Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2014
Review Meta AnalysisAccuracy of Continuous Noninvasive Hemoglobin Monitoring: A Systematic Review and Meta-Analysis.
Non-invasive haemoglobin monitoring devices show clinically-acceptable, though imperfect, accuracy when compared with laboratory Hb measurement.
pearl -
Anesthesia and analgesia · Aug 2014
Randomized Controlled Trial Multicenter StudySupplemental postoperative oxygen does not reduce surgical site infection and major healing-related complications from bariatric surgery in morbidly obese patients: a randomized, blinded trial.
12-16h of post-op supplemental O2 (80%) does not reduce wound infection or complication in the morbidly obese undergoing gastric bypass.
pearl -
Anesthesia and analgesia · Aug 2014
ReviewEvidence for the use of preoperative risk assessment scores in elective cranial neurosurgery: a systematic review of the literature.
Preoperative risk scores are designed to guide patient management by providing a means of predicting operative outcome. Several risk scores are used in neurosurgery, but studies on their clinical relevance are scarce. Therefore, it is not clear whether these risk scores are beneficial or helpful in predicting outcome after elective cranial neurosurgery. In this review, we summarize the current scientific evidence for using preoperative risk scores in elective cranial neurosurgery. ⋯ Large prospective studies are needed to validate the use of the reviewed risk scores in elective cranial neurosurgery. It appears, however, that the patient's preoperative physical and functional status can be used to predict the short- and long-term outcome in elective cranial neurosurgery.
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The clinical triad of micrognathia (small mandible), glossoptosis (backward, downward displacement of the tongue), and airway obstruction defines the Pierre Robin sequence (PRS). Airway obstruction and respiratory distress are clinical hallmarks. Patients may present with stridor, retractions, and cyanosis. ⋯ The anesthesiologist involved in the care of patients with PRS will interface with a multidisciplinary team in a variety of clinical settings. This perioperative review is a collaborative effort from multiple specialties including anesthesiology, plastic surgery, otolaryngology, and speech pathology. We will discuss the background and clinical presentation of patients with PRS, as well as some of the controversies regarding their care.
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Anesthesia and analgesia · Aug 2014
Randomized Controlled Trial Comparative StudyAccuracy of the Composite Variability Index as a Measure of the Balance Between Nociception and Antinociception During Anesthesia.
The Composite Variability Index (CVI), derived from the electroencephalogram, was developed to assess the antinociception-nociception balance, whereas the Bispectral Index (BIS) was developed to assess the hypnotic state during anesthesia. We studied the relationships between these indices, level of hypnosis (BIS level), and antinociception (predicted remifentanil effect-site concentrations, CeREMI) before and after stimulation. Also, we measured their association with movement in response to a noxious stimulus. ⋯ CVI appears to correlate with somatic responses to noxious stimuli. However, unstimulated CVI depends more on hypnotic drug effect than on opioid concentration.