Biomedical subjects

Phuping Akavipat

Publications and source records attributed to Phuping Akavipat.

5 recordsLinked to original sources

PubMed2006

Can electrocardiogram electrodes replace bispectral index electrodes for monitoring depth of anesthesia?

BACKGROUND: Bispectral index has been introduced to provide optimal level of anesthesia. However, Bispectral index monitoring may not be cost effective in a relatively short procedures due to the high costs of the electrode. The authors conducted the present study to compare the feasibility of commercially available electrocardiogram (ECG) electrodes instead of the Bispectral index (BIS) monitoring. MATERIAL AND METHOD: The authors evaluated the difference in signal quality index (SQI) and BIS values collected from two BIS monitors, using ECG electrodes and BIS electrodes on the same patients before anesthesia, during light anesthesia, deep anesthesia and the emergence period Both sets of electrodes were placed at bifrontal areas throughout the procedure. Statistical analysis was evaluated by mean difference 95% confidence limits of agreement and visualized by Bland-Altman plot. A parametric analysis was analyzed using paired t-test. RESULTS: There were 390 parallel signal quality index and BIS values recorded in the present study. During anesthesia the mean BIS values were 58.63 +/- 18.77 in the ECG electrode group and 56.99 +/- 19.84 in the BIS electrode group, which were not statistically different. The mean SQI values were 79.2 +/- 24.8 and 82.8 +/- 21.6 using ECG electrodes and BIS electrodes, respectively. The mean difference between BIS values was 1.65 with 95% confidence limits of agreement between 0.91 and 2.38. CONCLUSION: Commercial ECG electrodes could be used for monitoring depth of anesthesia with clinically acceptable mean bias and 95% confidence limits of agreement of BIS value obtained from BIS electrode.

Anesthesia, General↗

PubMed2005

Does preloading with colloids prevent hemodynamic changes when neurosurgical patients are subsequently changed to the seated position?

OBJECTIVE: This prospective, randomized, double-blind study was designed to determine and compare the usefulness of preloading colloids (Haemaccel) 10 ml/Kg before positioning whether it can prevent hemodynamic changes during seated positioning or not. MATERIAL AND METHOD: The authors studied 20 patients by randomly dividing them into 2 groups. The control group was given crystalloid as maintenance and deposit replacement but the study group was given extra colloids 10 ml/Kg 30 minutes before starting general anesthesia. Both groups were monitored and given anesthesia, balanced technique. Systolic and diastolic blood pressures, heart rate, central venous pressure (CVP) at different time intervals in the sitting position for 30 minutes were recorded. Statistical analysis was done by Student t-test, Chi-square test and ANOVA (p-value < 0. 05 considered significant). RESULTS: The results showed that systolic blood pressure at 15, 20, 30 minutes and CVP at 15, 25, 30 minutes after positioning in the study group was maintained significantly compared to the control group and there were no significant changes in diastolic blood pressure and heart rate. There were no other complications during the sitting period. CONCLUSION: It is concluded that preloading colloid fluid prior to repositioning could prevent the decrease of systolic blood pressure and central venous pressure during sitting positioning without other complications.

Adult↗

PubMed2005

The Thai Anesthesia Incidents Study (THAI Study) on nerve injury associated with anesthesia.

OBJECTIVES: The Thai Anesthesia Incidents Study (THAI Study) database was used to identify the incidence, outcome and contributing factors of nerve injuries associated with anesthesia in Thai people. MATERIAL AND METHOD: A prospective multicenter study was conducted in 20 hospital in Thailand from February 1, 2003 to January 31, 2004. All patients underwent anaesthesia were monitored for nerve injuries during the first 24 hours. The details of nerve injuries were recorded and analysed. RESULTS: The overall incidence of nerve injuries associated with anesthesia was 1.6 per 10,000 patients. Considering on spinal and regional anesthesia, the incidence was 5.2 per 10,000 patients. Lumbosacral roots comprised 65.4% of the injuries, the brachial plexus nerve 11.5%, and femoral nerve 7.7%. Contributing factors included type and duration of surgery and regional anesthesia. CONCLUSION: The incidence of nerve injuries associated with anesthesia in Thailand was 1.5 per 10,000 patients. The spinal anesthesia was predominantly associated with injury of lumbosacral root.

Adolescent↗

PubMed2005

Perioperative stroke and coma in Thai Anesthesia Incidents Study (THAI Study).

OBJECTIVES: To analyze perioperative stroke and coma using database of Thai Anesthesia Incidents Study (THAI Study) with regard to frequency, contributing factors, preventive and corrective strategies. MATERIAL AND METHOD: Details of perioperative neurological complications comprising stroke and coma in one year were recorded prospectively by attending anesthesiologists or nurse anesthetists in standardized record forms. All data were analyzed to identify contributing factors and preventive strategies. RESULTS: Among 172,592 anesthetics, there were 24 cases of coma, and 28 cases of stroke. Most cases of coma that eventually died (12/16 cases, 75%) had ASA physical status (ASA PS) ranging from 2E to 5E. Perioperative stroke was found mainly in patients with ASA PS 3 and most of the incidence (74%) occurred in patients who had no previous history of stroke. These patients already had pre-existing cardiovascular diseases and underwent high risk procedures. There were 54% of perioperative stroke cases that could be due to improper cardiovascular management and 42% due to improper emergency neurological management. CONCLUSION: The incidence of perioperative stroke and coma in this study was approximately 0.03%. The majority of cases had no prior stroke or coma, which suggested that a problem during perioperative period itself might predispose patients to these complications. Preventive strategies included quality assurance activity, improved communication, and practice guideline.

Adolescent↗

PubMed2005

The Thai Anesthesia Incidents Study (THAI Study) of perioperative convulsion.

OBJECTIVES: To identify the incidence of perioperative convulsion within 24 hours, outcome, predisposing risk factors, contributing factors related to anesthesia and corrective strategies. MATERIAL AND METHOD: The prospective cohort study enrolled all anesthetics from twenty eligible hospitals in Thailand between March 1, 2003, and February 28, 2004. Postoperative convulsion incidents were extracted from the Thai Anesthesia Incidents Study (THAI Study) database in terms of demographic data, details of events, outcome, contributing factors related to anesthesia and corrective strategies. RESULTS: The incidence of perioperative convulsion was 3.1 per 10,000 from all 172,592 anesthetics. Most patients (73.59%) recovered in 24 hours. The majority of risk factors were related to surgery (67.92%) and patient factors (54.72%) while anesthesia was the minor factor (30.19%). The contributing factors related to anesthesia were medication error (route, type, time) 43.75% and human error (inadequate care, inadequate knowledge, inadequate communication) 43.75%. The important corrective strategies included improved supervision and clinical practice guideline. CONCLUSION: The incidence of postoperative convulsion was 3.1 per 10000. Anesthesia was the minor contributing factor. The most important risk factors included medication error and human error.

Adolescent↗