Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2013
Editorial Comment"Never" events: anesthesiology's dirty little secret.
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Anesthesia and analgesia · Jul 2013
A retrospective identification of gastroesophageal reflux disease as a new risk factor for surgical site infection in cerebral palsy patients after spine surgery.
Neuromuscular scoliosis is a known risk factor for surgical site infection (SSI) after spinal fusion, with reported infection rates as high as 11.2%. Although risk factors such as antibiotic timing have been previously addressed, our objective was to identify intrinsic risk factors for SSI in cerebral palsy (CP) patients with neuromuscular scoliosis. We hypothesized that CP patients who develop SSI after spine fusion would have a risk profile similar to those who develop nosocomial infection. ⋯ We show that GERD increases the risk for infection in CP patients after spine fusion. Prospective multicenter studies are necessary to further validate the predictive value of this risk factor.
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Anesthesia and analgesia · Jul 2013
Randomized Controlled TrialPostoperative residual neuromuscular blockade is associated with impaired clinical recovery.
In this investigation, we sought to determine the association between objective evidence of residual neuromuscular blockade (train-of-four [TOF] ratio <0.9) and the type, incidence, and severity of subjective symptoms of muscle weakness in the postanesthesia care unit (PACU). ⋯ The incidence and severity of symptoms of muscle weakness were increased in the PACU in patients with a TOF <0.9.
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Anesthesia and analgesia · Jul 2013
Randomized Controlled Trial Comparative StudyA comparative trial of the GlideScope(R) video laryngoscope to direct laryngoscope in children with difficult direct laryngoscopy and an evaluation of the effect of blade size.
GlideScope® video laryngoscope (GVL) has been proposed to be useful for airway management, but its efficacy for difficult airways has not been confirmed in pediatric patients. In this study, we evaluated the usefulness of the GVL for improving the laryngoscopic view in patients whose Cormack and Lehane grade (C&L grade) was ≥3 under direct laryngoscopy. We also assessed the effect of GVL blade size on the laryngoscopic view. ⋯ In patients with C&L grade ≥3 under direct laryngoscopy, GVLs significantly improved the laryngoscopic view when compared with DL or GVLw. The GVLs is recommended for improving the laryngoscopic view in patients with a difficult airway.
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Anesthesia and analgesia · Jul 2013
Thromboelastometric maximum clot firmness in platelet-free plasma is influenced by the assay used.
Viscoelastic tests such as functional fibrinogen polymerization assays (FFPAs) in thrombelastography (TEG(®)) or thromboelastometry (ROTEM(®)) measure the elasticity of extrinsically activated clotting under conditions of platelet inhibition. There are no reports on whether components of the FFPAs have any effects on fibrin polymerization, aside from the effects of platelet inhibition. ⋯ We speculate that FIBTEM and FIBTEM PLUS may contain stabilizing agents that enhance fibrin polymerization whereas FFTEG might contain less tissue factor than the ROTEM assays.