Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jan 2021
Randomized Controlled TrialPectointercostal Fascial Block (PIFB) as a Novel Technique for Postoperative Pain Management in Patients Undergoing Cardiac Surgery.
To determine the efficacy of pectointercostal fascial block in relieving postoperative pain in patients undergoing cardiac surgery. ⋯ Pectointercostal fascial block is an easy and efficient technique to reduce postoperative pain after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Jan 2021
Meta AnalysisComparison of Hemodynamic Responses to Administration of Vasopressin and Norepinephrine Under General Anesthesia: A Systematic Review and Meta-analysis of Randomized Controlled Trials with Trial Sequential Analysis.
The authors performed a meta-analysis to determine if vasopressin improves hypotension more than norepinephrine under general anesthesia. ⋯ Vasopressin did not improve hypotension compared with norepinephrine under general anesthesia. The RIS was not reached in TSA, and Grading of Recommendations Assessment, Development and Evaluation is very low. Therefore, further research is needed to reach more robust conclusions.
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J. Cardiothorac. Vasc. Anesth. · Jan 2021
Case ReportsIntraoperative Off-Label Reversal of Apixaban by Andexanet Alfa while on VA-ECMO Immediately After Emergent Surgery for Acute Type A Aortic Dissection.
The authors report a case of intraoperative reversal of apixaban with andexanet alfa in a patient supported with venoarterial extracorporeal membrane oxygenation due to low- cardiac-output immediately after surgery for acute type A aortic dissection and massive intraoperative transfusion with administration of procoagulants. In this patient, andexanet alfa's off-label use was not associated with acute thrombotic complications despite being given during extracorporeal life support and after previous administration of prothrombin complex concentrates.
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J. Cardiothorac. Vasc. Anesth. · Jan 2021
ReviewAnesthetic Considerations for Patients With Williams Syndrome.
Williams syndrome (WS) is a relatively rare congenital disorder which manifests across multiple organ systems with a wide spectrum of severity. Cardiovascular anomalies are the most common and concerning manifestations of WS, with supravalvar aortic stenosis present in up to 70% of patients with WS. ⋯ This increased risk coupled with a disproportionately frequent need for anesthetic care renders it prudent for the anesthesiologist to have a firm understanding of the manifestations of WS. In the following review, the authors discuss pertinent clinical characteristics of WS along with particular anesthetic considerations for the anesthesiologist caring for patients with WS presenting for non-cardiac surgery.