Articles: postoperative.
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Anesthesia and analgesia · Sep 2023
Pro-Con Debate: Should All General Anesthesia Be Done Using Target-Controlled Propofol Infusion Guided by Objective Monitoring of Depth of Anesthesia?
In this Pro-Con commentary article, we discuss whether all general anesthesia should be done using target-controlled propofol anesthesia guided by monitoring of depth of anesthesia. This is an ongoing debate since more than 25 years, representing a scientific, cultural as well as geographical divide in the anesthesia community. The Pro side argues that total intravenous anesthesia causes less postoperative nausea and higher patient satisfaction than anesthesia using volatile anesthetics. ⋯ A well-balanced choice based on the available literature is recommended. The authors recommend careful consideration of advantages and disadvantages of each technique when tailoring an anesthetic to meet patient needs. Where appropriate, anesthesia providers are encouraged to account for unique features of anesthetic drug behavior, patient-reported and observed postoperative outcomes, and economic and environmental considerations when choosing any of the 2 described techniques.
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Paediatric anaesthesia · Sep 2023
Modified technique for endobronchial blocker placement in pediatric patients undergoing thoracic surgery.
One lung ventilation (OLV) in small children can be achieved using an Arndt endobronchial blocker (AEBB), but it presents challenges. OLV during thoracic procedures provides better surgical conditions and postoperative outcomes. ⋯ The described technique allows for fast, safe, and reliable OLV while maintaining the ability to reposition the AEBB.
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To investigate the influence of platelet volume indices (PVI) on postoperative pain and edema in patients undergoing bimaxillary surgery and assessed the associations between PVI parameters and other clinical factors. ⋯ Platelet indices, particularly PLT and PCT levels, were associated with postoperative pain and edema in patients undergoing bimaxillary surgery. These indices have the potential to serve as biomarkers for predicting and managing postoperative complications of orthognathic surgery. Further studies are required to explore the clinical utility and implications of these findings.
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Liposomal bupivacaine is claimed by the manufacturer to provide analgesia for up to 72 h postoperatively. ⋯ There is moderate level evidence that liposomal bupivacaine reduces rest pain scores by 0.9 out of 10 units, when compared with long-acting local anaesthetics at 24 hours after surgery, and by 0.7 up to 72 hours after surgery.
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Optimal intrathecal dosing regimens for hydromorphone are not well established for analgesia after abdominal surgery. ⋯ Drug-related side effects, opioid analgesics, outcome assessment, postoperative pain, spinal injections.