Articles: general-anesthesia.
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Comparative Study
The effect of general versus spinal anesthesia on perioperative innate immune function in patients undergoing total hip arthroplasty.
Increasing evidence shows that postoperative innate immune dysregulation is associated with delayed recovery and infectious complications. The aim of this study was to compare the effects of general versus spinal anesthesia on innate immune function during and after total hip arthroplasty (THA). ⋯ General anesthesia has a transient impact on innate immune function in patients undergoing THA, but the clinical significance of anesthesia-induced innate immune dysregulation might be limited as no differences were observed on POD1.
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Randomized Controlled Trial
Remimazolam for the prevention of emergence agitation in adults following nasal surgery under general anesthesia: a prospective randomized clinical controlled trial.
Remimazolam is a novel intravenous sedative/anesthetic drug that belongs to the ultra-short-acting class of benzodiazepines. The purpose of this study was to evaluate the effectiveness of postoperative use of remimazolam in preventing emergence agitation (EA) in adults following nasal surgery. ⋯ Postoperative intravenous infusion of 0.1 mg/kg remimazolam into adult patients undergoing nasal surgery can reduce the incidence of EA and severe EA, and provide stable hemodynamics.
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Anaesth Intensive Care · Jan 2025
The effect of type of anaesthetic on delirium after surgery for acute hip fracture: An instrumental variable analysis to assess causation.
Delirium is the most common in-hospital complication affecting older adults with acute hip fractures. Current evidence demonstrates inconsistent associations between anaesthetic type for acute hip fracture surgery and postoperative delirium. Using the Australian and New Zealand Hip Fracture Registry database, we conducted a retrospective cohort study of patients aged 50 years and over who underwent acute hip fracture surgery between 2015 and 2020. ⋯ After adjusting for known confounders, general anaesthesia patients were at slightly increased odds of developing delirium (OR 1.14, 95% CI 1.04 to 1.25, P = 0.0052). However, the instrumental variable analysis found no statistically significant difference between groups (OR 1.03, 95% CI 0.99 to 1.07, P = 0.141). Therefore, while a weak association was found between general anaesthesia exposure and postoperative delirium, an instrumental variable analysis to compensate for unmeasured confounding showed no causal association between general anaesthesia and postoperative delirium.
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J Neurosurg Anesthesiol · Jan 2025
Radiographic Predictors of Difficult Fiberscopic Intubation During General Anesthesia in Patients With a Cervical Collar to Simulate a Difficult Airway.
Predictors of difficult fiberscopic intubation have not been fully elucidated. This study focused on identifying radiographic predictors of difficult fiberscopic intubation during general anesthesia in patients with a cervical collar. ⋯ High tongue area/oral cavity area and long skin-glottis distance were predictive of difficult fiberscopic intubation during general anesthesia in patients with a cervical collar.
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Review Meta Analysis Comparative Study
The impact of spinal versus general anesthesia on the variability of surgical times: a systematic review and meta-analysis.
With spinal anesthesia, when cases are taking longer than usual, there may be behavioural tendencies for surgical teams to work more quickly. We conducted a systematic review with meta-analysis to examine standard deviations of surgical times for single-dose spinal anesthetics versus general anesthesia. We compared ratios of mean surgical times as a secondary endpoint. ⋯ PROSPERO ( CRD42023461952 ); first submitted 8 September 2023.