Acid-base disturbances and related factors in patients under general anesthesia

In patients undergoing surgery, acid-base imbalance during general anesthesia causes disruption in the function of cardiovascular, respiratory, musculoskeletal and the central nervous system. Since the potential complications of acid-base disturbances are serious, we decided to explore these changes and related causes so that prevention and compensation would be feasible. In this study, acid-base disruption and its causes during general anesthesia were studied in 60 patients. The patients were divided into three groups based on the location of surgery: abdominal [I], extremities [II], and head and neck [III]. Body central temperature, type, and volume of injected fluids and bicarbonate [as needed] were recorded. In the second, third, and fourth hours of surgery, arterial blood gases and pH were measured. The incidence and degree of metabolic acidosis in all patients were significantly related to the duration of the surgery. The number of patients with acidosis and the number of patients requiring treatment were also greater in groups I and II than in group III. Although all patients became hypothermic during the surgery, there was no significant relationship with development of acidosis. No relationship was found between the type and volume of the solution administered and development of acidosis. In our opinion, monitoring of acid-base status in prolonged surgeries especially in abdominal and extremity operations seems necessary

[Comparing the early complications of surgical wounds in two methods of open surgery and laparoscopy in Milad Hospital]

Incidence of early wound related complications was assessed in laparoscopic versus open abdominal surgeries. Complications of surgical wounds [esp. wound infections] are considered as a major problem in surgery wards. Complications of surgical wounds are classified as early and late. Common and early complications are hematoma, seruma and wound in fection. Medical records of 104 elective laparoscopic [A] and 106 diagnosis matched open surgeries [B] including appendectomy, cholecystectomy, ventral hernia repair, and bariatric surgery were prospectively reviewed. Study data included patients' sex, age, wound class, type of operation, and occurrence of early wound related complications. Surgical wounds were evaluated for presence of early complications during the post-op period and 10 to 15 days after the operation. The two groups were not different with respect to age, sex and wound classes. No patients in group A and 7 patients in group B developed wound infection. [P<0.05] Incidence of Hematoma was similar in the two groups; one case in each. No patient in the two groups experienced seruma and wound dehiscence. Gender, age and wound classes were not associated with higher rates of wound complications. Laparoscopic surgery significantly reduced the incidence of early wound complications, specially wound infection, and is a safe and effective alternative to conventional open procedures