Anesthesiology
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Randomized Controlled Trial
Increased Risk of Intraoperative Awareness in Patients with a History of Awareness.
Patients with a history of intraoperative awareness are five-times more likely to experience awareness than those without.
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Randomized Controlled Trial
Lidocaine Patch (5%) in Treatment of Persistent Inguinal Postherniorrhaphy Pain: A Randomized, Double-blind, Placebo-controlled, Crossover Trial.
Evidence-based pharmacological treatment options for patients with persistent inguinal postherniorrhaphy pain are lacking. ⋯ Lidocaine patch treatment did not reduce combined resting and dynamic pain ratings compared with placebo in patients with severe, persistent inguinal postherniorrhaphy pain.
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Randomized Controlled Trial Multicenter Study Comparative Study
Six Percent Hydroxyethyl Starch 130/0.4 (Voluven®) versus 5% Human Serum Albumin for Volume Replacement Therapy during Elective Open-heart Surgery in Pediatric Patients.
Although 5% albumin (human serum albumin [HSA]) is widely used in cardiac surgery children, synthetic colloids may provide a valuable alternative. This study compared 6% hydroxyethyl starch (HES) 130/0.4 with HSA for volume replacement in this population. ⋯ In pediatric cardiac surgery, HES showed equivalence to HSA with regard to volume replacement therapy in children aged from 2 to 12 yr. Although there was no suggestion of an imbalance of safety measures between HES and HSA, the study was not powered to provide any firm conclusions about safety of tetrastarch in this population.
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Perioperative cardiopulmonary arrests are uncommon and little is known about rates and predictors of in-hospital survival. ⋯ Among patients with a perioperative cardiac arrest, one in three survived to hospital discharge, and good neurological outcome was noted in two of three survivors.
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Approximately 80 million inpatient and outpatient surgeries are performed annually in the United States. Widely variable and fragmented perioperative care exposes these surgical patients to lapses in expected standard of care, increases the chance for operational mistakes and accidents, results in unnecessary and potentially detrimental care, needlessly drives up costs, and adversely affects the patient healthcare experience. ⋯ To justify implementation of this new healthcare delivery model to surgical colleagues, administrators, and patients and maintain the integrity of evidenced-based practice, the nascent PSH model must be rigorously evaluated. This special article proposes comparative effectiveness research aims or objectives and an optimal study design for the novel PSH model.