ABSTRACT
Background Neuromuscular blocking agents (NMBAs) are employed during general anesthesia induction for endotracheal intubation and to facilitate specific surgeries requiring muscle relaxation. However, residual neuromuscular blockade (RNMB) can lead to respiratory complications in post-anesthesia care units (PACUs). This study investigates RNMB incidence in PACUs and its association with postoperative airway and respiratory issues. Methods A prospective observational study on patients undergoing general anesthesia with NMBAs was conducted at the Department of Anesthesia, Salmaniya Medical Complex, Bahrain, over six months (April to September 2023). Train-of-four (TOF) ratios were calculated using an acceleromyograph upon PACU arrival. Data on demographics, perioperative variables, and postoperative complications were recorded. Results Among 82 patients, 30 (36.6%) had RNMB upon PACU arrival. RNMB incidence declined: 17.1% at 10 minutes, 6.1% at 20 minutes, and 2.4% at 30 minutes, resolving by 40 minutes. Demographics and procedure duration showed no correlation with RNMB. Postoperative respiratory complications affected 23.2% of patients, notably higher in those with RNMB (p = 0.001). Among patients with TOF <90% at PACU arrival, 46.7% experienced complications compared to 9.6% with TOF ≥90% (p<0.001). Participants without RNMB had a significantly higher weight (p = 0.046). Airway support was required for 30% of patients, all with TOF <90% (p<0.001). Conclusion This study emphasizes the importance of assessing and monitoring neuromuscular function to detect and prevent RNMB in PACUs. RNMB presence correlated with an increased susceptibility to postoperative respiratory complications. Regular quantitative neuromuscular monitoring is advisable in clinical practice to proactively mitigate RNMB incidence and its complications.
ABSTRACT
Within this work, we scrutinized the use of BeO nanotube (BeONT) as a nanocarrier for the anticancer drug hydroxyurea (HU) through density functional theory (DFT) calculations. We utilized the functional ê·B97XD and the basis set 6-31G**. Based on a detailed surface analysis, HU was adsorbed on the surface of the nanotube through 4 different orientations. Also, no vibrational spectra exhibited imaginary frequencies, showing the minimum energy of the relaxed structures. The maximum adsorption energy and the minimum adsorption energy are in strong physical adsorption. The BeONT exhibited p-type semiconducting characteristics in all orientations since it received electronic charge from HU. The results demonstrate the possibility of using the BeONT as a promising carrier for HU drugs.
Subject(s)
Antineoplastic Agents , Nanotubes , Antineoplastic Agents/chemistry , Beryllium , Hydroxyurea/chemistry , Models, Molecular , Nanotubes/chemistryABSTRACT
INTRODUÇÃO: Os profissionais que atuam na central de material e esterilização (CME) possuem a função de recepcionar, limpar, esterilizar, embalar e armazenar utensílios utilizados em cirurgias no hospital. Trata-se, assim, de uma profissão de grande exigência física e mental, com alta carga de trabalho e estresse. OBJETIVO: Analisar os riscos biomecânicos e os sintomas osteomioarticulares de servidores da CME de um complexo hospitalar público. MATERIAIS E MÉTODOS: Estudo observacional prospectivo que foi desenvolvido em um hospital público do sul do país. Participaram 20 profissionais, tais como auxiliares, técnicos e enfermeiros. Os critérios de inclusão foram que o indivíduo atuasse na CME, ser auxiliar, técnico ou enfermeiro da CME ao menos há 6 meses, idade igual ou maior que 18 anos, de ambos os sexos, e exercer qualquer função. Os critérios de exclusão foram estar em período de férias ou licença saúde/capacitação no período de coleta de dados, trabalhar no setor há menos de 6 meses. Instrumentos de coleta: questionário sociodemográfico internacional de atividade física (IPAQ) - versão curta e o Nórdico de Sintomas Osteomusculares. RESULTADOS: Verificou-se que 85% dos profissionais são do sexo feminino; a idade média foi de 47 anos; 70% são auxiliares de enfermagem; 85% dos profissionais possuem filhos; 35% apresentaram dores em pescoço, punhos/mãos e quadril/coxas; 85% sentem dores de cabeça recorrentes; 50% já sofreram algum acidente de trabalho, sendo 80% com perfurocortantes. CONCLUSÃO: Conclui-se que os servidores de CME têm riscos biomecânicos e ocupacionais. Assim, medidas preventivas devem ser adotadas para minimizar riscos à saúde física e mental dos mesmos.
INTRODUCTION: Professionals working in the Material and Sterilization Central (MSC) have the function of receiving, cleaning, sterilizing, packing, and storing utensils used in hospital surgeries. It is thus a profession of great physical and mental demand with high workload and stress. OBJECTIVE: To investigate the biomechanical and osteomioarticular symptoms of employees of a CME in a hospital complex. METHODS: It is characterized as observational and prospective, developed in a public hospital in the south of the country. Twenty professionals participated, such as assistants, technicians, and nurses, who answered the sociodemographic, international physical activity questionnaires (IPAQ) - short and Nordic Musculoskeletal Symptoms. RESULTS: It was found that 85% of professionals are female; the mean age was 47 years; 70% are nursing assistants; 85% of the professionals have children; 35% had neck pain, wrists/hands, and hip/thighs; 85% experience recurrent headaches; 50% have already suffered some work accident, 80% with sharps. CONCLUSION: It is concluded that MSC servers have biomechanical and occupational risks and that preventive measures should minimize risks to their physical and mental health.
