Articles: postoperative.
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Journal of neurosurgery · Apr 2022
The safety and efficacy of dexamethasone in the perioperative management of glioma patients.
In this single-institution retrospective cohort study, the authors evaluated the effect of dexamethasone on postoperative complications and overall survival in patients with glioma undergoing resection. ⋯ Combined pre- and postoperative dexamethasone use may increase the risk of postoperative wound infection, and dexamethasone use, specifically preoperative use, may negatively impact survival. These findings highlight the potential for serious negative consequences with dexamethasone use.
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Curr Opin Crit Care · Apr 2022
ReviewPerioperative screening and management in elective complex hepatobiliary surgery.
Preoperative optimization and structured evidence-based perioperative care of a patient undergoing complex hepatobiliary (HPB) surgery are essential components in their management. Apart from advances in surgical technique, these perioperative measures have resulted in substantial reductions in morbidity and mortality. There hence, remains a continued need to have evidence-based updation in their management algorithm to ensure optimal outcomes. ⋯ Perioperative care of these fragile patients is an evidence-based dynamic process. Optimal patient management undergoing HPB surgery requires risk assessment and stratification, and meticulous attention to the correction of underlying conditions. Despite this, postoperative morbidity remains relatively high and requires a cohesive multidisciplinary approach to minimize complications.
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Curr Opin Crit Care · Apr 2022
ReviewImmunosuppressive drugs and associated complications in abdominal organ transplantation.
Intensive care management of patients who have undergone organ transplantation of liver, small bowel, pancreas, and/or kidney requires a basic knowledge of immunosuppression principles and the management of immunosuppressive medications. This review highlights the core principles of immunosuppression management in abdominal organ transplantation with a focus on complications arising from immunosuppressive drugs, both in the immediate postoperative period and in long-term usage. ⋯ For the intensive care professional who cares for abdominal organ transplant recipients, a foundational knowledge of the core principles of immunosuppression management is essential. In addition, an understanding of the common immunosuppressive drug regimens and the complications associated with these regimens is required for optimal management, risk assessment, and outcomes.
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Observational Study
Association of Pre-operative Functional Disability with Chronic Postsurgical Pain: A Prospective Observational Study.
Chronic postsurgical pain negatively affects postoperative recovery. We aimed to assess the association between preoperative functional disability and chronic postsurgical pain. ⋯ Our study showed that in patients who undergo elective abdominal surgery, 12% with preoperative functional disability experience chronic postsurgical pain after 1 year. Preoperative functional disability is associated with chronic postsurgical pain, use of preoperative pain medications and acute postoperative pain. Patients with preoperative functional disability have higher pain numerical rating scale scores at any postoperative measurement point.
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Whether intra-operative hypertension causes postoperative complications remains unclear. ⋯ There was no clinically meaningful relationship between intra-operative systolic pressure and the composite of myocardial injury and mortality, or acute kidney injury, over the range from 120 and 200 mmHg.