Systematic literature review on reinforcement learning in non-communicable disease interventions.

There is evidence that reducing modifiable risk factors and strengthening medical and health interventions can reduce early mortality and economic losses from non-communicable diseases (NCDs). Machine learning (ML) algorithms have been successfully applied to preventing and controlling NCDs. Reinforcement learning (RL) is the most promising of these approaches because of its ability to dynamically adapt interventions to NCD disease progression and its commitment to achieving long-term intervention goals.

Partial vs full glottic view with CMAC D blade intubation of airway with simulated cervical spine injury: a randomized controlled trial.

Purpose: A previous study reported a shorter time to tracheal intubation by reducing percentage of glottic opening (POGO) view to <50% when intubating a normal adult airway using the Glidescope blade. We evaluate the efficacy of reducing POGO to <50% when intubating patients with rigid cervical immobilization using CMAC D blade.

Methods: One hundred and four adult patients were randomized to group POGO 100% or POGO <50% .

Population Pharmacokinetics and Dosing Simulations of Intravenous Oxycodone for Perioperative Pain Relief in Adult Surgical Patients with Obesity.

Background And Objective: Oxycodone, a semisynthetic thebaine derivative µ-opioid (MOP) receptor agonist, is effective for treating moderate and severe pain in different clinical conditions. The pharmacokinetics of intravenous oxycodone in the obese population has not been studied. This study aims to characterize the pharmacokinetic profile of oxycodone after intravenous administration and to simulate an appropriate dosage for analgesic efficacy in obese patients.

Preoperative amylmetacresol and dichlorobenzyl alcohol with lignocaine lozenge reduces postoperative sore throat following general anaesthesia using supraglottic airway devices: A double-blinded, randomised, placebo-controlled trial.

Background And Aims: Postoperative sore throat (POST) is an undesirable event reported in up to 62% of patients receiving general anaesthesia (GA). The incidence of POST following GA using a supraglottic airway device (SAD) is approximately 50%, with symptoms persisting up to 48 h. We examined the role of preoperative lozenges containing amylmetacresol and dichlorobenzyl alcohol (AMC/DCBA) with lignocaine (Strepsils Max Plus) in reducing the incidence and intensity of POST following GA using SAD.

Psychological distress among elderly surgical patients who had their surgery postponed during the COVID-19 pandemic.

Background: Many institutions withheld elective lists and triaged surgeries during the peak of coronavirus disease 2019 (COVID-19) pandemic. As a result, older surgical patients have had to wait for rescheduled dates in a long waitlist. This study aimed to identify the psychological impact in these patients when they returned for surgery.

The Use of Cerebral Oximetry in Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Objective: The evidence on the use of cerebral oximetry during surgery to minimize postoperative neurologic complications remains uncertain in the literature. The present authors aimed to assess the value of cerebral oximetry in the prevention of postoperative cognitive dysfunction, postoperative delirium, and postoperative stroke in adults undergoing surgery.

Design: A systematic review and meta-analysis.

Transversus Abdominis Plane Block Versus Intraperitoneal Local Anesthetics in Bariatric Surgery: A Systematic Review and Network Meta-analysis.

Background: Transversus abdominis plane (TAP) block and intraperitoneal local anesthetics (IPLA) are widely investigated techniques that potentially improve analgesia after bariatric surgery. The analgesic efficacy of TAP block has been shown in previous studies, but the performance of TAP block can be difficult in patients with obesity. We performed a systematic review and meta-analysis to compare the analgesic efficacy of TAP block and IPLA.

Hemodynamic Response of High- and Low-Dose Dexmedetomidine of Pediatric in General Anesthesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Dexmedetomidine is a highly selective α2-adrenoceptor agonist, which is off-labelled use for pediatric sedation. However, the hemodynamic responses of dexmedetomidine remain unclear in the pediatric population. The primary objectives of this systematic review and meta-analysis were to examine the hemodynamic effects of high-dose and low-dose dexmedetomidine in pediatric patients undergoing surgery.

Evaluate construct validity of the Revised American Pain Society Patient Outcome Questionnaire in gynecological postoperative patients using confirmatory factor analysis.

Background: The Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) evaluates the patient-reported quality of pain management in adults. A validated APS-POQ-R is pivotal to guide effective pain management with better patient satisfaction. Previous studies revealed that subscales of "patients' perception of pain management" were unstable cross-culturally.

Baska mask versus endotracheal tube in laparoscopic cholecystectomy surgery: a prospective randomized trial.

: Supraglottic airway devices have increasingly been used as the airway technique of choice in laparoscopic surgeries. This study compared the efficacy and safety of the Baska Mask with endotracheal tube (ETT) in patients undergoing elective laparoscopic cholecystectomy.: This single-center, prospective, randomized controlled trial recruited 60 patients aged 18-75 years with American Society of Anesthesiologists' classifications I to III.

A Developing Nation's Experience in Using Simulation-Based Training as a Preparation Tool for the Coronavirus Disease 2019 Outbreak.

Background: The coronavirus disease 2019 (COVID-19) pandemic affected and overwhelmed many health care systems around the world at an unprecedented speed and magnitude with devastating effects. In developing nations, smaller hospitals were unprepared to face this outbreak nor had strategies in place to do so at the beginning. Here, we describe the preparation in an anesthetic department using simulation-based training over 2 weeks, as the number of cases rose rapidly.

Effect of regional anaesthesia only versus general anaesthesia on cancer recurrence rate: A systematic review and meta-analysis with trial sequential analysis.

Objectives: There is growing evidence on the influence of general anaesthesia (GA) in promoting the proliferation of cancer cells. The benefits of regional anaesthesia (RA) on cancer recurrence rate in cancer surgery remains unclear in the literature. The primary objective of this review was to examine the effect of RA on the incidence of post-operative cancer recurrence rate in cancer resection surgery.

Clinical performance of the LMA Protector™ airway in moderately obese patients.

Background: The 4th National Audit Project of The Royal College of Anaesthetists and The Difficult Airway Society (NAP4) reported a higher incidence of supraglottic airway device (SAD) related pulmonary aspiration in obese patients especially with the first-generation SADs. The latest single-use SAD, the Protector™ provides a functional separation of the respiratory and digestive tracts and its laryngeal cuff with two ports allowing additional suction in tandem with the insertion of a gastric tube. The laryngeal cuff of LMA Protector™ allows a large catchment reservoir in the event of gastric content aspiration.

Evaluation of the quality of acute pain management in a pediatric surgical setting: Validation of a parent proxy modified version of the revised American Pain Society Patient Outcome Questionnaire.

Background: Effective pain management involves a cycle of continual pain assessment, good pain control strategies, and assessment of a standard quality improvement measures. A validated questionnaire that focuses on the quality of postoperative pain management in pediatric surgical patients and parental satisfaction on pain treatment is lacking. We, therefore, modified the revised American Pain Society Patient Outcome Questionnaire to evaluate the quality of postoperative pain management in a pediatric surgical setting.

Randomized comparison of the Baska FESS mask and the LMA Supreme in different head and neck positions.

Background: The Baska functional endoscopic sinus surgery (FESS) mask is a new supraglottic airway designed for head and neck procedures. This prospective, randomized controlled trial compared the oropharyngeal leak pressure (OLP) of the Baska FESS mask with the laryngeal mask airway (LMA) Supreme in different head and neck positions.

Methods: One hundred patients undergoing elective surgery were recruited.

Comparison of clinical performance of size 1.5 Supreme™ LMA and Proseal™ LMA among Asian children: a randomized controlled trial.

To date, most of the studies on safety and efficacy of supraglottic airway devices were done in Caucasian patients, and the results may not be extrapolated to Asian patients due to the different airway anatomy. We conducted this study to compare Supreme™ LMA (SLMA) and Proseal™ LMA (PLMA) size 1.5 in anaesthetized children among an Asian population.

The hemodynamic and pain impact of peripheral nerve block versus spinal anesthesia in diabetic patients undergoing diabetic foot surgery.

Purpose: Comparison of hemodynamic profiles and pain scores in diabetic patients undergoing diabetic foot surgery receiving peripheral nerve block (PNB) or spinal anesthesia [subarachnoid block (SAB)].

Methods: This was a prospective, randomised controlled trial. We recruited diabetic patients aged > 18 years, American Society of Anesthesiologists class II-III, who were scheduled for unilateral diabetic foot surgery below the knee.

[Intractable intraoperative brain herniation secondary to tension pneumocephalus: a rare life-threatening complication during drainage of subdural empyema].

Tension pneumocephalus is rare but has been well documented following trauma and neurosurgical procedures. It is a surgical emergency as it can lead to neurological deterioration, brainstem herniation and death. Unlike previous cases where tension pneumocephalus developed postoperatively, we describe a case of intraoperative tension pneumocephalus leading to sudden, massive open brain herniation out of the craniotomy site.

[Anesthesia in anti-N-methyl-d-aspartate receptor encephalitis - is general anesthesia a requisite? A case report].

Anti-N-methyl-d-aspartate receptor encephalitis is a recently described neurological disorder and an increasingly recognized cause of psychosis, movement disorders and autonomic dysfunction. We report 20-year-old Chinese female who presented with generalized tonic-clonic seizures, recent memory loss, visual hallucinations and abnormal behavior. Anti-N-methyl-d-aspartate receptor encephalitis was diagnosed and a computed tomography scan of abdomen reviewed a left adnexal tumor.

Prolonged drug-induced myoclonus: is it related to palonosetron?

We report a case of drug-induced myoclonus possibly related to palonosetron, a second-generation 5-hydroxytryptamine-3 receptor antagonist which was administered as a prophylaxis for postoperative nausea and vomiting in a 28-year-old female. The recurrent episodes of myoclonus jerk involving the head, neck and shoulder persisted for a period of 4 days. The patient also exhibited an episode of severe bradycardia leading to hypotension 7 h after surgery.