Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2025
Preoperative Psychological Factors, Postoperative Pain Scores, and Development of Posttraumatic Stress Disorder Symptoms After Pediatric Anterior Cruciate Ligament Reconstruction.
Acute orthopedic injuries and subsequent surgical repair can be challenging for children and adolescents and result in posttraumatic stress reactions that can be problematic after the acute perioperative period. In a cohort of patients undergoing anterior cruciate ligament reconstruction (ACLR), we investigated the incidence and explored risk factors associated with the development of posttraumatic stress disorder (PTSD) symptoms after surgery. ⋯ A portion of patients undergoing ACLR are at risk for the development of symptoms consistent with PTSD. Risk factors include preoperative anxiety or depression and high postoperative pain scores. Interventions designed to address preoperative risk factors and optimization of postoperative pain may represent opportunities to improve outcomes in this patient population.
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Anesthesia and analgesia · Jan 2025
The Association of the Coronavirus Disease-2019 Pandemic With Disparities in Maternal Outcomes.
In the United States, Black and Hispanic patients have substantially worse maternal outcomes than non-Hispanic White patients. The goals of this study were to evaluate the association between the coronavirus disease-2019 (COVID-19) pandemic and maternal outcomes, and whether Black and Hispanic patients were disproportionately affected by the pandemic compared to White patients. ⋯ In this national study of 2.5 million deliveries in the United States, the COVID-19 pandemic was associated with increases in maternal mortality and failure-to-rescue but not in severe maternal morbidity or cesarean deliveries. While the pandemic did not exacerbate disparities for Black and Hispanic patients with private or Medicaid insurance, uninsured Black patients experienced greater increases in mortality and failure-to-rescue compared to insured White patients.
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Anesthesia and analgesia · Jan 2025
Perioperative Pain Management in Patients With Cancer-Related Pain: A Narrative Review.
The number of cancer patients, cancer survivors, and cancer surgeries is expected to continue to grow and anesthesiologists will benefit from having a framework on how to approach treating perioperative pain in the oncologic population. This article presents general considerations for formulating a perioperative pain management plan including cancer-specific contraindications for epidurals and nerve blocks, common procedures for pain after thoracic and abdominal surgeries, and alternative pain management techniques.