Anesthesiology
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Meta Analysis
Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis.
Use of processed-EEG monitoring to guide anaesthesia depth is associated with a 38% odds reduction of developing postoperative delirium.
pearl -
An interesting exploration of the surgeon-anesthesiologist relationship, framed in terms of it being the critical dyad of the operating theatre team.
Cooper explores the positives and negatives, the stereotypes that each craftgroup holds of the other, and the ways in which these translate to team performance.
Most significantly, Cooper makes the point that when highly functional this relationship can lead to the highest quality patient care, but at its worst, dysfunction can lead to extreme harm and compromise patient safety.
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Observational Study
Cognitive Decline after Delirium in Patients Undergoing Cardiac Surgery.
Cardiac surgery is associated with cognitive decline and postoperative delirium. The relationship between postoperative delirium and cognitive decline after cardiac surgery is unclear ⋯ Patients who developed delirium had greater decline in a composite measure of cognition and in visuoconstruction and processing speed domains at 1 month. The differences in cognitive change by delirium were not significant at 1 yr, with the exception of processing speed.
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Randomized Controlled Trial
Preoperative Fascia Iliaca Block Does Not Improve Analgesia after Arthroscopic Hip Surgery, but Causes Quadriceps Muscles Weakness: A Randomized, Double-blind Trial.
WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Ambulatory hip arthroscopy is associated with postoperative pain routinely requiring opioid analgesia. The potential role of peripheral nerve blocks for pain control after hip arthroscopy is controversial. This trial investigated whether a preoperative fascia iliaca block improves postoperative analgesia. ⋯ Preoperative fascia iliaca blockade in addition to intraarticular local anesthetic injection did not improve pain control after hip arthroscopy but did result in quadriceps weakness, which may contribute to an increased fall risk. Routine use of this block cannot be recommended in this patient population.