Articles: anesthesia.
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There is controversy surrounding the influence of dexmedetomidine on the recovery of postoperative gastrointestinal dysfunction in patients under general anesthesia. The main purpose of this meta-analysis is to evaluate the effect of dexmedetomidine administration during the perioperative period on the recovery of gastrointestinal function in patients under general anesthesia. ⋯ Perioperative dexmedetomidine administration can promote the recovery of gastrointestinal function and reduce the length of hospital stay after abdominal surgery. The optimal dose and timing of dexmedetomidine and the influence on non-abdominal surgery need further investigation.
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Modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) is a trunk block that has been gaining attention for managing postoperative pain following abdominal surgeries since its first report in 2019. We conducted a scoping review on M-TAPA, aiming to comprehensively evaluate existing research, identify the gaps in knowledge, and understand the implications of M-TAPA. ⋯ M-TAPA may be considered a promising technique for postoperative pain management in upper abdominal laparoscopic surgeries. Further studies are warranted to elucidate the precise mechanisms and broader surgical applications.
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Scand J Trauma Resus · Dec 2024
Observational StudyHelicopter emergency medical services demonstrate reduced time to emergency anaesthesia in an undifferentiated trauma population: a retrospective observational analysis across three major trauma networks.
Early rapid sequence induction of anaesthesia (RSI) and tracheal intubation for patients with airway or ventilatory compromise following major trauma is recommended, with guidance suggesting a 45-min timeframe. Whilst on-scene RSI is recommended, the potential time benefit offered by Helicopter Emergency Medical Services (HEMS) has not been studied. We compared the time from 999/112 emergency call to delivery of RSI between patients intubated either in the Emergency Department or pre-hospital by HEMS. ⋯ Major trauma patients who had a pre-hospital RSI received this time-critical intervention sooner after their injury than those who received an emergency anaesthetic after conveyance to a specialist hospital. Patient outcome benefit of HEMS delivered early RSI should be explored.
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Postoperative nausea and vomiting (PONV) are common complications after gynecological laparoscopic surgery. Pyridoxine has been recommended as a first-line drug to prevent and treat nausea and vomiting during pregnancy; however, its efficacy in preventing PONV remains unclear. ⋯ In this single center randomized trial, pyridoxine plus dexamethasone and ondansetron reduced the incidence of PONV in patients undergoing elective gynecological laparoscopic surgery under general anesthesia. These findings need to be validated in multicenter studies in diverse populations to ensure generalizability.
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J Clin Monit Comput · Dec 2024
Entropy of difference works similarly to permutation entropy for the assessment of anesthesia and sleep EEG despite the lower computational effort.
EEG monitoring during anesthesia or for diagnosing sleep disorders is a common standard. Different approaches for measuring the important information of this biosignal are used. The most often and efficient one for entropic parameters is permutation entropy as it can distinguish the vigilance states in the different settings. ⋯ The distinguishing of the vigilance states between both measures is similar as the AUC values for the classification do not differ significantly. As the runtimes for the entropy of difference are smaller than for the permutation entropy, even though the performance stays the same, we state the entropy of difference could be a useful method for analyzing EEG data. Higher orders of entropic features may also be investigated better and more easily.