Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2020
Randomized Controlled Trial Multicenter StudyTransversus Abdominis Plane Block With Liposomal Bupivacaine for Pain After Cesarean Delivery in a Multicenter, Randomized, Double-Blind, Controlled Trial.
Transversus abdominis plane block with liposomal bupivacaine improved post-caesarean section analgesia when used as part of a multimodal analgesia protocol.
pearl -
Anesthesia and analgesia · Dec 2020
Multicenter StudyClinical Uses and Impacts of Emergency Manuals During Perioperative Crises.
Performing key actions efficiently during crises can determine clinical outcomes, yet even expert clinicians omit key actions. Simulation-based studies of crises show that correct performance of key actions dramatically increases when emergency manuals (EMs) are used. Despite widespread dissemination of EMs, there is a need to understand in clinical contexts, when, how, and how often EMs are used and not used, along with perceived impacts. ⋯ This study provides evidence that EMs in operating rooms are being used during many applicable crises and that clinicians perceive EM use to add value. The reported negative effects were minimal and potentially offset by positive effects.
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Anesthesia and analgesia · Dec 2020
Multicenter StudyAn Implementation-Effectiveness Study of a Perioperative Delirium Prevention Initiative for Older Adults.
Postoperative delirium is a common and serious problem for older adults. To better align local practices with delirium prevention consensus guidelines, we implemented a 5-component intervention followed by a quality improvement (QI) project at our institution. ⋯ A perioperative delirium prevention intervention was associated with reduced administration of Beers PIMs to older adults.
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Anesthesia and analgesia · Dec 2020
Multicenter StudyMusculoskeletal Trauma in Critically Injured Patients: Factors Leading to Delayed Operative Fixation and Multiple Organ Failure.
Musculoskeletal injuries are common following trauma and variables that are associated with late femur fracture fixation are important to perioperative management. Furthermore, the association of late fracture fixation and multiple organ failure (MOF) is not well defined. ⋯ In a cohort of multisystem trauma patients with femur fractures, greater injury severity and depth of shock, as measured by LacTW24h, were associated with late operative fixation. Late fixation was also associated with MOF. Strategies to reduce the burden of MOF in this population require further investigation.