about the impact of the combination of tiletamine- zolazepam for the recovery period is needed. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=anesthesia" title="anesthesia">anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=corallus%20hortulanus" title=" corallus hortulanus"> corallus hortulanus</a>, <a href="https://publications.waset.org/abstracts/search?q=ovoviparous" title=" ovoviparous"> ovoviparous</a>, <a href="https://publications.waset.org/abstracts/search?q=snake" title=" snake"> snake</a>, <a href="https://publications.waset.org/abstracts/search?q=tiletamine" title=" tiletamine"> tiletamine</a>, <a href="https://publications.waset.org/abstracts/search?q=zolazepam" title=" zolazepam"> zolazepam</a> </p> <a href="https://publications.waset.org/abstracts/137039/first-documented-anesthesia-with-use-of-low-doses-of-tiletamine-zolazepam-combination-in-ovoviparous-amazon-tree-boa-undergoing-emergency-coeliotomy-case-report" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/137039.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">246</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5157</span> Unexpected Acute Respiratory Failure following Administration of Rocuronium Bromide during Cesarean Delivery in a Severely Preeclamptic Parturient Treated with Magnesium Sulfate</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Joseph%20Carl%20Macalintal">Joseph Carl Macalintal</a>, <a href="https://publications.waset.org/abstracts/search?q=Erlinda%20Armovit"> Erlinda Armovit</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Magnesium sulfate has been a mainstay in the management of preeclampsia and is associated with a decreased incidence of morbidity and mortality. The syndrome has an unpredictable course, sometimes rapidly evolving to full-blown disease. In patients with deteriorating status, it is indicated to terminate the pregnancy via cesarean section. The anesthesiologists would prefer to have the procedure done under regional anesthesia; however, there may be cases when neuraxial anesthesia is contraindicated, or a general anesthesia would permit prompt delivery of the fetus. A patient with severe preeclampsia was given magnesium sulfate intrapartum, wherein a primary cesarean section was indicated for arrest in cervical dilatation, and was performed under general anesthesia. The patient developed acute respiratory failure and the causes of this occurrence were investigated in this report. It was later found out that neither the hypermagnesemia nor the muscle relaxant alone caused the patient’s condition but the interaction between the two. The patient was managed expectantly at the intensive care unit (ICU) and was eventually extubated during the 1st post-operative day. Knowledge of this drug interaction would allow obstetricians to advise their patients and their family about the possibility of prolonged intubation and ICU admission. This would also bring to the anesthesiologists’ attention the need to decrease the dose of muscle relaxant and to prepare drugs for immediate decurarisation. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=eclampsia" title="eclampsia">eclampsia</a>, <a href="https://publications.waset.org/abstracts/search?q=magnesium%20sulfate" title=" magnesium sulfate"> magnesium sulfate</a>, <a href="https://publications.waset.org/abstracts/search?q=preeclampsia" title=" preeclampsia"> preeclampsia</a>, <a href="https://publications.waset.org/abstracts/search?q=rocuronium%20bromide" title=" rocuronium bromide"> rocuronium bromide</a> </p> <a href="https://publications.waset.org/abstracts/39306/unexpected-acute-respiratory-failure-following-administration-of-rocuronium-bromide-during-cesarean-delivery-in-a-severely-preeclamptic-parturient-treated-with-magnesium-sulfate" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/39306.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">291</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5156</span> The Role of QX-314 and Capsaicin in Producing Long-Lasting Local Anesthesia in the Animal Model of Trigeminal Neuralgia</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Ezzati%20Givi%20M.">Ezzati Givi M.</a>, <a href="https://publications.waset.org/abstracts/search?q=Ezzatigivi%20N."> Ezzatigivi N.</a>, <a href="https://publications.waset.org/abstracts/search?q=Eimani%20H."> Eimani H.</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Trigeminal Neuralgia (TN) consists of painful attacks often triggered with general activities, which cause impairment and disability. The first line of treatment consists of pharmacotherapy. However, the occurrence of many side-effects limits its application. Acute pain relief is crucial for titrating oral drugs and making time for neurosurgical intervention. This study aimed to examine the long-term anesthetic effect of QX-314 and capsaicin in trigeminal neuralgia using an animal model. TN was stimulated by surgical constriction of the infraorbital nerve in rats. After seven days, anesthesia infiltration was done, and the duration of mechanical allodynia was compared. Thirty-five male Wistar rats were randomly divided into seven groups as follows: control (normal saline); lidocaine (2%); QX314 (30 mM); lidocaine (2%)+QX314 (15 mM); lidocaine (2%)+QX314 (22 mM); lidocaine (2%)+QX314 (30 mM); and lidocaine (2%)+QX314 (30 mM) +capsaicin (1μg). QX314 in combination with lidocaine significantly increased the duration of anesthesia, which was dose-dependent. The combination of lidocaine+QX314+capsaicin could significantly increase the duration of anesthesia in trigeminal neuralgia. In the present study, we demonstrated that the combination of QX-314 with lidocaine and capsaicin produced a long-lasting, reversible local anesthesia and was superior to lidocaine alone in the fields of the duration of trigeminal neuropathic pain blockage. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=trigeminal%20neuralgia" title="trigeminal neuralgia">trigeminal neuralgia</a>, <a href="https://publications.waset.org/abstracts/search?q=capsaicin" title=" capsaicin"> capsaicin</a>, <a href="https://publications.waset.org/abstracts/search?q=lidocaine" title=" lidocaine"> lidocaine</a>, <a href="https://publications.waset.org/abstracts/search?q=long-lasting" title=" long-lasting"> long-lasting</a> </p> <a href="https://publications.waset.org/abstracts/149111/the-role-of-qx-314-and-capsaicin-in-producing-long-lasting-local-anesthesia-in-the-animal-model-of-trigeminal-neuralgia" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/149111.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">114</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5155</span> The Effect of Remifentanil on Emergence Agitation after Sevoflurane Anesthesia in Children: A Meta-Analysis </h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Jong%20Yeop%20Kim">Jong Yeop Kim</a>, <a href="https://publications.waset.org/abstracts/search?q=Sung%20Young%20Park"> Sung Young Park</a>, <a href="https://publications.waset.org/abstracts/search?q=Dae%20Hee%20Kim"> Dae Hee Kim</a>, <a href="https://publications.waset.org/abstracts/search?q=Han%20Bum%20Joe"> Han Bum Joe</a>, <a href="https://publications.waset.org/abstracts/search?q=Ji%20Young%20Yoo"> Ji Young Yoo</a>, <a href="https://publications.waset.org/abstracts/search?q=Jong%20Bum%20Choi"> Jong Bum Choi</a>, <a href="https://publications.waset.org/abstracts/search?q=Sook%20Young%20Lee"> Sook Young Lee</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Emergence agitation (EA) is commonly reported adverse events after sevoflurane anesthesia in pediatric patients. The efficacy of prophylactic remifentanil, one of mu opioid agonist, in preventing EA is controversial. This meta-analysis assessed the effectiveness of remifentanil to decrease the incidence of EA from sevoflurane anesthesia in children. We searched for randomized controlled trials comparing sevoflurane alone anesthesia with sevoflurane and remifentanil anesthesia to prevent EA in the Cochrane Library, Embase, Pubmed, and KoreaMed, and included 6 studies with 361 patients. The number of patients of reporting EA was summarized using risk ratio (RR) with 95% confidence interval (CI), with point estimates and 95CIs derived from a random effects Mantel-Haenszel method. Overall incidence of EA was about 41%. Compared with sevoflurane alone anesthesia, intravenous infusion of remifentanil with sevoflurane significantly reduced the incidence of EA (RR 0.53, 95% CI 0.39-0.73, P < 0.0001), (heterogeneity, I2 = 0, P = 0.42). This meta-analysis suggested that continuous infusion of remifentanil could be effective in decreasing the EA of about 47% after sevoflurane anesthesia. However, considering limitations of the included studies, more randomized controlled studies are required to verify our results. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=emergence%20agitation" title="emergence agitation">emergence agitation</a>, <a href="https://publications.waset.org/abstracts/search?q=meta-analysis" title=" meta-analysis"> meta-analysis</a>, <a href="https://publications.waset.org/abstracts/search?q=remifentanil" title=" remifentanil"> remifentanil</a>, <a href="https://publications.waset.org/abstracts/search?q=pediatrics" title=" pediatrics"> pediatrics</a> </p> <a href="https://publications.waset.org/abstracts/76607/the-effect-of-remifentanil-on-emergence-agitation-after-sevoflurane-anesthesia-in-children-a-meta-analysis" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/76607.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">375</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5154</span> Assessment of the Electrical, Mechanical, and Thermal Nociceptive Thresholds for Stimulation and Pain Measurements at the Bovine Hind Limb</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Samaneh%20Yavari">Samaneh Yavari</a>, <a href="https://publications.waset.org/abstracts/search?q=Christiane%20Pferrer"> Christiane Pferrer</a>, <a href="https://publications.waset.org/abstracts/search?q=Elisabeth%20Engelke"> Elisabeth Engelke</a>, <a href="https://publications.waset.org/abstracts/search?q=Alexander%20Starke"> Alexander Starke</a>, <a href="https://publications.waset.org/abstracts/search?q=Juergen%20Rehage"> Juergen Rehage</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Three nociceptive thresholds of thermal, electrical, and mechanical thresholds commonly use to evaluate the local anesthesia in many species, for instance, cow, horse, cat, dog, rabbit, and so on. Due to the lack of investigations to evaluate and/or validate such those nociceptive thresholds, our plan was the comparison of two-foot local anesthesia methods of Intravenous Regional Anesthesia (IVRA) and our modified four-point Nerve Block Anesthesia (NBA). Materials and Methods: Eight healthy nonpregnant nondairy Holstein Frisian cows in a cross-over study design were selected for this study. All cows divided into two different groups to receive two local anesthesia techniques of IVRA and our modified four-point NBA. Three thermal, electrical, and mechanical force and pinpricks were applied to evaluate the quality of local anesthesia methods before and after local anesthesia application. Results: The statistical evaluation demonstrated that our four-point NBA has a qualification to select as a standard foot local anesthesia. However, the recorded results of our study revealed no significant difference between two groups of local anesthesia techniques of IVRA and modified four-point NBA related to quality and duration of anesthesia stimulated by electrical, mechanical and thermal nociceptive stimuli. Conclusion and discussion: All three nociceptive threshold stimuli of electrical, mechanical and heat nociceptive thresholds can be applied to measure and evaluate the efficacy of foot local anesthesia of dairy cows. However, our study revealed no superiority of those three nociceptive methods to evaluate the duration and quality of bovine foot local anesthesia methods. Veterinarians to investigate the duration and quality of their selected anesthesia method can use any of those heat, mechanical, and electrical methods. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=mechanical" title="mechanical">mechanical</a>, <a href="https://publications.waset.org/abstracts/search?q=thermal" title=" thermal"> thermal</a>, <a href="https://publications.waset.org/abstracts/search?q=electrical%20threshold" title=" electrical threshold"> electrical threshold</a>, <a href="https://publications.waset.org/abstracts/search?q=IVRA" title=" IVRA"> IVRA</a>, <a href="https://publications.waset.org/abstracts/search?q=NBA" title=" NBA"> NBA</a>, <a href="https://publications.waset.org/abstracts/search?q=hind%20limb" title=" hind limb"> hind limb</a>, <a href="https://publications.waset.org/abstracts/search?q=dairy%20cow" title=" dairy cow"> dairy cow</a> </p> <a href="https://publications.waset.org/abstracts/88289/assessment-of-the-electrical-mechanical-and-thermal-nociceptive-thresholds-for-stimulation-and-pain-measurements-at-the-bovine-hind-limb" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/88289.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">245</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5153</span> Regional Anesthesia: A Vantage Point for Management of Normal Pressure Hydrocephalus</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Kunal%20K.%20S.">Kunal K. S.</a>, <a href="https://publications.waset.org/abstracts/search?q=Shwetashri%20K.%20R."> Shwetashri K. R.</a>, <a href="https://publications.waset.org/abstracts/search?q=Keerthan%20G."> Keerthan G.</a>, <a href="https://publications.waset.org/abstracts/search?q=Ajinkya%20R."> Ajinkya R.</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=desh" title="desh">desh</a>, <a href="https://publications.waset.org/abstracts/search?q=NPH" title=" NPH"> NPH</a>, <a href="https://publications.waset.org/abstracts/search?q=VP%20shunt" title=" VP shunt"> VP shunt</a>, <a href="https://publications.waset.org/abstracts/search?q=cervical%20plexus%20block" title=" cervical plexus block"> cervical plexus block</a>, <a href="https://publications.waset.org/abstracts/search?q=transversus%20abdominis%20plane%20block" title=" transversus abdominis plane block"> transversus abdominis plane block</a> </p> <a href="https://publications.waset.org/abstracts/162216/regional-anesthesia-a-vantage-point-for-management-of-normal-pressure-hydrocephalus" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/162216.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">80</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5152</span> Technical Aspects of Closing the Loop in Depth-of-Anesthesia Control</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Gorazd%20Karer">Gorazd Karer</a> </p> <p class="card-text"><strong>Abstract:</strong></p> When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents are one of the main tasks of the anesthesiologist. However, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. The paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a UDP-based communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of a medical device manufacturer and is implemented in Matlab-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=closed-loop%20control" title="closed-loop control">closed-loop control</a>, <a href="https://publications.waset.org/abstracts/search?q=depth%20of%20anesthesia%20%28DoA%29" title=" depth of anesthesia (DoA)"> depth of anesthesia (DoA)</a>, <a href="https://publications.waset.org/abstracts/search?q=modeling" title=" modeling"> modeling</a>, <a href="https://publications.waset.org/abstracts/search?q=optical%20signal%20acquisition" title=" optical signal acquisition"> optical signal acquisition</a>, <a href="https://publications.waset.org/abstracts/search?q=patient%20state%20index%20%28PSi%29" title=" patient state index (PSi)"> patient state index (PSi)</a>, <a href="https://publications.waset.org/abstracts/search?q=UDP%20communication%20protocol" title=" UDP communication protocol"> UDP communication protocol</a> </p> <a href="https://publications.waset.org/abstracts/141095/technical-aspects-of-closing-the-loop-in-depth-of-anesthesia-control" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/141095.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">217</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5151</span> Maternal Perception of Using Epidural Anesthesia and the Childbirth Outcomes </h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Jiyoung%20Kim">Jiyoung Kim</a>, <a href="https://publications.waset.org/abstracts/search?q=Chae%20Weon%20Chung"> Chae Weon Chung</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Labor pain is one of the most common concerns of pregnant women, thus women are in need of possible options they could take to control the pain. So, this study aimed to explore maternal perception of epidural anesthesia and to compare the childbirth outcomes according to the use of epidural anesthesia. For this descriptive study, women who were over 36 weeks of pregnancy were recruited from an out-patient obstetric clinic in a public hospital in Seoul. Women were included in the study if agreed to participate, were pregnant singleton, without pregnancy complication, and expecting a natural birth. Data collection was done twice, the first one at the prenatal care visit and the second one at an in-patient ward on 2nd day postpartum. The instrument of the beliefs about epidural anesthesia, one item of asking intention to use epidural anesthesia, demographics, and obstetrical characteristics were incorporated into a questionnaire. One nurse researcher performed data collection with the structured questionnaire after the approval of the institutional review board. At the initial data collection 133 women were included, while 117 were retained at the second point after excluded 13 women due to the occurrence of complications. Analyses were done by chi-square, t-test, and ANOVA using the SPSS program. Women were aged 32.5 years old, 22.2% were over 35 years old. The average gestational age was 38.5 weeks, and 67.5% were nulliparous. Out of 38 multiparous women, 20 women (52.6%) had received epidural anesthesia in the previous delivery. At the initial interview, 62.6% (n=73) of women wanted to receive epidural anesthesia while 22.4% answered not decided and 15.4% did not want to take the procedure. However, there were changes in proportions between women’s intention to take it and actual procedures done, particularly, two-thirds of women (n=26) who had been undecided were found to receive epidural anesthesia during labor. There was a significant difference in the perception of epidural anesthesia measured before delivery between women who received and not received it (t=3.68, p < .001). Delivery outcomes were statistically different between the two groups in delivery mode (chi-square=8.64, p=.01), O₂ supply during labor (chi-square =5.01, p=.03), duration of 2nd stage of labor (t=3.70, p < .001), and arterial cord blood pH (t=2.64, p=.01). Interestingly, there was no difference in labor pain perceived between women with and without epidural anesthesia. Considering the preference and use of epidural anesthesia, health professionals need to assess coping ability of women undergoing delivery and to provide accurate information about pain control to support their decision making and eventually to enhance delivery outcomes for mothers and neonates. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=epidural%20anesthesia" title="epidural anesthesia">epidural anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=delivery%20outcomes" title=" delivery outcomes"> delivery outcomes</a>, <a href="https://publications.waset.org/abstracts/search?q=labor%20pain" title=" labor pain"> labor pain</a>, <a href="https://publications.waset.org/abstracts/search?q=perception" title=" perception"> perception</a> </p> <a href="https://publications.waset.org/abstracts/95424/maternal-perception-of-using-epidural-anesthesia-and-the-childbirth-outcomes" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/95424.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">153</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5150</span> The Evaluation of Superiority of Foot Local Anesthesia Method in Dairy Cows</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Samaneh%20Yavari">Samaneh Yavari</a>, <a href="https://publications.waset.org/abstracts/search?q=Christiane%20Pferrer"> Christiane Pferrer</a>, <a href="https://publications.waset.org/abstracts/search?q=Elisabeth%20Engelke"> Elisabeth Engelke</a>, <a href="https://publications.waset.org/abstracts/search?q=Alexander%20Starke"> Alexander Starke</a>, <a href="https://publications.waset.org/abstracts/search?q=Juergen%20Rehage"> Juergen Rehage</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Nowadays, bovine limb interventions, especially any claw surgeries, raises selection of the most qualified and appropriate local anesthesia technique applicable for any superficial or deep interventions of the limbs. Currently, two local anesthesia methods of Intravenous Regional Anesthesia (IVRA), as well as Nerve Blocks, have been routine to apply. However, the lack of studies investigating the quality and duration as well as quantity and onset of full (complete) local anesthesia, is noticeable. Therefore, the aim of our study was comparing the onset and quality of both IVRA and our modified NBA at the hind limb of dairy cows. For this abstract, only the onset of full local anesthesia would be consider. Materials and Methods: For that reason, we used six healthy non pregnant non lactating Holestein Frisian cows in a cross-over study design. Those cows divided into two groups to receive IVRA and our modified four-point NBA. For IVRA, 20 ml procaine without epinephrine was injected into the vein digitalis dorsalis communis III and for our modified four-point NBA, 10-15 ml procaine without epinephrine preneurally to the nerves, superficial and deep peroneal as well as lateral and medial branches of metatarsal nerves. For pain stimulation, electrical stimulator Grass S48 was applied. Results: The results of electrical stimuli revealed the faster onset of full local anesthesia (p < 0.05) by application of our modified NBA in comparison to IVRA about 10 minutes. Conclusion and discussion: Despite of available references showing faster onset of foot local anesthesia of IVRA, our study demonstrated that our modified four point NBA not only can be well known as a standard foot local anesthesia method applicable to desensitize the hind limb of dairy cows, but also, selection of this modified validated local anesthesia method can lead to have a faster start of complete desensitization of distal hind limb that is remarkable in any bovine limb interventions under time constraint. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=IVRA" title="IVRA">IVRA</a>, <a href="https://publications.waset.org/abstracts/search?q=four%20point%20NBA" title=" four point NBA"> four point NBA</a>, <a href="https://publications.waset.org/abstracts/search?q=dairy%20cow" title=" dairy cow"> dairy cow</a>, <a href="https://publications.waset.org/abstracts/search?q=hind%20limb" title=" hind limb"> hind limb</a>, <a href="https://publications.waset.org/abstracts/search?q=full%20onset" title=" full onset"> full onset</a> </p> <a href="https://publications.waset.org/abstracts/88288/the-evaluation-of-superiority-of-foot-local-anesthesia-method-in-dairy-cows" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/88288.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">151</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5149</span> Comparative Study for Neonatal Outcome and Umbilical Cord Blood Gas Parameters in Balanced and Inhalant Anesthesia for Elective Cesarean Section in Dogs</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Agnieszka%20Anto%C5%84czyk">Agnieszka Antończyk</a>, <a href="https://publications.waset.org/abstracts/search?q=Ma%C5%82Gorzata%20Ochota"> MałGorzata Ochota</a>, <a href="https://publications.waset.org/abstracts/search?q=Wojciech%20Ni%C5%BCa%C5%84ski"> Wojciech Niżański</a>, <a href="https://publications.waset.org/abstracts/search?q=Zdzis%C5%82Aw%20Kie%C5%82bowicz"> ZdzisłAw Kiełbowicz</a> </p> <p class="card-text"><strong>Abstract:</strong></p> The goal of the cesarean section (CS) is the delivery of healthy, vigorous pups with the provision of surgical plane anesthesia, appropriate analgesia, and rapid recovery of the dam. In human medicine, spinal or epidural anesthesia is preferred for a cesarean section as associated with a lower risk of neonatal asphyxia and the need for resuscitation. Nevertheless, the specificity of veterinary patients makes the application of regional anesthesia as a sole technique impractical, thus to obtain patient compliance the general anesthesia is required. This study aimed to compare the influence of balanced (inhalant with epidural) and inhalant anesthesia on neonatal umbilical cord blood gas (UCBG) parameters and vitality (modified Apgar scoring). The bitches (31) undergoing elective CS were enrolled in this study. All females received a single dose of 0.2 mg/kg s.c. Meloxicam. Females were randomly assigned into two groups: Gr I (Isoflurane, n=16) and Gr IE (Isoflurane plus Epidural, n=15). Anesthesia was induced with propofol at 4-6 mg/kg to effect, and maintained with isoflurane in oxygen; in IE group epidural anesthesia was also done using lidocaine (3-4 mg/kg) into the lumbosacral space. CSs were performed using a standard mid-line approach. Directly after the puppy extraction, the umbilical cord was double clamped before the placenta detachment. The vessels were gently stretched between forceps to allow blood sampling. At least 100 mcl of mixed umbilical cord blood was collected into a heparinized syringe for further analysis. The modified Apgar scoring system (AS) was used to objectively score neonatal health and vitality immediately after birth (before first aid or neonatal care was instituted), at 5 and 20 min after birth. The neonates were scored as normal (AS 7-10), weak (AS 4-6), or critical (AS 0-3). During surgery, the IE group required a lower isoflurane concentration compared to the females in group I (MAC 1.05±0.2 and 1.4±0.13, respectively, p<0.01). All investigated UCBG parameters were not statistically different between groups. All pups had mild acidosis (pH 7.21±0.08 and 7.21±0.09 in Gr I and IE, respectively) with moderately elevated pCO2 (Gr I 57.18±11.48, Gr IE 58.74±15.07), HCO3- on the lower border (Gr I 22.58±3.24, Gr IE 22.83±3.6), lowered BE (Gr I -6.1±3.57, Gr IE -5.6±4.19) and mildly elevated level of lactates (Gr I 2.58±1.48, Gr IE2.53±1.03). The glucose levels were above the reference limits in both groups of puppies (74.50±25.32 in Gr I, 79.50±29.73 in Gr IE). The initial Apgar score results were similar in I and IE groups. However, the subsequent measurements of AS revealed significant differences between both groups. Puppies from the IE group received better AS scores at 5 and 20 min compared to the I group (6.86±2.23 and 8.06±2.06 vs 5.11±2.40 and 7.83±2.05, respectively). The obtained results demonstrated that administration of epidural anesthesia reduced the requirement for isoflurane in dams undergoing cesarean section and did not affect the neonatal umbilical blood gas results. Moreover, newborns from the epidural anesthesia group were scored significantly higher in AS at 5 and 20 min, indicating their better vitality and quicker improvement post-surgery. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=apgar%20scoring" title="apgar scoring">apgar scoring</a>, <a href="https://publications.waset.org/abstracts/search?q=balanced%20anesthesia" title=" balanced anesthesia"> balanced anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=cesarean%20section" title=" cesarean section"> cesarean section</a>, <a href="https://publications.waset.org/abstracts/search?q=umbilical%20blood%20gas" title=" umbilical blood gas"> umbilical blood gas</a> </p> <a href="https://publications.waset.org/abstracts/137031/comparative-study-for-neonatal-outcome-and-umbilical-cord-blood-gas-parameters-in-balanced-and-inhalant-anesthesia-for-elective-cesarean-section-in-dogs" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/137031.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">177</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5148</span> Anesthesia for Spinal Stabilization Using Neuromuscular Blocking Agents in Dog: Case Report</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Agata%20Migdalska">Agata Migdalska</a>, <a href="https://publications.waset.org/abstracts/search?q=Joanna%20Berczynska"> Joanna Berczynska</a>, <a href="https://publications.waset.org/abstracts/search?q=Ewa%20Bieniek"> Ewa Bieniek</a>, <a href="https://publications.waset.org/abstracts/search?q=Jacek%20Sterna"> Jacek Sterna</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Muscle relaxation is considered important during general anesthesia for spine stabilization. In a presented case peripherally acting muscle relaxant was applied during general anesthesia for spine stabilization surgery. The patient was a dog, 11-years old, 26 kg, male, mix breed. Spine fracture was situated between Th13-L1-L2, probably due to the car accident. Preanesthetic physical examination revealed no sign underlying health issues. The dog was premedicated with midazolam 0.2 mg IM and butorphanol 2.4 mg IM. General anesthesia was induced with propofol IV. After the induction, the dog was intubated with an endotracheal tube and connected to an open-ended rebreathing system and maintained with the use of inhalation anesthesia with isoflurane in oxygen. 0,5 mg/ kg of rocuronium was given IV. Use of muscle relaxant was accompanied by an assessment of the degree of neuromuscular blockade by peripheral nerve stimulator. Electrodes were attached to the skin overlying at the peroneal nerve at the lateral cranial tibia. Four electrical pulses were applied to the nerve over a 2 second period. When satisfying nerve block was detected dog was prepared for the surgery. No further monitoring of the effectiveness of blockade was performed during surgery. Mechanical ventilation was kept during anesthesia. During surgery dog maintain stable, and no anesthesiological complication occur. Intraoperatively surgeon claimed that neuromuscular blockade results in a better approach to the spine and easier muscle manipulation which was helpful in order to see the fracture and replace bone fragments. Finally, euthanasia was performed intraoperatively as a result of vast myelomalacia process of the spinal cord. This prevented examination of the recovering process. Neuromuscular blocking agents act at the neuromuscular junction to provide profound muscle relaxation throughout the body. Muscle blocking agents are neither anesthetic nor analgesic; therefore inappropriately used may cause paralysis in fully conscious and feeling pain patient. They cause paralysis of all skeletal muscles, also diaphragm and intercostal muscles when given in higher doses. Intraoperative management includes maintaining stable physiological conditions, which involves adjusting hemodynamic parameters, ensuring proper ventilation, avoiding variations in temperature, maintain normal blood flow to promote proper oxygen exchange. Neuromuscular blocking agent can cause many side effects like residual paralysis, anaphylactic or anaphylactoid reactions, delayed recovery from anesthesia, histamine release, recurarization. Therefore reverse drug like neostigmine (with glikopyrolat) or edrofonium (with atropine) should be used in case of a life-threatening situation. Another useful drug is sugammadex, although the cost of this drug strongly limits its use. Muscle relaxant improves surgical conditions during spinal surgery, especially in heavily muscled individuals. They are also used to facilitate the replacement of dislocated joints as they improve conditions during fracture reduction. It is important to emphasize that in a patient with muscle weakness neuromuscular blocking agents may result in intraoperative and early postoperative cardiovascular and respiratory complications, as well as prolonged recovery from anesthesia. This should not appear in patients with recent spine fracture or luxation. Therefore it is believed that neuromuscular blockers could be useful during spine stabilization procedures. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=anesthesia" title="anesthesia">anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=dog" title=" dog"> dog</a>, <a href="https://publications.waset.org/abstracts/search?q=neuromuscular%20block" title=" neuromuscular block"> neuromuscular block</a>, <a href="https://publications.waset.org/abstracts/search?q=spine%20surgery" title=" spine surgery"> spine surgery</a> </p> <a href="https://publications.waset.org/abstracts/106785/anesthesia-for-spinal-stabilization-using-neuromuscular-blocking-agents-in-dog-case-report" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/106785.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">181</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5147</span> Medical Aspects, Professionalism, and Bioethics of Anesthesia in Caesarean Section on Self-Request</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Nasrudin%20Andi%20Mappaware">Nasrudin Andi Mappaware</a>, <a href="https://publications.waset.org/abstracts/search?q=Muh.%20Wirawan%20Harahap"> Muh. Wirawan Harahap</a>, <a href="https://publications.waset.org/abstracts/search?q=Erlin%20Syahril"> Erlin Syahril</a>, <a href="https://publications.waset.org/abstracts/search?q=Farah%20Ekawati%20Mulyadi"> Farah Ekawati Mulyadi</a> </p> <p class="card-text"><strong>Abstract:</strong></p> The increasing trend of cesarean sections, especially those performed on self-request without medical indications, presents complex dilemmas related to medical aspects, professionalism, and bioethics. This study aims to investigate the medical, professional, and bioethical considerations surrounding anesthesia in cesarean sections performed on self-request without medical indications. We report the case of a 27-year-old woman, G1P0A0 gravid 38 weeks, admitted to the hospital for a planned cesarean section on request for the reason that she could not tolerate pain and requested on a date that corresponded to the date and month of her mother's birth. Cesarean section on patient request fulfills the principle of autonomy, which states that patients have the right to themselves. However, this medical procedure is still considered no safer and riskier even though medical technology has developed rapidly. Furthermore, anesthesia during cesarean section at self-request without medical indications is a dilemma for anesthesiologists considering the risks and complications of anesthesia for both the fetus and the mother. The trend in increasing the number of cesarean sections is influenced by patient reasons such as not being able to tolerate pain, trust factors, and worry about damage to the birth canal. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=anesthesia" title="anesthesia">anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=bioethics" title=" bioethics"> bioethics</a>, <a href="https://publications.waset.org/abstracts/search?q=cesarean%20section" title=" cesarean section"> cesarean section</a>, <a href="https://publications.waset.org/abstracts/search?q=self-request" title=" self-request"> self-request</a>, <a href="https://publications.waset.org/abstracts/search?q=professionalism" title=" professionalism"> professionalism</a> </p> <a href="https://publications.waset.org/abstracts/186522/medical-aspects-professionalism-and-bioethics-of-anesthesia-in-caesarean-section-on-self-request" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/186522.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">52</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5146</span> Monitoring the Responses to Nociceptive Stimuli During General Anesthesia Based on Electroencephalographic Signals in Surgical Patients Undergoing General Anesthesia with Laryngeal Mask Airway (LMA)</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Ofelia%20Loani%20Elvir%20Lazo">Ofelia Loani Elvir Lazo</a>, <a href="https://publications.waset.org/abstracts/search?q=Roya%20Yumul"> Roya Yumul</a>, <a href="https://publications.waset.org/abstracts/search?q=Sevan%20Komshian"> Sevan Komshian</a>, <a href="https://publications.waset.org/abstracts/search?q=Ruby%20Wang"> Ruby Wang</a>, <a href="https://publications.waset.org/abstracts/search?q=Jun%20Tang"> Jun Tang</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Monitoring the anti-nociceptive drug effect is useful because a sudden and strong nociceptive stimulus may result in untoward autonomic responses and muscular reflex movements. Monitoring the anti-nociceptive effects of perioperative medications has long been desiredas a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively.To this end, electroencephalogram (EEG) based tools includingBIS and qCON were designed to provide information about the depth of sedation whileqNOXwas produced to informon the degree of antinociception.The goal of this study was to compare the reliability of qCON/qNOX to BIS asspecific indicators of response to nociceptive stimulation. Methods: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board(IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed o62n all patientsprior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. Results: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from74±13 mm Hg at baseline to 84± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76±12 BPM at baseline to 80±13BPM during noxious stimuli[p=0.078] respectively). Conclusion: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=antinociception" title="antinociception">antinociception</a>, <a href="https://publications.waset.org/abstracts/search?q=bispectral%20index%20%28BIS%29" title=" bispectral index (BIS)"> bispectral index (BIS)</a>, <a href="https://publications.waset.org/abstracts/search?q=general%20anesthesia" title=" general anesthesia"> general anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=laryngeal%20mask%20airway" title=" laryngeal mask airway"> laryngeal mask airway</a>, <a href="https://publications.waset.org/abstracts/search?q=qCON%2FqNOX" title=" qCON/qNOX"> qCON/qNOX</a> </p> <a href="https://publications.waset.org/abstracts/149281/monitoring-the-responses-to-nociceptive-stimuli-during-general-anesthesia-based-on-electroencephalographic-signals-in-surgical-patients-undergoing-general-anesthesia-with-laryngeal-mask-airway-lma" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/149281.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">92</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5145</span> Value of Unilateral Spinal Anaesthesia For Hip Fracture Surgery In The Elderly (75 Cases)</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Fedili%20Benamar">Fedili Benamar</a>, <a href="https://publications.waset.org/abstracts/search?q=Beloulou%20Mohamed%20Lamine"> Beloulou Mohamed Lamine</a>, <a href="https://publications.waset.org/abstracts/search?q=Ouahes%20Hassane"> Ouahes Hassane</a>, <a href="https://publications.waset.org/abstracts/search?q=Ghattas%20Samir"> Ghattas Samir</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background and aims: While in Western countries, unilateral spinal anesthesia has been widely practiced for a long time, it remains little known in the local anesthesia community, and has not been the object of many studies. However, it is a simple, practical and effective technique. Our objective was to evaluate this practice in emergency anesthesia management in frail patients and to compare it with conventional spinal anesthesia. Methods: This is a prospective, observational, comparative study between hypobaric unilateral and conventional spinal anaesthesia for hip fracture surgery carried out in the operating room of the university military hospital of Staoueli. The work was spread over of 12-month period from 2019 to 2020. The parameters analyzed were hemodynamic variations, vasopressor use, block efficiency, postoperative adverse events, and postoperative morphine consumption. Results: -75 cases (mean age 72±14 years) -Group1= 41 patients (54.6%) divided into (ASA1=14.6% ASA2=60.98% ASA3=24.39%) single shoot spinal anaesthesia -Group2= 34 patients (45.3%) divided into (ASA1=2.9%, ASA2=26.4% ASA3=61.7%, ASA4=8.8%) unilateral hypobaric spinal anesthesia. -Hemodynamic variations were more severe in group 1 (51% hypotension) compared to 30% in group 2 RR=1.69 and odds ratio=2.4 -these variations were more marked in the ASA3 subgroup (group 1=70% hypotension versus group 2=30%) with an RR=2.33 and an odds ratio=5.44 -39% of group 1 required vasoactive drugs (15mg +/- 11) versus 32% of group 2 (8mg+/- 6.49) - no difference in the use of morphine in post-op. Conclusions: Within the limits of the population studied, this work demonstrates the clinical value of unilateral spinal anesthesia in ortho-trauma surgery in the frail patient. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=spinal%20anaesthesia" title="spinal anaesthesia">spinal anaesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=vasopressor" title=" vasopressor"> vasopressor</a>, <a href="https://publications.waset.org/abstracts/search?q=morphine" title=" morphine"> morphine</a>, <a href="https://publications.waset.org/abstracts/search?q=hypobaric%20unilateral%20%20spinal%20anesthesia" title=" hypobaric unilateral spinal anesthesia"> hypobaric unilateral spinal anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=ropivacaine" title=" ropivacaine"> ropivacaine</a>, <a href="https://publications.waset.org/abstracts/search?q=hip%20surgery" title=" hip surgery"> hip surgery</a>, <a href="https://publications.waset.org/abstracts/search?q=eldery" title=" eldery"> eldery</a>, <a href="https://publications.waset.org/abstracts/search?q=hemodynamic" title=" hemodynamic"> hemodynamic</a> </p> <a href="https://publications.waset.org/abstracts/174506/value-of-unilateral-spinal-anaesthesia-for-hip-fracture-surgery-in-the-elderly-75-cases" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/174506.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">74</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5144</span> Model and Neural Control of the Depth of Anesthesia during Surgery</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Javier%20Fernandez">Javier Fernandez</a>, <a href="https://publications.waset.org/abstracts/search?q=Mayte%20Medina"> Mayte Medina</a>, <a href="https://publications.waset.org/abstracts/search?q=Rafael%20Fernandez%20de%20Canete"> Rafael Fernandez de Canete</a>, <a href="https://publications.waset.org/abstracts/search?q=Nuria%20Alcain"> Nuria Alcain</a>, <a href="https://publications.waset.org/abstracts/search?q=Juan%20Carlos%20Ramos-Diaz"> Juan Carlos Ramos-Diaz</a> </p> <p class="card-text"><strong>Abstract:</strong></p> At present, the experimentation of anesthetic drugs on patients requires a regulation protocol, and the response of each patient to several doses of entry drug must be well known. Therefore, the development of pharmacological dose control systems is a promising field of research in anesthesiology. In this paper, it has been developed a non-linear compartmental the pharmacokinetic-pharmacodynamical model which describes the anesthesia depth effect in a sufficiently reliable way over a set of patients with the depth effect quantified by the Bi-Spectral Index. Afterwards, an Artificial Neural Network (ANN) predictive controller has been designed based on the depth of anesthesia model so as to keep the patient in the optimum condition while he undergoes surgical treatment. For the purpose of quantifying the efficiency of the neural predictive controller, a classical proportional-integral-derivative controller has also been developed to compare both strategies. Results show the superior performance of predictive neural controller during BiSpectral Index reference tracking. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=anesthesia" title="anesthesia">anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=bi-spectral%20index" title=" bi-spectral index"> bi-spectral index</a>, <a href="https://publications.waset.org/abstracts/search?q=neural%20network%20control" title=" neural network control"> neural network control</a>, <a href="https://publications.waset.org/abstracts/search?q=pharmacokinetic-pharmacodynamical%20model" title=" pharmacokinetic-pharmacodynamical model"> pharmacokinetic-pharmacodynamical model</a> </p> <a href="https://publications.waset.org/abstracts/87956/model-and-neural-control-of-the-depth-of-anesthesia-during-surgery" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/87956.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">337</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5143</span> A Comparison of qCON/qNOX to the Bispectral Index as Indices of Antinociception in Surgical Patients Undergoing General Anesthesia with Laryngeal Mask Airway</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Roya%20Yumul">Roya Yumul</a>, <a href="https://publications.waset.org/abstracts/search?q=Ofelia%20Loani%20Elvir-Lazo"> Ofelia Loani Elvir-Lazo</a>, <a href="https://publications.waset.org/abstracts/search?q=Sevan%20Komshian"> Sevan Komshian</a>, <a href="https://publications.waset.org/abstracts/search?q=Ruby%20Wang"> Ruby Wang</a>, <a href="https://publications.waset.org/abstracts/search?q=Jun%20Tang"> Jun Tang</a> </p> <p class="card-text"><strong>Abstract:</strong></p> BACKGROUND: An objective means for monitoring the anti-nociceptive effects of perioperative medications has long been desired as a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively. To this end, electroencephalogram (EEG) based tools including BIS and qCON were designed to provide information about the depth of sedation while qNOX was produced to inform on the degree of antinociception. The goal of this study was to compare the reliability of qCON/qNOX to BIS as specific indicators of response to nociceptive stimulation. METHODS: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board (IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to the endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed on all patients prior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. RESULTS: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from 74 ±13 mm Hg at baseline to 84 ± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76 ± 12 BPM at baseline to 80 ± 13 BPM during noxious stimuli [p=0.078] respectively). CONCLUSION: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=antinociception" title="antinociception">antinociception</a>, <a href="https://publications.waset.org/abstracts/search?q=BIS" title=" BIS"> BIS</a>, <a href="https://publications.waset.org/abstracts/search?q=general%20anesthesia" title=" general anesthesia"> general anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=LMA" title=" LMA"> LMA</a>, <a href="https://publications.waset.org/abstracts/search?q=qCON%2FqNOX" title=" qCON/qNOX"> qCON/qNOX</a> </p> <a href="https://publications.waset.org/abstracts/148468/a-comparison-of-qconqnox-to-the-bispectral-index-as-indices-of-antinociception-in-surgical-patients-undergoing-general-anesthesia-with-laryngeal-mask-airway" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/148468.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">137</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5142</span> Incidences and Factors Associated with Perioperative Cardiac Arrest in Trauma Patient Receiving Anesthesia</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Visith%20Siriphuwanun">Visith Siriphuwanun</a>, <a href="https://publications.waset.org/abstracts/search?q=Yodying%20Punjasawadwong"> Yodying Punjasawadwong</a>, <a href="https://publications.waset.org/abstracts/search?q=Suwinai%20Saengyo"> Suwinai Saengyo</a>, <a href="https://publications.waset.org/abstracts/search?q=Kittipan%20Rerkasem"> Kittipan Rerkasem</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=perioperative%20cardiac%20arrest" title="perioperative cardiac arrest">perioperative cardiac arrest</a>, <a href="https://publications.waset.org/abstracts/search?q=trauma%20patients" title=" trauma patients"> trauma patients</a>, <a href="https://publications.waset.org/abstracts/search?q=emergency%20surgery" title=" emergency surgery"> emergency surgery</a>, <a href="https://publications.waset.org/abstracts/search?q=anesthesia" title=" anesthesia"> anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=factors%20risk" title=" factors risk"> factors risk</a>, <a href="https://publications.waset.org/abstracts/search?q=incidence" title=" incidence"> incidence</a> </p> <a href="https://publications.waset.org/abstracts/88790/incidences-and-factors-associated-with-perioperative-cardiac-arrest-in-trauma-patient-receiving-anesthesia" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/88790.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">169</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5141</span> Evaluation of the Effect of Intravenous Dexamethasone on Hemodynamic Variables and Hypotension in Female Undergoing Cesarean Section With Spinal Anesthesia</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Shekoufeh%20Behdad">Shekoufeh Behdad</a>, <a href="https://publications.waset.org/abstracts/search?q=Sahar%20Yadegari"> Sahar Yadegari</a>, <a href="https://publications.waset.org/abstracts/search?q=Alireza%20Ghehrazad"> Alireza Ghehrazad</a>, <a href="https://publications.waset.org/abstracts/search?q=Amirhossein%20Yadegari"> Amirhossein Yadegari</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: In this study, we compared the effect of intravenous dexamethasone with placebo on hemodynamic variables and hypotension in patients undergoing cesarean section under spinal anesthesia. Materials and methods: This double-blind, randomized clinical trial was conducted with the approval of the university ethics committee. Written informed consent was obtained from all participating patients. Before spinal anesthesia, patients were randomly assigned to receive either dexamethasone (8 mg IV) or placebo (normal saline). Hemodynamic variables, including systolic, diastolic, and mean arterial blood pressures, as well as heart rate, were measured before drug administration and every 3 minutes until the birth of the neonate and then every 5 minutes until the end of surgery. Side effects such as hypotension, bradycardia, nausea, and vomiting were assessed and recorded for all the patients. Results: There were no significant differences in mean systolic, diastolic, and mean arterial blood pressures before and after administration of the studied drugs in both groups (P.Value>0.05), but heart rate and the incidence of hypotension in the dexamethasone group were less than placebo significantly. Conclusions: Intravenous administration of 8 mg dexamethasone before spinal anesthesia in females undergoing cesarean section can reduce the incidence of post-spinal hypotension without causing serious side effects. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=cesarean%20section" title="cesarean section">cesarean section</a>, <a href="https://publications.waset.org/abstracts/search?q=hypotension" title=" hypotension"> hypotension</a>, <a href="https://publications.waset.org/abstracts/search?q=spinal%20anesthesia" title=" spinal anesthesia"> spinal anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=dexamethasone" title=" dexamethasone"> dexamethasone</a> </p> <a href="https://publications.waset.org/abstracts/176309/evaluation-of-the-effect-of-intravenous-dexamethasone-on-hemodynamic-variables-and-hypotension-in-female-undergoing-cesarean-section-with-spinal-anesthesia" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/176309.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">77</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5140</span> Effect of Different Local Anesthetic Agents on Physiological Parameters and Vital Signs during Extraction in Children</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Rasha%20F.%20Sharaf">Rasha F. Sharaf</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Administration of local anesthesia for a child is considered a painful procedure, which affects his vital signs, physiological parameters, and his further attitude in the dental clinic. During the extraction of mandibular molars, the nerve block technique is the most commonly used for the administration of local anesthesia; however, this technique requires deep penetration of the needle, which causes pain and discomfort for the child. Therefore, the inferior alveolar nerve block technique can be substituted with an infiltration technique which is not painful if a potent anesthetic solutions will be used. In the current study, the effect of Articaine 4% will be compared to Mepivacaine 2%, and their influence on the vital signs of the child, as well as their ability to control pain during extraction, will be assessed. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=anesthesia" title="anesthesia">anesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=articaine" title=" articaine"> articaine</a>, <a href="https://publications.waset.org/abstracts/search?q=pain%20control" title=" pain control"> pain control</a>, <a href="https://publications.waset.org/abstracts/search?q=extraction" title=" extraction"> extraction</a> </p> <a href="https://publications.waset.org/abstracts/158270/effect-of-different-local-anesthetic-agents-on-physiological-parameters-and-vital-signs-during-extraction-in-children" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/158270.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">122</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5139</span> The Prevalence of Intubation Induced Dental Complications among Hospitalized Patients</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Dorsa%20Rahi">Dorsa Rahi</a>, <a href="https://publications.waset.org/abstracts/search?q=Arghavan%20Tonkanbonbi"> Arghavan Tonkanbonbi</a>, <a href="https://publications.waset.org/abstracts/search?q=Soheila%20Manifar"> Soheila Manifar</a>, <a href="https://publications.waset.org/abstracts/search?q=Behzad%20Jafvarnejad"> Behzad Jafvarnejad</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background and Aim: Intraoral manipulation is performed during endotracheal intubation for general anesthesia, which can traumatize the soft and hard tissue in the oral cavity and cause postoperative pain and discomfort. Dental trauma is the most common complication of intubation. This study aimed to assess the prevalence of dental complications due to intubation in patients hospitalized in Imam Khomeini Hospital during 2018-2019. Materials and Methods: A total of 805 patients presenting to the Cancer Institute of Imam Khomeini Hospital for preoperative anesthesia consultation were randomly enrolled. A dentist interviewed the patients and performed a comprehensive clinical oral examination preoperatively. The patients underwent clinical oral examination by another dentist postoperatively. Results: No significant correlation was found between dental trauma (tooth fracture, tooth mobility, or soft tissue injury) after intubation with the age or gender of patients. According to the Wilcoxon test and McNemar-Bowker Test, the rate of mobility before the intubation was significantly different from that after the intubation (P=0.000). Maxillary central incisors, maxillary left canine and mandibular right and left central incisors had the highest rate of fracture. Conclusion: Mobile teeth before the intubation are at higher risk of avulsion and aspiration during the procedure. Patients with primary temporomandibular joint disorders are more susceptible to post-intubation trismus. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=oral%20trauma" title="oral trauma">oral trauma</a>, <a href="https://publications.waset.org/abstracts/search?q=dental%20trauma" title=" dental trauma"> dental trauma</a>, <a href="https://publications.waset.org/abstracts/search?q=intubation" title=" intubation"> intubation</a>, <a href="https://publications.waset.org/abstracts/search?q=anesthesia" title=" anesthesia "> anesthesia </a> </p> <a href="https://publications.waset.org/abstracts/134016/the-prevalence-of-intubation-induced-dental-complications-among-hospitalized-patients" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/134016.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">148</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5138</span> The Impact of Enhanced Recovery after Surgery (ERAS) Protocols on Anesthesia Management in High-Risk Surgical Patients</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Rebar%20Mohammed%20Hussein">Rebar Mohammed Hussein</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Enhanced Recovery After Surgery (ERAS) protocols have transformed perioperative care, aiming to reduce surgical stress, optimize pain management, and accelerate recovery. This study evaluates the impact of ERAS on anesthesia management in high-risk surgical patients, focusing on opioid-sparing techniques and multimodal analgesia. A retrospective analysis was conducted on patients undergoing major surgeries within an ERAS program, comparing outcomes with a historical cohort receiving standard care. Key metrics included postoperative pain scores, opioid consumption, length of hospital stay, and complication rates. Results indicated that the implementation of ERAS protocols significantly reduced postoperative opioid use by 40% and improved pain management outcomes, with 70% of patients reporting satisfactory pain control on postoperative day one. Additionally, patients in the ERAS group experienced a 30% reduction in length of stay and a 20% decrease in complication rates. These findings underscore the importance of integrating ERAS principles into anesthesia practice, particularly for high-risk patients, to enhance recovery, improve patient satisfaction, and reduce healthcare costs. Future directions include prospective studies to further refine anesthesia techniques within ERAS frameworks and explore their applicability across various surgical specialties. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=ERAS%20protocols" title="ERAS protocols">ERAS protocols</a>, <a href="https://publications.waset.org/abstracts/search?q=high-risk%20surgical%20patients" title=" high-risk surgical patients"> high-risk surgical patients</a>, <a href="https://publications.waset.org/abstracts/search?q=anesthesia%20management" title=" anesthesia management"> anesthesia management</a>, <a href="https://publications.waset.org/abstracts/search?q=recovery" title=" recovery"> recovery</a> </p> <a href="https://publications.waset.org/abstracts/191856/the-impact-of-enhanced-recovery-after-surgery-eras-protocols-on-anesthesia-management-in-high-risk-surgical-patients" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/191856.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">21</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5137</span> Intrathecal Sufentanil or Fentanyl as Adjuvants to Low Dose Bupivacaine in Endoscopic Urological Procedures</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Shikha%20Gupta">Shikha Gupta</a>, <a href="https://publications.waset.org/abstracts/search?q=Suneet%20Kathuria"> Suneet Kathuria</a>, <a href="https://publications.waset.org/abstracts/search?q=Supriya%20Sampley"> Supriya Sampley</a>, <a href="https://publications.waset.org/abstracts/search?q=Sunil%20Katyal"> Sunil Katyal</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Opioids are being increasingly used these days as adjuvants to local anesthetics in spinal anesthesia. The aim of this prospective, randomized, double‑blind study is to compare the effects of adding sufentanil or fentanyl to low dose bupivacaine in spinal anesthesia for endoscopic urological procedures. A total of 90 elective endoscopic urological surgery patients, 40‑80 years old, received spinal anesthesia with 7.5 mg hyperbaric bupivacaine 0.5% (Group A) or by adding sufentanil 10 μg (Group B) or fentanyl 25 μg (Group C) to 5 mg hyperbaric bupivacaine 0.5%. These groups were compared in terms of the quality of spinal anesthesia as well as analgesia. Analysis of variance and Chi‑square test were used for Statistical analysis. The onset of sensory and motor blockade was significantly rapid in Group A as compared with Groups B and C. The maximum upper level of sensory block was higher in Group A patients than Groups B and C patients. Quality of analgesia was significantly better and prolonged in sufentanil group as compared with other two groups. Motor block was more intense and prolonged in Group A as compared with Groups B and C patients. Request for post‑operative analgesic was significantly delayed in Group B patients. Hence in conclusions, spinal anesthesia for endoscopic urological procedures in elderly patients using low dose bupivacaine (5 mg) combined with 10 μg sufentanil is associated with a lower incidence of hemodynamic instability, better quality and prolonged duration as compared to that by adding 25 μg fentanyl. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=adjuvants" title="adjuvants">adjuvants</a>, <a href="https://publications.waset.org/abstracts/search?q=bupivacaine" title=" bupivacaine"> bupivacaine</a>, <a href="https://publications.waset.org/abstracts/search?q=fentanyl" title=" fentanyl"> fentanyl</a>, <a href="https://publications.waset.org/abstracts/search?q=intrathecal" title=" intrathecal"> intrathecal</a>, <a href="https://publications.waset.org/abstracts/search?q=low%20dose%20spinal" title=" low dose spinal"> low dose spinal</a>, <a href="https://publications.waset.org/abstracts/search?q=sufentanil" title=" sufentanil"> sufentanil</a> </p> <a href="https://publications.waset.org/abstracts/25450/intrathecal-sufentanil-or-fentanyl-as-adjuvants-to-low-dose-bupivacaine-in-endoscopic-urological-procedures" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/25450.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">375</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5136</span> Risk Factors for Post-Induction Hypotension Among Elderly Patients Undergoing Elective Non-Cardiac Surgery Under General Anesthesia</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Karuna%20Sutthibenjakul">Karuna Sutthibenjakul</a>, <a href="https://publications.waset.org/abstracts/search?q=Sunisa%20Chatmongkolchart"> Sunisa Chatmongkolchart</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Postinduction hypotension is common and occurs more often in elderly patients. We aimed to determine risk factors for hypotension after induction among elderly patients (aged 65 years and older) who underwent elective non-cardiac surgery under general anesthesia. Methods: This cohort study analyzed from 580 data between December 2017 and July 2018 at a tertiary university hospital in south of Thailand. Hypotension is defined as more than 30% decrease mean arterial pressure from baseline after induction within 20 minutes or the use of vasopressive agent to treat low blood pressure. Intraoperative parameters were blood pressure and heart rate at T0, TEI, T5, T10, T15 and T20 (immediately after arrival at operating room, time after intubation, 5, 10, 15 and 20 minutes after intubation) respectively. Results: The median age was 72.5 (68, 78) years. A prevalence of post-induction hypotension was 64.8%. The highest prevalence (39.7%) was at 15 minutes after intubation. The association of post-induction hypotension is rising with diuretic drug as preoperative medication (P-value=0.016), hematocrit level (P-value=0.031) and the degree of hypertension immediately after arrival at operating room (P-value<0.001). Increasing fentanyl dosage during induction was associated with hypotension at intubation time (P-value<0.01) and 5 minutes after intubation (P-value<0.001). There was no statistically significant difference in the increasing propofol dosage. Conclusion: The degree of hypertension immediately after arrival at operating room and increasing fentanyl dosage were a significant risk factors for postinduction hypotension in elderly patients. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=risk%20factors" title="risk factors">risk factors</a>, <a href="https://publications.waset.org/abstracts/search?q=post-induction" title=" post-induction"> post-induction</a>, <a href="https://publications.waset.org/abstracts/search?q=hypotension" title=" hypotension"> hypotension</a>, <a href="https://publications.waset.org/abstracts/search?q=elderly" title=" elderly"> elderly</a> </p> <a href="https://publications.waset.org/abstracts/102038/risk-factors-for-post-induction-hypotension-among-elderly-patients-undergoing-elective-non-cardiac-surgery-under-general-anesthesia" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/102038.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">131</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5135</span> Anesthetic Considerations for Carotid Endarterectomy: Prospective Study Based on Clinical Trials</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Ahmed%20Yousef%20A.%20Al%20Sultan">Ahmed Yousef A. Al Sultan</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: The aim of this review is based on clinical research that studies the changes in middle cerebral artery velocity using Transcranial Doppler (TCD) and cerebral oxygen saturation using cerebral oximetry in patients undergoing carotid endarterectomy (CEA) surgery under local anesthesia (LA). Patients with or without neurological symptoms during the surgery are taking a role in this study using triplet method of cerebral oximetry, transcranial doppler and awake test in detecting any cerebral ischemic symptoms. Methods: about one hundred patients took part during their CEA surgeries under local anesthesia, using triple assessment mentioned method, Patients requiring general anesthesia be excluded from analysis. All data were recorded at eight surgery stages separately to serve this study. Results: In total regional cerebral oxygen saturation (rSO2), middle cerebral artery (MCA) velocity, and pulsatility index were significantly decreased during carotid artery clamping step in CEA procedures on the targeted carotid side. With most observed changes in MCA velocity during the study. Discussion: Cerebral oxygen saturation and middle cerebral artery velocity were significantly decreased during clamping step of the procedures on the targeted side. The team with neurological symptoms during the procedures showed higher changes of rSO2 and MCA velocity than the team without neurological symptoms. Cerebral rSO2 and MCA velocity significantly increased directly after de-clamping of the internal carotid artery on the affected side. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=awake%20testing" title="awake testing">awake testing</a>, <a href="https://publications.waset.org/abstracts/search?q=carotid%20endarterectomy" title=" carotid endarterectomy"> carotid endarterectomy</a>, <a href="https://publications.waset.org/abstracts/search?q=cerebral%20oximetry" title=" cerebral oximetry"> cerebral oximetry</a>, <a href="https://publications.waset.org/abstracts/search?q=Tanscranial%20Doppler" title=" Tanscranial Doppler"> Tanscranial Doppler</a> </p> <a href="https://publications.waset.org/abstracts/85460/anesthetic-considerations-for-carotid-endarterectomy-prospective-study-based-on-clinical-trials" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/85460.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">169</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5134</span> A Comparative Study of Granisetron and Palonosetron in Postoperative Nausea and Vomiting Following Laparoscopic Surgery</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Burra%20Vijitha">Burra Vijitha </a> </p> <p class="card-text"><strong>Abstract:</strong></p> A prospective randomized comparative study for the prevention of postoperative nausea and vomiting in the patients undergoing general anesthesia ,for elective laparoscopic surgeries with respect to efficacy and side effects of granisetron and palonosetron. Sixty adult patients of class ASA 1,2 of either sex in age group between 20-70 yrs,scheduled for elective laparoscopic surgeries were selected for the study.Patients were randomly divided into two groups 30 each. Group G: Granisetron group (n=30), 40µg/kg; Group P: Palonosetron group (n=30), 0.075 mg. at end of surgery before extubation group G patients 40 µg/kg of inj.granisetron and group P patients received 0.075 mg of inj.palonosetron slow iv over 30 sec.In post anesthesia care unit, episodes of nausea and vomiting experienced by each patient was recorded by direct questioning the patient .study medication was assessed in terms of incidence of nausea and vomiting during periods of 0-4 hrs,4-12 hrs,12-24 hrs,24-48hrs.our study demonstrated that complete response for those patients who received granisetron were 86.66%,80% and 66.66% ,while those received palonosetron were 100%,86.6%,90% between 0-4hrs,4-12hrs,12-24 hrs. It shows no statistically signidficant differences between the baseline values of hemodynamic variables beween two groups during study. Keywords: Granisetron, nausea, palonosetron, vomiting. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=granisetron" title="granisetron">granisetron</a>, <a href="https://publications.waset.org/abstracts/search?q=palonosetron" title=" palonosetron"> palonosetron</a>, <a href="https://publications.waset.org/abstracts/search?q=nausea" title=" nausea"> nausea</a>, <a href="https://publications.waset.org/abstracts/search?q=vomiting" title=" vomiting"> vomiting</a> </p> <a href="https://publications.waset.org/abstracts/19976/a-comparative-study-of-granisetron-and-palonosetron-in-postoperative-nausea-and-vomiting-following-laparoscopic-surgery" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/19976.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">236</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5133</span> Comparison of Two Anesthetic Methods during Interventional Neuroradiology Procedure: Propofol versus Sevoflurane Using Patient State Index</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Ki%20Hwa%20Lee">Ki Hwa Lee</a>, <a href="https://publications.waset.org/abstracts/search?q=Eunsu%20Kang"> Eunsu Kang</a>, <a href="https://publications.waset.org/abstracts/search?q=Jae%20Hong%20Park"> Jae Hong Park</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Interventional neuroradiology (INR) has been a rapidly growing and evolving neurosurgical part during the past few decades. Sevoflurane and propofol are both suitable anesthetics for INR procedure. Monitoring of depth of anesthesia is being used very widely. SEDLine™ monitor, a 4-channel processed EEG monitor, uses a proprietary algorithm to analyze the raw EEG signal and displays the Patient State Index (PSI) values. There are only a fewer studies examining the PSI in the neuro-anesthesia. We aimed to investigate the difference of PSI values and hemodynamic variables between sevoflurane and propofol anesthesia during INR procedure. Methods: We reviewed the medical records of patients who scheduled to undergo embolization of non-ruptured intracranial aneurysm by a single operator from May 2013 to December 2014, retrospectively. Sixty-five patients were categorized into two groups; sevoflurane (n = 33) vs propofol (n = 32) group. The PSI values, hemodynamic variables, and the use of hemodynamic drugs were analyzed. Results: Significant differences were seen between PSI values obtained during different perioperative stages in both two groups (P < 0.0001). The PSI values of propofol group were lower than that of sevoflurane group during INR procedure (P < 0.01). The patients in propofol group had more prolonged time of extubation and more phenylephrine requirement than sevoflurane group (p < 0.05). Anti-hypertensive drug was more administered to the patients during extubation in sevoflurane group (p < 0.05). Conclusions: The PSI can detect depth of anesthesia and changes of concentration of anesthetics during INR procedure. Extubation was faster in sevoflurane group, but smooth recovery was shown in propofol group. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=interventional%20neuroradiology" title="interventional neuroradiology">interventional neuroradiology</a>, <a href="https://publications.waset.org/abstracts/search?q=patient%20state%20index" title=" patient state index"> patient state index</a>, <a href="https://publications.waset.org/abstracts/search?q=propofol" title=" propofol"> propofol</a>, <a href="https://publications.waset.org/abstracts/search?q=sevoflurane" title=" sevoflurane"> sevoflurane</a> </p> <a href="https://publications.waset.org/abstracts/81410/comparison-of-two-anesthetic-methods-during-interventional-neuroradiology-procedure-propofol-versus-sevoflurane-using-patient-state-index" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/81410.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">180</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5132</span> Long Standing Orbital Floor Fracture Repair: Case Report</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Hisham%20A.%20Hashem">Hisham A. Hashem</a>, <a href="https://publications.waset.org/abstracts/search?q=Sameh%20Galal"> Sameh Galal</a>, <a href="https://publications.waset.org/abstracts/search?q=Bassem%20M.%20Moeshed"> Bassem M. Moeshed</a> </p> <p class="card-text"><strong>Abstract:</strong></p> A 36 years old male patient presented to our unit with a history of motor-car accident from 7 months complaining of disfigurement and double vision. On examination and investigations, there was an orbital floor fracture in the left eye with inferior rectus muscle entrapment causing diplopia, dystopia and enophthalmos. Under general anesthesia, a sub-ciliary incision was performed, and the orbital floor fracture was repaired with a double layer Medpor sheet (30x50x15) with removing and freeing fibrosis that was present and freeing of the inferior rectus muscle. Remarkable improvement of the dystopia was noticed, however, there was a residual diplopia in upgaze and enophthalmos. He was then referred to a strabismologist, which upon examination found left hypotropia of 8 ΔD corrected by 8 ΔD base up prism and positive forced duction test on elevation and pseudoptosis. Under local anesthesia, a limbal incision approach with hangback 4mm recession of inferior rectus muscle was performed after identifying an inferior rectus muscle structure. Improvement was noted shortly postoperative with correction of both diplopia and pseudoptosis. Follow up after 1, 4 and 8 months was done showing a stable condition. Delayed surgery in cases of orbital floor fracture may still hold good results provided proper assessment of the case with management of each sign separately. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=diplopia" title="diplopia">diplopia</a>, <a href="https://publications.waset.org/abstracts/search?q=dystopia" title=" dystopia"> dystopia</a>, <a href="https://publications.waset.org/abstracts/search?q=late%20surgery" title=" late surgery"> late surgery</a>, <a href="https://publications.waset.org/abstracts/search?q=orbital%20floor%20fracture" title=" orbital floor fracture"> orbital floor fracture</a> </p> <a href="https://publications.waset.org/abstracts/60313/long-standing-orbital-floor-fracture-repair-case-report" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/60313.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">227</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5131</span> A Comparison and Discussion of Modern Anaesthetic Techniques in Elective Lower Limb Arthroplasties</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=P.%20T.%20Collett">P. T. Collett</a>, <a href="https://publications.waset.org/abstracts/search?q=M.%20Kershaw"> M. Kershaw</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: The discussion regarding which method of anesthesia provides better results for lower limb arthroplasty is a continuing debate. Multiple meta-analysis has been performed with no clear consensus. The current recommendation is to use neuraxial anesthesia for lower limb arthroplasty; however, the evidence to support this decision is weak. The Enhanced Recovery After Surgery (ERAS) society has recommended, either technique can be used as part of a multimodal anesthetic regimen. A local study was performed to see if the current anesthetic practice correlates with the current recommendations and to evaluate the efficacy of the different techniques utilized. Method: 90 patients who underwent total hip or total knee replacements at Nevill Hall Hospital between February 2019 to July 2019 were reviewed. Data collected included the anesthetic technique, day one opiate use, pain score, and length of stay. The data was collected from anesthetic charts, and the pain team follows up forms. Analysis: The average of patients undergoing lower limb arthroplasty was 70. Of those 83% (n=75) received a spinal anaesthetic and 17% (n=15) received a general anaesthetic. For patients undergoing knee replacement under general anesthetic the average day, one pain score was 2.29 and 1.94 if a spinal anesthetic was performed. For hip replacements, the scores were 1.87 and 1.8, respectively. There was no statistical significance between these scores. Day 1 opiate usage was significantly higher in knee replacement patients who were given a general anesthetic (45.7mg IV morphine equivalent) vs. those who were operated on under spinal anesthetic (19.7mg). This difference was not noticeable in hip replacement patients. There was no significant difference in length of stay between the two anesthetic techniques. Discussion: There was no significant difference in the day one pain score between the patients who received a general or spinal anesthetic for either knee or hip replacements. The higher pain scores in the knee replacement group overall are consistent with this being a more painful procedure. This is a small patient population, which means any difference between the two groups is unlikely to be representative of a larger population. The pain scale has 4 points, which means it is difficult to identify a significant difference between pain scores. Conclusion: There is currently little standardization between the different anesthetic approaches utilized in Nevill Hall Hospital. This is likely due to the lack of adherence to a standardized anesthetic regimen. In accordance with ERAS recommends a standard anesthetic protocol is a core component. The results of this study and the guidance from the ERAS society will support the implementation of a new health board wide ERAS protocol. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=anaesthesia" title="anaesthesia">anaesthesia</a>, <a href="https://publications.waset.org/abstracts/search?q=orthopaedics" title=" orthopaedics"> orthopaedics</a>, <a href="https://publications.waset.org/abstracts/search?q=intensive%20care" title=" intensive care"> intensive care</a>, <a href="https://publications.waset.org/abstracts/search?q=patient%20centered%20decision%20making" title=" patient centered decision making"> patient centered decision making</a>, <a href="https://publications.waset.org/abstracts/search?q=treatment%20escalation" title=" treatment escalation"> treatment escalation</a> </p> <a href="https://publications.waset.org/abstracts/128806/a-comparison-and-discussion-of-modern-anaesthetic-techniques-in-elective-lower-limb-arthroplasties" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/128806.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">127</span> </span> </div> </div> <ul class="pagination"> <li class="page-item disabled"><span class="page-link">&lsaquo;</span></li> <li class="page-item active"><span class="page-link">1</span></li> <li class="page-item"><a class="page-link" href="https://publications.waset.org/abstracts/search?q=general%20anesthesia&amp;page=2">2</a></li> <li class="page-item"><a class="page-link" href="https://publications.waset.org/abstracts/search?q=general%20anesthesia&amp;page=3">3</a></li> <li class="page-item"><a class="page-link" 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