Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2022
Validation of Continuous Noninvasive Blood Pressure Monitoring Using Error Grid Analysis.
Error grid analysis was recently proposed to compare blood pressure obtained by 2 measurement methods. This study aimed to compare continuous noninvasive blood pressure (CNBP) with invasive blood pressure (IBP) using the error grid analysis and investigate the confounding risk factors attributable to the differences between CNBP and IBP. ⋯ The error grid analysis revealed the larger clinical discrepancy between CNBP and IBP in MBP compared with that in SBP. Old age and longer finger cuff inflation time were significant factors of being in a more dangerous zone of the error grid, which could affect the hemodynamic management during surgery.
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Anesthesia and analgesia · Apr 2022
ReviewPatient-Controlled Sedation Versus Clinician-Administered Sedation for Endoscopic Retrograde Cholangiopancreatography: A Systematic Review.
Patient-controlled sedation (PCS) has been explored as a sedation method in endoscopic retrograde cholangiopancreatography (ERCP), yet a comprehensive review article on this topic is lacking. We performed a systematic review to compare PCS against clinician-administered sedation. The primary objectives are to compare the sedative dosage used and the sedation depth, while secondary objectives are to compare sedation failure rates, clinician intervention rates, and patient satisfaction. ⋯ The included studies demonstrated unclear to high risk of bias, particularly in randomization, incomplete outcome data, and outcome measurement. PCS appears to be a feasible option for sedation in ERCP. Nonetheless, large-scale, high-quality trials will be required before PCS can be regularly implemented in ERCP.
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Anesthesia and analgesia · Apr 2022
Meta AnalysisAirway Ultrasound as Predictor of Difficult Direct Laryngoscopy: A Systematic Review and Meta-analysis.
Despite several clinical index tests that are currently applied for airway assessment, unpredicted difficult laryngoscopy may still represent a serious problem in anesthesia practice. The aim of this systematic review and meta-analysis was to evaluate whether preoperative airway ultrasound can predict difficult direct laryngoscopy in adult patients undergoing elective surgery under general anesthesia. ⋯ Our study demonstrates that airway ultrasound index tests are significantly different between patients with easy versus difficult direct laryngoscopy, and the DSE is the most studied index test in literature to predict difficult direct laryngoscopy. However, it is not currently possible to reach a definitive conclusion. Further studies are needed with better standardization of ultrasound assessment to limit all possible sources of heterogeneity.