Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2020
Observational StudyAssociation Between Perioperative Hypotension and Delirium in Postoperative Critically Ill Patients: A Retrospective Cohort Analysis.
Intraoperative and postoperative hypotension are both associated with postoperative delirium among patients admitted to ICU.
pearl -
Anesthesia and analgesia · Mar 2020
ReviewAnesthetic Implications of the New Guidelines for Button Battery Ingestion in Children.
New guidelines for paediatric button battery ingestion recommend preoperative administration with honey and/or sucralfate, and post-removal irrigation with 0.25% acetic acid.
pearl -
Anesthesia and analgesia · Mar 2020
Randomized Controlled TrialA Randomized Controlled Trial of Enhanced Recovery After Surgery Versus Standard of Care Recovery for Emergency Cesarean Deliveries at Mbarara Hospital, Uganda.
Enhanced recovery after surgery (ERAS) expedites return to patient baseline and functional status by reducing surgical trauma, stress, and organ dysfunction. Despite the potential benefits of enhanced recovery protocols, limited research has been done in low-resource settings, where 95% of cesarean deliveries are emergent and could possibly benefit from the application of ERAS protocols. ⋯ Use of an ERAS protocol for women undergoing emergency cesarean delivery in a low-income setting is feasible and reduces length of hospital stay without generally increasing the complication rate.
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Anesthesia and analgesia · Mar 2020
Comparative Study Observational StudyGene Variants in Hepatic Metabolism, Gamma-Aminobutyric Acid-ergic Reward, and Prostaglandin Pathways in Opioid-Consuming and Opioid-Naïve Patients Presenting for Lower Extremity Total Joint Replacement.
Gene variants may contribute to individual differences in the experience of pain and the efficacy and reward of treatments. We explored gene variation in opioid-naïve and opioid-consuming patients undergoing elective lower extremity total joint replacement. ⋯ We report that for genes with possible or probable deleterious impact in these 3 pathways, opioid consumers had more gene variants than opioid-naïve patients (median 3 vs 1, P = .0092). We conclude that chronic opiate users may have genetic susceptibility to altered responses in reward/dependency and pain/inflammation pathways.