Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2014
Randomized Controlled Trial Multicenter StudyPostoperative Delirium in a Substudy of Cardiothoracic Surgical Patients in the BAG-RECALL Clinical Trial.
Low average volatile concentration shows some association with post-operative delirium in a sub-study analysis of cardiothoracic patients admitted post-operatively to ICU, although clinical implications are unclear. Use of BIS was not statistically significantly associated with a lower incidence of delirium, although there was a trend to lower incidence.
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Anesthesia and analgesia · Apr 2014
Randomized Controlled Trial Comparative StudyA comparison of posterior and medial cord stimulation for neurostimulation-guided vertical infraclavicular block: a randomized noninferiority clinical trial.
We investigated whether medial cord stimulation is inferior to posterior cord stimulation for vertical infraclavicular block with respect to block success. ⋯ Needle manipulation to elicit medial cord response is noninferior to posterior cord response of block success during neurostimulation-guided vertical infraclavicular block.
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Anesthesia and analgesia · Apr 2014
Cumulated time with low bispectral index values is not related to the risk of new cancer or death within 5 years after surgery in patients with previous or prevailing malignancy.
Preclinical data indicate that anesthesia and surgery may promote cancer growth. We previously found no increased risk of malignant disease within 5 years regarding duration of general anesthesia (TANESTH) and time with Bispectral Index (BIS) under 45 (TBIS < 45) in patients without any diagnosis or history of malignancy before or within 1 month after surgery. Because immunocompetence may be different in patients with previous malignant disease, we investigated the corresponding risk in patients with earlier or existing malignant disease at the time of surgery. ⋯ In patients with previous or existing malignant disease, neither duration of anesthesia nor increased cumulative time with profound sevoflurane anesthesia was associated with an increased risk for new cancer or death within 5 years after surgery. Monitoring "depth of anesthesia" is not expected to alter the risk of cancer proliferation after surgery.