Articles: postoperative.
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Regional anesthesia is associated with recognized physiological advantages; however trials evaluating its impact on postoperative outcomes have shown contrasting results, probably because these effects have not been utilized in a multimodal perioperative care program. Enhanced recovery has attracted clinical interest because of its standardized, coordinated, multidisciplinary perioperative care plan that incorporates several evidenced-based interventions with positive influence on postoperative patient recovery. ⋯ Clearly, there are synergistic benefits derived from integrating specific regional anesthetic and analgesic techniques with other perioperative elements characteristic of a particular surgical procedure. This challenge requires a team approach in delivering such integrated care, ultimately providing the best cure for patient.
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Paediatric anaesthesia · Nov 2014
Comparative StudyPerception of Pediatric Pain: a comparison of postoperative pain assessments between child, parent, nurse, and independent observer.
Pain is a subjective experience. In children with limited understanding and communication skills, reliable assessment of pain is challenging. Self-reporting of pain is the gold standard of pain measurement. For children who are unable to self-report their pain, assessments made by their parents are often used as a proxy measure. The validity of this approach has not been conclusively determined. ⋯ Children's pain self-reports should be used wherever possible to guide management, but in their absence, parental pain scores can be reliably used as a surrogate measure. Nurses and independent observers produce lower pain scores than parents or children, which may result in inadequate treatment of pain.
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Lung transplantation is a widely accepted therapeutic option for patients with end-stage lung disease. However, despite the significant medical progress achieved since the first human lung transplant was performed in 1963, perioperative and long-term patient outcomes are still jeopardised by a variety of complications. ⋯ However, in the absence of internationally recognised guidelines, the optimal strategies for managing lung transplant recipients remain unclear. This article presents a practical approach to the management of the early post-transplantation period aiming at standardising clinical care and improving patient outcome.
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Letter Case Reports
Severe hypophosphatemia: a rare cause of postoperative muscle weakness.