bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of pressure support ventilation vs. spontaneous ventilation on lung atelectasis during recovery from anesthesia for laparoscopic gastric sleeve surgery
Authors: Aboelsuod Mohamed Abdelgawad Abdelhalim , Farhat Abeer Elsayed Abdellatif , Abdalla Abdalla Mohamed , Hassnin Fareed Shawky Basiony 
Published: February 2024

Background & Objective: Pressure support ventilation (PSV) is a target pressure mode that offers breath by breath mode of ventilation support, started by patients, and timed to respiratory effort. The fundamental idea behind PSV is to assist spontaneous breathing in response to the patient-initiated breaths. We evaluated the effects of PSV and spontaneous ventilation during awakening from anesthesia on lung atelectasis in the patients following laparoscopic gastric sleeve surgery. Methodology: Following clearance from the institutional ethical council, we enrolled 64 patients and divided them into two groups at random; pressure support group (Group PS) to receive PSV, and control group or spontaneous group (Group S) to continue with spontaneous ventilation mode during awakening from anesthesia in the patients following laparoscopic gastric sleeve surgery. Results: In the pressure support group, atelectasis was less common than in the control group at PACU (P = 0.042). Over the first 48 h following surgery, there were substantial differences between the groups in the level of oxygen saturation as determined by pulse oximetry ≤ 92%. The incidence of SpO2 ≤ 92% during 48 h postoperatively in the Group S and Group PS was 34% vs 12% respectively. No patient needed mechanical ventilatory support during the 48 h postoperatively. Conclusions: Pressure support ventilation during the recovery from general anesthesia to patients after laparoscopic gastric sleeve surgery resulted in reduced incidence of postoperative atelectasis than those who were allowed spontaneous ventilation with occasional manual support. Abbreviations: PACU: Post-Anesthesia Care Unit; PEEP: Positive End Expiratory Pressure; PSV: Pressure support ventilation; VT: Tidal Volume. Key words: Gastric sleeve surgery; Laparoscopy; Lung atelectasis; Pressure support ventilation; Spontaneous ventilation. Citation: Aboelsuod MAA, Farhat AEA, Abdalla AM, Hassnin FSB. The effect of pressure support ventilation vs. spontaneous ventilation on lung atelectasis during recovery from anesthesia for laparoscopic gastric sleeve surgery. Anaesth. pain intensive care. 2023;27(3):301−307.DOI: 10.35975/apic.v27i3.2166 Received: March 09, 2023; Reviewed: March 20, 2023; Accepted: April 16, 2023.
Video laryngoscopy: a double-edged sword
Authors: MD Taizoon Q. Dhoon , MD Linsey Wilson , FAACD, FASA Govind RC Rajan, MBBS, 
Published: February 2024

Endotracheal intubation revolutionized anesthesia and allowed prolonged surgical procedures to be performed. It also made positive pressure ventilation possible in patients in respiratory insufficiency and being managed in intensive care units. But successful intubation required the development of laryngoscopes. A variety of blades were developed to be used in different sets of patients. A laryngoscope came to be known as a symbol of the specialty of anesthesiology. But it was not always safe, nor successful, necessitating more sophisticated instruments. Video laryngoscopes were introduced with a sigh of relief for the anesthesiologists in difficult airway cases. Many variations of video laryngoscopes with slight differences have been marketed. But cases of video laryngoscope related injuries have been reported. This paper gives an over-view of the possible mechanism and preventive measures.
Abbreviations: DL - Direct laryngoscopy; ETT – Endotracheal intubation; IDL - indirect laryngoscopy; VL - Video laryngoscopy;
Key words: Airway management; Instrumentation; Intubation, endotracheal; Laryngoscope; Laryngoscopy
Citation: Dhoon TQ, Wilson L, Rajan GRC. Video laryngoscopy: a double-edged sword. Anaesth. pain intensive care 2023;27(3):413−416; DOI: 10.35975/apic.v27i3.2219
Received: March 30, 2023; Reviewed: April 11, 2023; Accepted: April 15, 2023
Anesthetic management of omphalopagus twins with pentalogy of Fallot undergoing separation surgery
Authors: Purwoko Purwoko , Santosa Sugeng Budi , Novianto Bambang , Ganitafuri Handayu 
Published: February 2024

The management of conjoined twins has several special aspects, mostly linked to the parents of the twins, such as communication, ethics and trust issues. A multidisciplinary team approach plus high level of vigilance at each perioperative stage is required. Conjoined omphalopagus twins, aged one year, were planned for separation surgery. They had fused liver, fused portal and hepatic veins, and partially fused intestines. Patient B appeared with complications of pentalogy of Fallot (PoF). The patient also had polycythemia (hemoglobin 14.7 g/dL, hematocrit 50%). Radiological features showed anterior abdominal wall with images of interconnected intestinal system between the two. In thoracoabdominopagus conjoined twins, the possibility of shared circulation becomes important especially associated with injection of intravenous drugs. The goal of anesthesia in PoF is to maintain cardiac output by maintaining heart rate, contractility and preload; and preventing right to left shunting via ventricular septal defect (VSD). Induction can cause vasodilation and the resultant decrease in systemic vascular resistance (SVR) can exacerbate right-to-left shunts. Monitoring end tidal CO2 (EtCO2) is needed. We present a report of anesthesia for such a case.
Abbreviations: ASD: Atrial Septal Defect; PoF: Pentalogy of Fallot; VSD: Ventricular Septal Defect; SVR: Systemic Vascular Resistance
Key words: Conjoined Twins; Pentalogy of Fallot; Congenital Heart Disease; Cyanosis; Anesthesia
Citation: Purwoko, Santosa SB, Novianto B, Ganitafuri H. Anesthetic management of omphalopagus twins with pentalogy of Fallot undergoing separation surgery. Anaesth. pain intensive care 2023;27(3):434−440.
DOI: 10.35975/apic.v27i3.2224
Received: May 24, 2022; Reviewed: Sep 18, 2022; Accepted: Jan 04, 2023
Dexmedetomidine related apnea and desaturation during awake craniotomy: a case report
Authors: Hasyizan Hassan Mohamad , Mohd Nazaruddin Wan Hassan Wan , Laila Ab Mukmin , Zamzuri Idris , Zulfakar Mazlan Mohd 
Published: February 2024

Dexmedetomidine (Dex) is regarded as a novel sedative agent since the drug preserves respiration and makes ‘conscious sedation’ possible. This drug is widely used for monitored anesthesia care (MAC). We report a case of apnea and desaturation in awake craniotomy surgery under MAC after loading of Dex with 1 mg/kg over 10 min and discuss possible explanations. We advocate using Dex with a lower loading dose over a prolonged duration and the up-titration of the drug according to the patient’s response particularly in those who are underweight or elderly. Meticulous judgement for possible interactions of Dex with antiepileptics, opioids and other sedative agents is essential during MAC.
Abbreviations: BIS- Bispectral Index; Dex- Dexmedetomidine; DBS- Deep Brain Stimulation; MAC- Monitored Anesthesia Care; TCI- Targeted-Controlled Infusion
Key words: Dexmedetomidine; Craniotomy; Apnea; Conscious sedation; Balanced anesthesia; Anticonvulsant
Citation: Hasyizan HM, Mohd Nazaruddin WHWM, Laila AM, Zamzuri I, Zulfakar MM. Dexmedetomidine related apnea and desaturation during awake craniotomy: a case report. Anaesth. pain intensive care 2023;27(4):609−612; DOI: 10.35975/apic.v27i4.1901
Received: May 30, 2022; Reviewed: December 28, 2022; Accepted: May 22, 2023
Dexmedetomidine vs. fentanyl as adjuvants to hyperbaric bupivacaine for unilateral spinal anesthesia in lower limb orthopedic surgeries: a randomized trial
Authors: Tawadros Safaa Ishak Ghaly , El Mageed Azza Mohammed Shafik Abd , El Taher Waleed Abd El Mageed Mohammed , Salama Mariam Gamal Motawashleh , Ansary Amin Amin Mohamed Al 
Published: February 2024

Background & Objective: Opioids and α2 adrenergic receptor agonists are commonly used as adjuvants to intrathecal local anesthetics to improve the quality and duration of spinal anesthesia (SA). Fentanyl and dexmedetomidine (DEX) are the most commonly used opioid and α2 agonist respectively. We compared the efficacy of these two when used as adjuvants to hyperbaric bupivacaine for SA for lower limb surgeries.
Methods: A total of 54 patients were randomly assigned to receive unilateral spinal anesthesia with bupivacaine 2.5 ml. Group F (n = 27) received 25 μg fentanyl, and Group D received 10 μg DEX added to the spinal bupivacaine. Time to first analgesic request was the primary outcome, while sensory and motor block characteristics, nalbuphine consumption as rescue analgesic, pain scores, side effects and sedation levels were the secondary outcomes.
Results: Patients receiving dexmedetomidine as an adjuvant to hyperbaric bupivacaine for spinal anesthesia for lower limb surgeries had a significantly longer time to rescue analgesia than those receiving fentanyl. The mean time to rescue analgesia in Group D was 409.63 ± 74.60 min vs. 295.93 ± 36.72 min (P = 0.000) in the Group F. Also, patients in Group D had significantly longer sensory and motor blocks.
Conclusion: Intrathecal dexmedetomidine 10 μg seems to be a good alternative to fentanyl 25 μg when used as an adjuvant in unilateral spinal anesthesia for lower limb orthopedic surgeries with better quality postoperative analgesia and with minimal side effects.
Abbreviations: DEX - Dexmedetomidine; NYHA - New York Heart Association; BMI - Body mass index; MBP - Mean blood pressure; SBP- Systolic blood pressure; DBP- Diastolic blood pressure; VAS - Visual Analog Scale
Key words: Dexmedetomidine; Fentanyl; Bupivacaine; Anesthesia, Spinal
Citation: Ghaly SI, Shafik AM, AlTaher WAMM, Motawashleh MG, Alansary AM. Dexmedetomidine vs. fentanyl as adjuvants to hyperbaric bupivacaine for unilateral spinal anesthesia in lower limb orthopedic surgeries: a randomized trial. Anaesth. pain intensive care 2023;27(4):456−463. DOI: 10.35975/apic.v27i4.2191
Received: March 30, 2023; Reviewed: April 22, 2023; Accepted: April 22, 2023
Anesthetic management of a patient with pheochromocytoma and peripartum cardiomyopathy for cesarean section
Authors: Ayesha Kiran , Khan Javeriah , Sikander Rana Imran , Fatima Naheed 
Published: February 2024

Pheochromocytoma and peripartum cardiomyopathy is associated with significant maternal mortality. Cause of death can be heart failure, myocardial infarction, arrhythmias and thromboembolism. Pheochromocytoma can be one of the causes of dilated cardiomyopathy. Anesthesia in an obstetric patient with pheochromocytoma and peripartum cardiomyopathy is challenging. Early diagnosis and a multidisciplinary management is required to improve outcome. Elective cesarean section must be planned and epidural anesthesia should be the preferred technique. We present a case of 34 y old female patient with pheochromocytoma and peripartum cardiomyopathy who underwent cesarean section under epidural anesthesia and had uneventful recovery.
Key words: Pheochromocytoma; Peripartum Cardiomyopathy; Cesarean Section; Epidural Anesthesia
Citation: Ayesha K, Khan J, Sikander RI, Fatima N. Anesthetic management of a patient with pheochromocytoma and peripartum cardiomyopathy for cesarean section. Anaesth. pain intensive care 2023;27(4):596−599.
DOI: 10.35975/apic.v27i4.2208
Received: April 16, 2023; Reviewed: May 09, 2023; Accepted: June 06, 2023
The impact of simulation-based training on the knowledge and skills of postgraduate medical students in the management of cardiac arrest
Authors: Patil Archita , Kadam Sandeep , Monnaiah Pradhan , Patil Sanket , Sethiya Srishti , Singh Srashti 
Published: February 2024

Background: Use of simulation as a teaching learning method is said to improve the learners’ skills and clinical decision making in a risk-free environment. The effectiveness of simulation in imparting protocol-based training of a critical situation like cardiac arrest to postgraduate students, needs to be evaluated. We aimed to train students in a simulation-based training session for Advanced Cardiac Life Support (ACLS) in the management of in-hospital cardiac arrest, and assess the effect on the pre-training efficacy.
Methodology: Thirty post-graduate students were subjected to a pre-test in knowledge and skills regarding ACLS, followed by a didactic lecture and a training session on a high-fidelity mannequin for the same. The assessment was conducted one week later. A self-perception questionnaire from the students was obtained at the end of the whole program. Mean score of knowledge, skill, time to initiating CPR and time to defibrillation in pre-test and post-test were compared using the paired-t test. P < 0.05 was considered statistically significant.
Results: There was statistically significant improvement in the post-test knowledge score (13.5 ± 2.87; P < 0.0001) and skills score (6.066 ± 1.25; P < 0.0001). Objective improvement was noticed in time to start cardiopulmonary resuscitation (pre-test 60 ± 19.76 sec vs. post-test 26.56 ± 16.07 sec; P = 0.0001). Time to defibrillation was markedly reduced (pre-test 118.6 ± 28.28 sec vs. post-test 93 ± 33.38 sec; P = 0.0022). Majority of the students strongly agreed that the training session resulted in improved confidence (76.7%), which enhanced clinical decision making in emergency situations (83.3%).
Conclusion: The simulation-based training session significantly increases the knowledge and psychomotor skills of the post-graduate students with enhanced confidence to manage a victim of cardiac arrest as self-judged by the participants.
Abbreviations: ACLS – Advanced Cardiac Life Support; CBME - Competency Based Medical Education CPR - Cardiopulmonary Resuscitation; CVR - Content Validity Ratio
Key words: Simulation Training; Cardiopulmonary Resuscitation
Citation: Patil A, Kadam S, Monnaiah P, Patil S, Sethiya S. Singh S. The impact of simulation-based training on the knowledge and skills of medical postgraduate students in the management of cardiac arrest. Anaesth. pain intensive care 2023;27(4):496−501. DOI: 10.35975/apic.v27i4.2258
Received: October 13, 2022; Reviewed: June 09, 2023; Accepted: June 13, 2023
Granulicatella adiacens infective endocarditis complicated with splenic infarct in pregnancy: A case report and literature review
Authors: Hamid Norjihan Abdul , P.S Muthialu V. Rubini Nair Muthi @ , Mazlan Mohd Zulfakar , Wan Isa Wan Yus Haniff , Hashim Alwi Muhd Besari@ , Mamat Ahmad Zuhdi , Zon Erinna Mohamad , Hassan Siti Asma’ , Salmuna Zeti Norfidiyati 
Published: February 2024

Infective endocarditis (IE) contributes to high morbidity and mortality due to therapeutic challenges despite of advances in treatment options. The epidemiology, clinical manifestations, complications, diagnostic difficulties and dilemmas, suitable timing for surgery were constantly changing and leading to poor prognosis of this illness. We report a case of Granulicatella adiacens infective endocarditis complicated with embolism and splenic infarct in a pregnant lady with chronic rheumatic heart disease successfully treated with antimicrobial therapy and surgical intervention.
Key words: G. adiacens, Infective Endocarditis, Splenic Infarct, Pregnancy
Citation: Hamid NA, PS Muthialu VRNM, Mazlan MZ, Wan Isa WYH, Hashim AMB, Mamat AZ, Zon EM, Hassan SA, Salmuna ZN. Granulicatella adiacens infective endocarditis complicated with splenic infarct in pregnancy: A case report and literature review. Anaesth. pain intensive care 2023;27(6):786−789; DOI: 10.35975/apic.v27i6.2359
Received: November 15, 2023; Reviewed: November 16, 2023; Accepted: November 16, 2023
Lavender aromatherapy: Its effect on preoperative anxiety and propofol requirement for anesthesia
Authors: Rahman Raha Abdul , Dewan Menaga M. Vasu , Sayed Masri Syarifah Noor Nazihah , Mokhtar Mohammad Nizam , Abdullah Farah Hanim , Nor Nadia Md 
Published: February 2024

Background & objective: Preoperative anxiety is a natural human psychology, and the physicians usually prescribe tranquillizers to allay the anxiety of their anxiety. Various other means have also been employed for this purpose. We aimed to investigate the impact of lavender aromatherapy on preoperative anxiety and propofol requirement at induction of anesthesia.
Methodology: A total of 108 female patients were enrolled in the study, and their anxiety levels were evaluated using the Visual Analogue Scale (VAS) at three different time points. Patients were randomly divided into two groups. Group A (Lavender Group) patients were given lavender aromatherapy via a cotton strip infused with two drops of 100% pure lavender essential oil, while the patients in Group B (Control Group) had no aromatherapy.
Results: The results showed that the lavender aromatherapy significantly reduced anxiety in Group A (P < 0.001) compared to Group B, and the mean differences of VAS scores for all anxiety assessments were also significantly reduced in Group A (P < 0.000). In addition, the mean total amount of propofol required was significantly less in Group A than in Group B (118.46 ± 40.01 vs 140.38 ± 35.29 mg; P = 0.003), while the mean duration to reach loss of consciousness was similar in both groups.
Conclusion: The findings of our study suggest that lavender aromatherapy can be a simple, safe, and cost-effective way to reduce preoperative anxiety and decrease the amount of propofol required for the induction of anesthesia. Therefore, the use of lavender aromatherapy may be a valuable addition to the preoperative care of patients undergoing elective surgeries.
Abbreviations: APAIS- Amsterdam Preoperative and Information Scale; LOC- Loss of Consciousness; OT- Operation Theatre; OR- Operating Room; STAI- State-Trait Anxiety Inventory; VAS- Visual Analogue Scale
Key words: Aromatherapy; Benzodiazepines; Lavender; Anxiety, Preoperative; Propofol; Anxiety / therapy; Anxiety Disorders
Citation: Rahman RA, Vasu Dewan MM, Sayed Masri SNN, Mokhtar MN, Abdullah FH, Md Nor N. Lavender aromatherapy: Its effect on preoperative anxiety and propofol requirement for anesthesia. Anaesth. pain intensive care 2024;28(1):20−25; DOI: 10.35975/apic.v28i1.2376
Received: April 26, 2023; Reviewed: November 22, 2023; Accepted: November 22, 2023
Evaluation of the effects of the local anesthetics on immunity during mastectomy
Authors: Angjushev Darko Lazar , Sholjakova Marija V. , Kartalov Andrijan , Kuzmanovska Biljana , Kishman Aleksandar , Demjanski Vasko , Srceva Marija Jovanovski , Kokareva Anita , Angjushev Marija Kotevska 
Published: February 2024

Background & objective: Surgery and some anesthetic techniques can contribute to tumor cells dissemination. It is known that the use of local anesthetics and regional blocks during mastectomy preserved the immune function. We evaluated and compared, the levels of some cytokines (IFNγ, TNFα, IL2, IL12) responsible for immune function, as well as the level of leukocytes before and after breast carcinoma surgery; and to find out and compare the effects of local anesthetics on blood pressure (BP) and on postoperative complications, e.g., pain, vomiting, headache, the need for analgesia and surgical complications.
Methodology: In this randomized prospective study, 45 patients were allocated in 3 equal groups: Group GA (n = 15) for standard general anesthesia; Group LA (n = 15) for general anesthesia and infusion of lidocaine; Group PECS (n = 15) for pectoralis I/II block with bupivacaine and general anesthesia. Blood samples were taken to ascertain cytokines and leukocytes levels before surgery and 24 h after surgery.
Results: Lidocaine caused fall of BP (P = 0.002t), but bupivacaine (PECS I/II block) produced stable BP during mastectomy (P = 0.1). A significant increase of leucocytes after surgery was seen in Group PECS compared to Group GA (P = 0.033). In 24-h intervals after surgery, lidocaine and bupivacaine produced an increase of TNFα (P < 0.05). Bupivacaine showed a significantly low intensity of postoperative pain compared to other techniques and zero postoperative complications.
Conclusion: Local anesthetics lidocaine and bupivacaine enhance the immune response and produce more stable hemodynamics compared to general anesthesia alone during mastectomy in patients with breast carcinoma.
Abbreviations: CTL- Cytotoxic T Lymphocytes; IFNγ- Interferon Gamma; TNFα- Tumour Necrosis Factor α, IL2- Interleukin-2; NKCs- Natural Killer Cells; Th1- Type 1 T Helper Cells; VAS- Visual Analog Scale
Keywords: Breast Carcinoma; Lidocaine; Bupivacaine; PECS I/II block; Cytokines
Citation: Angjushev DL, Sholjakova MV, Kartalov A, Kuzmanovska B, Kishman A, Demjanski V, Srceva MJ, Kokareva A, Angjushev MK. Evaluation of the effects of the local anesthetics on immunity during mastectomy. Anaesth. pain intensive care 2024;28(1):108−114; DOI: 10.35975/apic.v28i1.2383
Received: November 14, 2023; Reviewed: November 17, 2023; Accepted: December 09, 2023
Alon–Boppana-Type Bounds for Weighted Graphs
Authors: Polyanskii Alexander , Sadykov Rynat 
Published: February 2024

The unraveled ball of radius $r$ centered at a vertex $v$ in a weighted graph $G$ is the ball of radius $r$ centered at $v$ in the universal cover of $G$. We present a general bound on the maximum spectral radius of unraveled balls of fixed radius in a weighted graph.
The weighted degree of a vertex in a weighted graph is the sum of weights of edges incident to the vertex. A weighted graph is called regular if the weighted degrees of its vertices are the same. Using the result on unraveled balls, we prove a variation of the Alon–Boppana theorem for regular weighted graphs.
Upaya Meningkatkan Hasil Belajar Matematis Siswa dengan Menggunakan Model Pembelajaran Peer Teaching
Authors: Yusita Yusita 
Published: February 2024

Penelitian ini bertujuan untuk meningkatkan hasil belajar materi Translasi melalui metode pembelajaran Peer Teaching siswa Kelas IX SMP Negeri 9 Batam. Penelitian ini adalah penelitian tindakan kelas yang terdiri dari perencanaan, pelaksanaan, observasi, dan refleksi yang dilaksanakan pada semester genap tahun ajaran 2021/2022. Subjek penelitian adalah peserta didik kelas IX sebanyak 27 orang. Sumber data terdiri dari sumber data primer dan data sekunder. Instrumen penelitian ini peneliti sendiri, dan menggunakan lembar observasi, pedoman wawancara, dan catatan lapangan untuk mengumpulkan data kualitatif. Teknik analisis data menggunakan analisis kualitatif. Hasil penelitian menunjukkan bahwa melalui metode dapat meningkatkan hasil belajar siswa materi kelas IX SMP Negeri 9 Batam.
PENGEMBANGAN MEDIA BUKU CERITA BERGAMBAR UNTUK MENINGKATKAN KEMAMPUAN BAHASA ANAK USIA DINI KELOMPOK B TKK ST YOSEPH SADHA
Authors: Ine Laka Yustina , Meka Marsianus , Fono Yasinta Maria 
Published: February 2024

Peneliti bertujuan untuk menghasilkan media buku cerita bergambar anak usia dini, tema binatang dalam meningkatkan kemampuan bahasa anak dan mengetahui kualitas hasil uji coba produk pengembangan media buku cerita bergambar pada tema binatang untuk anak usia dini kelompok B di TKK St. Yoseph Sadha. Media buku cerita bergambar ini dikembangkan dengan model ADDIE.. Dengan demikian, berdasarkan hasil uji coba media buku cerita bergambar AUD Oleh ahli dan anak sebagai pengguna produk dinyatakan layak untuk digunakan dalam proses pembelajaran dan media buku cerita bergambar anak usia dini yang dikembangkan untuk meningkatkan kemampuan bahasa ini layak digunakan dalam proses pembelajaran di TKK St. Yoseph Sadha.