Association between risk of neonatal pneumothorax and mode of anesthesia for cesarean delivery at term: a nationwide population-based retrospective cohort study

Effect of Different Anesthesia Methods on Emergence Agitation and Related Complications in Postoperative Patients with Osteosarcoma

Purpose

To explore the effect of different anesthesia methods on emergence agitation (EA) and related complications in postoperative patients with osteosarcoma.

Methods

According to the order of admission, 115 patients requiring osteosarcoma surgery treated in our hospital from January 2018 to December 2020 were selected as the research object and randomly divided into the control group (n = 57, accepted the general anesthesia with tracheal intubation) and the experimental group (n = 58, accepted the combined spinal-epidural anesthesia) to compare their anesthesia effect, incidence rates of agitation and complications, and other indexes.

Results

In terms of the hemodynamic indexes (MAP, HR, and CVP values), both groups had lower ones at T₁ than at T₀, but the decline of the experimental group was generally lesser than that of the control group; at T₂, no statistical difference was shown within the experimental group's indexes when comparing with those at T₁, but the control group obtained a significant increase; at T₃ and T₄, both groups had their hemodynamic indexes increased, but such increase within the experimental group showed no statistical difference when comparing with those at T₀, while the control group achieved obviously higher values at T₄ than at T₀ (before the anesthesia); and the between-group difference in the hemodynamic indexes at T₁ and T₄ was significant. Compared with the control group, the experimental group achieved better VAS scores and anesthesia indexes and lower incidence rates of EA and complications such as the hypoxemia, cardiovascular response, delayed recovery, and headache. In addition, the differences in the incidence rates of hypotension and cognitive dysfunction between the two groups were not statistically significant.

Conclusion

When comparing with tracheal intubation general anesthesia, the combined spinal-epidural anesthesia has a better effect in osteosarcoma surgery, with less hemodynamics influence on patients, reduced postoperative pain and stress reaction, and lowered incidence rates of postoperative EA and complications, which is worthy of wide application in clinical treatment.

Neonatal pneumothorax: symptoms, signs and timing of onset in the post-surfactant era

AIM

The primary objective was to describe the incidence, symptoms, clinical signs, and time of onset of neonatal pneumothorax in Örebro County during 2011-2017. Secondary objectives were to describe risk factors, diagnostic procedures, treatments, and mortality and to compare preterm with term/post-term neonates.

MATERIALS AND METHODS

This retrospective population-based descriptive study included all neonates born in Örebro County during 2011-2017 and admitted to the neonatal intensive care unit at Örebro University Hospital at age <28 days with an x-ray verified diagnosis of "Pneumothorax originating in the perinatal period" in their medical record.

RESULTS

Seventy-five neonates matched the inclusion criteria. The incidence of neonatal pneumothorax in Örebro County during the study period was 3.1 (95% CI: 2.5-3.8) per 1000 live births. All neonates were <48 h at debut of respiratory symptoms and the most common symptom was tachypnea. Twelve (16%) received invasive treatment. The mortality rate was 2 (3%), none due to pneumothorax.

CONCLUSION

The incidence of 3.1 per 1000 live births was relatively high, but the frequency of invasive treatment and mortality was low, indicating a high proportion of mild pneumothoraces. The lack of patients aged >48 h indicates that most neonatal pneumothoraces now occur very early in life.