Journal of clinical anesthesia
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According to the 2015 National Survey on Drug Use and Health, marijuana continues to be the most common illicit recreational drug used in the US. Cannabis is associated with systemic reactions that potentially affect perioperative outcomes. We have reviewed the most important pharmacological aspects and pathophysiological effects that should be considered during the perioperative management of chronic cannabis/cannabinoids users. ⋯ Severe vascular complications associated with cannabis exposure may include malignant arrhythmias, coronary spasm, sudden death, cerebral hypoperfusion and stroke. Bronchial hyperreactivity and upper airway obstruction are commonly reported in cannabis users. Postoperative hypothermia, shivering and increased platelet aggregation have been also documented.
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Review Meta Analysis
Depth of anesthesia measured by bispectral index and postoperative mortality: A meta-analysis of observational studies.
Whether anesthesia depth affects postoperative mortality remains uncertain. ⋯ We observed a significant relationship between deep anesthesia and long-term mortality, though this was not significant 30 days following surgery. In patients who had received cardiac surgery, deep anesthesia may increase mortality. However, this trend was not observed in patients who had undergone other forms of surgery.
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Review Meta Analysis
Depth of anesthesia measured by bispectral index and postoperative mortality: A meta-analysis of observational studies.
Whether anesthesia depth affects postoperative mortality remains uncertain. ⋯ We observed a significant relationship between deep anesthesia and long-term mortality, though this was not significant 30 days following surgery. In patients who had received cardiac surgery, deep anesthesia may increase mortality. However, this trend was not observed in patients who had undergone other forms of surgery.
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Review Comparative Study
Cognitive impairment and postoperative outcomes in patients undergoing primary total hip arthroplasty: A systematic review.
Total hip arthroplasty (THA) is a common surgical procedure in the elderly. Varying degrees of cognitive impairment (CI) are frequently seen in this patient population. To date, there has been no systematic review of the literature specifically examining the impact of CI on outcomes after elective THA. The aim of this systematic review was to identify studies that compare the postoperative outcomes of patients with and without CI after undergoing elective primary THA. ⋯ We demonstrate that there are strong associations between patients with pre-existing CI undergoing THA and increased POD, hospital mortality, hospital complications, and hospital LOS. We report good quality evidence linking complications after THA to preexisting CI. Screening for CI can improve care and better predict the risk of developing postoperative complications such as delirium. Further investigations can address perioperative factors that can help reduce complications and show the utility of more widespread assessment of preoperative cognitive impairment.
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Review Comparative Study
Cognitive impairment and postoperative outcomes in patients undergoing primary total hip arthroplasty: A systematic review.
Total hip arthroplasty (THA) is a common surgical procedure in the elderly. Varying degrees of cognitive impairment (CI) are frequently seen in this patient population. To date, there has been no systematic review of the literature specifically examining the impact of CI on outcomes after elective THA. The aim of this systematic review was to identify studies that compare the postoperative outcomes of patients with and without CI after undergoing elective primary THA. ⋯ We demonstrate that there are strong associations between patients with pre-existing CI undergoing THA and increased POD, hospital mortality, hospital complications, and hospital LOS. We report good quality evidence linking complications after THA to preexisting CI. Screening for CI can improve care and better predict the risk of developing postoperative complications such as delirium. Further investigations can address perioperative factors that can help reduce complications and show the utility of more widespread assessment of preoperative cognitive impairment.