Articles: postoperative.
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Curr Opin Crit Care · Aug 2014
ReviewPrevention of renal dysfunction in postoperative elderly patients.
To describe the effect of ageing on kidney function and to summarize the benefits of advocated measures to prevent perioperative acute kidney injury (AKI) in elderly patients. ⋯ The future increase in elderly patients being exposed to surgery calls for improved perioperative management to prevent collaterally increased AKI. Although pharmacological therapies aiming to protect the kidneys from harm are under evaluation, hemodynamic optimization and avoidance of nephrotoxic drugs, including HES and hyperchloremic solutions, are critical for the elderly perioperative patient.
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Acta Anaesthesiol Scand · Aug 2014
Observational StudyTissue near infra red spectroscopy change is not correlated with patients' outcome in elective cardiac surgery.
Microcirculatory disturbances following cardiac surgery with cardiopulmonary bypass (CPB) are thought to be at the origin of organ dysfunction, although few studies have correlated microvascular alterations with outcome. We aimed to assess the microcirculation with near infrared spectroscopy (NIRS) and correlate NIRS parameters with intensive care length of stay and organ dysfunction. ⋯ This study confirms, through a non-invasive technology, a significant but transient alteration of the microcirculation during elective cardiac surgery. However, as these microvascular alterations were not correlated with patient's outcome, NIRS-derived parameters seem to be of limited interest in the cardiac surgery setting.
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Minerva anestesiologica · Aug 2014
Multicenter Study Observational StudyClinical utility of preoperative screening with STOP-Bang questionnaire in elective surgery.
Obstructive sleep apnea (OSA) is a common disease which increases the risk of perioperative complications. The aim of this study is to assess the clinical utility of preoperative screening for OSA in determining the prevalence of patients at high risk of OSA in a surgical population, the incidence of difficult airway management and the incidence of perioperative complications. ⋯ In conclusion, this study demonstrates that the prevalence of high OSA risk patients in the surgical population is high. The increase in the rates of perioperative complications justifies the implementation of perioperative strategies that use the STOP-Bang as a tool for triage.
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Acta Anaesthesiol Scand · Aug 2014
Major complications of epidural anesthesia: a prospective study of 5083 cases at a single hospital.
We undertook a prospective study of non-obstetric epidurals placed in surgical inpatients at a single teaching hospital to evaluate the incidence of and potential risk factors for major complications of continuous epidural anesthesia. ⋯ Serious complications were very rare; only one patient had permanent sequelae, and a single epidural hematoma was diagnosed. Post-operative neurologic deficits were more common, but most complications resolved spontaneously within 3 months and they rarely required intervention.
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Journal of anesthesia · Aug 2014
Randomized Controlled Trial Comparative StudyUltrasound-guided sciatic nerve block: a comparison between four different infragluteal probe and needle alignment approaches.
Our aim was compare onset time of sciatic nerve blockade (SNB) performed distal to the subgluteal fold using four different ultrasound (US)-guided approaches in patients undergoing foot or ankle surgery. ⋯ The LA-IP approach resulted in a rapid onset of SNB and was associated with the best satisfaction for postoperative analgesia in comparison with LA-OP, SA-IP, and SA-OP approaches for patients undergoing foot and ankle surgery.