Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2009
The prevalence of perioperative visual loss in the United States: a 10-year study from 1996 to 2005 of spinal, orthopedic, cardiac, and general surgery.
Perioperative visual loss (POVL) accompanying nonocular surgery is a rare and potentially devastating complication but its frequency in commonly performed inpatient surgery is not well defined. We used the Nationwide Inpatient Sample to estimate the rate of POVL in the United States among the eight most common nonocular surgeries. ⋯ The results confirm the clinical suspicion that the risk of POVL is higher in cardiac and spine fusion surgery and show for the first time a higher risk of this complication in patients undergoing lower extremity joint replacement surgery. The prevalence of POVL in the eight most commonly performed surgical operations in the United States has decreased between 1996 and 2005. Increased odds of POVL with male gender and comorbidity index indicate that some risk factors for POVL may not presently be modifiable. The conclusions of this study are limited by factors affecting data accuracy, such as lack of data on the intraoperative course and inability to confirm the diagnostic coding of any of the discharges in the database.
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Anesthesia and analgesia · Nov 2009
A cost-effective screening method for preoperative hyperglycemia.
The preoperative encounter may offer a cost-effective opportunity for diabetes screening. ⋯ This preoperative blood glucose screening test was implemented at a cost of approximately one-tenth of current methods.
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Anesthesia and analgesia · Nov 2009
Comparative StudyIncrease in quality, but not quantity, of clinical trials in acute pain: 1992 versus 2007.
The annual number of published clinical trials in acute postoperative pain in adults has changed little in 15 yr and, as a fraction of all clinical trials published in the six highest impact journals in anesthesiology, has actually decreased from 16% (95% confidence interval: 12-20) to 11% (95% confidence interval: 9-15). However, the methodological quality of reports has improved, with explicit statements on power analysis, allocation concealment, and specification of primary end points exceeding 90% of reports in 2007. There has been a shift in hypothesis interests away from neuraxial analgesia and toward multimodal analgesia.
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Anesthesia and analgesia · Nov 2009
Case ReportsA hemodynamic profile for consciousness during cardiopulmonary resuscitation.
We report the quantification of a hemodynamic profile sufficient to support consciousness during cardiopulmonary resuscitation. A 62-yr-old man experienced cardiac arrest while being evaluated for heart failure after heart transplantation. ⋯ A mean arterial blood pressure of 50 mm Hg with a heart rate of 100 bpm supported consciousness during cardiac arrest. This case helps to validate the recent emphasis on hard, fast, basic life support.