Anesthesia and analgesia
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Anesthesia and analgesia · May 2013
Randomized Controlled Trial Multicenter StudyNitrous oxide and serious morbidity and mortality in the POISE trial.
Nitrous oxide exposure was not associated with 30-day MI, stroke, death or hypotension in an observational analysis of POISE subjects.
pearl -
Anesthesia and analgesia · May 2013
Review Meta AnalysisRegional scalp block for postcraniotomy analgesia: a systematic review and meta-analysis.
Meta-analysis suggests regional scalp block may reduce post-operative pain after craniotomy, although relies on small, low-quality studies.
pearl -
Anesthesia and analgesia · May 2013
Randomized Controlled TrialThe VeinViewer vascular imaging system worsens first-attempt cannulation rate for experienced nurses in infants and children with anticipated difficult intravenous access.
The VeinViewer (Luminetx, Memphis, TN) helps identify veins by projecting an image of subcutaneous vasculature on the skin surface. We tested the primary hypothesis that VeinViewer use improves cannulation success by skilled nurses in pediatric patients with anticipated difficult IV access. A secondary goal was to evaluate the relationship between obesity and cannulation success. ⋯ The VeinViewer worsened first-attempt IV insertion success by skilled nurses. Surprisingly, first-attempt success for IV cannulation was not worsened by obesity.
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Anesthesia and analgesia · May 2013
The association between nitrous oxide and postoperative mortality and morbidity after noncardiac surgery.
Nitrous oxide (N2O) has been widely used in clinical anesthesia for >150 years. However, use of N2O has decreased in recent years because of concern about the drug's metabolic side effects. But evidence that routine use of N2O causes clinically important toxicity remains elusive. We therefore evaluated the relationship between intraoperative N2O administration and 30-day mortality as well as a set of major inpatient postoperative complications (including mortality) in adults who had general anesthesia for noncardiac surgery. ⋯ Intraoperative N2O administration was associated with decreased odds of 30-day mortality and decreased odds of in-hospital mortality/morbidity. Aside from its specific and well-known contraindications, the results of this study do not support eliminating N2O from anesthetic practice.
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Anesthesia and analgesia · May 2013
Decreased erythrocyte deformability after transfusion and the effects of erythrocyte storage duration.
Erythrocyte cell membranes undergo morphologic changes during storage, but it is unclear whether these changes are reversible. We assessed erythrocyte cell membrane deformability in patients before and after transfusion to determine the effects of storage duration and whether changes in deformability are reversible after transfusion. ⋯ The findings demonstrate that increased duration of erythrocyte storage is associated with decreased cell membrane deformability and that these changes are not readily reversible after transfusion.