Articles: cations.
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Epidemiological data show a continuous expansion of elderly population in Europe. Older individuals require more medical services relative to their younger counterparts. The aim of this review was to summarize the most recent considerations in regards to preoperative assessment, postoperative outcomes, patient satisfaction and cost-effectiveness analysis of day surgery in the elderly. ⋯ A lot of studies show that even elderly patients can successfully undergo day surgery procedures by implementing evidence-based perioperative care programs, minimizing operative duration and tissue trauma and providing a comfortable setting.
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Nonconvulsive seizures (NCS) occur in as many as 20 % of comatose critically ill patients. These seizures need to be treated; however, the urgency with which this must be done and the medications that should be used are unclear. Often, data from treatment of convulsive status epilepticus (SE) is used to determine the best therapy for NCS. ⋯ Though limited, the available data suggests that valproic acid and lacosamide may be preferable to phenytoin/fosphenytoin and levetiracetam based on efficacy and side effect profiles. Other AEDs such as topiramate and pregabalin have also been used, but their data is even more limited, and they do not have an intravenous formulation. Clinical trials that have recently been completed and those that are ongoing will further inform our decisions about which drugs to use in the future.
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Opioids are the cornerstone of pain treatment in burn patients. Undertreatment of pain has been associated with psychological sequela. However, prescription opioids have been increasingly associated with adverse drug effects. ⋯ Continued opioid therapy is necessary as the patients transition to the out-patient setting. This study identified several areas that could be modified to align with safer opioid prescribing practices, including lowering daily amount of prescribed opioids, prescribing only short-acting opioids, and providing patient opioid education. Future studies should focus on the adverse effects of opioid use in burn patients.
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Although mirror pain occurs after cordotomy in patients experiencing unilateral pain via a referred pain mechanism, no studies have examined whether this pain mechanism operates in patients who have bilateral pain. ⋯ These results show that a referred pain mechanism causes increased or new pain after cordotomy in patients with bilateral pain. Nevertheless, cordotomy can still be indicated for patients with bilateral pain because postoperative pain is better controlled than the original pain.