Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2014
Review Meta AnalysisAccuracy of Continuous Noninvasive Hemoglobin Monitoring: A Systematic Review and Meta-Analysis.
Non-invasive haemoglobin monitoring devices show clinically-acceptable, though imperfect, accuracy when compared with laboratory Hb measurement.
pearl -
Anesthesia and analgesia · Aug 2014
ReviewEvidence for the use of preoperative risk assessment scores in elective cranial neurosurgery: a systematic review of the literature.
Preoperative risk scores are designed to guide patient management by providing a means of predicting operative outcome. Several risk scores are used in neurosurgery, but studies on their clinical relevance are scarce. Therefore, it is not clear whether these risk scores are beneficial or helpful in predicting outcome after elective cranial neurosurgery. In this review, we summarize the current scientific evidence for using preoperative risk scores in elective cranial neurosurgery. ⋯ Large prospective studies are needed to validate the use of the reviewed risk scores in elective cranial neurosurgery. It appears, however, that the patient's preoperative physical and functional status can be used to predict the short- and long-term outcome in elective cranial neurosurgery.
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Anesthesia and analgesia · Aug 2014
Randomized Controlled TrialA Simulator Study of Tube Exchange with Three Different Designs of Double-Lumen Tubes.
We sought to determine whether the design of 3 different double-lumen endobronchial tubes (DLT) (Rusch, Mallinckrodt, Fuji) has an effect on the ease of placement over an airway exchange catheter (AEC) using a video laryngoscope. ⋯ The Fuji-Phycon DLT was easier to pass over an AEC in this simulator trial and warrants consideration in patients with difficult airways who require 1-lung ventilation.
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Anesthesia and analgesia · Aug 2014
Multicenter Study Observational StudyTransversus Abdominis Plane Block in Children: A Multicenter Safety Analysis of 1994 Cases from the PRAN (Pediatric Regional Anesthesia Network) Database.
Currently, there is not enough evidence to support the safety of the transversus abdominis plane (TAP) block when used to ameliorate postoperative pain in children. Safety concerns have been repeatedly mentioned as a major barrier to performing large randomized trials in children. The main objective of the current investigation was to determine the incidence of overall and specific complications resulting from the performance of the TAP block in children. In addition, we evaluated patterns of local anesthetic dosage selection in the same population. ⋯ The upper incidence of overall complications associated with the TAP block in children was 0.3%. More important, complications were very minor and did not require any additional interventions. In contrast, the large variability of local anesthetic dosage used can not only minimize potential analgesic benefits of the TAP block but also result in local anesthetic toxicity. Safety concerns should not be a major barrier to performing randomized trials to test the efficacy of the TAP block in children as long as appropriate local anesthetic dose regimens are selected.
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Anesthesia and analgesia · Aug 2014
Length of Red Cell Unit Storage and Risk for Delirium After Cardiac Surgery.
The time that red cell units are stored before transfusion may be associated with postoperative complications, although the evidence is conflicting. However, the association between the length of red cell unit storage and postoperative delirium has not been explored. We hypothesized that the length of storage of transfused red cell units would be associated with delirium after cardiac surgery. ⋯ Transfusion of red cell units that have been stored for >14 days is not associated with increased odds of delirium. However, each additional day of storage >14 or 21 days may be associated with increased odds of postoperative delirium in patients undergoing cardiac surgery. More research is needed to further characterize the association between delirium and storage duration of transfused red cell units.