Articles: operative.
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The objective of this study was to determine whether postoperative morphine requirement in obese patients undergoing laparoscopic bariatric surgery was reduced by opioid-free anesthesia (OFA), as compared to an anesthetic strategy using opioids (opioid balanced anesthesia (OBA)) and to investigate the differences that may exist between the use of clonidine and dexmedetomidine in the context of OFA. ⋯ OFA is associated with a lower morphine requirement than with OBA during the first 24 h after bariatric surgery. In addition, OFAD seems to be more effective than OFAC in order to reduce morphine consumption.
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Minerva anestesiologica · Oct 2022
Observational StudyIncreased preoperative serum vitamin B12 level as a predictor of postoperative mortality in patients undergoing cardiac surgery.
Serum vitamin B
12 level is a useful prognostic marker for various conditions. The present study examined whether preoperative serum vitamin B12 level can predict mortality after cardiac surgery. ⋯ Preoperative measurement of serum vitamin B12 level may be an alternative for predicting the prognosis of patients undergoing cardiac surgery. -
Anesthesia, perioperative and critical care medicine are specific areas where registries, biobanks and big data are gaining a leading role in increasing knowledge and improving patients' care. The adoption of these robust data infrastructures - aimed at bridling, manipulating, aggregating, and linking patients' multiparametric data - supports anesthesiologists and intensive care physicians in several aspects of bedside practice and clinical research. Indeed, registries-integrated calculators may promote the concept of personalized medicine acting as "sniffers," electronic alarm systems, or decision support systems. ⋯ In a different way, the role of biobanks primarily relies on translational medical research. These allow rapidly creating pools of biological samples available for epidemiological description, pathophysiological definition, and treatment effectiveness verification, basically acting as an accelerator of knowledge production in critical care and perioperative medicine. Nowadays, registries and biobanks are thus routine tools for anesthesiologists and critical care physicians.
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The SARS-CoV-2 pandemic caused severe disruption to scheduled surgery in Ireland but its impact on emergency abdominal surgery (EAS) is unknown. ⋯ Significant improvements in patient flow following admission for EAS during the pandemic were observed. These changes were not associated with greater mortality nor increased readmission rates and offer important insights into optimal delivery of EAS services.
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Case Reports
Pulsatile Femoral Vein Doppler and Congestive Delirium, What Is the Relationship?: A Case Report.
Delirium is common in patients undergoing cardiac surgery, and venous congestion has been reported as an important risk factor. We report a 69-year-old patient who developed postoperative delirium in the intensive care unit following aortic valve replacement surgery. The postoperative course was complicated by delirium for which echographic signs of venous congestion on the portal and the renal but also the femoral veins and their resolution correlated with the course of delirium. The use of common femoral vein Doppler as a simple bedside technique to predict and identify congestive delirium has not been reported before.