Articles: postoperative.
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Asian Cardiovasc Thorac Ann · Jul 2014
Randomized Controlled Trial Comparative StudyPatient-controlled analgesia after coronary bypass: Remifentanil or sufentanil?
adequate pain control after cardiac surgery is mandatory to reduce its remarkable morbidity. In this study, we aimed to compare the efficacy of patient-controlled analgesia with remifentanil or sufentanil for pain management after coronary artery bypass grafting. ⋯ our study showed that both remifentanil and sufentanil patient-controlled analgesia can provide acceptable analgesia after coronary artery bypass. The difference between their efficacies was inconspicuous until 24 h postoperatively. Remifentanil seems to result in better pain relief at 24 h postoperatively.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2014
Review[Subsyndromal delirium - Experiences from the psychiatry - expectations for postoperative management].
The phenomenon of delirium is well known since over 100 years. The anesthesiology has recognized that early detection and therapy results in significant improvement of postoperative clinical state of health of the patients. In the following article it will be discussed that it could be profitable to make a further step: threatening the subsyndromal delirium. Because there are only few experiences in anesthesiology, this thesis will be substantiated by datas from psychiatry.
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Pediatr Crit Care Me · Jul 2014
Evaluation of Dexmedetomidine and Postoperative Pain Management in Patients With Adolescent Idiopathic Scoliosis: Conclusions Based on a Retrospective Study at a Tertiary Pediatric Hospital.
This study evaluated the effectiveness of dexmedetomidine in decreasing opioid use in children with adolescent idiopathic scoliosis following posterior spinal fusion surgery at a pediatric tertiary care hospital over the past 10 years. ⋯ There was no difference in opioid use related to dexmedetomidine on any postoperative day. The only variable showing a significant opioid sparing effect was the use of local anesthetic infusions via elastomeric pumps. Using continuous local anesthetic infusions instead of dexmedetomidine could eliminate the need for ICU admission, require shorter hospital stays, and reduce costs while still providing safe and effective pain control.
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Anaesth Intensive Care · Jul 2014
The effect of patient sex on the incidence of early adverse effects in a population of elderly patients.
Patient sex is known to influence the response to general and regional anaesthesia and recovery after surgery. However, most studies come from analyses carried out on middle-aged patients. As most of the patients admitted to the post-anaesthesia recovery room in our institution are elderly, we took the opportunity to investigate the association between sex and incidence of early adverse events in this older population of patients after major surgery. ⋯ Women showed a higher incidence of shivering (relative difference +48%, P=0.0003), postoperative nausea and vomiting (+91%, P<0.0001), hypotension (+32%, P=0.044) and desaturation (+60%, P=0.0030) than men. The incidence of hypertensive response, arrhythmias and acute respiratory failure were not statistically significantly different. The findings of this exploratory study suggest that women have a higher risk of early postoperative adverse events even in a more elderly population.
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This study aimed to determine if intravenous acetaminophen [paracetamol] (IV APAP) could decrease visual analog pain scores (VAS), opioid exposure and subsequent opioid related adverse effects (nausea, vomiting, constipation) in spinal surgery patients. ⋯ It appears IV APAP can be used effectively as an adjuvant pain management therapy in spinal surgery patients to decrease opioid exposure, but does not necessarily reduce the incidence of opioid related adverse effects or VAS pain scores.