Journal of clinical anesthesia
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To analyze the use of neuraxial techniques in total hip or knee arthroplasty patients who previously underwent lumbar spine surgeries. ⋯ Previous lumbar fusion -but not decompression- surgery is associated with lower neuraxial anesthesia in THA/TKA patients, despite its use being universally associated with decreased length of stay. More research is needed to address the importance of neuraxial techniques in patients with prior spine surgery.
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To compare the occurrence of cefazolin perioperative anaphylaxis (POA) in patients with and without a penicillin allergy label (PAL) to determine whether the prevalence of cefazolin POA differs based on the presence of a PAL. ⋯ The prevalence of cefazolin POA does not exhibit significant differences between patients with and without PALs, and notably, the incidence remains remarkably low. Based on these findings, it is advisable to view cefazolin as an acceptable choice for prophylaxis in patients carrying a PAL.
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Observational Study
Association between severe preoperative hearing impairment and postoperative emergence agitation among elderly patients undergoing middle ear surgery.
Hearing impairment is an established independent risk factor for delirium.Whether preoperative hearing impairment is associated with postoperative emergence agitation (POEA) in elderly patients remains unknown. This study aimed to investigate the association between preoperative hearing impairment and POEA in elderly patients undergoing ear surgery. ⋯ Pending confirmative studies, these findings suggest that severe preoperative hearing impairment could serve as an independent predictor of POEA in older patients undergoing middle ear surgery. These results highlight the need for further research to better understand the biomarker and pathogenesis of POEA, leading to identification of targeted interventions of POEA and improvement of postoperative outcomes in patients.
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Increased regulatory requirements for sterilization in recent years have prompted a widespread transition from reusable to single-use laryngoscopes. The purpose of this study was to determine if the transition from metallic reusable to metallic single-use laryngoscopes impacted the performance of direct laryngoscopy at an academic medical center. ⋯ Metallic single-use laryngoscopes were associated with less need for rescue intubation with alternate devices and lower incidence of poor laryngeal view compared to reusable metallic laryngoscopes.
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Observational Study
External validation of a predictive model for reintubation after cardiac surgery: A retrospective, observational study.
Explore validation of a model to predict patients' risk of failing extubation, to help providers make informed, data-driven decisions regarding the optimal timing of extubation. ⋯ Future work is needed to explore how to optimize models before local implementation.