[Show abstract][Hide abstract] ABSTRACT: To evaluate the effectiveness of two-different doses of prophylactic dexamethasone intravenous administration in reducing the prevalence of postoperative sore throat following general endotracheal anesthesia.
All patients (105 cases) of different procedures of elective surgery scheduled to have general anesthesia performed with endotracheal intubations were included. The subjects randomized into three pre-operative intravenous substance/drug administrations, group I (35 cases) with normal saline 2 ml, group II (35 cases) with dexamethasone 4 mg, and group III (35 cases) with dexamethasone 8 mg, respectively. The prevalence of sore throat and its severity was assessed, using visual analogue scale (VAS), scores of O to 10; 0 = no pain, and 10 = most severe pain.
Among three groups, the duration of surgery, and intubation-induced trauma had no statistical significance. The prevalence of sore throat at 1-hour/24-hour postoperative was 48.6/48.6%, 54.3/28.6%, and 54.3/42.9% in group I, II, and III respectively, and without statistical significance.
The intravenous dexamethasone had no significant effectiveness against postoperatively sore throat after endotracheal intubation.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 05/2012; 95(5):657-60.
[Show abstract][Hide abstract] ABSTRACT: Evaluate the effectiveness of variation of prophylactic antibiotic in laparoscopic cholecystectomy.
A retrospective data review was undertaken of patients who received a laparoscopic cholecystectomy between January 1, 2005 and December 31, 2008 in Songklanagarind Hospital. The prevalence of surgical site infection (SSI), the variation of antibiotic prescription, and associated factors with SSI were reviewed and analyzed.
Four hundred thirty nine patients received a successful laparoscopic cholecystectomy. The prophylactic antibiotic was utilized in 328 patients (74.7%). Cefazolin was the most common antibiotic used. Only 3 patients (0.9%) received the antibiotic according to the recommendation of center for disease control and prevention (CDC). The SSI was accounted in 41 patients (9.3%); 29 had the prophylactic antibiotic, while 12 did not. There was no statistically significant difference in the prevalence of SSI between the two groups (p = 0.54). Factor significantly associated with SSI was the operative time more than three hours (p = 0.03).
Various patterns of prophylactic antibiotic were encountered. The practice variation seemed to be ineffective in the prevention of SSI. The selectively risk factors should be considered in the antibiotic prophylaxis.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 01/2012; 95(1):48-51.
[Show abstract][Hide abstract] ABSTRACT: To evaluate expectations, experiences, and attitudes of orthopedic patients undergoing arthroscopic cruciate ligament reconstruction in terms of postoperative pain and management.
This prospective study involved 115 patients. Preoperatively, patients completed a preoperative questionnaire regarding expectations toward postoperative pain and management. Postoperatively, they completed a postoperative questionnaire regarding exact pain experiences and attitudes in relation to their pain and management.
Almost all expected (95.6%) and experienced (98.3%) pain. The median values of maximum and average pain measured by a verbal numerical rating score were 7.7 and 5.6, respectively. Approximately 3/5 reported marked and maximum relief from analgesics received Only one patient was not satisfied with pain management while the rest were satisfied in varying degrees. A large proportion showed incorrect conceptions concerning postoperative pain and management.
Postoperative pain management is still an area for improvement. Misunderstandings of patients should be explored and corrected as they can pose a barrier for effective pain relief Pain management should begin with preoperative explanations and advice followed by good care intraoperatively and postoperatively.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 11/2010; 93(11):1268-73.
[Show abstract][Hide abstract] ABSTRACT: The Airtraq laryngoscope (AL) is a new disposable tracheal intubation device. The authors reported the case of a successful awake intubation with AL of the trachea in a morbidly obese patient. A 54-year-old female, morbidly obese (BMI 38 kg/m), patient was scheduled for a tumor removal of the right eye under general anesthesia. She had symptoms of gastroesophageal reflux. The preoperative airway assessment showed difficult ventilation and intubation. An awake intubation under sedation and topical airway anesthesia were chosen. The first attempt of tracheal intubation with AL was unsuccessful because the tip of endotracheal tube (ET-tube) pointed to the arytenoid cartilage. The second attempt, with slight rotation of AL, glottic view showed grade I and the ET-tube passed through the vocal cords easily The authors 'experiences demonstrated that the AL could be used while awake and may be an alternative laryngoscope for airway management in morbidly obese patients.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 05/2008; 91(4):564-7.