Although agents, such as corticosteroids, intravenous immunoglobulins and cyclosporine, are used in the treatment, we think that the use of cytokine filters will contribute to recovery by stopping the cytokine storm in these cases.

Prevention of cardiopulmonary arrest in hospitalised patients is the first and most important step in the life-saving chain. When the condition of the inpatients is worsened, nurses are usually the first to see and evaluate the patient. The aim of this study was to evaluate the attitudes of the nurses working at the Mersin University Hospital, during their routine follow-up to the deteriorating patients and the early warning scoring (EWS) awareness.

A web-based questionnaire was sent to all nurses working in inpatient services and intensive care units (ICUs) and registered to the hospital database at Mersin University Hospital via e-mail. In the questionnaire, a total of 10 multiple-choice questions were asked to the nurses questioning the unit they worked for, the EWS they used, the complaints they frequently complain about and the applications for the call for help. A total of 146 nurses were included in the study.

43.8% (n ¼ 64) of the participants were in ICU, and 56.1% (n ¼ 82) were in service units. Participants were asked whether they used a special scoring system to recognise the deteriorating patient; 45.2% (n ¼ 66) used the scoring system; and 54.8% (n ¼ 80) reported that they did not use it. Participants working in ICU were more likely to use EWS system. Participants answered the most commonly used scoring system as the Glasgow Coma Scale (n ¼ 40). The participants reported that the most common respiratory distress (n ¼ 135), changes in consciousness (n ¼ 109), palpitations (n ¼ 98) and chest pain (n ¼ 92) occurred in the deteriorating patients. Participants reported that they frequently asked for help from a doctor (80.1%), other nurses (7.5%) and a blue code team (7.5%).

According to the findings, it is necessary to determine the habits of calling for help and raising awareness for a functional EWS.

According to the findings, it is necessary to determine the habits of calling for help and raising awareness for a functional EWS.

Glottic view differed when assistants provide external laryngeal manipulation (ELM) from right or left side. Objectives were to compare glottic view during direct laryngoscopy with ELM applied by assistant stationed on right side of scopist versus left. Primary outcome was best percentage of glottic opening (POGO) score. Secondary outcome was proportion of patients requiring switch back to initial intervention for best glottic view and intubation.

With Institutional Review Board and Ethics Committee approval and written informed consent, this randomised cross over trial enrolled participants of American Society of Anesthesiologists (ASA) grade I-II aged 20-70 years for elective surgery under General Anaesthesia (GA). Study interventions were application of ELM during modified bimanual laryngoscopy by trained assistant on right (ELM-R) and left (ELM-L) sides in each participant as per random sequence.

Of the 150 participants, 68 were analysed for study interventions using Wilcoxon matched pairs test. Thirty three participants received interventions first from ELM-R and subsequently from ELM-L, while 35 had interventions vice versa. Median POGO score with ELM-R was 40 (IQR 32.5, 50) and with ELM-L 30 (IQR 20, 40). There was 10% difference in POGO score between interventions found to be significant (P < .05). Fifty six out of 68 (82.35%) participants had better POGO score when intervention was from right side. Proportion requiring switch back to initially applied intervention was 66.7% (22 out of 33) with ELM-R and 2.9% (one out of 35) with ELM-L.

For best glottic view, ELM applied by an assistant by right hand standing on right side of scopist is more effective.

For best glottic view, ELM applied by an assistant by right hand standing on right side of scopist is more effective.

Paediatric pain management has remained understated practice over a period of time. Recently ultrasound-guided (USG) guided techniques are gaining popularity for perioperative analgesia, especially in the paediatric population. So, the aim of the present study was to evaluate the efficacy of reduced dose ropivacaine-dexmedetomidine combination compared to standard 0.375% ropivacaine in USG guided transversus abdominis plane (TAP) block.

Sixty children of either sex, aged 2-10 years, posted for elective open herniotomy under general anaesthesia were randomly divided into two groups of 30 patients each. Group RD received 0.2% ropivacaine with dexmedetomidine 1 mg kg 1 while group R received 0.375% ropivacaine at 0.5mL kg 1. Meantime to first rescue and total analgesics, Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) and Ramsay sedation score, haemodynamic parameters and adverse effects were noted.

Time to first rescue analgesia in group RD and group R were 16.32 6 3.11 hours and 10.82 6 2.16 hours, respectively (P < .0001). Mean CHEOPS score were 4.48 6 1.1 and 6.3 6 1.74 (P < .024) in group RD and R. Post-op Ramsay sedation score was significantly greater in group RD. Heart rate and blood pressure remained similar in either of the group. No episode of respiratory depression, bradycardia or hypotension was noted perioperatively.

Combination of 1 mg kg 1 dexmedetomidine with reduced concentration of ropivacaine (0.2%) produced significantly longer duration of post-operative analgesia and lowered post-operative CHEOPS pain score in comparison with 0.375% ropivacaine alone in USG guided TAP block for paediatric hernia repair.

Combination of 1 mg kg 1 dexmedetomidine with reduced concentration of ropivacaine (0.2%) produced significantly longer duration of post-operative analgesia and lowered post-operative CHEOPS pain score in comparison with 0.375% ropivacaine alone in USG guided TAP block for paediatric hernia repair.

The physical status classification of the American Society of Anaesthesiology (ASA) is the most used score in the preoperative evaluation, but inconsistent evaluations and low reliability have been reported. The aim of this study is to evaluate the variability in the evaluation of ASA physical status classification among Portuguese anaesthesiologists.

Cross-sectional study, in which an electronic questionnaire, was distributed to Portuguese anaesthesiologists with questions regarding their demographic characteristics, professional experience, place of work and how they would categorise 15 clinical cases regarding ASA classification. Three anaesthesiologists and a medicine student wrote the cases. Data analyses were done using R suite version 1.0.143 and IBM SPSS Statistics. The agreement among participants was evaluated through intraclass correlation coefficient (ICC). A value of P < .05 was assumed as statistically significant.

1,850 e-mails were sent, and 259 answers were obtained. Median age of participants was 47 years. 172 were female and 87 males. Ninety percent of work is in the public sector, and 99.6% use this classification on their daily practice. Participants’ agreement ranged from 3 to 15 responses, with a mean of 9.2 (SD 6 2.4). In none of the cases was observed a total agreement with the author’s classification. The ICC among the participants was 0.726 (0.585; 0.869; P < .001), showing a moderate degree of agreement.

The results of this sample revealed that the agreement among Portuguese anaesthetists is satisfactory and similar to the values observed in other countries where there were no significant differences between trainees and specialists.

The results of this sample revealed that the agreement among Portuguese anaesthetists is satisfactory and similar to the values observed in other countries where there were no significant differences between trainees and specialists.

Number of deliveries is utilised to estimate obstetric anaesthesiologist workload; however, this may not reflect true workload. The goal of this analysis was to assess if including type of procedure, time required and length of each shift would better predict clinical workloads.

We queried the electronic medical records at a high volume, academic centre for 12 consecutive months of maternal deliveries. Data extracted included delivery type, analgesic/anaesthetic procedure and whether delivery occurred during weekday, weeknight or weekend shifts. To generate an hourly comparison of shifts of varying duration, procedures were divided by the number of hours per shift. To calculate obstetric anaesthesiology time-based workload, delivery type was multiplied by estimated time associated with the analgesic/anaesthetic procedure.

A total of 4,598 deliveries occurred in the 12-month study period. The caesarean delivery rate was 32%, and labour epidural rate was 85%. 1,564 anaesthetic procedures occurred during wperform them, not just number of deliveries when considering obstetric anaesthesiology workload.

To compare analgesic efficacy, improvement in the quality of life, psychology and learning curve for iliopsoas (IP) injection using ultrasound (US) versus fluoroscopy (FL).

Thirty-six patients with chronic low back pain secondary to IP myofascial pain were randomly allocated into two groups and were given IP injection in prone position, using either FL or US as a guide. Pain scores were assessed using numerical rating scale (NRS); learning curve was evaluated by the number of attempts, time taken and subjective ease of performing the procedure. The psychological and quality of life assessment were done using Depression Anxiety Stress Scale (DASS) and Oswestry Disability Index (ODI), respectively.

FL and US guided IP injection had equianalgesic efficacy with a decrease in preprocedure NRS pain scores from mean value of 7.06 6 0.24 and 6.78 6 0.24, respectively, to 2.22 6 0.29 and 1.78 6 0.26 (at 24 hours), 1.50 6 0.22 and 1.50 6 0.23 (1 week), 0.50 6 0.12 and 0.56 6 0.15 (4 weeks) and 0.33 6 0.11 and 0.44 6 0.15 (12 weeks) (P < .001). The learning curve was easier for US intervention with average attempts of 1-2 compared to 1-3 for FL. The average time taken to perform IP intervention was lesser for US group. The improvement in DASS and ODI was comparable in both groups.

FL and US both are effective modalities for IP muscle injection as they provide equal relief from pain, disability and psychological stress. US guided IP injections are easier to learn and perform in comparison with FL.

FL and US both are effective modalities for IP muscle injection as they provide equal relief from pain, disability and psychological stress. US guided IP injections are easier to learn and perform in comparison with FL.

Brachial plexus anaesthesia has been an indispensable tool in the anaesthesiologist’s armamentarium. Clinical studies have shown that levobupivacaine and ropivacaine have fewer adverse effects on the cardiovascular and central nervous system making them more advantageous in regional anaesthesia techniques. Less information is available regarding their comparable clinical data. Only a few studies have compared levobupivacaine and ropivacaine for brachial plexus blocks; hence, this study was aimed to compare the analgesic effectiveness and nerve block characteristics of ropivacaine and levobupivacaine in supraclavicular brachial plexus blocks in upper limb surgeries.

Patients with American Society of Anaesthesiologists physical status I or II coming for elective upper limb surgeries were included in the study. Total numbers of 62 patients were randomly allocated into two groups, group A and group B. Group A received 25mL of 0.75% ropivacaine, and group B received 25mL of 0.5% levobupivacaine. The duration of analgesia, onset of block, duration of sensory, and motor blockade were studied and compared.