BMC anesthesiology
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Randomized Controlled Trial Multicenter Study
The prevention of delirium in elderly surgical patients with obstructive sleep apnea (PODESA): a randomized controlled trial.
Obstructive sleep apnea (OSA) is associated with neurocognitive impairment - a known risk factor for postoperative delirium. However, it is unclear whether OSA increases the risk of postoperative delirium and whether treatment is protective. The objectives of this study were to identify OSA with a home sleep apnea test (HSAT) and to determine whether auto-titrating positive airway pressure (APAP) reduces postoperative delirium in older adults with newly diagnosed OSA undergoing elective hip or knee arthroplasty. ⋯ We had an unexpectedly low rate of postoperative delirium thus we were unable to determine if postoperative delirium was reduced in older adults with newly diagnosed OSA receiving APAP vs. those who did not receive APAP after elective knee or hip arthroplasty.
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Observational Study
Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study.
Intraoperative hyperglycemia has been associated with multiple postoperative complications such as surgical site infection, myocardial infarction, stroke, and death. These complications are not confined to only diabetic patients. However, the incidence of intraoperative hyperglycemia in non-diabetic patients has not been fully elucidated. Additionally, these patients' risk factors were not well established in previous studies. ⋯ The incidence of intraoperative hyperglycemia was significant in non-diabetic patients during intermediate- to high-risk surgery. Risk factors should be identified to prevent intraoperative hyperglycemia.
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This study aimed to investigate the effects of morning and afternoon surgeries on the early postoperative sleep function in patients undergoing general anesthesia. ⋯ Both morning and afternoon surgeries have significant impacts on the sleep function in patients undergoing general anesthesia, while afternoon surgery has a more serious impact on sleep function.
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The objective of this study was to compare analgesic efficacy of erector spinae plane block(ESPB) and thoracic paravertebral block(TPVB) combined with intercostal nerve block(ICNB) after video assisted thoracoscopic surgery(VATS). ⋯ The present randomized trial showed that the analgesic effect of TPVB + ICNB was superior to that of INCB after VATS, the analgesic effect of ESPB was equivalent to that of TPVB and ICNB.
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Postoperative major adverse cardiovascular events (MACEs) account for more than one-third of perioperative deaths. Geriatric patients are more vulnerable to postoperative MACEs than younger patients. Identifying high-risk patients in advance can help with clinical decision making and improve prognosis. This study aimed to develop a machine learning model for the preoperative prediction of postoperative MACEs in geriatric patients. ⋯ In this prospective study, we developed machine learning models for preoperative prediction of postoperative MACEs in geriatric patients. The XGB model showed the best performance. Undersampling method achieved further improvement of model performance.