Journal of clinical anesthesia
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Review Meta Analysis
The effect of magnesium sulfate on emergence agitation in children undergoing general anesthesia: A systematic review and meta-analysis.
Emergence agitation (EA) is a common complication in pediatric patients after general anesthesia. The effectiveness of magnesium sulfate in decreasing the incidence of EA in children remains controversial. Therefore, a systematic review and meta-analysis was performed to assess the efficacy of magnesium sulfate in preventing EA in pediatric patients following general anesthesia. ⋯ Administration of magnesium sulfate during general anesthesia did not affect the occurrence of EA in pediatric patients. However, magnesium sulfate can prolong the emergence time without adverse effects. PROSPERO registration number: CRD42021252924.
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Hospital administrators often seek to increase operating room (OR) elective caseload. Previous studies from Iowa demonstrated that surgical growth is mostly from low-caseload surgeons (ie, ≤2 cases per week). We repeated that study using data from Florida, a much more populous state, to confirm the generalizability of the findings. ⋯ Surgical growth in elective surgery at Florida hospitals accrued mostly from the increased activity of low-caseload surgeons averaging ≤2.0 cases per week during the preceding year, confirming the generalizability of the previous Iowa study. If growth in caseload is desired, surgical governance committees should ensure that low-caseload surgeons have access to the OR schedule.
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Randomized Controlled Trial
The effect of delirium preventive measures on the occurrence of postoperative cognitive dysfunction in older adults undergoing cardiovascular surgery. The DelPOCD randomised controlled trial.
This trial examines the effect of delirium preventive measures on the incidence of postoperative cognitive dysfunction in older adults. ⋯ These findings suggest that an intervention combining specific measures extracted from established postoperative delirium prevention programs did not reduce the rate of postoperative cognitive dysfunction in older adults.
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Multicenter Study Observational Study
Comparison of neuromuscular block measured by compressomyography at the upper arm and electromyography at the adductor pollicis muscle in obese and non-obese patients: An observational study.
Quantitative neuromuscular monitoring is traditionally evaluated at the adductor pollicis muscle. By contrast, the TOF-Cuff compressomyograph evaluates neuromuscular block (NMB) at the upper arm. However, compressomyography has not been fully validated against other monitoring entities. This study evaluates the agreement between NMB measured by compressomyography at the upper arm and electromyography at the adductor pollicis muscle during various levels of neuromuscular block in patients with and without obesity. ⋯ There is variable disagreement between the level of NMB measured at the upper arm by compressomyography and at the adductor pollicis muscle measured by electromyography, throughout the various stages of NMB in obese and non-obese patients. Recovery of NMB on compressomyography preceded recovery on electromyography, which may have consequences for reversal and extubation decisions in clinical practice.