Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Mar 2025
Review Meta AnalysisHigh-dose glucocorticoids in the treatment of postoperative pain after video-assisted thoracoscopic surgery-protocol for systematic review and meta-analysis.
Video-assisted thoracoscopic surgery (VATS) is widely used in lung cancer surgery, as this technique causes less pain and faster recovery than open thoracotomy. However, significant postoperative pain persists in a number of patients, often leading to increased opioid use and opioid-related adverse events in addition to prolonged admission times. Perioperatively administered glucocorticoids have been demonstrated effective in reducing pain after other types of surgeries, but the effect in VATS remains unclear. ⋯ This systematic review and meta-analysis will provide an overview of the current evidence of how glucocorticoids affect postoperative pain and recovery in adult patients undergoing VATS.
-
Acta Anaesthesiol Scand · Mar 2025
Randomized Controlled Trial Comparative StudyComparison of plasma concentration and sedative effect of sublingual and intranasal dexmedetomidine in children: A double-blind randomised controlled study.
Pharmacokinetics and sedative effects of sublingual dexmedetomidine have not been established in children. The primary aim was to compare peak plasma concentration, time to reach peak plasma concentration and area under the curve with 2 μg/kg sublingual and intranasal dexmedetomidine. The secondary aims were to compare the depth of sedation, parental separation anxiety, mask acceptance, heart rate changes, analgesic requirements and recovery time with 2 μg/kg sublingual and intranasal dexmedetomidine in children. ⋯ This study compared the pharmacokinetics and sedative effects of sublingual versus intranasal dexmedetomidine in children, finding that intranasal administration resulted in significantly higher peak plasma concentration and faster time to peak concentration. Both routes achieved comparable sedation, parental separation anxiety scores and mask acceptance, with no significant adverse effects observed.
-
Acta Anaesthesiol Scand · Mar 2025
Randomized Controlled Trial Comparative StudyIntubating conditions during rapid sequence induction with either rocuronium or suxamethonium in elderly patients. A randomised study.
During rapid sequence induction, either rocuronium 1.0 mg kg-1 or suxamethonium 1.0 mg kg-1 can be administered to facilitate endotracheal intubation. We hypothezised that rocuronium provided a larger proportion of excellent intubating conditions compared to suxamethonium in elderly patients. ⋯ This reports a superiority trial comparing standardised doses of rocuronium and suxamethonium at 60 s for quality of intubating conditions in the rapid sequence context, and this in an elderly cohort. The findings showed no difference between the drugs concerning intubation outcomes, though the onset or time to peak effect was shorter for suxamethonium, again demonstrated in a cohort 80 years old or older.
-
Acta Anaesthesiol Scand · Mar 2025
Conus medullaris termination: Assessing safety of spinal anesthesia in the L2-L3 interspace.
Classic teaching is that spinal anesthesia is safe at or below the L2-L3 interspace. To evaluate this, we sought to determine the percentage of individuals with a conus medullaris termination (CMT) level at or below the L1-L2 interspace. Further, the relationship of CMT level to age, sex, body mass index (BMI), and spinal pathology was examined, as was the reliability of using Tuffier's line (TL) as an anatomical landmark. ⋯ Unlike previous smaller studies, this retrospective study included MRI data from a total of 944 patients. The present study confirms that spinal anesthesia at the L2-L3 interspace or below can be considered safe. The findings indicate that Tuffier's line can be used as a reliable anatomical landmark.
-
Acta Anaesthesiol Scand · Mar 2025
What matters to mothers: A qualitative exploration of pain and recovery after cesarean section.
Fast recovery after cesarean section is vital since the mother not only has to take care of herself but also the newborn. Recovery scores are useful tools to measure and compare recovery; however, standardized questionnaires may miss in-depth patient experiences. What is important to women in the postoperative period after cesarean section can vary in different populations, making it crucial to understand the specific needs of one's own population. This study aims to explore what matters most to Danish mothers during the early phase of recovery following elective cesarean section. ⋯ In this qualitative, explorative study, participants were interviewed by telephone 4-7 days following their elective cesarean section. The focus was the women's experience of recovery, pain, and mobilization, both in hospital and when going home. The findings identified a need for more information about the perioperative course, as most participants were surprised and unprepared both for the pain from other areas than the scar and for the surgery experience being unpleasant, and many requested physical rehabilitation plans.