Browsing by Author "Bagi, Bojan (57202392974)"

Introduction Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications. The incidence in adult population is 20-30%, and it can be up to 80% in high-risk population such as gynecological and laparoscopic surgeries. The objective of this study is to compare the efficiency of the combination therapy in comparison with monotherapy in the prevention of PONV in gynecological and laparoscopic surgeries. Methods An observational prospective cohort study was conducted on a sample of 64 patients (32 patients per group) treated postoperatively at the Gynecology and Obstetrics Ward of GH Subotica, in the period from January-March 2017. The anesthesiologist in charge administered the combination of dexasone and metoclopramide or granisetron in monotherapy according to protocol to patients for prevention of PONV. Results The demographic characteristics of patients are homogenous and show a statistically significant difference only in the characteristics of length of smoker status and maximum intra-abdominal pressure during surgery. The total incidence of postoperative nausea in the fifth, 15th and 60th minute was 15.6%, 17.2% and 18.7% respectively, and in the fourth, eighth, 12th, and 24th postoperative hour it was 12.5%, 7.8%, 10.9%, and 6.2%, respectively. The incidence of postoperative vomiting in the fifth, 15th, and 60th minute was 1.6%, 4.7%, and 4.7%, respectively, and in the fourth, eighth, 12th, and 24th postoperative hour it was 1.6%, 3.2%, 1.6%, and 1.6%, respectively. Conclusion The study proved that the combination effect of dexasone and metoclopramide is not inferior compared to monotherapy with granisetron. © 2019, Serbia Medical Society. All rights reserved.

Introduction/Objective Intraoperative variations in blood pressure and/or cardiac dysrhythmias (IOVBP/CD) represent one of the most common causes of morbidity and mortality in surgical patients. The aim of the study was to determine the incidence and risk factors for IOVBP/CD in thyroid surgery patients with comorbidities. Methods The study included 1,252 euthyroid patients with ASA 2 and ASA 3 status (American Society of Anesthesiologists – physical status classification) who underwent thyroid surgery. The following risk factors were examined: sex, age, body mass index (BMI), ASA status, admission diagnoses, type of operation, duration of surgery, time under general anesthesia, difficult intubation of trachea, and coexisting diseases – hypertension, cardiomyopathy, cardiac arrhythmias, angina pectoris, diabetes mellitus, kidney disease. The following intraoperative events were recorded: hypertension, severe hypertension, hypotension, and cardiac arrhythmias. We used Pearson χ2 square test, univariate, and multivariate logistic regression for statistical analysis. Results The majority of patients were female (86.3%). In 903 (72.1%) patients IOVBP/CD were detected. The most common problem was intraoperative hypertension (61.4%). Eight risk factors for IOVBP/CD were registered by univariate analysis: advanced age, ASA 3 status, BMI > 25 kg/m², duration of surgery, time under general anesthesia, hypertension, and cardiomyopathy as a coexisting disease. The multivariate regression model identified three independent predictors for IOVBP/CD: age, hypertension, and cardiomyopathy. Conclusion IOVBP/CD are common in thyroid surgery. The most common is intraoperative hypertension. Older age, hypertension, and cardiomyopathy as a coexisting disease are independent risk factors for IOVBP/CD. © 2018, Serbia Medical Society. All rights reserved.