European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Bilateral suprazygomatic maxillary nerve blocks vs. infraorbital and palatine nerve blocks in cleft lip and palate repair: A double-blind prospective, randomised study.
Cleft defects are common craniofacial malformations which require early surgical repair. These patients are at high risk of postoperative airway obstruction and respiratory failure. Cleft surgery may require high doses of opioids which may contribute to these complications. ⋯ Bilateral suprazygomatic maxillary nerve block is an effective and safe alternative to the traditional peripheral nerve blocks for cleft lip and cleft palate surgery, in a mixed paediatric and adult population.
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Comparative Study Observational Study
Anaesthesia care team improves outcomes in surgical patients compared with solo anaesthesiologist: An observational study.
In anaesthesiology, little attention has been drawn to the role of anaesthesia nurses as support personnel on quality of care. ⋯ Anaesthesia given by teams of anaesthesiologists and anaesthesia nurses is associated with decreased 30-day postoperative mortality and shorter length of stay when compared with solo anaesthesiologists. Even without any demonstration of causality, this emphasises the benefits of the anaesthesia care team model.
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Peri-operative critical events are still a major problem in paediatric anaesthesia care. Access to more experienced healthcare teams might reduce the adverse event rate and improve outcomes. ⋯ In this study on incidences of peri-operative paediatric cardiac arrest from a European tertiary care university hospital, implementation of a specialised paediatric anaesthesia team and training programme was associated with lower incidences of peri-operative paediatric cardiac arrest and a reduced probability of anaesthesia-attributable cardiac arrest.
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Randomized Controlled Trial
Low-dose ketamine infusion reduces postoperative hydromorphone requirements in opioid-tolerant patients following spinal fusion: A randomised controlled trial.
The current opioid epidemic highlights the urgent need for effective adjuvant therapies to complement postoperative opioid analgesia. Intra-operative ketamine infusion has been shown to reduce postoperative opioid consumption and improve pain control in opioid-tolerant patients after spinal fusion surgery. Its efficacy for opioid-naïve patients, however, remains controversial. ⋯ Postoperative low-dose ketamine infusion reduces opioid requirements for the first 24 h following spinal fusion surgery in opioid-tolerant, but not in opioid-naïve patients.