Articles: postoperative.
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Anesthesia and analgesia · Jan 2023
Multicenter StudyAnesthetic Practice Trends and Perceptions Toward Postoperative Delirium: A Mixed-Methods Analysis.
Delirium is the most common postoperative complication in older adults, though anesthesiologist awareness of delirium prevention guidelines-and associated practice trends-remains unknown. ⋯ Perioperative practice trends are indicative of an improving environment for postoperative delirium. However, delirium guideline awareness remains variable among anesthesiologists, and key barriers continue to exist for identifying and preventing postoperative delirium.
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Anesthesia and analgesia · Jan 2023
Randomized Controlled TrialVolatile Versus Total Intravenous Anesthesia on Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery: A Randomized Clinical Trial.
The effect of anesthesia regimens on postoperative delirium after on-pump cardiac valve surgery is yet undetermined. This study aimed to evaluate the effect of volatile anesthesia compared with propofol-based total intravenous anesthesia (TIVA) on the occurrence of delirium after on-pump cardiac valve surgery. ⋯ Among patients undergoing on-pump cardiac valve surgery, anesthesia maintenance with a volatile agent did not result in significantly fewer occurrences of postoperative delirium than propofol-based TIVA.
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Randomized Controlled Trial
Celecoxib-tramadol co-crystal in patients with moderate-to-severe pain following bunionectomy with osteotomy: a phase 3, randomized, double-blind, factorial, active- and placebo-controlled trial.
Celecoxib-tramadol co-crystal (CTC) is a first-in-class analgesic co-crystal of celecoxib and racemic tramadol with an improved pharmacologic profile, conferred by the co-crystal structure, compared with its active constituents administered alone/concomitantly. ⋯ CTC provided greater analgesia than comparable daily doses of tramadol and celecoxib, with similar tolerability to tramadol. CTC is approved in the United States.
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Minerva anestesiologica · Jan 2023
Randomized Controlled TrialComparison of ultrasound-quided quadratus lumborum block and erector spinae plane block in terms of their effects on postoperative pain in open nephrectomy.
Ultrasound-guided quadratus lumborum block (QLB 2) and erector spinae plane block (ESPB) were suggested to prevent somatic and visceral pain in a small number of abdominal surgeries. In this study, we aimed to compare these fascial plane blocks in terms of efficacy and safety in patients undergoing open nephrectomy. ⋯ Ultrasound-guided QLB 2 and ESP block were found to achieve similar results on at rest and at movement pain scores and morphine consumption of the patients undergoing open nephrectomy. Both blocks may be preferred, depending on the clinician's experience.
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We aimed to determine the relationship between number and type of analgesic modalities utilized and postoperative pain after percutaneous spinal cord stimulator implantation. Secondary measures include opioid requirements, discharge times, and effects of specific modalities. ⋯ Ketamine administration and use of ≥5 analgesic modalities were associated with more postoperative pain for unclear reasons. Patients receiving NSAIDs or ≥4 analgesic modalities had shorter recovery times. These data may lead to further work that could optimize ambulatory practices for stimulator implantation. More work is warranted on this subject.