Journal of clinical anesthesia
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Review Meta Analysis
Incidence of preoperative instrumental activities of daily living (IADL) dependence and adverse outcomes in older surgical patients: A systematic review and meta-analysis.
Instrumental activities of daily living (IADLs) are essential to patient function and quality of life after surgery. In older surgical patients, the incidence of preoperative IADL dependence has not been well characterized in the literature. This systematic review and meta-analysis aimed to determine the pooled incidence of preoperative IADL dependence and the associated adverse outcomes in the older surgical population. ⋯ There is a high incidence of IADL dependence in older surgical patients undergoing non-cardiac and cardiac surgery. Preoperative IADL dependence was associated with a two-fold risk of postoperative delirium. Further work is needed to determine the feasibility of using the IADL scale preoperatively as a predictive tool for postoperative adverse outcomes.
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Review Meta Analysis
The effectiveness of supplemental oxygen and high-flow nasal cannula therapy in patients with obstructive sleep apnea in different clinical settings: A systematic review and meta-analysis.
To evaluate the effectiveness of supplemental oxygen therapy and high-flow nasal cannula (HFNC) therapy in patients with obstructive sleep apnea (OSA) in different clinical settings to assess its application to surgical patients in the postoperative setting. ⋯ Oxygen therapy effectively reduces AHI and increases SpO2 in patients with OSA. CPAP is more effective in reducing AHI than oxygen therapy. HFNC therapy is effective in reducing AHI. Although both oxygen therapy and HFNC therapy effectively reduce AHI, more research is needed to draw conclusions on clinical outcomes.
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Meta Analysis
Airway nerve blocks for awake tracheal intubation: A meta-analysis of randomized control trials and trial sequential analysis.
This systematic review and meta-analysis aimed to assess the superiority of airway nerve blocks versus airway anesthesia without nerve blocks for awake tracheal intubation (ATI). ⋯ Based on current published evidence, airway nerve blocks provide better airway anesthesia quality for ATI with a shorter intubation time, better intubation conditions including higher no reaction to placement of the flexible scope and tracheal tube, lower cough or gag reflex during intubation, higher excellent patient satisfaction, and lower overall complications.
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Review Meta Analysis
Validity of non-contact methods for diagnosis of Obstructive Sleep Apnea: a systematic review and meta-analysis.
Obstructive Sleep Apnea (OSA) is associated with increased perioperative cardiac, respiratory and neurological complications. Pre-operative OSA risk assessment is currently done through screening questionnaires with high sensitivity but poor specificity. The objective of this study was to evaluate the validity and diagnostic accuracy of portable, non-contact devices in the diagnosis of OSA as compared with polysomnography. ⋯ Available data indicate contactless methods have high pooled sensitivity and specificity for OSA diagnosis with moderate to high level of evidence. Future research is needed to evaluate these tools in the perioperative setting.
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Meta Analysis
Overall anesthesia department quality of clinical supervision of trainees over a year evaluated using mixed effects models.
Earlier studies of supervision in anesthesiology focused on how to evaluate the quality of individual anesthesiologist's clinical supervision of trainees. What is unknown is how to evaluate clinical supervision collectively, as provided by the department's faculty anesthesiologists. This information can be a metric that departments report annually or use to evaluate the effect of programs on the quality of clinical supervision over time. ⋯ Random effects meta-analysis of percentage incidences of maximum scores is a suitable statistical approach to analyze the daily supervision scores of individual anesthesiologists to evaluate the overall quality of clinical supervision provided to the trainees by the department over a year.