Articles: general-anesthesia.
-
Randomized Controlled Trial Multicenter Study
The safety of addition of nitrous oxide to general anaesthesia in at-risk patients having major non-cardiac surgery (ENIGMA-II): a randomised, single-blind trial.
Nitrous oxide use in non-cardiac surgery does not increase the risk of death, cardiovascular complications or wound infection.
pearl -
Anesthesia and analgesia · Oct 2014
Multicenter StudyThe Safety of Modern Anesthesia for Children with Long QT Syndrome.
Patients with long QT syndrome (LQTS) may experience a clinical spectrum of symptoms, ranging from asymptomatic, through presyncope, syncope, and aborted cardiac arrest, to sudden cardiac death. Arrhythmias in LQTS are often precipitated by autonomic changes. This patient population is believed to be at high risk for perioperative arrhythmia, specifically torsades de pointes (TdP), although this perception is largely based on limited literature that predates current anesthetic drugs and standards of perioperative monitoring. We present the largest multicenter review to date of anesthetic management in children with LQTS. ⋯ With optimized perioperative management, modern anesthesia for incidental surgery in patients with LQTS is safer than anecdotal case report literature might suggest. Our series suggests that the risk of perioperative TdP is concentrated in neonates and infants requiring urgent interventions after failed first-line management of LQTS.
-
Multicenter Study Comparative Study
Hemodynamic changes in patients undergoing carotid endarterectomy under cervical block and general anesthesia.
The objective of this study was to assess differences in hemodynamic stability for patients undergoing carotid endarterectomy (CEA) under general anesthesia (GA) as compared with cervical block anesthesia (CBA). ⋯ For patients undergoing CEA, CBA resulted in less hemodynamic fluctuations and fewer intraoperative vasoactive medication requirements as compared with GA.
-
Multicenter Study
Predictors of Functional Outcome after Intraoperative Cardiac Arrest.
Few outcome data are available about intraoperative cardiac arrest (IOCA). The authors studied 90-day functional outcomes and their determinants in patients admitted to the intensive care unit after IOCA. ⋯ By day 90, 45% of IOCA survivors had good functional outcomes. The main outcome predictors were directly related to IOCA occurrence and postcardiac arrest syndrome; they suggest that the intensive care unit management of postcardiac arrest syndrome may be amenable to improvement.
-
Randomized Controlled Trial Multicenter Study
High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial.
High intraoperative PEEP and recruitment manoeuvres during open abdominal surgery do not protect against post-op pulmonary complications, though are associated with intraoperative hypotension.
pearl