Search results for: Sunisa Chatmongkolchart

Authors: Pitchaporn Purngpiputtrakul, Suttasinee Petsakul, Sunisa Chatmongkolchart

Abstract:

Nasogastric tube (NGT) insertion in anaesthetized and intubated patients can be challenging even for experienced anesthesiologists. Various techniques have been proposed to facilitate NGT insertion in these patients. This study aimed to compare the success rate and time required for NGT insertion between the GlideScope visualization and neck flexion with lateral neck pressure techniques. This randomized clinical trial was performed at a teaching hospital on 86 adult patients undergoing abdominal surgery under relaxant general anaesthesia who required intraoperative NGT insertion. The patients were randomized into two groups, the GlideScope group (group G) and the neck flexion with lateral neck pressure group (group F). The success rate of first and second attempts, duration of insertion, and complications were recorded. The total success rate was 79.1% in Group G compared with 76.7% in Group F (P=1) The median time required for NGT insertion was significantly longer in Group G, for both first and second attempts (97 vs 42 seconds P<0.001) and (70 vs 48.5 seconds P=0.015), respectively. Complications were reported in 23 patients (53.5%) in group G and 13 patients (30.2%) in group F. Bleeding and kinking were the most common complications in both techniques. Using GlideScope visualization to facilitate NGT insertion was comparable to neck flexion with lateral neck pressure technique in degree of success rate of insertion, while neck flexion with lateral neck pressure technique had fewer complications and was less time-consuming.

Keywords: anaesthesia, nasogastric tube, GlideScope, intubation

Procedia PDF Downloads 163

Authors: Asamaporn Puetpaiboon, Sunisa Chatmongkolchart, Nalinee Kovitwanawong, Osaree Akaraborworn

Abstract:

Traumatic patients with massive bleeding require intensive resuscitation. The actual cost of anesthesia per case has never been clarified, so our study aimed to quantify the direct cost, and cost-to-charge ratio of anesthetic care in traumatic patients with intraoperative massive bleeding. This study was a prospective, observational, cost analysis study, conducted in Prince of Songkla University hospital, Thailand, with traumatic patients, of any mechanisms being recruited. Massive bleeding was defined as estimated blood loss of at least one blood volume in 24 hours, or a half of blood volume in 3 hours. The cost components were identified by the micro-costing method, and valued by the bottom-up approach. The direct cost was divided into 4 categories: the labor cost, the capital cost, the material cost and the cost of drugs. From September 2017 to August 2018, 10 patients with multiple injuries were included. Seven patients had motorcycle accidents, two patients fell from a height and another one was in a minibus accident. Two patients died on the operating table, and another two died within 48 hours. The median Sequential Organ Failure Assessment (SOFA) score was 8. The median intraoperative blood loss was 3,500 ml. The median direct cost, per case, was 250 United States Dollars (2017 exchange rate), and the cost-to-charge ratio was 0.53. In summary, the direct cost was nearly half of the hospital charge, for these traumatic patients with massive bleeding. However, our study did not analyze the indirect cost.

Keywords: cost, cost-to-charge ratio, micro-costing, trauma

Procedia PDF Downloads 147

Authors: Karuna Sutthibenjakul, Sunisa Chatmongkolchart

Abstract:

Background: Postinduction hypotension is common and occurs more often in elderly patients. We aimed to determine risk factors for hypotension after induction among elderly patients (aged 65 years and older) who underwent elective non-cardiac surgery under general anesthesia. Methods: This cohort study analyzed from 580 data between December 2017 and July 2018 at a tertiary university hospital in south of Thailand. Hypotension is defined as more than 30% decrease mean arterial pressure from baseline after induction within 20 minutes or the use of vasopressive agent to treat low blood pressure. Intraoperative parameters were blood pressure and heart rate at T0, TEI, T5, T10, T15 and T20 (immediately after arrival at operating room, time after intubation, 5, 10, 15 and 20 minutes after intubation) respectively. Results: The median age was 72.5 (68, 78) years. A prevalence of post-induction hypotension was 64.8%. The highest prevalence (39.7%) was at 15 minutes after intubation. The association of post-induction hypotension is rising with diuretic drug as preoperative medication (P-value=0.016), hematocrit level (P-value=0.031) and the degree of hypertension immediately after arrival at operating room (P-value<0.001). Increasing fentanyl dosage during induction was associated with hypotension at intubation time (P-value<0.01) and 5 minutes after intubation (P-value<0.001). There was no statistically significant difference in the increasing propofol dosage. Conclusion: The degree of hypertension immediately after arrival at operating room and increasing fentanyl dosage were a significant risk factors for postinduction hypotension in elderly patients.

Keywords: risk factors, post-induction, hypotension, elderly

Procedia PDF Downloads 130

Authors: Marasri Junsi, Sunisa Siripongvutikorn, Chutha Takahashi Yupanqui, Worrapong Usawakesmanee

Abstract:

Thunbergia laurifolia has been used for folklore medicine purposes and consumed in the form of herbal tea in Thailand since ancient times. To evaluate the bioactive compounds of aqueous leave extract possessed antioxidant and anti-inflammatory activities. The antioxidant activities were examined by total extractable phenolic content (TPC), total extractable flavonoid content (TFC), ABTS radical scavenging, DPPH radical scavenging, FRAP reducing antioxidant power expressed as mg of gallic acid trolox and caffeic acid for the equivalents. Results indicated that the extract had high TPC and antioxidant activities. In addition, the HPLC-DAD analysis of phenolics and flavonoids indicated the presence of caffeic acid and rutin as bioactive compounds. Exposure of cells with the extract using nitric oxide (NO) production in RAW 264.7 murine macrophage cell line induced by lipopolysaccharide (LPS) was significantly reduced NO production and increased cell proliferation. The obtained results demonstrated that the extract contains a high potential to be used as anti-inflammatory and antioxidant substances.

Keywords: Thunbergia laurifolia, anti-inflammatory, antioxidant activities, RAW264.7

Procedia PDF Downloads 309

Authors: Cherish Romina Prajitno, Sunisa Thaichinda

Abstract:

One indicator of facial aging is wrinkles. Not only that, but wrinkles are a key indicator in our world of facial aesthetics. Wrinkles occur where fault lines develop in aging skin. Nowadays, people are more motivated to keep up their appealing and young appearance. Many individuals are seeking a fast recovery time for their aesthetic procedures and are interested in non-invasive techniques that have a proven track record for successful outcomes. The purpose of this study is to see the efficacy of 100% (pure) grapeseed oil for reducing periorbital wrinkles. This study used the split-face, double-blind method, and this treatment was administered for three months at random to fifteen patients, with the grapeseed oil at one side of the face and the other side with the placebo. The main outcome measure was determined by conducting a comparative analysis of the participants' wrinkle results during each visit using the VIsioscan® VC98. Additionally, we evaluated the skin's elasticity and barrier function using the Cutometer® MP 530 and Tewameter® TM300. Furthermore, we administered a satisfaction score questionnaire to the patients in the 12th week. The findings of the study indicate that grapeseed oil exhibited a noteworthy effect in diminishing the appearance of wrinkles in the periorbital region, enhancing the viscoelastic properties of the periorbital skin, and improving the functionality of the skin barrier in the periorbital area.

Keywords: periorbital wrinkles, pure grapeseed oil, split-face method

Procedia PDF Downloads 69

Authors: Rattanamanee Chomchan, Sunisa Siripongvutikorn, Panupong Puttarak

Abstract:

Ricegrass or young rice sprouts can be introduced as one of functional product since cereal sprouts have been much interested in this era due to their high nutritive values. Bio-fortification of selenium is one strategy to improve plant bioactive compounds. However, the level of selenium used are varied among species of plants, hence, the proper level need to be investigated. In this current study, influence of selenium bio-fortification hydroponically in the form of sodium selenite following the range 0, 10, 20, 30 and 40 mg Se/L on growth characteristics, selenium content, total extractable phenolic content (TPC) accumulation, lipid peroxidation and anti-oxidative properties of ricegrass were investigated. Results revealed that selenium bio-fortified exogenously increased the accumulation of selenium in ricegrass by 5.3 fold at 40 mg Se/L treatment without significant changes in leaves biomass at harvesting day while root part weight were slightly decreased when increased selenium level, respectively. Selenium at low concentration (10 and 20 mg Se/L) can stimulate the production of phenolic compounds and antioxidant activities in young ricegrass as measured by DPPH, ABTS and FRAP assay. Conversely, higher level of selenium fortification reduced the accumulation of phenolics in ricegrass afterward by acting as pro-oxidant. Moreover, highest significant reduction in oxidative stress, measured as malondialdehyde content was also observed at 20 mg Se/L treatment which in correlation to high TPC and antioxidant activities. In conclusion, selenium bio-fortification can be used as a technique to improve precious to ricegrass.

Keywords: antioxidant activities, bio-fortification, ricegrass, selenium

Procedia PDF Downloads 280