Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2019
Meta AnalysisPerioperative Dextrose Infusion and Postoperative Nausea and Vomiting: A Meta-analysis of Randomized Trials.
Perioperative IV dextrose infusions have been investigated for their potential to reduce the risk of postoperative nausea and vomiting. In this meta-analysis, we investigated the use of an intraoperative or postoperative infusion of dextrose for the prevention of postoperative nausea and vomiting. ⋯ The use of perioperative dextrose did not result in a statistically significant association with postoperative nausea and vomiting. When utilized, plasma glucose monitoring is recommended to assess for postoperative hyperglycemia. Further prospective trials are necessary to examine the potential impact of timing of administration of a dextrose infusion on incidence of postoperative nausea and vomiting and rescue antiemetic requirements.
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Anesthesia and analgesia · Oct 2019
Comparative Study Observational StudyDesign and Evaluation of a Wireless Electrocardiogram Monitor in an Operating Room: A Pilot Study.
Wired electrocardiogram monitors are an important component of current perioperative monitoring. Wireless monitoring units could help reduce the number of cables attached to patients and thus improve anesthesia ergonomics and patient management. However, there is concern that electromagnetic interference generated by electrosurgical units may prevent effective wireless signals in the operating room. To evaluate the extent of this problem, we developed a Bluetooth electrocardiogram prototype monitor and compared its electrocardiogram traces to those captured with a standard wired electrocardiogram monitor in our operating room. ⋯ Wireless electrocardiogram using Bluetooth can be reliably used in the operating room. The electrosurgical unit induces electric rather than electromagnetic artifacts, thus affecting wired and wireless electrocardiogram in a similar fashion.
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Anesthesia and analgesia · Oct 2019
Observational StudyRed Blood Cell Transfusion in Pediatric Orthotopic Liver Transplantation: What a Difference a Few Decades Make.
Liver transplantation in children is often associated with coagulopathy and significant blood loss. Available data are limited. In this observational retrospective study, we assessed transfusion practices in pediatric patients undergoing liver transplantation at a single institution over the course of 9 years. ⋯ In contrast to historically reported trends, evaluation of current transfusion practices reveals that most patients undergoing liver transplantation receive <1 BV of packed RBCs. More than 1 in 4 transplantations require no transfusion at all. Risk factors for greater transfusion need include younger age, total parenteral nutrition-related liver failure, and repeat transplantation.