Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2014
Randomized Controlled Trial Multicenter StudySupplemental postoperative oxygen does not reduce surgical site infection and major healing-related complications from bariatric surgery in morbidly obese patients: a randomized, blinded trial.
12-16h of post-op supplemental O2 (80%) does not reduce wound infection or complication in the morbidly obese undergoing gastric bypass.
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Anesthesia and analgesia · Aug 2014
ReviewThe Effectiveness of Interventions Aimed at Reducing Anxiety in Health Care Waiting Spaces: A Systematic Review of Randomized and Nonrandomized Trials.
Reducing waiting anxiety is an important objective of patient-centered care. Anxiety is linked to negative health outcomes, including longer recovery periods, lowered pain thresholds, and for children in particular, resistance to treatment, nightmares, and separation anxiety. The goals of this study were (1) to systematically review published research aimed at reducing preprocedural waiting anxiety, and (2) to provide directions for future research and development of strategies to manage preprocedural waiting anxiety in health care environments. ⋯ Music is a well-established means of decreasing anxiety in adult patients awaiting medical interventions. The effect of music on children's anxiety is not known. Limited studies and heterogeneity of interventions and methods in the areas of aromatherapy, interior design, digital media, and play opportunities (for children) suggest the need for future research.
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Anesthesia and analgesia · Aug 2014
Randomized Controlled Trial Comparative StudyAccuracy of the Composite Variability Index as a Measure of the Balance Between Nociception and Antinociception During Anesthesia.
The Composite Variability Index (CVI), derived from the electroencephalogram, was developed to assess the antinociception-nociception balance, whereas the Bispectral Index (BIS) was developed to assess the hypnotic state during anesthesia. We studied the relationships between these indices, level of hypnosis (BIS level), and antinociception (predicted remifentanil effect-site concentrations, CeREMI) before and after stimulation. Also, we measured their association with movement in response to a noxious stimulus. ⋯ CVI appears to correlate with somatic responses to noxious stimuli. However, unstimulated CVI depends more on hypnotic drug effect than on opioid concentration.
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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.