Background: In critically ill patients, a poor sleep quality can escalate mortality and the length of hospital stays. Albeit being the gold standard for sleep assessment, polysomnography (PSG) is expensive and complicated. The Richards-Campbell sleep questionnaire (RCSQ) is another tool with proof of good correlation with PSG. RCSQ was translated into many languages. However, the Thai version (T-RCSQ) has not been developed.

This study aimed to determine the effect of hard candies on gastric content volume and pH in patients undergoing elective esophagogastroduodenoscopy and colonoscopy. Additionally, the study evaluated the difficulty of the procedure, complications, and satisfaction levels of the endoscopist and patient. Patients and Methods: A randomized controlled study equally recruited 108 outpatients to candy and control groups. The patients in the candy group could consume sugar-free candies within 2 hours before anesthesia, while the controls remained fasted. The endoscopic procedure began under topical pharyngeal anesthesia and intravenous sedation. A blinded endoscopist suctioned the gastric volume through an endoscope. A blinded anesthesia provider tested the gastric pH with a pH meter. The primary outcome variables were gastric volume and pH. The secondary outcome variables were complications, the difficulty of the procedure, and endoscopist and patient satisfaction. Results: The characteristics of both patient groups were comparable. The mean gastric volume of the candy group (0.43 [0.27-0.67] mL/kg) was not significantly different from that of the control group (0.32 [0.19-0.55] mL/kg). The gastric pH of both groups was similar: 1.40 (1.10-1.70) for the candy group and 1.40 (1.20-1.90) for the control group. The procedure-difficulty score of the candy group was higher than that of the control group. The satisfaction scores rated by the endoscopist and the patients in both groups were comparable. In addition, most endoscopists and patients in the candy and control groups reported being "very satisfied". No complications were observed in either group. Conclusion: Hard candies did not affect gastric volume or pH. Elective gastrointestinal endoscopic procedures in adult patients who preoperatively consume candies could proceed to prevent delays and disruption of workflows.

Background: Nocturnal or postoperative dexmedetomidine has been shown to reduce the incidence of delirium in critically ill surgical patients without an increase in any complications. However, it is not clear whether dexmedetomidine has preventive effect against delirium in the patients with high risk of postoperative delirium (POD) since no previous studies have clearly emphasized high-risk surgical patients. Method: In this single-center, double-blind, randomized controlled trial, we randomize 114 high risk POD patients defined by developed predictive scores and admitted to surgical intensive care units (SICUs) into 2 groups: nocturnal dexmedetomidine (9 pm – 6 am) and placebo. The outcomes were incidence of POD, delirium-free days, secondary delirium-related complications and concerned complications including hypotension and bradycardia. Other treatments apart from intervention are standardized. Intention to treat analysis is used to analyze all data. Hypothesis: We hypothesize that nocturnal dexmedetomidine giving to high-risk POD patients admitted to SICUs postoperatively would (1) reduce incidence of POD (2) improve delirium-free days (3) reduce secondary delirium-related complications (4) show no difference in hypotension and bradycardia between groups. Ethics and dissemination: The trial receives ethic approval from Siriraj Institutional Review Board. We plan to disseminate the results in peer-reviewed critical care medicine or anesthesiology-related journals, conferences nationally and internationally. Trial registration: TCTR20210217001