Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2020
ReviewAnesthetic Implications of the New Guidelines for Button Battery Ingestion in Children.
New guidelines for paediatric button battery ingestion recommend preoperative administration with honey and/or sucralfate, and post-removal irrigation with 0.25% acetic acid.
pearl -
Anesthesia and analgesia · Mar 2020
Comparative StudyGoal-Directed Fluid Therapy Does Not Improve Early Glomerular Filtration Rate in a Porcine Renal Transplantation Model.
Insufficient fluid administration intra- and postoperatively may lead to delayed renal graft function (DGF), while fluid overload increases the risk of heart failure, infection, and obstipation. Several different fluid protocols have been suggested to ensure optimal fluid state. However, there is a lack of evidence of the clinical impact of these regimens. This study aimed to determine whether individualized goal-directed fluid therapy (IGDT) positively affects the initial renal function compared to a high-volume fluid therapy (HVFT) and to examine the effects on renal endothelial glycocalyx, inflammatory and oxidative stress markers, and medullary tissue oxygenation. The hypothesis was that IGDT improves early glomerular filtration rate (GFR) in pigs subjected to renal transplantation. ⋯ IGDT did not improve early GFR; however, it may reduce tissue inflammation and could possibly lead to preservation of the glycocalyx compared to HVFT.
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Anesthesia and analgesia · Mar 2020
Observational StudyAssociation Between Perioperative Hypotension and Delirium in Postoperative Critically Ill Patients: A Retrospective Cohort Analysis.
Intraoperative and postoperative hypotension are both associated with postoperative delirium among patients admitted to ICU.
pearl -
Anesthesia and analgesia · Mar 2020
Individualized Quality Data Feedback Improves Anesthesiology Residents' Documentation of Depth of Neuromuscular Blockade Before Extubation.
Reversal of neuromuscular blockade is an important anesthesia quality measure, and anesthesiologists should strive to improve both documentation and practice of this measure. We hypothesized that the use of an electronic quality database to give individualized resident anesthesiologist feedback would increase the percentage of cases that residents successfully documented quantitative depth of neuromuscular blockade before extubation. The mean baseline success rate among anesthesiology residents was 80% (95% confidence interval [CI], 78-81) and increased by 14% (95% CI, 11-17; P < .001) after the residents were given their individualized quality data. Practice patterns improved quickly but were not sustained over 6 months.
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Anesthesia and analgesia · Mar 2020
Comparative StudyComparison of Nitroglycerin and Terbutaline for External Cephalic Version in Women Who Received Neuraxial Anesthesia: A Retrospective Analysis.
External cephalic version is a technique that decreases the need for cesarean delivery in patients with breech presentation. Several techniques exist to increase the success of external cephalic version; however, there are no studies comparing different tocolytics in patients who also received neuraxial anesthesia. We, therefore, performed a review of 198 patients who presented for external cephalic version and compared their success rates based on the tocolytic medication utilized. The external cephalic version success rate for patients who received terbutaline was significantly higher than for those who received nitroglycerin (N [%]: 57 [65.6] terbutaline group versus 40 [36.0] nitroglycerin group; P < .001).