Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2021
Observational StudyAssociation Between Lower Preoperative Cognition With Intraoperative Electroencephalographic Features Consistent With Deep States of Anesthesia in Older Patients: An Observational Cohort Study.
Older patients with low pre-operative cognitive performance may inadvertently be receiving a relative overdose during volatile general anaesthesia.
pearl -
Anesthesia and analgesia · Jul 2021
Randomized Controlled TrialThe Effect of High-Flow Nasal Oxygen on Carbon Dioxide Accumulation in Apneic or Spontaneously Breathing Adults During Airway Surgery: A Randomized-Controlled Trial.
Significant CO2 accumulation occurs during apneic oxygenation with high-flow nasal oxygen, potentially limiting safety during prolonged apnea.
pearl -
Anesthesia and analgesia · Jul 2021
Randomized Controlled TrialThe Effects of Intraoperative Caffeine on Postoperative Opioid Consumption and Related Outcomes After Laparoscopic Surgery: A Randomized Controlled Trial.
Intraoperative caffeine does not reduce postoperative morphine consumption after laparoscopic abdominal surgery.
pearl -
Anesthesia and analgesia · Jul 2021
Trends in Peripheral Nerve Block Usage in Mastectomy and Lumpectomy: Analysis of a National Database From 2010 to 2018.
Compared to general anesthesia, regional anesthesia confers several benefits including improved pain control and decreased postoperative opioid consumption. While the benefits of peripheral nerve blocks (PNB) have been well studied, there are little epidemiological data on PNB usage in mastectomy and lumpectomy procedures. The primary objective of our study was to assess national trends of the annual proportion of PNB use in breast surgery from 2010 to 2018. We also identified factors associated with PNB use for breast surgery. ⋯ We found increased annual utilization of PNB for mastectomy and lumpectomy since 2010, although absolute prevalence is low. PNB use was associated with year of procedure for both lumpectomy and mastectomy, particularly post-2014.
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Anesthesia and analgesia · Jul 2021
Multicenter Study Observational StudyAssociation of Obstructive Sleep Apnea With Difficult Intubation: Prospective Multicenter Observational Cohort Study.
Obstructive sleep apnea (OSA) has been found to be associated with difficult airway, although there is a paucity of prospective studies investigating thresholds of OSA severity with difficult airway outcomes. The aim of this study was to examine the association between OSA and difficult intubation or difficult mask ventilation. We also explored the utility of the Snoring, Tiredness, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, and Gender (STOP-Bang) score for difficult airway prediction. ⋯ Moderate and severe OSA were associated with difficult intubation, and increasing neck circumference was associated with difficult mask ventilation. A higher STOP-Bang score of 3 or more may be associated with difficult intubation versus STOP-Bang score of 0-2. Anesthesiologists should be vigilant for difficult intubation when managing patients suspected or diagnosed with OSA.