Knowledge

Collections with the topic tag Postoperative complications

Is anaesthesia-related neurotoxicity significant in young children?

Anesthesia Pediatric anesthesia Postoperative complications
- Review
  
  Perioperative central nervous system injury in neonates.
  
  Br J Anaesth. 2012 Dec 1;109 Suppl 1:i60-i67.
- Review
  
  Anesthesia for the young child undergoing ambulatory procedures: current concerns regarding harm to the developing brain.
  
  Curr Opin Anaesthesiol. 2013 Dec 1;26(6):677-84.
  
  Anesthesia neurotoxicity may affect the developing human brain, however methodological challenges limit the conclusiveness of current evidence.
  pearl
- Review
  
  Anesthesia-related neurotoxicity and the developing animal brain is not a significant problem in children.
  
  Paediatr Anaesth. 2015 Jan 1;25(1):65-72.
expand and show 8 more articles
Perioperative stroke

Cerebrovascular Perioperative medicine Postoperative complications
- Review
  
  Perioperative stroke.
  
  Can J Anaesth. 2016 Feb 1; 63 (2): 193-204.
- Article
  
  Time elapsed after ischemic stroke and risk of adverse cardiovascular events and mortality following elective noncardiac surgery.
  
  JAMA. 2014 Jul 16;312(3):269-77.
  
  Elective surgery should be delayed at least 9 months after stroke or cerebrovascular event, although there is a persisting increased risk of perioperative stroke in these patients.
  pearl
- Multicenter Study
  
  Perioperative covert stroke in patients undergoing non-cardiac surgery (NeuroVISION): a prospective cohort study.
  
  Lancet. 2019 Sep 21; 394 (10203): 1022-1029.
expand collection
Postoperative mortality and intraoperative anesthetic depth

Anesthesia Perioperative medicine Postoperative complications
There has been some observational evidence that a greater depth of anesthesia, as measured by BIS, may be associated with an increase in post-operative mortality. In particular the association of the "triple low state" (low BIS, low volatile-ET, low MAP) with post-operative mortality is worrying.

Completion of the Balanced Anaesthesia Study Group’s large RCT looking at this issue however brings us as close to a final word as we may expect. Short et al. (2019) showed no difference in 1-year mortality for older patients undergoing major surgery, whether they received a deep (BIS target 35) or light (BIS target 50) general anaesthetic.

It is likely that earlier observational studies were showing the consequences of intraoperative hypotension resulting from anaesthetic depth, rather than anaesthetic depth itself.
summary
- Randomized Controlled Trial
  
  Association between intraoperative electroencephalographic suppression and postoperative mortality.
  
  Br J Anaesth. 2014 Dec 1;113(6):1001-8.
- Randomized Controlled Trial
  
  Concurrence of Intraoperative Hypotension, Low Minimum Alveolar Concentration, and Low Bispectral Index Is Associated with Postoperative Death.
  
  Anesthesiology. 2015 Oct 1;123(4):775-85.
- Randomized Controlled Trial
  
  A pilot study for a prospective, randomized, double-blind trial of the influence of anesthetic depth on long-term outcome.
  
  Anesth. Analg.. 2014 May 1;118(5):981-6.
  
  Greater depth of anaesthesia may be associated with a higher incidence of wound infection, mortality and composite risk of complications.
  pearl
expand and show 2 more articles
Does ondansetron prevent post-operative shivering?

Ondansetron Postoperative complications
- Meta Analysis
  
  Efficacy and safety of ondansetron in preventing postanesthesia shivering: a meta-analysis of randomized controlled trials.
  
  BMC Anesthesiol. 2014 Jan 1;14:12.
- Review
  
  Efficacy spectrum of antishivering medications: meta-analysis of randomized controlled trials.
  
  Crit. Care Med.. 2012 Nov 1;40(11):3070-82.
- Randomized Controlled Trial
  
  Ondansetron given before induction of anesthesia reduces shivering after general anesthesia.
  
  Anesth. Analg. 2000 Jun 1;90(6):1423-7.
expand and show 5 more articles
Does preoperative dexamethasone for PONV prophylaxis increase infection risk?

Dexamethasone Postoperative complications Postoperative nausea & vomiting
- Randomized Controlled Trial
  
  Intraoperative dexamethasone does not increase the risk of postoperative wound infection: a propensity score-matched post hoc analysis of the ENIGMA-II trial (EnDEX).
  
  Br J Anaesth. 2017 Feb 1; 118 (2): 190-199.
- Review
  
  The impact of prophylactic dexamethasone on postoperative sore throat: an updated systematic review and meta-analysis.
  
  J Pain Res. 2018 Jan 1; 11: 2463-2475.
- Article
  
  Infection safety of dexamethasone in total hip and total knee arthroplasty: a study of eighteen thousand, eight hundred and seventy two operations.
  
  Int Orthop. 2019 Aug 1; 43 (8): 1787-1792.
expand collection

1
2