Anesthesiology
-
Review Meta Analysis
Epidural Injections for Spinal Pain: A Systematic Review and Meta-analysis Evaluating the "Control" Injections in Randomized Controlled Trials.
Epidural steroid injection is the most frequently performed pain procedure. This study of epidural steroid "control" injections aimed to determine whether epidural nonsteroid injections constitute a treatment or true placebo in comparison with nonepidural injections for back and neck pain treatment. ⋯ Epidural nonsteroid injections may provide improved benefit compared with nonepidural injections on some measures, though few, low-quality studies directly compared controlled treatments, and only short-term outcomes (≤12 weeks) were examined.
-
Over 600 operating room fires occur annually although many cases go unreported. Over 81% of operating room fires involve surgical drapes, yet limited data exist on the differing degrees of flammability of drapes and other surgical fuel sources in varying oxygen concentrations. The purpose of this study is to assess the flammability characteristics of fuels in the operating room under varying oxygen concentrations. ⋯ Operating room personnel should be aware that common materials in the operating room support rapid combustion in oxygen-enriched environments. The risk of ignition and speed of fire propagation increase as oxygen exposure increases. Advances in material science may reduce perioperative fire risk.
-
Editorial Comment
A Burning Issue: Preventing Patient Fires in the Operating Room.
-
Guidelines suggest a plateau pressure (PPLAT) of 30 cm H(2)O or less for patients with acute respiratory distress syndrome, but ventilation may still be injurious despite adhering to this guideline. The shape of the curve plotting airway pressure versus time (STRESS INDEX) may identify injurious ventilation. The authors assessed accuracy of PPLAT and STRESS INDEX to identify morphological indexes of injurious ventilation. ⋯ The best threshold values for discriminating morphological indexes associated with injurious ventilation were Pplat,Rs greater than 25 cm H(2)O and STRESS INDEX,RS greater than 1.05. Although a substantial discrepancy between Pplat,Rs and PPLAT,L occurs, STRESS INDEX,RS reflects STRESS INDEX,L.