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We compared post-treatment pain, quality of recovery and complications between those who did not receive (Group I) and received (Group II) intravenous low-dose Midazolam (0.05 mg/kg) and Pethidine (0.5 mg/kg) during radiofrequency ablation (RFA) of benign thyroid nodules.Both groups received local anesthesia. Post-treatment pain was rated by a 0-10 numerical rating scale (NRS). The Quality-of-Recovery-9 (QoR9) questionnaire was completed upon discharge.Each group included 25 patients. Baseline characteristics were comparable (p 0.05). Group II had lower pain NRS than group I both immediately (0 (0-3.5) vs. 4 (3-5), p = 0.002) and 4 h after RFA (2 (0.5-4) vs 3.5 (2-5), p = 0.031). There were no differences in complications and QoR9 score (Group I: 15 (13-17) vs Group II: 16 (14-18), p = 0.254). Both groups were discharged within the same day.Low dose intravenous sedation improved pain control without affecting recovery or safety in thyroid RFA.

Objective: We aimed to characterize SGLT2 inhibitor (SGLT2i) -associated post-operative diabetic ketoacidosis (DKA) in type 2 diabetes patients. Methods: We analyzed a territory-wide cohort of type 2 diabetes patients who underwent operations during 2015-2020. Patients who had SGLT2i prescriptions within 6 months before operations were assigned to SGLT2i group while others to control group. Inverse probability treatment weighting with propensity scores was used to balance the baseline covariates between two groups. Post-operative DKA was defined by DKA within 30 days post-operatively. Results: In total, 151488 type 2 diabetes adults undergoing elective (3260 SGLT2i users; 105540 controls) and emergency operations (1087 SGLT2i users; 416controls) were included. SGLT2i users who underwent emergency operations had higher incidence of post-operative DKA (24.5/1000 person-years) than elective operations (1.0/1000 person-years; p8% (64mmol/mol) and baseline insulin use increased the risk of post-operative DKA. SGLT2i users who developed post-operative DKA had worse outcomes (mechanical ventilation, intensive care and length of hospitalization; p Conclusion: Preoperative SGLT2i use was associated with increased risks of post-operative DKA in type 2 diabetes, higher among patients who underwent emergency operations than elective ones. Clinicians should be vigilant regarding the high-risk group. Effective strategies to mitigate risks of SGLT2i-associated post-operative DKA are urgently needed given the associated morbidities. Disclosure D.T.W.Lui: None. T.Wu: None. X.Liu: None. C.Au: None. C.Lee: None. M.Fung: None. Y.Woo: None. K.C.Tan: None. C.K.Wong: None.