Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2010
Randomized Controlled Trial Comparative StudyInhaled fluticasone propionate reduces postoperative sore throat, cough, and hoarseness.
Sore throat is a common complication after surgery. Postoperative cough and hoarseness can also be distressing to patients. We sought to determine the effect of an inhaler steroid on sore throat, cough, and hoarseness during the first 24 hours of the postoperative period. ⋯ Inhaled fluticasone propionate decreases the incidence and severity of postoperative sore throat, cough, and hoarseness in patients undergoing cesarean delivery under general anesthesia.
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Anesthesia and analgesia · Oct 2010
Editorial CommentPostoperative sore throat: more answers than questions.
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Anesthesia and analgesia · Oct 2010
Randomized Controlled Trial Comparative StudyGoal-directed fluid management based on the pulse oximeter-derived pleth variability index reduces lactate levels and improves fluid management.
Dynamic variables predict fluid responsiveness and may improve fluid management during surgery. We investigated whether displaying the variability in the pulse oximeter plethysmogram (pleth variability index; PVI) would guide intraoperative fluid management and improve circulation as assessed by lactate levels. ⋯ PVI-based goal-directed fluid management reduced the volume of intraoperative fluid infused and reduced intraoperative and postoperative lactate levels.
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Anesthesia and analgesia · Oct 2010
Randomized Controlled Trial Comparative StudyDexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy.
Dexmedetomidine, a specific α(2) agonist, has an analgesic-sparing effect and reduces emergence agitation. We compared an intraoperative dexmedetomidine infusion with bolus fentanyl to reduce perioperative opioid use and decrease emergence agitation in children with obstructive sleep apnea syndrome undergoing adenotonsillectomy (T&A). ⋯ An intraoperative infusion of dexmedetomidine combined with inhalation anesthetics provided satisfactory intraoperative conditions for T&A without adverse hemodynamic effects. Postoperative opioid requirements were significantly reduced, and the incidence and duration of severe emergence agitation was lower with fewer patients having desaturation episodes.
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Anesthesia and analgesia · Oct 2010
Comparative StudyEarly postoperative subcutaneous tissue oxygen predicts surgical site infection.
Subcutaneous oxygen partial pressure is one of several determinants of surgical site infections (SSIs). However, tissue partial pressure is difficult to measure and requires invasive techniques. We tested the hypothesis that early postoperative tissue oxygen saturation (Sto(2)) measured with near-infrared spectroscopy predicts SSI. ⋯ Sto(2) measured at the upper arm only 75 minutes after colorectal surgery predicted development of postoperative SSI, although the infections were typically diagnosed more than a week later. Although further testing is required, Sto(2) measurements may be able to predict SSI and thus allow earlier preventive measures to be implemented.