Articles: postoperative.
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Curr Opin Anaesthesiol · Aug 2022
ReviewRespiratory monitoring of nonintubated patients in nonoperating room settings: old and new technologies.
Postoperative mortality in the 30 days after surgery remains disturbingly high. Inadequate, intermittent and incomplete monitoring of vital signs in the nonoperating room environment is common practice. The rise of nonoperating room anaesthesia and sedation outside the operating room has highlighted the need to develop new and robust methods of portable continuous respiratory monitoring. This review provides a summary of old and new technologies in this environment. ⋯ Respiratory monitoring is required in several situations and patient categories outside the operating room. The chosen modality must be able to detect respiratory compromise in a timely and accurate manner. Combing several modalities in a nonobtrusive, nontethered system and having an integrated output seems to give a reliable and responsive signal.
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Randomized Controlled Trial
Effects of transcranial direct current stimulation in pain and opioid consumption after spine surgery.
Transcranial direct current stimulation (tDCS) has shown promising results in alleviating different types of pain. The present study compares the efficacy of three sessions of anodal tDCS applied over primary motor area (M1) or the left dorsolateral prefrontal cortex (DLPFC) or sham on reducing pain and the total opioid consumption in postoperative spine surgery patients. ⋯ tDCS is a promising tool for alleviating pain in the field of postoperative spine surgery.
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Whether a particular surgeon's opioid prescribing behavior is associated with prolonged postoperative opioid use is unknown. This study tested the hypothesis that the patients of surgeons with a higher propensity to prescribe opioids are more likely to utilize opioids long-term postoperatively. ⋯ Among Medicare fee-for-service patients undergoing total knee arthroplasty, surgeon-level variation in opioid utilization in the immediate perioperative period was associated with statistically significant but clinically insignificant differences in opioid utilization in the medium- and long-term postoperative periods.
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Observational Study
Isoelectric Electroencephalography in Infants and Toddlers During Anesthesia for Surgery-an International Observational Study.
Intraoperative isoelectric electroencephalography (EEG) has been associated with hypotension and postoperative delirium in adults. This international prospective observational study sought to determine the prevalence of isoelectric EEG in young children during anesthesia. The authors hypothesized that the prevalence of isoelectric events would be common worldwide and associated with certain anesthetic practices and intraoperative hypotension. ⋯ Isoelectric events were common worldwide in young children during anesthesia and associated with age, specific anesthetic practices, and intraoperative hypotension.
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Randomized Controlled Trial
Impact of Pain on Postoperative Recovery and Participation in Care Following Knee Arthroplasty Surgery: A Qualitative Descriptive Study.
Patient participation in care is key to optimising postsurgical outcomes and the quality of acute care delivery. ⋯ Despite the known benefits of patient participation in pain management, gaps remain in providing patients with the knowledge and opportunity to take an active role in their recovery. Interventions to overcome identified barriers need to be developed and evaluated.