Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2025
Randomized Controlled TrialGastric ultrasound assessment of two preoperative fasting regimens in pediatric patients: A randomized clinical trial.
Preoperative fasting aims to reduce the risk of pulmonary aspiration. Our aim was to compare the incidence of increased gastric content after preoperative liberal versus a standard fasting in children. ⋯ Prolonged preoperative fasting may be unnecessary. The 6-4-0 fasting regimen can be applied to pediatric patients before elective surgeries without increasing the incidence of "at risk stomach," but further studies with larger sample size are needed to confirm these results.
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Acta Anaesthesiol Scand · Nov 2024
Randomized Controlled TrialEffect of individualized anesthesia and analgesia on postoperative pain in patients stratified for pain sensitivity: A study protocol for the PeriOPerative individualization trial randomized controlled trial.
Despite advancements in surgical and anesthesia techniques, acute and persistent postoperative pain are still a common challenge. Postoperative pain has direct effects on individual patient care and outcome, as well as putting strain on limited health care resources. Several prediction methods for postoperative pain have been described. One such method is the assessment of pain during peripheral venous cannulation (VCP). It is not known if different approaches to anesthesia and analgesia, depending on the evaluation of risk for postoperative pain, can improve outcome. The aim of this study is to evaluate if individualized anesthesia and analgesia can affect postoperative pain and recovery after surgery, in patients stratified by VCP. ⋯ Individualized perioperative pain management has the potential to improve patient care. This study will examine the impact of different anesthesia and analgesia regimes, in patients with differing pain sensitivity, on postoperative pain.
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Acta Anaesthesiol Scand · Oct 2024
Randomized Controlled TrialPerioperative association between c-reactive protein, pain catastrophizing and acute pain after total knee arthroplasty: A secondary analysis of two randomised trials.
Total knee arthroplasty is associated with an inflammatory response and high levels of pain in a subset of patients. Pain catastrophizing has been associated with acute postoperative pain. The association between these variables has not been investigated in an optimised fast-track setup including preoperative glucocorticoids. The aim of this study was, first, to investigate the correlation between the increase in postoperative c-reactive protein (CRP) and acute postoperative pain after total knee arthroplasty, and second, to investigate the correlation between the increase in CRP and preoperative pain catastrophizing. ⋯ There was no association between the postoperative CRP response and postoperative acute pain or pain catastrophizing in patients undergoing total knee arthroplasty in a well-defined multimodal fast-track regime including preoperative glucocorticoids. These results suggest that acute pain after knee arthroplasty is not reflected by CRP when applying preoperative glucocorticoids.
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Acta Anaesthesiol Scand · Oct 2024
Randomized Controlled Trial Comparative StudyCocaine versus xylometazoline to prevent epistaxis after nasotracheal intubation: A randomized trial.
Nasotracheal intubation is associated with a risk of epistaxis. Several drugs, including cocaine and xylometazoline may be used as decongestants prior to nasotracheal intubation to prevent this. We hypothesized that xylometazoline would prevent epistaxis more effectively than cocaine, demonstrated by a lower proportion of patients with bleeding after nasotracheal intubation. ⋯ We found no statistically significant difference between cocaine and xylometazoline in preventing epistaxis after nasotracheal intubation, and the choice of vasoconstrictor should be based on other considerations, such as pricing, availability and medicolegal issues.
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Acta Anaesthesiol Scand · Oct 2024
Randomized Controlled TrialAssociations between enteral nutrition and outcomes in the SUP-ICU trial: Results of exploratory post hoc analyses.
Enteral nutrition may affect risks of gastrointestinal bleeding, pneumonia and mortality in critically ill patients and may also modify the effects of pharmacological stress ulcer prophylaxis. We undertook post hoc analyses of the stress ulcer prophylaxis in the intensive care unit trial to assess for any associations and interactions between enteral nutrition and pantoprazole. ⋯ Enteral nutrition was associated with an increased risk of pneumonia and a reduced risk of gastrointestinal bleeding. The interaction between pantoprazole and enteral nutrition suggesting an increased risk of mortality requires further study.