Articles: operative.
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Ultrasound-guided scalp blocks may revolutionize regional anesthesia for neurosurgery. In this report, we demonstrate that ultrasound-guided scalp blocks can be used effectively for a craniotomy. A 48-year-old patient with a brain tumor at the motor cortex was scheduled for an awake craniotomy. ⋯ A total of 29 mL of levobupivacaine 0.3% was used. No additional local anesthetic agent was given for skull pinning, skin incision, or the craniotomy. Postoperatively, the patient remained pain-free, and she was discharged without complications.
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Minerva anestesiologica · Sep 2022
ReviewArtificial intelligence and telemedicine in anesthesia: potential and problems.
The application of novel technologies like artificial intelligence (AI), machine learning (ML) and telemedicine in anesthesiology could play a role in transforming the future of health care. In the present review we discuss the current applications of AI and telemedicine in anesthesiology and perioperative care, exploring their potential influence and the possible hurdles. ⋯ The utilization of AI and telemedicine is promising encouraging results in perioperative management, nevertheless several hurdles remain to be overcome before these tools could be integrated in our daily practice. AI models and telemedicine can significantly influence all phases of perioperative care, helping physicians in the development of precision medicine.
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Minerva anestesiologica · Sep 2022
Randomized Controlled TrialThe effect of timing and dosing of 5% and 10% Dextrose versus Saline on postoperative nausea and vomiting in high-risk women following ambulatory surgeries: a randomized double-blind controlled trial.
A common complication after outpatient surgeries is postoperative nausea and vomiting (PONV) which is concomitant with high levels of patient distress and dissatisfaction. Perioperative dextrose-containing fluid administration has been used as a non-pharmacologic preventive measure against postoperative nausea and vomiting (PONV). However, its efficacy remains unclear. This study aimed to compare different concentrations of dextrose solution on PONV for 24 hours after surgery. ⋯ There was a potential role for preoperative IV infusion of dextrose 10% solution that significantly reduces the incidence and severity of PONV and pain in patients at high risk for PONV.
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Anesthesia and analgesia · Sep 2022
Center Variation in Use of Preoperative Dual Antiplatelet Therapy and Platelet Function Testing at the Time of Coronary Artery Bypass Grafting in Maryland.
Patients presenting with acute coronary syndrome are administered a P2Y 12 inhibitor and aspirin before coronary catheterization to prevent further myocardial injury from thrombosis. Guidelines recommend a standard waiting period between the time patients are administered dual antiplatelet therapy (DAPT) and elective cardiac surgery. Since 25% to 30% of the population may be considered nonresponders to clopidogrel, platelet function testing can be utilized for timing of surgery and to assess bleeding risks. The extent to which a standard waiting period or platelet function testing is used across centers is not established, representing an important opportunity to standardize practice. ⋯ There is significant variability in DAPT usage within 5 days of CABG between hospital centers. Preoperative platelet function testing may allow for earlier timing of surgery for those on DAPT without increased bleeding risks.