Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2021
Observational StudyAnesthetic Complications Associated with SARS-CoV-2 in Pediatric Patients.
Coronavirus disease 2019 (COVID-19) is associated with high perioperative morbidity and mortality among adults. The incidence and severity of anesthetic complications in children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unknown. We hypothesized that there would be an increased incidence of intra- and postoperative complications in children with SARS-CoV-2 infection as compared to those with negative testing. ⋯ Pediatric patients with nonsevere SARS-CoV-2 infection had higher rates of perianesthetic respiratory complications than matched controls with negative testing. However, severe morbidity was rare and there were no mortalities. The incidence of complications was similar to previously published rates of perianesthetic complications in the setting of an upper respiratory tract infection. This risk persisted after adjustment for preoperative upper respiratory symptoms, suggesting an increased risk in symptomatic or asymptomatic SARS-CoV-2 infection.
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Anesthesia and analgesia · Aug 2021
Observational StudyDissemination of anesthesia information during COVID-19 through Twitter: an infodemiology study.
Twitter is a web-based social media platform that allows instantaneous sharing of user-generated messages (tweets). We performed an infodemiology study of the coronavirus disease 2019 (COVID-19) Twitter conversation related to anesthesiology to describe how Twitter has been used during the pandemic and ways to optimize Twitter use by anesthesiologists. ⋯ The toll of the pandemic has been reflected in the anesthesiology conversation on Twitter, representing 0.01% of all COVID-19 tweets. Daily tweet activity showed how the Twitter community used the platform to learn about important topics impacting anesthesiology practice during a global pandemic. Twitter is a relevant platform through which to communicate about anesthesiology topics, but further research is required to delineate its effectiveness, benefits, and limitations for anesthesiology discussions.
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Anesthesia and analgesia · Aug 2021
Meta AnalysisThe Association of Preoperative Frailty and Postoperative Delirium: A Meta-analysis.
Both frailty and postoperative delirium (POD) are common in elective surgical patients 65 years of age and older. However, the association between preoperative frailty and POD remains difficult to characterize owing to the large number of frailty and POD assessment tools used in the literature, only a few of which are validated. Furthermore, some validated frailty tools fail to provide clear score cutoffs for distinguishing frail and nonfrail patients. We performed a meta-analysis to estimate the relationship between preoperative frailty and POD. ⋯ This meta-analysis provides evidence for a significant association between preoperative frailty and POD in elective surgical patients age 65 years or older.
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Anesthesia and analgesia · Aug 2021
Comparative Study Controlled Clinical TrialNeuromuscular and Clinical Recovery in Thoracic Surgical Patients Reversed With Neostigmine or Sugammadex.
Patients undergoing thoracoscopic procedures may be at high-risk for incomplete neuromuscular recovery and associated complications. The aim of this clinical investigation was to assess the incidence of postoperative residual neuromuscular blockade in adult thoracic surgical patients administered neostigmine or sugammadex when optimal dosing and reversal strategies for these agents were used. The effect of choice of reversal agent on hypoxemic events and signs and symptoms of muscle weakness were also determined. Additionally, operative conditions in each group were graded by surgeons performing the procedures. ⋯ Despite the application of strategies documented to reduce the risk of residual neuromuscular blockade, a high percentage of thoracoscopic patients whose neuromuscular blockade was reversed with neostigmine were admitted to the PACU with clinical evidence of residual paralysis. In contrast, muscle weakness was rarely observed in patients whose neuromuscular blockade was antagonized with sugammadex.
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Anesthesia and analgesia · Aug 2021
Multicenter StudyThe Society for Obstetric Anesthesia and Perinatology (SOAP) COVID-19 Registry: An analysis of outcomes among pregnant women delivering during the initial SARS-CoV-2 outbreak in the United States.
Early reports associating severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with adverse pregnancy outcomes were biased by including only women with severe disease without controls. The Society for Obstetric Anesthesia and Perinatology (SOAP) coronavirus disease 2019 (COVID-19) registry was created to compare peripartum outcomes and anesthetic utilization in women with and without SARS-CoV-2 infection delivering at institutions with widespread testing. ⋯ In this large, multicenter US cohort study of women with and without peripartum SARS-CoV-2 infection, differences in obstetric and neonatal outcomes seem to be mostly driven by symptomatic patients. Lower utilization of neuraxial analgesia in laboring patients with asymptomatic or symptomatic infection compared to patients without infection requires further investigation.