Articles: operative.
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Randomized Controlled Trial
Predictors of subacute postoperative pain after total knee arthroplasty: A secondary analysis of two randomized trials.
Methods for identifying high-pain responders undergoing total knee arthroplasty remain important to improve individualized pain management. This study aimed at evaluating pre- and perioperative predictors of pain on Days 2-7 after total knee arthroplasty. ⋯ This study investigated factors associated with pain after total knee arthroplasty beyond the immediate postoperative period. The analysis revealed significant associations between preoperative pain levels and, particularly, pain 24 h postoperatively, with subsequent subacute pain the following week. These findings can assist in identifying patients who would benefit from enhanced, individualized analgesic interventions to facilitate postoperative recovery.
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Randomized Controlled Trial
Overtime work of anesthesiologists is associated with increased delirium in older patients admitted to intensive care unit after noncardiac surgery: a secondary analysis.
Overtime work is common in anesthesiologists due to shortage of manpower. Herein, we analyzed if overtime work of anesthesiologists was associated with delirium development in older patients after surgery. ⋯ Overtime work of anesthesiologists was associated with an increased risk of delirium development in older patients admitted to ICU after major noncardiac surgery.
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Randomized Controlled Trial Multicenter Study Comparative Study
Short-term outcomes in infants following general anesthesia with low-dose sevoflurane/dexmedetomidine/remifentanil versus standard dose sevoflurane (The TREX trial).
The Trial Remifentanil DEXmedetomidine (TREX) trial aimed to determine whether, in children less than 2 yr old, low-dose sevoflurane/dexmedetomidine/remifentanil anesthesia is superior to standard-dose sevoflurane anesthesia in terms of global cognitive function at 3 yr of age. The aim of the current secondary analyses was to compare incidence of intraoperative hypotension and bradycardia, postoperative pain, time to recovery, need for treatment of intraoperative hypotension and bradycardia, incidence of light anesthesia and need for treatment, need for postoperative pain medications, and morbidity and mortality outcomes at 5 days between the two arms. ⋯ These early postoperative results suggest that in children less than 2 yr of age receiving greater than 2 h of general anesthesia, the low-dose sevoflurane/dexmedetomidine/remifentanil anesthesia technique and the standard sevoflurane anesthesia technique are broadly clinically similar, with no clear evidence to support choosing one technique over the other.
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Minerva anestesiologica · Dec 2024
Randomized Controlled Trial Comparative StudyComparison of postoperative awakening between ciprofol and propofol in elderly patients undergoing hip replacement surgery: a single-blind, randomized, controlled trial.
The aim of this paper was to compare the impact of continuous infusion of ciprofol versus propofol on postoperative awakening in elderly patients following hip replacement surgery. ⋯ Compared to propofol, the administration of ciprofol in elderly patients following hip replacement surgery is associated with prolonged awakening time, spontaneous breathing recovery time, and extubation. The average intravenous maintenance dosage of ciprofol in geriatric patients under general anesthesia was 0.8 mg·kg-1·h-1.
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Minerva anestesiologica · Dec 2024
Randomized Controlled TrialRopivacaine and magnesium sulfate in sciatic nerve block at the popliteal level: randomized double-blind study.
Following surgical procedures, over 80% of patients experience acute pain, with half of them expressing dissatisfaction with pain relief. The modern approach to surgical treatment and pain management increasingly relies on implementing multimodal analgesia, which includes the use of adjuvants in addition to long-acting local anesthetics (such as ropivacaine). This double-blind randomized study evaluated the analgesic effect of magnesium sulfate added to ropivacaine in the sciatic nerve block at the popliteal level for bunion correction surgery. ⋯ Our results suggest that magnesium added to the local anesthetic extends sensory block duration, reduces postoperative pain, improves the quality of analgesia, decreases the need for additional opioids. Further studies are needed to confirm these preliminary findings.