Articles: operative.
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Randomized Controlled Trial Multicenter Study
Association of mechanical energy and power with postoperative pulmonary complications in lung resection surgery: A post hoc analysis of randomized clinical trial data.
Mechanical power (MP), the rate of mechanical energy (ME) delivery, is a recently introduced unifying ventilator parameter consisting of tidal volume, airway pressures, and respiratory rates, which predicts pulmonary complications in several clinical contexts. However, ME has not been previously studied in the perioperative context, and neither parameter has been studied in the context of thoracic surgery utilizing one-lung ventilation. ⋯ ME and, in cases requiring longer periods of mechanical ventilation, MP were independently associated with postoperative pulmonary complications in thoracic surgery.
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Minerva anestesiologica · May 2024
Meta AnalysisPeripheral nerve block and cognitive impairment after thoracic surgery: a systematic review and meta-analysis.
Postoperative cognitive impairment is common in surgical patients, including postoperative delirium and postoperative cognitive dysfunction. Several studies investigating the association between peripheral nerve block and the risk of cognitive impairment after thoracic surgery showed conflicting results. Therefore, we conducted the current systematic review and meta-analysis to determine the effects of peripheral nerve block on postoperative cognitive impairment in thoracic surgical patients. ⋯ This meta-analysis revealed positive effects of peripheral nerve block on improving postoperative cognitive impairment in patients following thoracic surgery.
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Anesthesia and analgesia · May 2024
ReviewEthical Principles Do Not Support Mandatory Preanesthesia Pregnancy Screening Tests: A Narrative Review.
Respect for patient autonomy is a pillar of medical ethics, manifested predominantly through informed consent. Mandatory (routine) nonconsented preoperative urine pregnancy testing does not adequately respect patient autonomy, is potentially coercive, and has the potential to cause harm medically, psychologically, socially, and financially. ⋯ Not performing a preanesthesia pregnancy test has not been associated with significant medicolegal consequences. We review the ethical implications of mandatory preanesthesia pregnancy testing in light of these facts.
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Minerva anestesiologica · May 2024
Randomized Controlled TrialThe effect of an ultrasound-guided sacral erector spinae plane block on the postoperative pain of lumbar discectomy: a randomized controlled trial.
Pain management is essential after discectomy, the surgical treatment for lumbar disc herniation. This study evaluated the effect of sacral erector spinae plane block (SESPB) versus standard analgesic methods on postoperative analgesia and opioid consumption in lumbar discectomy operations. ⋯ In lumbar discectomy surgery, ultrasound-guided SESPB provided adequate analgesia by reducing opioid consumption and pain scores without complications.