Background: Emerging of anesthetics opens a new era to medical discipline in relieving patients' pain and stress when undergoing surgery but simultaneously exposes the healthcare personnel working in areas of anesthetics exposure to many adverse health effects including reproductive outcomes effects. Thus, this study aimed to assess the effect of inhalational anesthetics exposure on reproductive outcomes and its predictors among health care personnel in hospitals of Jimma zone public hospitals. Methods: A comparative cross-sectional study was conducted from May 01 to 30, 2021. We approached 483 healthcare personnel in Jimma zone public hospitals to partake in this study. Of this number, we recruited 292 healthcare personnel, comprising 146 exposed healthcare personnel and 146 unexposed healthcare personnel. Structured questionnaires were used to assess the reproductive outcomes. Data were entered into EPI-data version 4.6.1 and exported to SPSS version 24 for analysis. Binary logistic regressions were carried out to identify associated factors with reproductive outcomes. Statistical significance was declared using a p value <0.05. Results: The overall prevalence of bad reproductive outcome status was high (30.8%) and the prevalence was much higher among exposed HCPs (20.9%) when compared to unexposed HCPs (9.9%). Among a total of 292 HCPs the likelihood of occurred bad reproductive outcomes was higher among an exposed group (AOR=3.17, 95% CI: 1.40-7.16) and those who smoke cigarettes (AOR=8.44, 95% CI: 1.93-36.91). The occurrence rate of bad reproductive outcome was higher among 30-45h/week exposure (AOR=11.94, 95% CI: 1.25-24.95) if separately analyzed among exposed and age of couple above 41 years among unexposed (AOR=5.87, 95% CI: 1.56-22.06) were significantly associated with bad reproductive outcomes. Conclusion: Prevalence of bad reproductive outcomes was higher among exposed HCPs. Hence, it requires attention to create awareness about the danger of anesthetics exposure in the study setting, suggesting the need to further minimize the exposure.

Background: A retropharyngeal abscess is a bacterial infection of the back of the throat. It rarely results in deadly complications such as mediastinitis and thoracic empyema from deep neck infections involving soft tissues of the face, arising from oropharyngeal infections, particularly dental caries. Thus, complicating retropharyngeal abscess extending to mediastinitis poses an increased risk of high mortality rate as a result of its significant invasive potential and the fact that the recognition and diagnosis must be made early, as this is usually delayed. Complicating retropharyngeal abscess increases airway compromise and difficult airway management during anesthesia. We present a 40-year-old, male patient who transferred from another primary hospital to our institution's surgical emergency outpatient department with a complaint of neck swelling of 10 days secondary to tooth extraction. He had a complaint of dull-itching pain, localized initially to the submandibular area and subsequently involving the oropharyngeal, neck, and descending to the chest and mediastinum. He was diagnosed with a complicated retropharyngeal abscess extending to the mediastinum (mediastinitis) and thoracic empyema as a complication of odontogenic infection in origin. Besides intravenous antimicrobial therapy, deep neck incision and drainage, and thoracotomy was done under general anesthesia. After adequate venous access and the patient positioned in head-up position, premedication was given. General anesthesia with an endotracheal tube was provided with a ready tracheostomy set. Inhalational induction was conducted and laryngoscopy was performed after the adequate depth of anesthesia was achieved. We experienced anticipated difficult intubation after induction. After multiple attempts, the tracheal tube was placed correctly by using a bougie. Halothane was used for maintenance anesthesia with intermediate-acting muscle relaxant under controlled ventilation. Conclusion: On top of a detailed review of the patient's history, physical examination, laboratory investigations, and imaging profiles; early recognition of the airway compromise from the complicated retropharyngeal abscess, and proper readiness to manage potentially challenging airway compromise, and difficult airway management during the perioperative period.

Background. Emergence delirium is a common and serious postoperative complication in older surgical patients. It occurs at any time in the perioperative period, during or immediately following emergence from general anesthesia. Unfortunately, it is highly associated with postoperative complications such as a decrease in functional capacity, prolonged hospital stay, an increase in health care costs, and morbidity and mortality. The goal of this study was to determine the prevalence of emergence delirium and associated factors among older patients who underwent elective surgery in the teaching hospitals of Ethiopia at the postanesthesia care unit in 2021. Methods. A multicenter prospective observational study was conducted at the postanesthetic care unit in the four teaching hospitals of Ethiopia. Older surgical patients admitted to the postanesthesia care unit who underwent elective surgery in the four teaching hospitals of Ethiopia were selected by using simple random sampling. Pretested structured questionnaire was used to collect data. Data were entered into EpiData (version 4.6) and exported to the SPSS (version 25.0). Binary logistic regression was used to identify factors independently associated with the emergence delirium. Results. Out of 384 older patients included in the study, the prevalence of emergence delirium was 27.6%. Preoperative low hemoglobin levels (AOR: 2.0, 95% CI; 1.77–3.46), opioid (AOR: 8.0, 95% CI; 3.22–27.8), anticholinergic premedications (AOR: 8.5, 95% CI; 6.85–17.35), and postoperative pain (AOR: 3.10, 95 CI; 2.07–9.84) at PACU were independently associated with emergence delirium. Conclusion. The prevalence of emergence delirium was high among older patients who underwent elective surgery. Opioid and anticholinergic premedication, low preoperative hemoglobin, and the presence of postoperative pain were independently associated with the emergence delirium. Adequate preoperative optimization and postoperative analgesia may reduce the prevalence of emergence delirium.

Background Emergence Delirium is a common and serious post-operative complication in surgical patients, especially in the old-age. It occurs at any time in the peri-operative period, during or immediately following emergence from general anesthesia. Unfortunately, it was highly associated with post-operative complications such as decrease in functional capacity, prolonged hospital stay, an increase in healthcare costs and morbidity and mortality. The goal of this study was to determine the magnitude of emergence delirium and associated factors among old-age patients who underwent elective surgery in the Teaching Hospitals of Ethiopia at post anesthesia care unit, 2021. Methods A multi-center prospective observational study was conducted at Post-anesthesia Care Unit in four Teaching Hospitals of Ethiopia. Old-age surgical patients admitted to Post-anesthesia Care Unit who underwent elective surgery in the four Teaching Hospitals of Ethiopia were selected by using simple random sampling. Pretested structured questionnaire was used to collect data. Data were entered in to Epidata (version 4.6) and exported to the SPSS (version 25.0). Binary logistic regression was used to identify factors independently associated to emergence delirium. Results Out of 384 old-age patients included in the study with 100% response rate, the magnitude of emergence delirium was 27.6%. Preoperative low hemoglobin levels (AOR: 2.0, 95%CI; 1.77–3.46), opioids (AOR: 8.0, 95%CI; 3.22–27.8) and anti-cholinergic premedications (AOR: 8.5, 95%CI; 6.85–17.35), and post-operative pain (AOR: 3.10, 95CI; 2.07–9.84) at PACU were independently associated with emergence delirium. Conclusion The magnitude of emergence delirium was high. Old-age patients who were premedicated with anti-cholinergic and opioids, those patients who had low pre-operative hemoglobin and post-operative pain were independently associated with emergence delirium. Adequate pre-operative optimization and post-operative analgesia may reduce the magnitude of emergence delirium.

Background: PACU discharge score criteria facilitate a risk safe and timely discharge of surgical patients under satisfactory safety conditions, thereby improving post-operative patient outcomes and requiring minimum resources. The aim of this best practice study was to provide best evidence-based practice on post-anesthesia discharge score criteria among nurses at the post-anesthesia care unit in the Jimma Medical Center. Methods: An audit and re-audit inter-professional study was employed. Twenty-four post-anesthesia care unit nurses were interviewed for baseline audit and 118 post-anesthesia care unit discharge scoring opportunities were observed for follow-up audit using three audit criteria. Results: First stage of the audit showed a performance of 37.5% for successful pain assessment, level of consciousness, nausea, vomiting, and blood pressure prior to patient discharge from the post-anesthesia care unit, and 62.5% for routine use of discharge criteria score to determine discharge readiness of patients from the post-anesthesia care unit. Re-audit results revealed an average of 40% improvement of the audit criteria practice toward post-anesthesia care unit discharge score. Conclusion:This study revealed that the use of various strategies such as role modeling, posting reminders about PACU discharge criteria, and presenting guidelines to the recovery teams resulted in improved practice toward best available evidence for postanesthesia care unit discharge score practice. Including the stakeholders in determining the strategies to upgrade practice is crucial in the accomplishment of promoting successful PACU discharge score. To ensure sustainable compliance to successful PACU discharge score criteria, a planned schedule of random report was employed by the clinical team.