Articles: postoperative.
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Randomized Controlled Trial
Displacement of popliteal sciatic nerve catheters after major foot and ankle surgery: a randomized controlled double-blinded magnetic resonance imaging study.
Popliteal sciatic nerve catheters (PSNCs) are associated with a high frequency of displacement. We aimed to estimate the frequency of catheter displacement after 48 h with magnetic resonance imaging (MRI) in patients with PSNCs after major foot and ankle surgery randomized to catheter insertion either with a short-axis in-plane (SAX-IP) approach perpendicular to the nerve or with a short-axis out-of-plane (SAX-OOP) approach parallel to the nerve. ⋯ NCT02200016.
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Acta Anaesthesiol Scand · Aug 2016
Comment ReviewAdverse event assessment and reporting in trials of newer treatments for post-operative pain.
Assessment and reporting of adverse events (AEs) in studies of perioperative interventions is critical given the potential for unintended and preventable iatrogenic morbidity and mortality. This focused review evaluated the quality of AE assessment and reporting in acute post-operative pain treatment trials. Since older analgesics (e.g., opioids, NSAIDs) already have a well-characterized safety profile, we concentrated on trials of pregabalin and gabapentin as a representative sample of studies where the perioperative safety profile was relatively unknown. ⋯ Considerable widespread improvements are needed in AE reporting for post-operative pain treatment trials. In addition to heightened awareness among clinical investigators, mandatory journal editorial policies may further facilitate improvements in safety assessment and reporting.
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Minerva anestesiologica · Aug 2016
Randomized Controlled TrialEvaluation of the efficacy of solifenacin and darifenacin for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study.
Urinary catheterization during surgical interventions causes postoperative catheter-related bladder discomfort (CRBD). Antimuscarinic agents are the mainstay of treatment for overactive bladder (OAB). As the symptoms of CRBD mimic to OAB, so we designed this study to assess the efficacy of solifenacin and darifenacin for prevention of CRBD. ⋯ Pretreatment with oral solifenacin or darifenacin reduces catheter-related bladder discomfort with no clinically relevant significant side effects.
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Acta Anaesthesiol Scand · Aug 2016
CommentDexamethasone as adjuvant for femoral nerve block following knee arthroplasty: a randomized, controlled study.
We examined the effect of the addition of dexamethasone to bupivacaine for femoral nerve blocks on the block duration and the quality of post-operative analgesia following total knee replacement surgery. ⋯ The addition of dexamethasone to bupivacaine for femoral nerve block prolonged the duration of analgesia, improved early post-operative pain following total knee arthroplasty.
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Acta Anaesthesiol Scand · Aug 2016
Oliguria without serum creatinine increase after living donor liver transplantation is associated with adverse post-operative outcomes.
Acute kidney injury (AKI) is a common complication after liver transplantation and is associated with significant morbidity and mortality. Although clinical guidelines recommend defining AKI based on serum creatinine increase and oliguria, the validity and utility of the oliguric component of AKI definition remains largely unexplored. This study examined the incidence and the impact on clinical outcomes of oliguria meeting the urine output criterion of AKI in patients undergoing liver transplantation. The authors hypothesised that oliguria was an independent risk factor for adverse post-operative outcomes. ⋯ Oliguria is common after liver transplantation, and incorporating oliguria into the diagnostic criteria dramatically increases the measured incidence of AKI. Oliguria without serum creatinine increase was significantly associated with adverse post-operative outcomes.