Prevalence and Causes of Elective Surgery Cancellations After Patients are Taken to the Operating Room: A Prospective, Cross-Sectional Study.

Objective: This study aimed to investigate the causes and prevalence of elective surgery cancellations in the operating room, and the clinical outcomes of affected patients. Methods: This prospective, cross-sectional study assessed the prevalence and causes of elective surgery cancellations once patients are in the operating room. A tertiary academic referral center hosted the study between January 2022 and January 2023. The study sample consisted of 7,482 adult patients scheduled for elective surgeries and taken to the operating room. The 7,415 completed procedures were in Group 2, whereas the 67 cancelled surgeries were in Group 1. Patients were divided into two groups on the basis of whether their surgeries were completed or cancelled. Factors such as age, American Society of Anesthesiologists (ASA) status, and surgical department were analyzed. The two groups were compared on the basis of age, ASA status, surgical department, and surgery time (month and day). Results: Elective surgery cancellations occurred in the operating room at a rate of 0.9%. Group 1 was substantially older than Group 2 (p<0.001). Group 1 had a larger number of ASA III patients (p<0.001). The department with the highest cancellation rate was ophthalmology (2.5%), followed by general surgery (2.1%), urology (1.5%), and ear, nose, and throat (1.4%). It was possible to avoid 59.7% of cancelations. Conclusion: The study revealed a 0.9% prevalence rate of elective surgery cancelations in the operating room. Older age and higher ASA status greatly influenced these cancellations. Optimized surgery scheduling and patient assessment processes may prevent many of these cancellation.

Dexpanthenol protects against lipopolysaccharide-induced acute kidney injury by restoring aquaporin-2 levels via regulation of the silent information regulator 1 signaling pathway.

BACKGROUND: Acute kidney injury (AKI) is a serious pathology that causes dysfunction in concentrating urine due to kidney damage, resulting in blood pressure dysregulation and increased levels of toxic metabolites. Dexpanthenol (DEX), a pantothenic acid analog, exhibits anti-inflammatory and anti-apoptotic properties in various tissues. This study investigated the protective effects of DEX against systemic inflammation-induced AKI. METHODS: Thirty-two female rats were randomly assigned to the control, lipopolysaccharide (LPS), LPS+DEX, and DEX groups. LPS (5 mg/kg, single dose on the third day, 6 h before sacrifice) and DEX (500 mg/kg/d for 3 d) were administered intraperitoneally. After sacrifice, blood samples and kidney tissues were collected. Hematoxylin and eosin, caspase-3 (Cas-3), and tumor necrosis factor alpha (TNF-α) staining were performed on the kidney tissues. The total oxidant status (TOS) and total antioxidant status were measured using spectrophotometric methods. Aquaporin-2 (AQP-2), silent information regulator 1 (SIRT1), and interleukin-6 (IL-6) were detected using quantitative reverse transcription-polymerase chain reaction analysis. RESULTS: Histopathological analysis revealed that DEX treatment ameliorated histopathological changes. In the LPS group, an increase in the blood urea nitrogen, creatinine, urea, IL-6, Cas-3, TNF-α, and TOS levels and oxidative stress index was observed compared with the control group, whereas AQP-2 and SIRT1 levels decreased. DEX treatment reversed these effects. CONCLUSIONS: DEX was found to effectively prevent inflammation, oxidative stress, and apoptosis in the kidneys via the SIRT1 signaling pathway. These protective properties suggest DEX's potential as a therapeutic agent for the treatment of kidney pathologies.

Comparison of ProSeal laryngeal mask airway (PLMA) with cuffed and uncuffed endotracheal tubes in infants.

We aimed to compare cuffed and uncuffed endotracheal tubes (ETTs) with ProSealTM laryngeal mask airway (PLMA) in terms of airway security and extubation, starting out from the hypothesis that PLMA will provide alternative airway safety to the endotracheal tubes, and that airway complications will be less observed. After obtaining approval from the local Ethics Committee and parental informed consent, 120 pediatric patients 1-24 months old, American Society of Anesthesiologists physical status I-II, requiring general anesthesia for elective lower abdominal surgery, were randomized into PLMA (Group P, n = 40), cuffed ETT (Group C, n = 40), and uncuffed ETT (Group UC, n = 40) groups. The number of intubation or PLMA insertion attempts was recorded. Each patient's epigastrium was auscultated for gastric insufflation, leak volumes and air leak fractions (leak volume/inspiratory volume) were recorded. Post-operative adverse events related to airway management were also followed up during the first post-operative hour. Demographic and surgical data were similar among the groups. There were significantly fewer airway manipulations in the Group P than in the other groups (p < 0.01), and leak volume and air leak fractions were greater in the Group UC than in the other two groups (p < 0.01). Laryngospasm was significantly lower in the Group P during extubation and within the first minute of post-extubation than in the other groups (p < 0.01). Based on this study, PLMA may be a good alternative to cuffed and uncuffed ETTs for airway management of infants due to the ease of manipulation and lower incidence of laryngospasm.