Articles: postoperative.
-
Patients receiving extended-release (XR) naltrexone who are having surgery present unique challenges to anesthesia providers, the most obvious of which is an altered response to the effects of opioid agonists. Based on the timing of the last XR naltrexone dose, patients may be refractory to the effects of opioid agonists or potentially more sensitive to dangerous side effects due to receptor upregulation and hypersensitivity. ⋯ We present a case of a 22-year-old woman receiving XR naltrexone for a history of heroin abuse undergoing a thyroidectomy and neck dissection. We discuss the intraoperative and postoperative anesthetic and analgesic planning, as well as solutions to some of the challenges these patients pose.
-
Eur. J. Obstet. Gynecol. Reprod. Biol. · Dec 2014
Comparative StudyMultimodal pain control is associated with reduced hospital stay following open abdominal hysterectomy.
To study the association of a multimodal pain protocol (MMPC) and reduced hospital stay after open abdominal hysterectomy. ⋯ Multimodal pain control is associated with significantly reduced hospital stay after open abdominal hysterectomy.
-
Critical care medicine · Dec 2014
Extent, Risk Factors, and Outcome of Fluid Overload After Pediatric Heart Surgery.
Fluid overload is associated with poor PICU outcomes in different populations. Little is known about fluid overload in children undergoing cardiac surgery. We described fluid overload after cardiac surgery, identified risk factors of worse fluid overload and also determined if fluid overload predicts longer length of PICU stay, prolonged mechanical ventilation (length of ventilation) and worse lung function as estimated by the oxygenation index. ⋯ Fluid overload occurs early after cardiac surgery and is associated with prolonged PICU length of stay and ventilation. Future fluid overload avoidance trials may confirm or refute a true fluid overload-outcome causative association.
-
To obtain expert consensus on essential criteria required to assess patient readiness for discharge from the postanaesthetic care unit. ⋯ The findings of this study have informed the development of an evidence-based tool to be piloted in a subsequent funded study of nursing assessment of patient readiness for discharge from the postanaesthetic care unit.