Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Retracted Publication
Thoracolumbar interfascial plane block provides effective perioperative pain relief for patients undergoing lumbar spinal surgery; a prospective, randomized and double blinded trial.
Background: Although bilateral ultrasound-guided thoracolumbar interfascial plane (TLIP) block provides effective analgesia to the lumbar spinal region, a few previous studies for the TLIP block have only been reported up to the present. We aimed to study whether the TLIP block in combination with general anesthesia would provide more effective pain relief compared to general anesthesia alone. ⋯ Bilateral TLIP block combined with general anesthesia provides more effective perioperative pain relief than that provided by general anesthesia alone in patients who undergo lumbar spinal surgery.
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To identify modifiable preoperative factors that might influence the morbidity and mortality associated with non-elective, inpatient hip fracture surgeries in the geriatric surgical population. ⋯ Hip fractures remain a major source of morbidity in geriatric patients. Baseline dementia and inability to sign surgical consent are significant risk factors for adverse outcomes after hip fractures and should be considered in the informed consent process. Data from this study and currently ongoing randomized trials will help guide reductions in morbidity and mortality in this population.
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The LACE index (Length of stay, admission Acuity, Charlson comorbidity index, and Emergency department visits within 6 months of current admission) is a practical tool designed to predict the risk of readmission or mortality within 30 days of hospital discharge. We sought to validate and examine its performance in a large surgical population at both the preoperative assessment and discharge time points. ⋯ The LACE model for surgical and procedural admissions had good discrimination and adequate calibration. Analysis of the model applied to surgical admissions using ELOS demonstrated slightly better overall performance than ALOS, suggesting that LACE could be utilized for readmission risk stratification at the time of preoperative assessment. Clinical Trial and Registry URL: Not applicable.
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Review Meta Analysis
The effectiveness of BIS monitoring during electro-convulsive therapy: A systematic review and meta-analysis.
Electroconvulsive therapy (ECT) has been shown to be highly effective in patients suffering from treatment-resistant depression. ECT procedure is performed under general anesthesia but the impact of anesthesia depth on seizure characteristics and clinical outcome remains unclear. We aimed to study the effects of BIS monitoring on electric and clinical response to ECT treatment. ⋯ High values of pre-ictal BIS are associated with improved seizure duration. The usefulness of systematic BIS monitoring during all ECT procedures should be further studied to better identify adequate BIS levels according to patient's characteristics.
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Observational Study
Platelet function, but not thrombin generation, is impaired in acute normovolemic hemodilution (ANH) blood.
We investigated the coagulation changes that might occur in acute normovolemic hemodilution (ANH) blood over several hours during cardiac surgery requiring cardiopulmonary bypass. ⋯ Little data exists regarding the quality of coagulation factors in autologous blood. Our study confirms ANH collection results in decreased platelet aggregation with TRAP stimulation; however, this is not appreciated with ADP stimulation. Thrombin generation capacity remains preserved.