Articles: postoperative.
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Reg Anesth Pain Med · Jun 2021
CommentReal-time ultrasound-guided low thoracic epidural catheter placement: technical consideration and fluoroscopic evaluation.
Thoracic epidural analgesia can significantly reduce acute postoperative pain. However, thoracic epidural catheter placement is challenging. Although real-time ultrasound (US)-guided thoracic epidural catheter placement has been recently introduced, data regarding the accuracy and technical description are limited. Therefore, this prospective observational study aimed to assess the success rate and describe the technical considerations of real-time US-guided low thoracic epidural catheter placement. ⋯ Real-time US guidance appears to be a feasible option for facilitating thoracic epidural insertion. Whether or not this technique improves the procedural success and quality compared with landmark-based techniques will require additional study.
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Reg Anesth Pain Med · Jun 2021
Automated text messaging follow-up for patients who receive peripheral nerve blocks.
Routine follow-up of patients who receive a nerve block for ambulatory surgery typically consists of a phone call from a regional anesthesia clinician. This process can be burdensome for both patients and clinicians but is necessary to assess the efficacy and complication rate of nerve blocks. ⋯ Given the wide availability of REDCap, we believe this automated text messaging system can be implemented in a variety of health systems at low cost with minimal technical expertise and will improve both the consistency of patient follow-up and the service efficiency of regional anesthesia practices.
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Observational Study
Clinical performance of a machine-learning algorithm to predict intra-operative hypotension with noninvasive arterial pressure waveforms: A cohort study.
Intra-operative hypotension is associated with adverse postoperative outcomes. A machine-learning-derived algorithm developed to predict hypotension based on arterial blood pressure (ABP) waveforms significantly reduced intra-operative hypotension. The algorithm calculates the likelihood of hypotension occurring within minutes, expressed as the Hypotension Prediction Index (HPI) which ranges from 0 to 100. Currently, HPI is only available for patients monitored with invasive ABP, which is restricted to high-risk procedures and patients. In this study, the performance of HPI, employing noninvasive continuous ABP measurements, is assessed. ⋯ This study demonstrated that the algorithm can be employed using continuous noninvasive ABP waveforms. This opens up the potential to predict and prevent hypotension in a larger patient population.