Cardiac tamponade is potentially fatal medical condition, which rarely occurs as a complication of lung lobectomy. We present the first case of cardiac tamponade to develop in a Post-Anesthesia Care Unit following a lung lobectomy. A 54-year-old man with pulmonary squamous cell carcinoma underwent an apparently uncomplicated lung lobectomy. His hemodynamics was unremarkable throughout the surgery and initially in the Post-Anesthesia Care Unit. However, after 5 min in the Post-Anesthesia Care Unit, he suddenly became hypotensive and dyspneic. He responded poorly to inotropics and fluid resuscitation. Transesophageal echocardiography conducted by an anesthesiologist who suspected a cardiac etiology revealed a pericardial effusion compressing the heart. After a failed attempt of pericardiocentesis, an emergency pericardial window operation was performed. The patient improved dramatically once the heart was decompressed. Since cardiac tamponade is generally not suspected as a cause of hemodynamic instability after a lung lobectomy, as it was in this case, a misdiagnosis of the patient's condition may have led to improper management resulting in death. As anesthesiologists are often involved in the initial resuscitation of morbid patients in Post-Anesthesia Care Units, their acquaintance with various postoperative complications and competence in echocardiography for assessing cardiac problems may contribute to patient survival. O tamponamento cardíaco é uma condição médica potencialmente fatal, cuja ocorrência como uma complicação da lobectomia pulmonar é muito rara. Apresentamos o primeiro caso de tamponamento cardíaco desencadeado na sala de recuperação pós-anestésica (SRPA) após uma lobectomia pulmonar. Paciente do sexo masculino, 54 anos de idade, com carcinoma de células escamosas pulmonares, submetido à lobectomia pulmonar aparentemente sem complicações. Sua hemodinâmica não apresentou alteração durante toda a cirurgia e também inicialmente na sala de resuperação pós-anestésica. Porém, após cinco minutos na SRPA, o paciente apresentou hipotensão e dispneia de forma repentina e respondeu mal ao inotrópico e à reanimação hídrica. Uma ecocardiografia transesofágica realizada por um anestesiologista que suspeitou de etiologia cardíaca revelou um derrame pericárdico que comprimia o coração. Após tentativa malsucedida de pericardiocentese, foi realizada uma janela pericárdica de emergência. O paciente apresentou melhora dramática com a descompressão do coração. Como o tamponamento cardíaco geralmente não é suspeito como causa de instabilidade hemodinâmica após lobectomia pulmonar, como ocorreu neste caso, um diagnóstico errado da condição do paciente poderia ter levado a um manejo inadequado, resultando em morte. Como os anestesiologistas estão frequentemente envolvidos na reanimação inicial de pacientes debilitados em salas de recuperação pós-anestesia, seu conhecimento de várias complicações pós-operatórias e competência na ecocardiografia para avaliar problemas cardíacos podem contribuir para a sobrevivência do paciente.

Background and Objectives: Assessing pain deception is challenging due to its subjective nature. The main goal of this study was to evaluate the diagnostic value of pain deception using machine learning (ML) analysis with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales, considering accuracy, precision, recall, and f1-score as diagnostic parameters. Materials and Methods: This study was a single-blinded, randomized controlled trial. Subjects were randomly allocated into a non-deception (ND) group and a deception (D) group. Pain deception, as a form of psychological intervention, was taught to subjects in the D group to deceive the physician. MMPI-2, Waddell’s sign, and salivary alpha-amylase (SAA) were also measured. For analyzing the MMPI-2, the XGBoost ML algorithm was applied. Results: Of a total of 96 participants, 50 and 46 were assigned to the ND group and the D group, respectively. In the logistic regression analysis, pain and MMPI-2 did not show diagnostic value. However, in the ML analysis, values of the selected MMPI-2 (sMMPI-2) scales related to pain deception showed an accuracy of 0.724, a precision of 0.692, a recall of 0.692, and an f1-score of 0.692. Conclusions: Using MMPI-2 test results, ML can diagnose pain deception better than the conventional logistic regression analysis method by considering different scales and patterns together.