Anesthesiology
-
Randomized Controlled Trial
Efficacy of tranexamic acid in pediatric craniosynostosis surgery: a double-blind, placebo-controlled trial.
Extensive blood loss is common in pediatric craniosynostosis reconstruction surgery. Tranexamic acid (TXA) is increasingly used to reduce perioperative blood loss in various settings, but data on its efficacy are limited in children. The purpose of this randomized, double-blind, placebo-controlled, parallel trial was to evaluate the efficacy of TXA in pediatric craniosynostosis correction surgery. The primary and secondary outcome variables were reduction in perioperative blood loss and reduction in blood transfusion, respectively. ⋯ TXA is effective in reducing perioperative blood loss and transfusion requirement in children undergoing craniosynostosis reconstruction surgery.
-
Comparative Study
Chronic β blockade is associated with a better outcome after elective noncardiac surgery than acute β blockade: a single-center propensity-matched cohort study.
Current guidelines on perioperative care recommend the prophylactic use of β blockers in high-risk patients undergoing noncardiac surgery. However, recent studies show that, in some instances, perioperative β blockade can cause harm. Furthermore, chronic β blockade, titrated to effect before surgery, may be superior to acute perioperative β blockade. The primary objective of this study was to compare major acute cardiac outcomes in patients who underwent surgery with chronic β blocker therapy with those in patients with acute β-blocker therapy. ⋯ Acute β blockade, initiated within the first 2 days after surgery, was associated with worse cardiac outcome compared with a matched cohort of patients who underwent surgery on chronic β blockade. These results should be validated in a larger prospective trial.
-
Editorial Comment
Tranexamic acid in elective craniosynostosis surgery: it works, but how?