Introduction: Emergence agitation is one of the significant anesthetic and surgery-related complications. It is usually short-lived but causes self-injury during agitation and it led to parental anxiety. This study was aimed to assess incidence and factors associated with emergence agitation after general anesthesia and surgery among pediatric patients at University of Gondar specialized hospital. Methods: A prospective follow-up study conducted on 153 pediatric patients aged 2–9 years who were operated from first February to April 30, 2019. Emergence agitation was recorded by the pediatrics anesthesia emergence delirium scale. Descriptive statistics performed to determine the incidence. To identify the associated factors multi-variable binary logistic regression was held, and a p-value <0.05 was considered as significant. Results: Emergence agitation was experienced on eighty (52.3%) children with a mean and standard deviation of 12 ± 5.9 min of duration. Among agitated children, 8 (10%) of them developed adverse events related to agitation. Difficult parental separation behaviour (AOR = 2.688, 95% CI = 1.131–6.39), children aged 2–5 years (AOR = 2.688, 95% CI = 1.131–6.3925), isoflurane maintenance (AOR = 4.001, 95% CI = 1.733–9.234) and propofol administration after maintenance closure (AOR = 0.145, 95% CI = 0.030–0.695) were significantly associated with agitation. Conclusion: Being a preschool child, difficult parental separation and isoflurane maintenance were associated with emergence agitation. But propofol administration after maintenance closure was found to be protective. So, agitation should be assessed and detected in the postoperative period and efforts should apply to prevent emergence agitation. Highlights:

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Introduction: Immediate and effective airway management is a priority to save the victim's life. Maintaining a patent airway and ensuring adequate oxygenation is vital to protect the patient from secondary injury due to hypoxia. This study was aimed to assess the practice of emergency traumatic brain injury patient intubation outside the operation theatre. Methods: This study was conducted from 1st September 2018 to February 28, 2019. All trauma patients that were admitted to the emergency department were included. The data was collected by a standardized questionnaire prepared from the recommendations of an Eastern Association for the surgery of trauma practice, by direct observation while performing the procedure and reviewing the patient's chart for any drug given and any documented procedure. Result: A total of 75 trauma patients intubation was observed during the study period. All of the patients were successfully intubated but the standards of maintaining hemodynamic stability, administration of vomiting prophylaxis, and application of capnograph had nil performance. Rapid sequence intubation and maintenance of cervical spine mobility were underperformed. Conclusion: Even though emergency intubations were successfully performed most of the standards of intubation did not meet the criteria, and it needs improvement. Regarding the findings of this audit emergency, traumatic patient intubation needs to be improved in line with the standards for a better patient outcome to avoid secondary injury. Highlights:

Background Spinal anesthesia-induced maternal hypotension is the most frequent complication associated with maternal morbidity and mortality during cesarean section. The aim of this study was to compare the incidence and magnitude of hemodynamic changes in preeclamptic and non-preeclamptic parturients undergone cesarean section under spinal anesthesia. Method A prospective cohort study was conducted from February to May 2019 in University of Gondar comprehensive specialized hospital. A total of 122 ASA II and ASA III parturients were recruited consecutively and assigned to two groups (81non-preeclamptics, and 41 preeclamptics). The data analysis was done by SPSS version 22 statistical software. The data were tested for normality with Shapiro Wilk U-test and normally distributed data were compared by using the independent student’s t-test. Whereas non-normally distributed data were compared using the Mann-Whitney U- test. Fisher’s exact test was used for intergroup comparison of proportion. All P values <0.05 were considered statistically significant. Result The incidence of spinal anesthesia-induced hypotension was higher in non-preeclamptic parturients than preeclamptic parturients (55.6% vs. 34.1%, respectively) and the degree of blood pressure drop was significantly greater in the non-preeclamptic parturients compared to those with preeclampsia; As well intraoperative fluid consumption was significantly greater in the non-preeclamptics parturients compared to those with preeclamptics. Conclusion The incidence and magnitude of spinal anesthesia-induced hypotension in parturients undergone cesarean section were less in preeclamptic parturients than in non-preeclamptic parturients. Therefore, don’t deny spinal anesthesia for preeclamptic parturients due to fear of profound hypotension, unless there is a contraindication for spinal anesthesia.

Background In patients who are liable to the risk of pulmonary aspiration, airway control is the primary and first concern for the anesthetists both in emergency and elective surgical procedures. Rapid sequence induction is universally required in any occasion of emergent endotracheal intubation needed for unfasted patients or patients' fasting status is unknown. Methods institutional-based prospective observational study was conducted from December 2017 to January 2018 in all elective and emergency adult or pediatric patients with a risk of pulmonary aspiration who were operated under general anesthesia with rapid sequence induction and intubation during the audit period. Result A total of 35 patients were operated during the study period. Of these, 31 (88.57%) patients were adults and 4 (11.43%) patients were pediatrics. Most of the patients were emergency (29 (82.857%)), and the rest were elective (6 (17.142%)). Conclusion Most anesthetists were good at preparing all available monitoring and drugs, making sure that IV line is well-functioning, preparing suction with a suction machine, preoxygenation, application of cricoid pressure, and checking the position of the ETT after intubation was performed. Preparing difficult airway equipment during planning of rapid sequence induction and intubation, giving roles and told to proceed their assigned role for the team, attempt to ventilate with a small tidal volume, and routine use of bougie or stylet to increase the chance of success of intubation needed improvement.