Articles: postoperative.
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Internal medicine journal · Jan 2023
High rate of false-positive postoperative venous thromboembolism identified using hospital ICD-10 coding.
The Health Roundtable, a national benchmarking body, identified our institution as an outlier with a high number of postoperative venous thromboembolism (VTE) events. We performed a retrospective study to determine the accuracy of hospital coding for the incidence and severity of postoperative VTE. ⋯ Approximately one third (n = 68) of all VTE were asymptomatic, diagnosed incidentally. Thus, coding data are inherently flawed with inaccuracy and overrepresent the true number of VTE events, with a substantial proportion of limited clinical relevance.
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Objective: Vital signs abnormalities in the post-anaesthesia care unit (PACU) may identify patients at risk of severe postoperative complications in the general ward, but are sparsely investigated by continuous monitoring. We aimed to assess if the severity of vital signs abnormalities in the PACU was correlated to the duration of severe vital signs abnormalities and serious adverse events (SAEs) in the general ward. Design: Prospective cohort study. ⋯ Seventeen patients (18%) experienced SAEs, without significant association to the PACU stay (area under the receiver operating characteristic [AUROC], 0.59; 95% CI, 0.46-0.73). Conclusion: Vital signs abnormalities in the PACU did not show a tendency towards predicting overall severe vital signs abnormalities or SAEs during the first days in the general ward. Circulatory abnormalities in the PACU showed a tendency towards predicting circulatory complications in the ward.
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Minerva anestesiologica · Dec 2022
Randomized Controlled TrialParavertebral block versus erector spinae plane block for analgesia in modified radical mastectomy: a randomized, prospective, double-blind study.
Pain control after breast surgery is crucial and supported with regional techniques. Paravertebral block (TPVB) is shown to be effective in postoperative pain management. Erector spinae plane block (ESPB) is assumed to have a similar analgesic effect as an easier and safer block. Our aim was to compare TPVB and ESPB for modified radical mastectomy (MRM) in terms of analgesic efficiency and dermatomal spread. ⋯ Thoracal paravertebral block reduced morphine consumption compared to ESPB after MRM, albeit a small difference. A through coverage of TPVB may be preferred with experienced operators in MRM due to lower pain scores.
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Observational Study
Postoperative Pain Management and Patient Evaluations After Five Different Surgical Procedures. A Prospective Cohort Study.
Sufficient pain management is a necessity and can play an important role in patients' contentment. ⋯ The analgesic treatment varied between procedures and patients and a significant number of patients did not achieve "no worse than mild pain" (Numeric Rating Scale ≤3). A significant association between patient contentment and experience of severe pain, pain relief, and involvement in own pain treatment, was found.