Journal of clinical anesthesia
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Randomized Controlled Trial
The effects of dexamethasone, light anesthesia, and tight glucose control on postoperative fatigue and quality of life after major noncardiac surgery: A randomized trial.
Why is this important?
Post-operative fatigue (POF) is common and has significant effects on post-operative recovery and quality of life.
Past studies have linked post-operative fatigue to the pro-inflammatory effects of surgery and anesthesia. Other studies have suggested anti-inflammatory benefits of steroids, tight glucose control and avoiding deep anesthesia.
What did they do?
Abdelmalak and team randomized 381 patients using a 3-factorial design for the three interventions. 306 patients were analysed for POF outcome.
Surgical interventions covered a wide range of major non-cardiac procedures, with mean surgical length just under 5 hours and 75% of patients being ASA 3 or 4.
And they found?
No difference for any of the interventions for either fatigue or quality of life.
Hang on...
While it may be that post-operative inflammation is not the causative factor for POF, more likely the study interventions had insufficient impact on inflammation to change fatigue outcomes.
For minor and moderate surgery of shorter duration in lower-acuity patients (ASA 1 & 2) who have experienced significant POF previously, these simple interventions may still be beneficial.
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Multicenter Study Observational Study
Incidence, risk factors, and consequences of residual neuromuscular block in the United States: The prospective, observational, multicenter RECITE-US study.
Residual neuromuscular block is common at the time of extubation, occurring in up to two thirds of patients in the absence of quantitative neuromuscular monitoring.
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Letter Case Reports Comparative Study
Selection of anesthesia for lower extremity surgery of patients with Proteus Syndrome.
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Letter Case Reports
Virtual reality use in adult ICU to mitigate anxiety for a patient on V-V ECMO.
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Evaluate feasibility of 1-day OR management course for anesthesiology residents and determine if course content increases trust in OR management science. ⋯ The 1-day course increases resident trust in OR course management content. Participants with less pre-course confidence in statistical application and decision making had greater increases in trust.