ABSTRACT
OBJECTIVES: Each surgical patient is preoperatively, intraoperatively and postoperatively exposed to stress. The aim of this study was to determine the existence of preoperative anxiety, and to determine its impact on hemodynamic parameters (blood pressure, heart rate) in patients and dose of anesthetics during induction of anesthesia. METHODS: A prospective clinical study conducted at the Department of Anesthesiology and Reanimation and Surgery Clinic of University Clinical Center Tuzla (UCC) in the period May 2012. to January 2015. The 80 patients were analyzed which were planned for and done an elective cholecystectomy surgery or herniectomy surgical intervention. Preoperative anxiety was measured with the help of Spielberg test and evaluation of depth of anesthesia was performed with BIS monitoring. RESULTS: The results showed that all patients had some degree of preoperative manifest anxiety. Average values of mean arterial pressure, preoperatively and after the induction of general anesthesia, differed for 15,4 mm/Hg, but were not observed significant association between Spielberg score and differences in blood pressure. Preoperative anxiety is a significant predictor of administered dose of anesthetic. Each additional score on Spielberg scale reduces the dose of anesthetic for 0,304 mg/kgTT. CONCLUSION: Adequate assessment of preoperative anxiety and undertaking of certain steps to reduce it can assist in accurately determining the required dosage of anesthetic for the introduction of general anesthesia.
Subject(s)
Anesthetics/administration & dosage , Anxiety/physiopathology , Arterial Pressure , Heart Rate , Adult , Aged , Anesthesia, General , Cholecystectomy, Laparoscopic/psychology , Elective Surgical Procedures , Female , Herniorrhaphy/psychology , Humans , Male , Middle Aged , Preoperative Period , Prospective Studies , Young AdultABSTRACT
UNLABELLED: Supracondylar fractures are the result of a fall on outstretched hand in more than 70% of cases, and more common in the non-dominant arm. Bauman's angle is used to determine the degree of displacement and angulation, and the quality of fracture reduction. Carrying angle is the clinical parameter ofvarus-valgus angulation with elbow fully extended and forearm completely supinated. PATIENTS AND METHODS: The study was a retrospective-prospective and there were analyzed children under 14 years of age with supracondylar humerus fracture. They were analyzed by X-ray anteroposterior view of injured elbow, made before and after the surgery, with measuring Bauman's angle. Clinical examination was performed after completing physical therapy, when was measured carrying angle of the injured and healthy elbow using a goniometer. RESULTS AND DISCUSSION: The results showed that there is a negative correlation Bauman and carrying angle of injured elbow (r = -0.543, p < 0.0001). Analyzing Bauman's angle deviation from value of 75 degrees and the loss of carrying angle there is noticed significant positive correlation between the Bauman angle deviation and loss of carrying angle. Bauman's angle correlates well with the carrying angle and can be used as an indicator of the potential cosmetic complications. CONCLUSION: Carrying angle of uninjured elbow measured when reviewing a child who has suffered supracondylar fracture, can serve as a useful parameter in the assessment of real Bauman's angle, thereby the adequacy of fracture reduction on the injured arm. KEYWORDS: supracondylar fracture,
