Articles: postoperative.
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Review Meta Analysis
A systematic review and meta-analysis of ultrasound versus electrical stimulation for peripheral nerve location and blockade.
We systematically reviewed peripheral nerve blockade guided by ultrasound versus electrical stimulation. We included 26 comparisons in 23 randomised controlled trials of 2125 participants. Ultrasound reduced the rate of pain during the procedure, relative risk (95% CI) 0.60 (0.41-0.89), p = 0.01. ⋯ The rate of rescue was unaffected by the addition of electrical stimulation to ultrasound, relative risk (95% CI) 1.07 (0.54-2.10), p = 0.85. Ultrasound, with or without electrical stimulation, reduced the pooled rate of vascular puncture, relative risk (95% CI) 0.23 (0.15-0.37), p < 0.0001. There was no difference in the rate of postoperative neurological side-effects, relative risk (95% CI) 0.76 (0.53-1.09), p = 0.13.
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Int J Geriatr Psychiatry · Sep 2015
ReviewPreoperative risk factors for postoperative delirium following hip fracture repair: a systematic review.
Systematically identify preoperative clinical risk factors for incident postoperative delirium in individuals undergoing hip fracture repair in order to guide clinicians in identifying high risk patients at admission. ⋯ In our systematic review, cognitive impairment was one of the strongest preoperative risk factors for postoperative delirium after hip fracture surgery. Preoperative cognitive assessment may be one of the most useful methods of identifying those who are at high risk for postoperative delirium and prioritizing delivery of delirium prevention measures.
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Perioperative complications commonly include oxygenation and ventilation abnormalities. The best outcome is associated with prevention. Ventilation impairment may be due to either neurologic compromise such as cervical intervertebral disk disease or severe parenchymal disease, while oxygenation failure may result from either the underlying disease or severe complications such as aspiration pneumonia, volume overload, pulmonary thromboembolism, or acute respiratory distress syndrome. This article reviews the approach to the patient with perioperative complications and provides recommendations on the management approach.
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Despite great progress in our understanding and management of pain, undertreatment of postoperative pain is still a major problem. There are individual patient differences in terms of nociception and perception, as well as varying responses to pain management. Postoperative pain can impact on the length of hospital stay, mobilization after surgery, and patient satisfaction. --This report is adapted from paineurope 2015: Issue 1, ©Haymarket Medical Publications Ltd, and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International, LTD and is distributed free of charge to healthcare professionals in Europe. Archival issues can be viewed via the website: www.paineurope.com at which health professionals can find links to the original articles and request copies of the quarterly publication and access additional pain education and pain management resources.