Articles: treatment.
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Anesthesia and analgesia · Dec 2024
ReviewAnesthesiologists' Role in Recognition, Prevention, and Treatment of Childbirth-Related Posttraumatic Stress Disorder.
Childbirth-related posttraumatic stress disorder (CB-PTSD) is increasingly common and consequential for pregnant patients. Throughout the labor experience and beyond, anesthesiologists are central to creating a psychological safe space for patients and play an essential role in preventing, recognizing, and treating CB-PTSD. This narrative review summarizes the current literature surrounding risk factors for CB-PTSD that are relevant to anesthesiologists; patients' symptoms or signs anesthesiologists should look out for; and ways anesthesiologists may be involved in preventing and treating this condition.
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Curr Opin Anaesthesiol · Dec 2024
ReviewMitigating and preventing perioperative opioid-related harm.
Although necessary for treatment of acute pain, opioids are associated with significant harm in the perioperative period and further intervention is necessary perioperatively to mitigate opioid-related harm. ⋯ We will review policy and guidelines regarding perioperative opioid management and identify challenges and future directions to mitigate opioid-related harm.
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Meta Analysis
Lidocaine patch for treatment of acute localized pain in the emergency department: a systematic review and meta-analysis.
Lidocaine patches are commonly prescribed for acute localized pain. Most of the existing evidence is, however, derived from postoperative or chronic pain. The objective of this study is to assess the efficacy and safety of lidocaine patch compared to placebo patch or nonsteroidal anti-inflammatory drugs (NSAIDs) for acute localized pain. ⋯ The risk of adverse events was similar between the groups (risk ratio: 0.90; 95% CI: 0.48-1.67; moderate-quality evidence). In the two trials comparing lidocaine patches with NSAIDs, there was no statistically significant difference in pain relief between the treatments. Low to moderate-quality evidence from small trials supports the efficacy and safety of lidocaine patch for the treatment of acute localized pain.
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Semin Respir Crit Care Med · Dec 2024
Review"SWALLOWING AND ASPIRATION: HOW TO EVALUATE AND TREAT SWALLOWING DISORDERS ASSOCIATED WITH ASPIRATION PNEUMONIA IN OLDER PERSONS".
Aspiration pneumonia (AP) is the most severe complication of oropharyngeal dysphagia (OD). It is highly underdiagnosed and undertreated among older patients hospitalized with community-acquired pneumonia (CAP). Our aim is to review the state of the art in the diagnosis and treatment of swallowing disorders associated with AP. ⋯ The diagnosis of AP must be based on standardized criteria providing evidence on the main etiological factor, oropharyngeal aspiration. Clinical algorithms are valid in the diagnosis of AP and the identification of its main risk factors. Combination of AI-based tools with V-VST can lead to massive screening of OD and save resources and improve efficiency in the detection of AP.
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Semin Respir Crit Care Med · Dec 2024
ReviewIs There a Role for Bronchoscopy in Aspiration Pneumonia?
Aspiration represents the passage of oropharyngeal content to the lower respiratory tract. The interplay between the host and the aspirate proprieties determines the subsequent aspiration syndrome. A low pH, typical of gastric aspirate, favors chemical pneumonitis, whereas an increased bacterial inoculum causes aspiration pneumonia. ⋯ Invasive microbiological studies increase diagnostic yield and enable a tailored antibiotic treatment. In conjunction with stewardship programs, invasive sampling and novel molecular diagnostics can decrease the amount of inappropriate antibiotic therapy. In the context of foreign body aspiration, bronchoscopy represents both diagnostic and treatment gold standard.