Articles: postoperative.
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Minerva anestesiologica · Jun 2018
Effectiveness of spinal anesthesia in transanal endoscopic microsurgery: a 3-year experience.
The feasibility and safety of transanal endoscopic microsurgery (TEM) performed under spinal anesthesia (SA) has been recently demonstrated. This retrospective study compared the differences in opioid consumption and postoperative recovery in patients undergoing TEM under GA and SA. ⋯ SA seems to be the treatment of choice, when not contraindicated, in patients undergoing TEM, allowing a reduction in perioperative opioid consumption and a faster postoperative recovery.
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Sudden postoperative hearing loss is rare, and thought to be caused by a variety of mechanisms. Here we report on a patient with Crouzon syndrome who experienced multiple episodes of postoperative hearing loss, with persistent hearing loss occurring after she received nitrous oxide as part of a general anesthetic. ⋯ Patients with craniofacial syndromes may have acoustic nerve compression from skull base and cartilage anomalies that cause narrowing of the internal acoustic meatus. These anatomic variations may make patients more susceptible to increased middle ear pressure secondary to nitrous oxide, increasing their risk for hearing loss.
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Anesthesia and analgesia · Jun 2018
Is Compliance With Surgical Care Improvement Project Cardiac (SCIP-Card-2) Measures for Perioperative β-Blockers Associated With Reduced Incidence of Mortality and Cardiovascular-Related Critical Quality Indicators After Noncardiac Surgery?
While continuation of β-blockers (BBs) perioperatively has become a national quality improvement measure, the relationship between BB withdrawal and mortality and cardiovascular-related critical quality indicators has not been studied in a contemporary cohort of patients undergoing noncardiac surgery. ⋯ Perioperative withdrawal of BBs was associated with increased risk for mortality within 48 hours after noncardiac surgery and with decreased risk for need of vasopressor during the early postoperative period and a shorter stay in the postanesthesia care unit.
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Anesthesia and analgesia · May 2018
Randomized Controlled TrialReduced Left Ventricular Global Longitudinal Strain Predicts Prolonged Hospitalization: A Cohort Analysis of Patients Having Aortic Valve Replacement Surgery.
Left ventricular ejection fraction (LVEF) is often preserved in patients with aortic stenosis and thus cannot distinguish between normal myocardial contractile function and subclinical dysfunction. Global longitudinal strain and strain rate (SR), which measure myocardial deformation, are robust indicators of myocardial function and can detect subtle myocardial dysfunction that is not apparent with conventional echocardiographic measures. Strain and SR may better predict postoperative outcomes than LVEF. The primary aim of our investigation was to assess the association between global longitudinal strain and serious postoperative outcomes in patients with aortic stenosis having aortic valve replacement. Secondarily, we also assessed the associations between global longitudinal SR and LVEF and the outcomes. ⋯ Global longitudinal strain and SR are useful predictors of prolonged hospitalization in patients with aortic stenosis having an aortic valve replacement.