Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Sep 2022
Observational Study"Do not resuscitate" order and end-of-life treatment in a cohort of deceased in a Norwegian University Hospital.
A "Do not resuscitate" (DNR) order implies that cardiopulmonary resuscitation will not be started. Absent or delayed DNR orders in advanced chronic disease may indicate suboptimal communication about disease stage, prognosis, and treatment goals. The study objective was to determine clinical practice and patient involvement regarding DNR and the prevalence of life-prolonging treatment in the last week of life. ⋯ The findings of a high prevalence of life-prolonging treatment in the last week of life and DNR orders being made close to the time of death indicate that decisions about limiting life-prolonging treatment are often postponed until the patient's death is imminent.
-
Acta Anaesthesiol Scand · Sep 2022
A novel technique of ultrasound-guided lateral cutaneous branch of the iliohypogastric nerve block: a cadaveric study.
The lateral cutaneous branch of the iliohypogastric nerve (LCBIN) block combined with the lateral femoral cutaneous, superior cluneal and subcostal nerve blocks has been shown to provide complete anaesthetic coverage for the incisions used for hip arthroplasty. Successful ultrasound-guided selective nerve blocks have been described for these nerves, except for the LCBIN. The objective of this cadaveric study was to determine the position of the LCBIN in order to provide the anatomical basis for an ultrasound-guided nerve block approach. Furthermore, we aimed to evaluate the spread of injected dye after using the ultrasound-guided nerve block approach. ⋯ The present study showed that the LCBIN has a constant location and is sonographically easy visualized in a well-defined anatomical space. Thus, the ultrasound guided LCBIN block may be an alternative to the blind injection technique.
-
Acta Anaesthesiol Scand · Sep 2022
ReviewUse of prokinetic agents in hospitalised adult patients: Protocol for a scoping review.
Gastrointestinal motility is an important contributor to the effective uptake of water and nutrition. However, it is often impaired in acutely ill hospitalised patients. Amongst other indications, prokinetic agents are used to improve GI motility, but the body of evidence is not well described. Accordingly, we aim to systematically describe and explore the body of evidence on the use of prokinetic agents in hospitalised adults. ⋯ The outlined scoping review will provide a summary of the body of evidence on the use, indications, effects and side effects of prokinetic agents in hospitalised adults.
-
Acta Anaesthesiol Scand · Sep 2022
Review Meta AnalysisFraction of Inspired Oxygen During General Anesthesia for Non-Cardiac Surgery: Systematic Review and Meta-Analysis.
Controversy exists regarding the effects of a high versus a low intraoperative fraction of inspired oxygen (FiO2 ) in adults undergoing general anesthesia. This systematic review and meta-analysis investigated the effect of a high versus a low FiO2 on postoperative outcomes. ⋯ In adults undergoing general anesthesia for non-cardiac surgery, a high FiO2 did not improve outcomes including surgical site infections, length of stay, or mortality. However, the certainty of the evidence was assessed as low.
-
Acta Anaesthesiol Scand · Sep 2022
Randomized Controlled TrialChanges in lung aeration and respiratory function after open abdominal surgery: a quantitative magnetic resonance imaging study.
Atelectasis is one of the most common respiratory complications in patients undergoing open abdominal surgery. Peripheral oxygen saturation (SpO2 ) and forced vital capacity (FVC) are bedside indicators of postoperative respiratory dysfunction. The aim of this study was to describe the changes in lung aeration, using quantitative analysis of magnetic resonance imaging (MRI) and the diagnostic accuracy of SpO2 and FVC to detect postoperative atelectasis. ⋯ SpO2 and FVC correlated with the amount of postoperative non-aerated lung volume, showing acceptable diagnostic accuracy in bedside detection of postoperative atelectasis.