ABSTRACT
Background: Obesity has become a serious problem not only in adult patients but also in pediatric patients. Aim: To evaluate whether obesity affects the recovery profile after general anesthesia in children. Participants: 40 children (aged 2–12 years) who underwent surgery under general anesthesia and had an American Society of Anesthesiologists (ASA) physical I and II. Methods: This prospective cohort study was conducted over a period of 3 months (January- April, 2021). The patients were divided into two groups according to body mass index (BMI): Group I comprised obese children (BMI ?95th for age percentile) (n=20) and Group II comprised children with a normal BMI (25– 75th for-age percentile) (n=20). Anesthesia induction and maintenance were performed as per standard guidelines in both the groups. Outcome: The recovery profile was evaluated with the following parameters: time to spontaneous ventilation, laryngeal mask airway removal time, time to open eyes, and postanesthesia care unit discharge time. Results: When the recovery profiles were compared, no significant differences were found between the groups. Time to spontaneous ventilation [mean difference (95% CI); 0.66 (0.09- 1.42); P=0.085], laryngeal mask airway removal time [MD (95% CI); 1.12 (0.06–2.22); P=0.057), time to open eyes [MD (95% CI) 0.66 (0.40–1.74); P=0.217], and post-anesthesia care unit discharge time [MD (95% CI) 3.60 (0.59-7.25); P=0.054] were higher in Group II; however, these differences lacked both statistical and clinical significance. Conclusion: The results suggest that obesity has no effect on the recovery profile after general anesthesia in children in our setting.
ABSTRACT
ABSTRACT BACKGROUND: Both postoperative pain control and range of motion are important in total knee arthroplasty (TKA). However, in the literature, there is little comparison of peripheral nerve blocks and periarticular infiltration techniques using levobupivacaine. The aim of our study was to measure pain with visual analogue scale (VAS) and knee range of motion (ROM) between in patients undergoing adductor canal block (ACB) for TKA using levobupivacaine compared to periarticular levobupivacaine infiltration (PAI-L). DESIGN AND SETTING: Prospective randomized clinical trial in a university hospital. METHODS: Patients aged 40-85 years who underwent unilateral TKA were included; 39 were treated withperiarticular infiltration using 40 ml (0.125 mg) of levobupivacaine (PAI-L group); and 40 were treated with ACB using 20 ml of 0.25% levobupivacaine (ACB-L group). Postoperative pain scores at rest and during active physical therapy were assessed using a VAS, along with knee ROM in flexion and extension. In addition, 100-foot walking time results, total morphine consumption and time of first analgesia requirement were recorded postoperatively. RESULTS: VAS scores at rest and during active physical therapy and the total amount of morphine consumed were lower in the ACB-L group than in the PAI-L group (P < 0.05). In contrast, knee ROM in flexion and extension and 100-foot walking times were greater in the PAI-L group than in the ACB-L group (P < 0.05). CONCLUSION: ACB-L was superior to PAI-L regarding pain treatment after TKA; however, PAI-L was superior to ACB-L regarding postoperative ROM and walking ability. CLINICAL TRIAL REGISTRY: ACTRN-12618000438257.