Journal of clinical anesthesia
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To determine whether obesity status is associated with perioperative complications, discharge outcomes and hospital length of stay in older surgical patients. ⋯ Obesity class 2-3 status has prognostic value in predicting an increased incidence of postoperative complications, increased hospital LOS, and non-home discharge location. These results have important clinical implications for preoperative informed consent and provide areas to target for care improvement for the older obese individual.
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Delirium is a highly relevant complication of surgical interventions. Current research indicates that despite increased awareness for delirium, it is often overlooked. ⋯ This appears to be a promising approach to improve detection of delirium, especially for underrecognized forms and in peripheral wards without intensive screening. We present a case in which the AI identified delirium, confirmed by our routine screening and specialist evaluation.
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Rising rates of obesity and outpatient performance of parathyroidectomies are making it increasingly crucial to investigate the association of obesity with post-operative complications. ⋯ There is no significant difference in rates of same-day admission or 30-day readmission between any Class 3 (BMI ≥40 kg/m2) obesity cohort and the Class 1 and 2 (BMI ≥30 and < 40 kg/m2) reference cohort following outpatient parathyroidectomy. This corroborates the notion that BMI classes cannot be used in a vacuum to determine eligibility for outpatient parathyroidectomy - a concept that can guide safe and cost-effective institutional practices.
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Letter Case Reports
Effectiveness of liposomal bupivacaine in adductor canal blocks for pediatric knee procedures: A case series.
Adductor canal block (ACB) using liposomal bupivacaine (LB) has been shown to be effective in achieving prolonged postoperative pain control for knee procedures in adults. However, published literature on the use of ACB with LB in pediatric patients continues to be lacking. We present a case series on the effectiveness of ACB using LB in achieving extended postoperative pain control for pediatric patients undergoing knee surgeries. Our patients reported at least 96 h of pain relief with zero postoperative opioid requirements and no major adverse reactions from LB.
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To describe how the introduction of an Objective Structured Clinical Examination (OSCE) by the American Board of Anesthesiology (ABA) to its initial certification impacted anesthesiology residencies in the United States. ⋯ The introduction of the OSCE by the ABA for board certification has affected the curriculum of many residencies. Approximately 3 in 5 program directors perceived the ABA OSCE measures skills essential to anesthesiologists' practice. Future studies should assess residency graduates' perspective on the usefulness of both mock OSCE preparation and the ABA OSCE, and whether the ABA OSCE performance predicts future clinical practice.