Articles: anesthesia.
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Anesthesia and analgesia · Jan 2020
Multicenter Study Comparative StudyFactors Associated With Failure of Spinal Anesthetic: An 8-Year Retrospective Analysis of Patients Undergoing Elective Hip and Knee Joint Arthroplasty.
The primary outcome of this 8-year retrospective review was the failure of spinal anesthetic (SA) in elective hip and knee joint arthroplasty surgery. Of 3542 SAs, a total of 135 failures were identified (3.8%). Factors associated with increased odds of failure were younger age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01-1.05), lower body mass index (BMI; OR, 1.04 [1.01-1.08]), hip arthroplasty (OR, 1.90 [1.28-2.84]) compared to knee arthroplasty, needle insertion at L4-5 (OR, 4.61 [2.02-10.54]) and L5-S1 (OR, 7.66 [2.47-23.7]) compared to L2-3, 22-gauge needle size (OR, 2.17 [1.34-3.52]) compared to 25-gauge needle, and hyperbaric bupivacaine (OR, 1.66 [1.09-2.53]) compared to isobaric bupivacaine.
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Advances in therapy · Jan 2020
Multicenter Study Clinical Trial Observational StudyFactors Determining the Choice of Spinal Versus General Anesthesia in Patients Undergoing Ambulatory Surgery: Results of a Multicenter Observational Study.
Available short-acting intrathecal anesthetic agents (chloroprocaine and prilocaine) offer an alternative to general anesthesia for short-duration surgical procedures, especially ambulatory surgeries. Factors determining the choice of anesthesia for short-duration procedures have not been previously identified. ⋯ Patient's choice, patient fear of the alternative technique, patient stress/anxiety, the expected ease of recovery, and the efficacy of the technique were identified as the main factors influencing patient choice of short-acting local anesthesia or general anesthesia. Spinal anesthesia with short-acting local anesthetics was preferred to general anesthesia in ambulatory surgeries and was associated with a high degree of patient satisfaction.
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Randomized Controlled Trial Multicenter Study Comparative Study
Effects of oxygen on post-surgical infections during an individualised perioperative open-lung ventilatory strategy: a randomised controlled trial.
In the context of optimal, individualised lung ventilation, high inspired oxygen does not reduce surgical infections compared with conventional FiO2.
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Advances in therapy · Jan 2020
Multicenter Study Observational StudyImpact of Chloroprocaine on the Eligibility for Hospital Discharge in Patients Requiring Ambulatory Surgery Under Spinal Anesthesia: An Observational Multicenter Prospective Study.
This observational study was designed to assess the use of spinal anesthesia with chloroprocaine in the context of ambulatory surgery. ⋯ This study showed positive results on the effectiveness of chloroprocaine as a short-duration anesthetic and could be used to reduce the time to achieve eligibility for hospital discharge.
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Multicenter Study Observational Study
The effect of combined Epidural-general Anesthesia on Hemodynamic Instability during Pheochromocytoma and Paraganglioma Surgery: A multicenter retrospective cohort study.
Objectives: The purpose of this study was to compare the effects of combined epidural-general anesthesia with those of general anesthesia alone on hemodynamic instability (intraoperative hypotension and hypertensive crisis) during pheochromocytoma and sympathetic paraganglioma surgery. Methods: A total of 119 patients' medical records were reviewed who were diagnosed as having pheochromocytoma and sympathetic paraganglioma on the basis of histological findings. Intraoperative hypotension was defined as a mean blood pressure < 60 mmHg or a decrease > 30% in baseline systolic blood pressure after adrenal vein ligation. ⋯ In contrast, an increased attenuation number on unenhanced computed tomography was the only independent predictor of hypertensive crisis (1.087 [1.021-1.158], p = 0.009). Conclusions: The combined epidural-general anesthesia was not effective in attenuating hypertensive responses, but could have exacerbated intraoperative hypotension. These findings should be taken into account before selecting the anesthetic technique in pheochromocytoma and sympathetic paraganglioma surgery.