Anesthesia and analgesia
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Anesthesia and analgesia · May 2014
Randomized Controlled Trial Multicenter StudyA pilot study for a prospective, randomized, double-blind trial of the influence of anesthetic depth on long-term outcome.
Greater depth of anaesthesia may be associated with a higher incidence of wound infection, mortality and composite risk of complications.
pearl -
Anesthesia and analgesia · May 2014
Randomized Controlled TrialThe Effects of Perineural Versus Intravenous Dexamethasone on Sciatic Nerve Blockade Outcomes: A Randomized, Double-Blind, Placebo-Controlled Study.
Neither IV or perineural dexamethasone as part of a sciatic nerve block improved the quality of surgical recovery, but did prolong block duration.
pearl -
Anesthesia and analgesia · May 2014
Randomized Controlled TrialUltrasound-Guided Supraclavicular Brachial Plexus Block: Single Versus Triple Injection Technique for Upper Limb Arteriovenous Access Surgery.
While single-injection supraclavicular nerve block is faster to perform, triple-injection has faster onset and greater block success at 20 minutes.
pearl -
Anesthesia and analgesia · May 2014
Comparative StudyA Prospective Comparison of a Noninvasive Cardiac Output Monitor Versus Esophageal Doppler Monitor for Goal-Directed Fluid Therapy in Colorectal Surgery Patients.
The NICOM non-invasive cardiac output monitor is non-inferior to oesophageal doppler monitoring for guiding fluid therapy in colorectal surgery.
pearl -
Anesthesia and analgesia · May 2014
Randomized Controlled Trial Comparative StudySedation depth during spinal anesthesia and survival in elderly patients undergoing hip fracture repair.
Low intraoperative Bispectral Index (BIS) values may be associated with increased mortality. In a previously reported trial to prevent delirium, we randomized patients undergoing hip fracture repair under spinal anesthesia to light (BIS >80) or deep (BIS approximately 50) sedation. We analyzed survival of patients in the original trial. ⋯ However, among patients with serious comorbidities (Charlson score >4), 1-year mortality was reduced in the light (22.2%) vs deep (43.6%) sedation group (hazard ratio [HR], 0.43; 95% confidence interval, 0.19-0.97; P = 0.04) during spinal anesthesia. Similarly, among patients with Charlson score >6, 1-year mortality was reduced in the light (28.6%) vs deep (52.6%) sedation group (HR 0.33; 95% confidence interval, 0.12-0.94; P = 0.04) during spinal anesthesia. Further research on reduced mortality after light sedation during spinal anesthesia is needed.