Journal of clinical anesthesia
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Review Meta Analysis Comparative Study
Meta-analysis of the effect of central neuraxial regional anesthesia compared with general anesthesia on postoperative natural killer T lymphocyte function.
To compare the effect of central neuraxial (spinal or epidural) anesthesia with general anesthesia on postoperative natural killer (NK) T lymphocyte function. ⋯ Anesthetic technique does not appear to significantly affect postoperative NK T lymphocyte function. Given the heterogeneity observed, further clinical studies in cancer patients of the effect of anesthetic technique on immune function in general, and NK T lymphocyte function in particular, are needed.
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There is rapidly increasing prevalence of obesity throughout Western societies and increasing numbers of patients undergoing surgery are obese. Obesity is a condition of chronic systemic inflammation and is associated with an increased burden of comorbidities. Despite traditional teaching, obesity may not be an independent risk factor for poor postoperative outcomes. The Obesity Paradox describes the observation that small amounts of excess body fat may be protective against postoperative complications.
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Lung transplantation has become an accepted option for many patients with end-stage pulmonary diseases. Anesthesia and surgery following lung transplantation may be required for various diseases that may affect both systemic organs and the transplanted graft. When a patient with a lung transplant undergoes surgery, there is the potential for interference with lung function, depending on the type of intervention and its anatomical site. Accurate preoperative evaluation, an understanding of the physiology of the transplanted lung, proper airway instrumentation, individualized management of intraoperative ventilation, and fluid balance are essential for a positive perioperative outcome.
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von Willebrand disease (VWD) is the most common hereditary bleeding disorder in humans, with an estimated prevalence of 0.5% to 1%. Patients with VWD are at increased risk of perioperative bleeding complications. This review provides an evidence-based overview of VWD and its management during the perioperative period.
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Carcinoid tumors are uncommon, slow-growing neoplasms. These tumors are capable of secreting numerous bioactive substances, which results in significant potential challenges in the management of patients afflicted with carcinoid syndrome. Over the past two decades, both surgical and medical therapeutic options have broadened, resulting in improved outcomes. The pathophysiology, clinical signs and symptoms, diagnosis, treatment options, and perioperative management, including anesthetic considerations, of carcinoid syndrome are presented.