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Background: "Difficult airway" is the clinical situation in which a conventionally trained anesthesiologist experiences difficulty with mask ventilation, laryngoscopy, and difficulty with tracheal intubation, or both. Associated factors and predictive value difficult airways, maxillofacial surgery study setup is under studied., Objective: To determine the magnitude and associated factors of difficult airways and predictive value of airway examinations among adult patients who underwent maxillofacial surgery at public hospitals in Southern Ethiopia 2022., Methods and Materials: An institutional-based multicenter cross-sectional study was conducted among 250 maxillofacial patients from March to 30 June 2022 at selected hospitals. The data were entered into Epi_Data software version 4.3 and analyzed by STATA software version 14. All variables that were statistically significant in bivariate analysis, at the P less than 0.25, were included in the multivariate logistic regression analysis. The predictive value or the effectiveness of airway examinations in predicting difficult airways was analyzed by receiver operating curve., Results: In the current study, the magnitude of difficult airways was 21.2% (95% CI = 16.3-26.1%) and the magnitude of difficult intubation, difficult laryngoscopy, and difficult mask ventilation was 6.4% (95% CI 3.3-9.4%), 9.6% (95% CI 6.1-13%), and 13.6% (95% CI (9.1-16.8%), respectively. History of head and neck surgery adjusted odds ratio (AOR)=6.3, 95% CI (2.85-14.34), cervical collar AOR=4.9, 95% CI (1.96-12.49), and cervical spine injury AOR=2.4, 95% CI (1.07-5.38) were independently and significantly associated with difficulty of airway. Modified Mallampati class and sternomental distance were identified as good preoperative tests to predict difficult laryngoscopy, intubation, and mask ventilation., Conclusion and Recommendation: The magnitude of difficult airways was maxillofacial surgery. Among various airway assessment tests, no single test was perfectly accurate. Anaesthesia professionals are recommended to use a combination of preoperative airway assessments., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction: The axillary brachial plexus block is a popular nerve block for forearm, wrist, and hand surgery. The aim of this study was to assess the effectiveness of perineural administration of dexamethasone as an adjunct to lidocaine with adrenaline on the onset of sensory block and early postoperative analgesia in trans-arterial axillary brachial plexus block., Methodology: This single-centered prospective cohort study recruited 68 adult patients, 34 in each groups. The frequently used 8 mg dexamethasone combined with 1% lidocaine and adrenaline was investigated. The normality of the data was checked using the Shapiro-Wilk test. An independent t -test was used to compare the mean values of symmetric numeric data. Categorical variables between the two groups were analyzed using χ 2 . The Mann-Whitney U test and Kaplan-Meier method using the log-rank test were used to compare asymmetric numeric data, and a P -value of <0.05 was considered as significant., Results: The median onset time of sensory block was comparable between the nonexposed (24(6) min) and exposed group (24(6) min) ( P =0.068). However, the duration of sensory block was significantly longer in the exposed group (235.5±37.51 min) than the nonexposed group (172.76±28.19 min) ( P <0.001). The time to the first analgesic request was significantly longer in the exposed than the nonexposed group ( P <0.01). Postoperative pain scores were significantly lower at 4 and 8 h in the exposed group ( P <0.05)., Conclusion and Recommendations: The addition of 8 mg dexamethasone to 1% lidocaine with adrenaline solution in trans-arterial axillary brachial plexus block for ambulatory elective hand, wrist, and forearm surgeries prolonged the duration of sensory blockade and the first analgesic request time but did not reduce the onset time of sensory block. The authors recommend the addition of 8 mg dexamethasone to 1% lidocaine with adrenaline solution to prolong the duration of sensory block and the first analgesic request time., Competing Interests: The authors declare no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Surgery is linked with fear and stress that disrupt metabolic and neuroendocrine activities, which impair normal maintained glucose metabolism that leads to stress hyperglycaemia. This study aimed to compare the effect of general and spinal anaesthesia on perioperative blood glucose levels in patients undergoing lower abdominal and pelvic surgery., Methods: This prospective observational cohort study recruits 70 adult patients who underwent lower abdominal and pelvic surgery under general and spinal anaesthesia; 35 in each group. A systematic random sampling technique was used to select study participants. Capillary blood glucose was measured at four perioperative times. An independent t -test, dependent t -test, and Manny-Whitney U test were used for statistical analysis, as appropriate. P values less than 0.05 were considered statistically significant., Results: No statistically significant difference was observed in mean blood glucose levels at baseline and 5 min after induction of general anaesthesia and complete blocks of spinal anaesthesia. But at the end of surgery and 60 min after the end of surgery the mean blood glucose levels were statistically significantly higher in the general anaesthesia group compared with the spinal anaesthesia group ( P <0.05). And the blood glucose level was significantly increased from baseline compared with the different time intervals in the general anaesthesia group., Conclusion: The mean blood glucose levels were lower in patients undergoing surgery under spinal anaesthesia compared with general anaesthesia. The authors recommend spinal over general anaesthesia whenever possible for patients undergoing lower abdominal and pelvic surgery., Competing Interests: The authors have no conflicts of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)