Journal of Clinical Anesthesiology: Open Access

Local anesthetics are drugs that produce temporary and localized blockage of nerve conduction. Depending on the place of administration and the dose used, they can lead to interruption of sensitivity, autonomous innervation and motricity, and must associate properties that, in addition to efficacy, ensure safety.

Most pharmaceutical drugs are released in racemic form. The study of the chirality of substances is an important field in the pharmaceutical industry and agrochemicals. Several review articles on chirality have been published, but none of them address the presence of an enantiomeric excess. In Brazil, an enantiomeric excess local anesthetic containing 75% of the S-enantiomer and 25% of the R-enantiomer was investigated, and later approved for use in regional anesthesia.

Abdominal surgeries produce the highest number of Surgical Site Infections (SSI) than any other surgical procedures. Pathology specimens from these procedures (either fluid or tissue) have been analyzed for bacterial isolates in diagnostic labs using various plating and culture methods for years. While these methods have been effective, newer technology and tests based on whole genome sequencing have shortened the time for microbial identification. Six different molecular diagnostic platforms: quantitative Reverse Transcription-PCR (RT-qPCR) Laboratory-Developed Test (LDT), a COBAS SARS-CoV-2 high-throughput system, three direct RT-qPCR kits, and Reverse Transcription loop-mediated isothermal AMPlification (RT-LAMP) plus rapid antigen tests were evaluated for their diagnostic capacity to detect SARS-CoV-2 RNA by 103 SARS-CoV-2 positive patient samples were tested with these 7 methods and viral RNA being detected between 50.5% - 81.6% of samples on molecular platforms. Antigens were detected only 11.7% of samples when tested by rapid antigen test. Despite varying sensitivities on the different platforms, each platform was verified as a reliable detection tool for the virus with rapid antigen testing being a less reliable option for detecting coronavirus RNA. Increased precision and sensitivity from molecular testing platforms provide more accuracy and efficiency when looking for pathogenic bacteria causing surgical site infections in recovering patients. Early detection of bacterial isolates in surgical incisions post-surgery is imperative to the recovery of patients after a procedure. This project will investigate which molecular genomic platform is better at detecting pathogenic bacteria after abdominal surgery.

Background: Mechanical ventilating was an essential life supporting method for crucially ill cases. The weaning outcomes influences the morbidities and mortalities of cases when their main disorder advances.

Aim and objectives: To evaluate the predictive value of heart, lung and diaphragmatic US in the process of weaning in mechanically ventilated patients over 48 hours.

Methods: This is a prospective observational single group research which was performed at Menoufia University hospitals between (May 2019 and May 2020).  The study included 62 mechanically ventilated patients over 48 hours fulfilling weaning criteria underwent one Hour Spontaneous Breathing Trail (SBT). Before extubating, data collection comprised US evaluation of LVEF, LVDF was assessed using Left Atrial Area (LAA), early diastolic transmitral flowing velocity wave (E), late diastolic transmitral flow velocity wave (A), early diastolic mitral annulus velocity E′ (average septal and lateral E′), E/A, E de-acceleration time, E/E′, lungs losing of ventilation scoring and diaphragmatic movements./

Results: A high significant relation was found among weaning and LVEF, E’, E/E’ and LAA (p< 0.001) and statistically significant relation between weaning and E/A.Using aeration score it was shown that above 15.5, it can predict failure of weaning with Area Under Curve (AUC) of 0.781. Using diaphragmatic dysfunction, it was shown that if there were full diaphragmatic dysfunction, it can predict failure of weaning with AUC of 0.639.

Conclusion: The US characteristics of heart, lung, and diaphragm providing serious information around cardio-pulmonary and diaphragmatic job throughout SBT. Unsuccessful weaning was more predominant if markers of left ventricular diastolic dysfunctions, increased Lung aeration score and diaphragmatic dysfunction were present.

Purpose: The aim of the study is to evaluate the effectiveness of lavender aromatherapy on patients undergoing outpatient surgery to reduce anxiety scores, improve patient’s vital signs, and reduce the use of anti-anxiety medications.

Methods: Vital signs and anxiety scores were documented before and after 30 minutes of lavender aromatherapy in perioperative area. Patients’ interest in anti-anxiety medication before surgery, and patient experience with the aromatherapy was also assessed.

Findings: 75% of patients reported a decrease in their anxiety score number and 57% reported a decrease in anxiety range 30 minutes after the start of aromatherapy. 39% of patients saw a reduction in the Mean Arterial Pressure (MAP) by 10 units or more and 31% saw a reduction in heart rate by 10 units or more after aromatherapy use (p values<<0.05). 22% of patients did not require an anxiolytic medication prior to entering the OR (Operating Room). 55% of patients returned surveys back with mainly positive feedback about the project.

Conclusions: Lavender aromatherapy proves to be an effective method in reducing anxiety scores, improving patient’s vital signs, and reducing use of anti-anxiety medications among patients undergoing outpatient surgery.

Abstract

Background: Caesarean delivery is one of the most commonly performed surgical procedures all over the world. The choice of anesthesia for cesarean section is regional and general anesthesia. Some of the factors influencing the choice of anesthesia type for cesarean section are the degree of urgency, maternal and fetal condition, and willingness of the mother, the experience of the anesthetists, and availability of all anesthesia equipment. Hence, the aim of this study was to identify factors influencing types of anesthesia selection for cesarean section.

Methods: A prospective cross-sectional study design was conducted on factors influencing the choice of anesthesia type for mothers who underwent cesarean section in Jimma specialized hospital from April to June, 2018. All mothers who underwent cesarean section were included. Regular supervision and follow-up were made. Descriptive statistics were used to identify factors influencing types of anesthesia. Data was entered and analysis was done using SPSS version 25.

Coronavirus complaint 2019 makes it more delicate to give parturients with perioperative care( COVID- 19). This study's ideal is to examine postoperative complications and hemodynamic stability in COVID- 19 positive expectant maters who are giving birth while entering spinal anaesthesia. 31 COVID- 19 positive parturients were linked between January and June 2021 as part of this prospective experimental study at a tertiary tutoring sanitarium in Jordan. Each COVID- 19 positive parturient passed anaesthesia in the identical conditions as the control group, while each COVID- 19 negative parturient was matched with a COVID- 19 positive parturient. Of the 31 COVID- 19 cases, 22(71) had normal health overall, while 8(25.7) passed exigency caesarean sections. After 10 twinkles, the COVID- 19 positive group's sensitive degree of spinal block was T8( T6- T10) as opposed to T4( T4- T6) in the COVID- 19 negative group.