Acta anaesthesiologica Scandinavica
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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.
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Acta Anaesthesiol Scand · Mar 2025
Observational StudyAdverse event signal analysis of remimazolam using the FDA adverse event reporting system database.
Remimazolam, a novel ultra-short-acting benzodiazepine, has gained popularity in various anesthetic applications due to its pharmacokinetic advantages. However, as its use increases, safety concerns also rise, necessitating thorough examination. Additionally, the limited reports on its side effects require a broader investigation to better understand the drug's safety profile. ⋯ This study analyzed adverse drug events (ADEs) associated with remimazolam using the FAERS database, identifying serious safety signals like allergic reactions, respiratory and cardiac arrests, and vascular access site occlusions, especially in older patients. The findings highlight the need for vigilant monitoring, cautious off-label use, and ongoing post-marketing surveillance.
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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.
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Acta Anaesthesiol Scand · Feb 2025
Recovery trajectories after major abdominal surgery: A retrospective pooled cohort study.
Recovery from major surgery can be difficult to predict given the many factors involved in treating disease and restoring preoperative function. Postoperative recovery metrics such as length of stay, complications, and mortality are typically described. However, large data quantities for patient-reported recovery are scarce. In this retrospective study, we aimed to describe the multidimensional recovery trajectory of patients undergoing major abdominal surgery 4-8 weeks after surgery and explore factors related to incomplete overall recovery. ⋯ Major surgical procedures are often followed by a lengthy and difficult recovery period. Traditional measures such as mortality and complications are usually analysed, but this 653-patient study investigated patient-reported recovery scores after major abdominal surgery. Novel findings include that only 42% of patients have recovered fully in all recovery domains at weeks 4-8, and these patients also had longer hospital stays. Preoperative risk factors were analysed for associations with recovery trajectories.
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Acta Anaesthesiol Scand · Feb 2025
Invasive mechanical ventilation strategies, adjuvants treatments and adverse events among ICU patients with COVID-19 in Denmark.
To describe the use of invasive mechanical ventilation core strategies, adjuvant treatments and the occurrence of barotrauma and prolonged ventilation in ICU patients with COVID-19 in Denmark, retrospectively. ⋯ Lung protective ventilation and prone positioning were used in many of the Danish ICU patients with COVID-19, but barotrauma, prolonged ventilation and death occurred frequently.