Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Tonsillectomy is one of the most common ambulatory procedures performed in children worldwide, with around 40,000 procedures performed in Canada every year. Although a prior systematic review indicated a clear role for dexamethasone as an analgesic adjunct, the quantity effect on opioid consumption is unknown. In the current systematic review with meta-analysis, we hypothesized that the use of dexamethasone reduces perioperative opioid consumption in pediatric tonsillectomy but does not increase rates of postoperative hemorrhage. ⋯ PROSPERO ( CRD42023440949 ); first submitted 4 September 2023.
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Intraoperative hypoglycemia is presumed to be rare, but generalizable multicentre incidence and risk factor data for adult patients are lacking. We used a multicentre registry to characterize adults with intraoperative hypoglycemia and hypothesized that intraoperative insulin administration would be associated with hypoglycemia. ⋯ In this large cross-sectional retrospective multicentre cohort study, intraoperative hypoglycemia was a rare event. Intraoperative insulin use was not associated with hypoglycemia.
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The management of pain following cancer-related surgeries involves the use of opioid analgesics. Nevertheless, there is little evidence characterizing the utility and prescription patterns of opioids after these procedures. Our primary aim was to identify patients from three types of cancer surgery who were overprescribed with opioids. The secondary aim was to determine the potential predictors of overprescribing in the same period. ⋯ Our study shows that the majority of recruited patients undergoing breast, gynecologic, or head and neck cancer surgery were overprescribed opioids. Individualized assessments on patients' 24-hr opioid requirements before discharge and supplying for less than five days are important considerations to reduce overprescribing in opioid-naïve patients after cancer surgery.
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Initially introduced as a safer alternative to smoking, electronic cigarettes (e-cigarettes) and vaping have since been associated with lung injury. Nevertheless, there is limited perioperative data on their potential contribution to the harmful effects of mechanical ventilation on the lungs. We hypothesized that, in adults undergoing noncardiothoracic surgeries, preoperative vaping/e-cigarette use is associated with hypoxemia during the first postoperative hour, and with an increased incidence of intraoperative and postoperative pulmonary complications. ⋯ Vaping/e-cigarette use was neither associated with clinically significant hypoxemia during the first hour in the postanesthesia care unit nor with an increase in pulmonary complications. Nevertheless, our findings cannot definitively exclude the deleterious effects of vaping and e-cigarette use on the lungs, and anesthesiologists should consider potential perioperative complications.