Anesthesia and analgesia
-
Anesthesia and analgesia · Dec 2014
Sodium Homeostasis During Liver Transplantation and Correlation with Outcomes.
Reports of perioperative serum sodium increase in liver transplant (LT) recipients are mostly restricted to unintentional rapid serum sodium overcorrection with subsequent development of central pontine myelinolysis. We examined intraoperative serum sodium changes and their effect on short-term outcomes after LT. ⋯ A larger intraoperative increase in ΔNa is associated with worse recipient short-term outcomes. Patients with preoperative hyponatremia may be at particular risk. ΔNa increases with the intraoperative use of NaHCO3, quantity of FFP, and PRBCs transfused, as well as with intraoperative hyperglycemia. Potential differences on sodium homeostasis between NaHCO3 and tromethamine use for intraoperative pH adjustment should be prospectively investigated.
-
Anesthesia and analgesia · Dec 2014
Anesthesiologist Staffing Considerations Consequent to the Temporal Distribution of Hypoxemic Episodes in the Postanesthesia Care Unit.
Hypoxemia, as measured by pulse oximetry (SpO2), is common in postanesthesia care unit (PACU) patients. The temporal distribution of desaturation has managerial implications because treatment may necessitate the presence of an anesthesiologist. ⋯ Because most (68.8%) hypoxemic episodes in the PACU occur ≥30 minutes after admission, a time by which the anesthesia provider who transported the patient usually would no longer be present (>99% of cases), the PACU needs to be considered when anesthesiologist operating room staffing and assignment decisions are made.
-
Anesthesia and analgesia · Dec 2014
Review Meta AnalysisThe Effectiveness of Suggestive Techniques in Reducing Postoperative Side Effects: A Meta-Analysis of Randomized Controlled Trials.
Suggestive techniques may reduce postoperative anxiety and pain, although not analgesic consumption or nausea.
pearl