Journal of anesthesia
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Journal of anesthesia · Apr 2022
Review Meta AnalysisEffects of individualized positive end-expiratory pressure combined with recruitment maneuver on intraoperative ventilation during abdominal surgery: a systematic review and network meta-analysis of randomized controlled trials.
Low tidal volume ventilation strategy may lead to atelectasis without proper positive end-expiratory pressure (PEEP) and recruitment maneuver (RM) settings. RM followed by individualized PEEP was a new method to optimize the intraoperative pulmonary function. We conducted a systematic review and network meta-analysis of randomized clinical trials to compare the effects of individualized PEEP + RM on intraoperative pulmonary function and hemodynamic with other PEEP and RM settings. ⋯ The main results showed that IPEEP + RM group was superior to all other groups regarding to both oxygenation index and dynamic compliance. LPEEP group was inferior to LPEEP + RM, MPEEP, MPEEP + RM, and IPEEP + RM in terms of oxygenation index and LPEEP + RM, MPEEP, MPEEP + RM, HPEEP + RM, IPEEP, and IPEEP + RM in terms of dynamic compliance. All comparisons were similar for secondary outcomes. Our analysis suggested that individualized PEEP and RM may be the optimal low tidal volume ventilation strategy at present, while low PEEP without RM is not suggested.
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Journal of anesthesia · Apr 2022
Meta AnalysisUltrasound-guided quadratus lumborum block for postoperative analgesia in renal surgery: a systematic review and meta-analysis of randomized controlled trials.
Quadratus lumborum block (QLB) guided by ultrasound is a novel local block anesthesia technique, which can be used in various surgeries for multimodal analgesia. Its analgesic effectiveness for renal surgery is still uncertain. The aim of this meta-analysis was to assess the postoperative analgesic efficacy of QLB in adult patients undergoing renal surgery. ⋯ PROSPERO Registration CRD42021260821.
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Journal of anesthesia · Apr 2022
Quality of life and mortality among survivors of acute respiratory distress syndrome in South Korea: a nationwide cohort study.
Worsening quality of life (QOL) is an important health issue in acute respiratory distress syndrome (ARDS) survivors. We aimed to investigate the prevalence of worsening QOL among ARDS survivors and their association with mortality. ⋯ At the 1-year follow-up period, one-third of ARDS survivors experienced worsening QOL in South Korea. Specifically, newly acquired disability was associated with a higher risk of 2-year all-cause and respiratory mortality among patients who survived ARDS.
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Journal of anesthesia · Apr 2022
ReviewBayesian statistics in anesthesia practice: a tutorial for anesthesiologists.
This narrative review intends to provide the anesthesiologist with the basic knowledge of the Bayesian concepts and should be considered as a tutorial for anesthesiologists in the concept of Bayesian statistics. The Bayesian approach represents the mathematical formulation of the idea that we can update our initial belief about data with the evidence obtained from any kind of acquired data. It provides a theoretical framework and a statistical method to use pre-existing information within the context of new evidence. ⋯ It starts with a general introduction to the theorem and its related concepts of prior and posterior probabilities. Second, there is an explanation of the basic concepts of the Bayesian statistical inference. Last, a summary of the applicability of some of the Bayesian statistics in current literature is provided, such as Bayesian analysis of clinical trials and PKPD modeling.
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Journal of anesthesia · Apr 2022
Randomized Controlled TrialComparison of clinical effects of meperidine and sufentanil added to 0.5% hyperbaric bupivacaine for spinal anesthesia in patients undergoing cesarean delivery: a randomized controlled trial.
The objective of this study was to compare the effect of adding meperidine or sufentanil to hyperbaric bupivacaine in patients undergoing elective cesarean delivery (CD) under spinal anesthesia. The primary outcome was the first analgesic request time, and secondary outcomes included an analgesic requirement in the first 24 h and intraoperative and postoperative side effects. ⋯ ClinicalTrials.gov (NCT04446715).