Articles: surgery.
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Controlled Clinical Trial
What Are We Transfusing? Evaluating the Quality and Clinical Utility of Intraoperatively Salvaged Red Blood Cells in Spinal Deformity Surgery: A Nonrandomized Controlled Trial.
Intraoperative red blood cell (RBC) salvage is frequently used in contemporary spine surgery, despite clinical concern in its efficacy as a surrogate for blood-banked allogeneic packed RBCs (pRBCs). During spine surgery, salvaged RBCs (sRBCs) are exposed to injurious high-heat electrocautery, prolonged stasis, and abrasive pharmaceuticals, potentially making sRBCs a poor blood substitute. We therefore sought to scientifically and objectively define the quality of sRBCs in the context of complex spine surgery. ⋯ RBCs salvaged during posterior thoracolumbar spine surgery are irreversibly injured, with hemolysis index exceeding Food and Drug Administration and Council of Europe transfusion standards in all samples, questioning their efficacy and safety as a blood substitute.
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Preoperative medical evaluation can minimize inefficiencies and improve outcomes. Thoughtful use of preoperative testing can aid in that effort, but, conversely, indiscriminate testing can detract from it. ⋯ Testing is supported only when clinical indications are present. Particularly in low-risk patients, such as those with an ASA classification of 1 or 2 who are undergoing ambulatory procedures, evidence suggests that preoperative testing fails to reduce the risk of complications.
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To evaluate the short-term surgical outcomes and the reimbursement patterns, after treatment of type 2 odontoid fractures using the anterior or posterior approach. ⋯ In this matched analysis, the anterior approach for type 2 odontoid fractures was superior to the posterior approach. The anterior approach was associated with significantly shorter operation times, hospital stays, fewer transfusions, nonroutine discharges, and higher reimbursements.
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Comparative Study
A Comparison of Palliative Care Perceptions Across Metastatic Spine Patients and the General Population.
Background: Palliative care (PC) has been shown to benefit patients with metastatic cancer by managing symptoms, improving quality of life, and facilitating advance care planning. Despite this, PC is often misunderstood and underutilized. Objective: To deepen our understanding of PC barriers seen among the spine metastasis population. ⋯ Conclusion: MST patients are often referred to PC services due to the extreme symptom burden of their disease. Based on this study, in comparison to the GP, people with MST tended to have a more accurate and well-adjusted perception of the goals and functions of PC. Although reassuring, there remains a high proportion of patients who have no knowledge of PC, and groups erroneously associated PC with hospice status.
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Minerva anestesiologica · Nov 2024
Randomized Controlled TrialEffect of non-invasive bilateral sphenopalatine ganglion block on postoperative pain in patients undergoing septorhinoplasty surgery: a randomized controlled study.
The objective of this study was to assess the impact of preoperative sphenopalatine ganglion block (SPGB) on postoperative pain and assess intraoperative and postoperative analgesic consumption in patients undergoing septorhinoplasty. ⋯ We advocate for the adoption of the noninvasive SPGB method in patients undergoing septorhinoplasty surgery. This approach significantly reduces the need for intraoperative analgesics, alleviates postoperative pain, and reduces the demand for postoperative analgesics. Moreover, it improves the overall surgical experience because of its ease of application, contributing to a more comfortable surgical process.