Search

Postoperative delirium has the potential to impact individuals of all age groups, with a significant emphasis on the elderly population. Its presence leads to an increase in surgical morbidity and mortality rates, as well as a notable prolongation of hospital stays. However, there is a lack of research regarding the prevalence, risk factors, and implications of postoperative delirium in developing nations like Ethiopia, which affects both patients and healthcare institutions. An observational study was conducted at hospitals in the South Gondar Zone to diagnose postoperative delirium in the Post-Anesthesia Care Unit (PACU) using the Nursing Delirium Screening Scale. Both bivariable and multivariable logistic regression techniques were employed to analyze the association between independent factors and postoperative delirium. The strength of the association was indicated by the odds ratio with a 95% confidence interval (CI). Any p-values below 0.05 were considered statistically significant. The incidence of postoperative delirium was determined to be 41%. In the multivariate logistic regression analysis, several factors were identified as significantly associated with postoperative delirium. These factors include an age of 75 or older (AOR, 11.24; 95% CI, 4.74–26.65), ASA-PS IV (AOR, 3.25; 95% CI, 1.81–5.85), severe functional impairment of activities of daily living (AOR, 3.29; 95% CI, 1.06–10.20), premedication with benzodiazepine (AOR, 4.61; 95% CI, 2.48–8.57), intraoperative estimated blood loss exceeding 1000 ml (AOR, 2.74; 95% CI, 1.50–4.98), and intraoperative ketamine use (AOR, 3.84; 95% CI, 2.21–6.68). Additionally, postoperative delirium was found to significantly prolong the duration of stay in the post-anesthesia care unit (PACU) and the length of hospital stay (p-value < 0.05). Patients aged 75 or older, ASA-PS IV, experiencing severe functional impairment of ADL, patients premedicated with benzodiazepine, patients with intraoperative estimated blood loss exceeding 1000 ml, and intraoperative ketamine use were identified as risk factors for post-operative delirium. [ABSTRACT FROM AUTHOR] more...

Background: Spinal Anesthesia (SA) is a common technique used worldwide for cesarean sections. A common, but potentially fatal, complication is hypotension. It can cause a significant effect on the mother and fetus. Hydration has become the cornerstone of prophylaxis of hypotension in obstetrics previously but recent studies showed that co-loading also may be a better option in the prevention of spinal induced hypotension. This study aimed to assess the effect of preloading and co-loading in the prevention of hypotension among mothers who underwent cesarean delivery under spinal anesthesia. Methods: Prospective cohort study was conducted at Debre Tabor Comprehensive Specialized Hospital from February 15 to April 15/2021 Ninety-six pregnant mothers who have c/s were included in the study period. The pregnant were given 20 ml/kg of fluid. The preload group gave fluid 20 minutes before spinal block; while the co-load group received fluid starting as soon as CSF was tapped. Independent sample t-test and Chi-square test were used. Data was entered and analyzed using SPSS version 25. Results: The incidence of systolic hypotension after spinal anesthesia was 77.1% in the preload group and 35.4% in the co-load. The preload group mothers develop more hypotension than co load mothers. Conclusion: Hypotension occurred 77.1% of the time in the preload group and 35.4 percent of the time in the co-load group, according to this study. As a result, crystalloid co-loading was superior to preloading in preventing spinal anesthesia-induced hypotension in mothers who had a cesarean section. [ABSTRACT FROM AUTHOR] more...