Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Effects of Neuraxial or General Anesthesia on the Incidence of Postoperative Pulmonary Complications in Patients Undergoing Peripheral Vascular Surgery: A Randomized Controlled Trial.
Postoperative complications after major surgery, especially in vascular procedures, are associated with a significant increase in costs and mortality. Postoperative pulmonary complications (PPCs) have a notable impact on morbidity and mortality. The primary aim of this present study was to evaluate the effects of spinal anesthesia compared with general anesthesia on the incidence of PPCs in patients undergoing lower extremity bypass surgery. ⋯ In this study, spinal anesthesia did not significantly reduce the incidence of PPCs in patients undergoing peripheral vascular surgery compared with general anesthesia. Neuraxial anesthesia may reduce the incidence of hypotension and the need for hemodynamic pharmacological support in patients undergoing peripheral arterial surgery, although further dedicated studies are required to validate these findings.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Adjunctive Fresh Frozen Plasma Versus Adjunctive Cryoprecipitate in Cardiac Surgery Patients Receiving Platelets for Perioperative Bleeding.
This study was designed to assess the relative association between adjunctive fresh frozen plasma (FFP) or adjunctive cryoprecipitate and morbidity and mortality in cardiac surgery patients receiving platelets for perioperative bleeding. ⋯ In cardiac surgery patients receiving platelets for perioperative bleeding, adjunctive FFP was independently associated with greater morbidity and mortality compared with adjunctive cryoprecipitate. These hypothesis-generating findings warrant further prospective investigation.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
ReviewPain Management in Open Abdominal Aortic Aneurysm Repair: Potential Alternatives to Epidural Anesthesia.
Despite significant advances in endovascular techniques, open abdominal aortic aneurysm (AAA) repair continues to play an important role in vascular surgery. Many studies have described the advantages of epidural anesthesia combined with general anesthesia over general anesthesia alone as an analgesic method for open AAA repair. Several recent guidelines have recommended epidural anesthesia as the first option for pain management in open AAA repair. ⋯ Although the efficacy and safety of ultrasound-guided nerve blocks, continuous local wound infiltration, and intravenous administration of lidocaine in open AAA repair have been evaluated in several studies, few studies have evaluated the efficacy of continuous nerve blocks compared with epidural anesthesia. In this article, the authors present a narrative review of pain management techniques used in open AAA repair, focusing on pain management techniques other than epidural anesthesia. Research gaps and the need for further studies on this topic are also discussed.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Sex-Based Differences in Ruptured Abdominal Aortic Aneurysm Management and Outcomes: An Update.
This study aimed to evaluate sex-based differences in outcomes following ruptured abdominal aortic aneurysm (AAA) repair, focusing on mortality, morbidity, and postoperative complications. ⋯ Significant sex-based disparities were found in AAA repair outcomes. Men had higher comorbidity burdens while women presented at an older age with an increased time from symptom onset to repair. These findings support the need for sex-specific guidelines and interventions to improve outcomes for both women and men.