Articles: adult.
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Review Practice Guideline
Preoperative assessment of adults undergoing elective noncardiac surgery: Updated guidelines from the European Society of Anaesthesiology and Intensive Care.
When considering whether a patient is fit for surgery, a comprehensive patient assessment represents the first step for an anaesthetist to evaluate the risks associated with the procedure and the patient's underlying diseases, and to optimise (whenever possible) the perioperative surgical journey. These guidelines from the European Society of Anaesthesiology and Intensive Care Medicine (ESAIC) update previous guidelines to provide new evidence on existing and emerging topics that consider the different aspects of the patient's surgical path. ⋯ Each patient should have a tailored assessment of their fitness to undergo procedures requiring the involvement of an anaesthetist. The anaesthetist's role is essential in this phase to obtain a broad vision of the patient's clinical conditions, to coordinate care and to help the patient reach an informed decision.
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Meta Analysis
Percutaneous Electrical Stimulation Improves Chronic Knee Pain and Function. A Systematic Review and Meta-analyses.
The aim of this systematic review and meta-analysis was to evaluate the effectiveness of percutaneous electrical stimulation in the modulation of pain and its implication in the function of patients with a painful knee condition. ⋯ This review showed a positive effect of applying the percutaneous electrical stimulation for reducing pain and improving function in adults with a painful knee.
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A recent Lancet Commission raised concerns about the management of child and adolescent pain. We aimed to undertake a comprehensive review of qualitative research to understand children and adolescent pain experiences across contexts. We used the 7 stages of meta-ethnography to synthesise findings. ⋯ We report 6 themes focusing on transition to adulthood: (1) I want to stay within the safety of home; (2) don't exclude me from my own care; (3) it might hurt but it's for my own good; (4) I rely on others but I want some independence; (5) I am no longer a child but I am not an adult yet; and (6) I wasn't prepared for the transfer to adult health care. Our findings focus on the complex transition into adulthood and the importance of creating a genuine healthcare partnership with young people by acknowledging their perspectives, creating a safe and supportive environment, and preparing them for the transition to adult pain care. Arts-based methods have the potential to make findings from qualitative evidence syntheses accessible and impactful for compassionate health care.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Review Meta AnalysisHemodynamic Impact of the Trendelenburg Position: A Systematic Review and Meta-analysis.
To systematically evaluate the impact of the Trendelenburg position on hemodynamic parameters in adult patients. ⋯ The Trendelenburg position significantly increases stroke volume and improves multiple hemodynamic parameters in adult patients. These results confirm the position's potential clinical relevance in hemodynamic management and suggest the possibility of a tailored application in selected clinical settings. The duration of the beneficial effects of the Trendelenburg position and the possible side effects should be the focus of further investigation.
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J Neurosurg Anesthesiol · Jan 2025
ReviewPerioperative Methadone for Spine Surgery: A Scoping Review.
Complex spine surgery is associated with significant acute postoperative pain. Methadone possesses pharmacological properties that make it an attractive analgesic modality for major surgeries. This scoping review aimed to summarize the evidence for the perioperative use of methadone in adults undergoing complex spine surgery. ⋯ On the basis of the available literature, methadone has been associated with reduced postoperative pain scores and reduced postoperative opioid consumption. Though safety concerns have been raised by observational studies, these have not been confirmed by prospective randomized studies. Further research is required to explore optimal methadone dosing regimens, the potential synergistic relationships between methadone and other pharmacological adjuncts, as well as the potential long-term antinociceptive benefits of perioperative methadone administration.