Gastric content assessed with gastric ultrasound in paediatric patients prescribed a light breakfast prior to general anaesthesia: A prospective observational study

2019 ◽  
Vol 29 (12) ◽  
pp. 1173-1178 ◽  
Author(s):  
Hanna Andersson ◽  
Peter Frykholm
Keyword(s):  
Observational Study ◽  
General Anaesthesia ◽  
Gastric Content ◽  
Prospective Observational Study ◽  
Paediatric Patients

scholarly journals A prospective observational study testing liquid crystal phase change type thermometer placed on skin against oesophageal/pharyngeal placed thermometers in participants undergoing general anesthesia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
G. Simpson ◽  
R. N. Rodseth
Keyword(s):  
Observational Study ◽  
Surface Temperature ◽  
General Anaesthesia ◽  
Prospective Observational Study ◽  
Standard Of Care ◽  
Skin Surface ◽  
Temperature Monitoring ◽  
Skin Surface Temperature ◽  
Limits Of Agreement ◽  
Non Invasive

Abstracts Background Patient outcomes are influenced by intraoperative temperature management. Oesophageal/pharyngeal temperature monitoring is the standard of care at our institute but is not well tolerated in awake patients. Many non-invasive temperature monitors have been studied. Only the TraxIt® Wearable Children’s Underarm Thermometer which contains liquid crystals that undergo phase changes according to temperature is available at our institution. We tested these non-invasive monitors against our standard of care which is the oesophageal/pharyngeal temperature monitor. Methods We conducted a prospective observational study of 100 patients receiving general anaesthesia for elective surgery. Patients were eligible for inclusion if they were ≥ 18 years old, were planned to have a general anaesthetic > 60 min during which no body cavity (chest or abdomen) would be opened. Patient temperature was measured with an oesophageal/pharyngeal thermistor probe and skin surface temperature monitors placed over the forehead, in the axilla, over the sternum, and behind the ear (over major vessels to the brain). Temperatures were recorded and then analysed using Altman-Bland plots. Pre-determined clinically relevant limits of agreement were set at −/+ 0.5 °C. Results From the 100 patients we collected 500 data points for each monitor with an average monitoring time of 102 min (30–300 min) across a range of surgical procedures. None of the skin surface temperature monitors achieved the pre-determined limits of agreement and results were impacted by the use of a forced air warmer. Conclusion The TraxIt® Wearable Children’s Underarm Thermometers are not suitable for temperature monitoring during general anaesthesia.

scholarly journals Multicentre prospective observational study of sodium-glucose cotransporter-2 inhibitor-associated postoperative ketoacidosis: the SAPKA study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049592
Author(s):  
Hiroyuki Seki ◽  
Norifumi Kuratani ◽  
Toshiya Shiga ◽  
Yudai Iwasaki ◽  
Kanae Karita ◽  
...  
Keyword(s):  
Observational Study ◽  
General Anaesthesia ◽  
Study Protocol ◽  
Prospective Observational Study ◽  
Surgical Stress ◽  
Sglt2 Inhibitor ◽  
Sglt2 Inhibitors ◽  
Sodium Glucose Cotransporter ◽  
Urinary Glucose ◽  
Tract Infections

IntroductionSodium-glucose cotransporter 2 (SGLT2) inhibitors are a new class of antihyperglycaemic agents that promote urinary glucose excretion in the renal proximal tubule and have cardio-protective and renal-protective properties. However, there are several safety concerns related to increased risks of hypoglycaemic, urinary tract infections and ketoacidosis. Ketoacidosis is a potentially fatal complication that often presents as euglycaemic ketoacidosis during SGLT2 inhibitor treatment. Furthermore, invasive treatment and related surgical stress may increase the risk of ketogenesis. Therefore, this study aims to clarify the incidence of SGLT2 inhibitor-associated postoperative ketoacidosis (SAPKA) among patients who are receiving SGLT2 inhibitors and undergoing surgery under general anaesthesia.Methods and analysisThis multicentre, prospective, observational study will recruit 750 adult Japanese patients with diabetes who are receiving SGLT2 inhibitors and undergoing surgery under general anaesthesia. Urine samples will be collected on postoperative days 0, 1, 2 and 3. Blood gas analysis will be performed when urine ketone positivity is detected. The incidence of postoperative ketoacidosis will be identified based on urine ketone positivity and a blood pH of ≤7.3. The study will also collect data to identify risk factors for SAPKA.Ethics and disseminationThe study protocol has been approved by the ethics committee of Kyorin University (approval number: 785, 26 October 2020) and local ethical approval will be required at each participating centre. Study findings will be submitted to peer-reviewed journals and abstracts will be submitted to relevant national and international meetings.Trial registration numberUMIN000042795

A possible future for anaesthesia in breast surgery: thoracic paravertebral block and awake surgery. A prospective observational study

2020 ◽  
pp. 030089162095162
Author(s):  
Domenico P. Santonastaso ◽  
Annabella de Chiara ◽  
Emanuele Russo ◽  
Emiliano Gamberini ◽  
Leonardo Lucchi ◽  
...  
Keyword(s):  
Observational Study ◽  
General Anaesthesia ◽  
Prospective Observational Study ◽  
Rating Scale ◽  
Breast Surgery ◽  
Numeric Rating Scale ◽  
Paravertebral Block ◽  
Awake Surgery ◽  
Thoracic Paravertebral Block ◽  
Numeric Rating

Introduction: Quadrantectomy is a surgical procedure traditionally performed under general anaesthesia with intraoperative and postoperative opioid-based analgesia. The use of locoregional anaesthesia techniques in breast surgery has become widespread and allows excellent management of intraoperative and postoperative pain with reduced opioid consumption. We chose thoracic paravertebral block as regional anaesthesia technique in breast surgery to investigate the possibility of carrying out this surgery with the patient awake. Methods: A prospective observational study on 50 patients was designed. The primary outcome for this study was the possibility to carry out the surgery with only the paravertebral block associated with mild sedation without general anaesthesia. Forty minutes before the start of the surgery, an ultrasound-guided thoracic paravertebral block was performed at two thoracic levels, and for each level, 7 mL of ropivacaine 0.7% was injected. Sedation was obtained with target-controlled infusion of propofol. Results: Forty-nine patients underwent the operation awake; in one case, we had to place an I-gel and perform general anaesthesia. No patient needed intraoperative or postoperative opioids. The numeric rating scale, recorded at 0, 2, 6, 12, 24, and 36 hours, was greater than 3 in only five patients. Conclusions: We believe that if in the future we try to make quadrantectomy an intervention in which the anaesthesia is exclusively regional, therefore with a patient awake and collaborating, it will not be possible to ignore the use of thoracic paravertebral block.

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