Anesthesiology
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Randomized Controlled Trial Comparative Study
Spinal Anesthesia with Targeted Sedation Based on Bispectral Index Values Compared with General Anesthesia with Masked Bispectral Index Values to Reduce Delirium: The SHARP Randomized Controlled Trial.
Spinal anaesthesia with BIS-targeted sedation did not reduce post-operative delirium after lumbar fusion, compared to non-targeted general anaesthesia.
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Randomized Controlled Trial Multicenter Study
Preoperative Paravertebral Block and Chronic Pain after Breast Cancer Surgery: A Double-blind Randomized Trial.
Paravertebral block for breast surgery reduces acute postoperative pain, but not the incidence of chronic pain.
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Observational Study
Carbon Footprint of General, Regional, and Combined Anesthesia for Total Knee Replacements.
Health care itself contributes to climate change. Anesthesia is a "carbon hotspot," yet few data exist to compare anesthetic choices. The authors examined the carbon dioxide equivalent emissions associated with general anesthesia, spinal anesthesia, and combined (general and spinal anesthesia) during a total knee replacement. ⋯ All anesthetic approaches had similar carbon footprints (desflurane and nitrous oxide were not used for general anesthesia). Rather than spinal being a default low carbon approach, several choices determine the final carbon footprint: using low-flow anesthesia/total intravenous anesthesia, reducing single-use plastics, reducing oxygen flows, and collaborating with engineers to augment energy efficiency/renewable electricity.