Articles: cations.
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Disparities in postoperative nausea and vomiting (PONV) and its prophylaxis may exist based on race, ethnicity, and socioeconomic status (SES). Our objective was to evaluate whether patients from racial and ethnic minority groups and patients from lower SES backgrounds received less appropriate PONV prophylaxis and experienced higher rates of PONV and post-discharge nausea and vomiting (PDNV). ⋯ The study identified differences in appropriate PONV prophylaxis by race and ethnicity as well as community-level SES. There were no differences in PONV by our predictors, but higher odds of PDNV by race and ethnicity and payor. This study underscores the importance of data stratification in quality measures to identify disparities in perioperative care; it can lead to changes in perioperative anesthetic management. Further research should explore these associations in a broader cohort and address potential confounding sources.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
ReviewAdvances in Anesthesia Techniques for Postoperative Pain Management in Minimally Invasive Cardiac Surgery: An Expert Opinion.
Minimally invasive cardiac surgery (MICS) often leads to severe postoperative pain. At present, multimodal analgesia schemes for MICS have attracted much attention, and the application of various chest wall analgesia techniques is becoming increasingly widespread. ⋯ This article provides an overview of the anatomy and procedures involved in these analgesic techniques, their mechanisms of action, and the latest clinical trial evidence. It also evaluates their progress in MICS, compares their advantages and disadvantages, and discusses practical challenges.
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Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. However, current evidence on postoperative outcomes exhibits variability due to small sample sizes, nonstandardized outcome assessment, and variations in surgical techniques. The aim of this study was to overcome these limitations by assessing standardized outcome measures after surgical intervention for CSDH at a high-volume population-based center favoring a uniform burr-hole craniotomy (BHC) approach. ⋯ This study provided standardized outcome measures in a large cohort of patients treated for CSDH at a center where BHC was consistently used. Most postoperative complications were mild and either did not require intervention or were managed with pharmacological treatment. The identified predictors of CSDH reoperation and moderate-to-severe postoperative complications offer considerations for clinical management and patient care.
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Evaluate an electronic platform for remote symptom monitoring to enhance postdischarge care in thoracic surgery using patient reporting of symptoms. ⋯ Electronic reporting adds an additional mechanism of communication between the patient and the clinical team, with the potential to lower the odds of readmission.
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Extent of resection (EOR) is prognostic for meningioma outcomes. DNA methylation profiling can shed light on biological drivers and therapeutic vulnerabilities. The goal of this study was to re-evaluate the impact of EOR on clinical outcomes across meningioma DNA methylation groups. ⋯ MRI-defined GTR is associated with improved LFFR across all meningioma DNA methylation groups and improved OS for patients with Hypermitotic meningiomas. These data continue to support maximal safe resection when feasible and demonstrate how molecular classification systems complement rather than supersede the prognostic impact of surgery.