Trending Articles
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Spinal anaesthesia should not be performed above the L3/4 interspace if relying on surface anatomy to determine spinal level.
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Anesthesia and analgesia · Oct 2018
Neuraxial Anesthesia During Cesarean Delivery for Placenta Previa With Suspected Morbidly Adherent Placenta: A Retrospective Analysis.
Cesarean section for morbidly adherent placenta can be successfully managed with neuraxial anesthesia, although with a modest conversion rate to general anesthesia.
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Anesthesia and analgesia · Mar 2017
Observational StudyTranscutaneous Carbon Dioxide Measurements in Women Receiving Intrathecal Morphine for Cesarean Delivery: A Prospective Observational Study.
Hypercapnia events are common in women receiving 150 mcg intrathecal morphine for cesarean delivery, although clinical significance is uncertain.
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Evidence for cricoid pressure continues to be inadequate to make recommendations for its use or avoidance in patients at risk of pulmonary aspiration.
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Randomized Controlled Trial
The effects of dexamethasone, light anesthesia, and tight glucose control on postoperative fatigue and quality of life after major noncardiac surgery: A randomized trial.
Why is this important?
Post-operative fatigue (POF) is common and has significant effects on post-operative recovery and quality of life.
Past studies have linked post-operative fatigue to the pro-inflammatory effects of surgery and anesthesia. Other studies have suggested anti-inflammatory benefits of steroids, tight glucose control and avoiding deep anesthesia.
What did they do?
Abdelmalak and team randomized 381 patients using a 3-factorial design for the three interventions. 306 patients were analysed for POF outcome.
Surgical interventions covered a wide range of major non-cardiac procedures, with mean surgical length just under 5 hours and 75% of patients being ASA 3 or 4.
And they found?
No difference for any of the interventions for either fatigue or quality of life.
Hang on...
While it may be that post-operative inflammation is not the causative factor for POF, more likely the study interventions had insufficient impact on inflammation to change fatigue outcomes.
For minor and moderate surgery of shorter duration in lower-acuity patients (ASA 1 & 2) who have experienced significant POF previously, these simple interventions may still be beneficial.
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