Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
Comparison of esophageal Doppler and plethysmographic variability index to guide intraoperative fluid therapy for low-risk patients undergoing colorectal surgery.
This study aims to investigate if there is equivalence in volumes of fluid administered when intravenous fluid therapy is guided by Pleth Variability Index (PVI) compared to the established technology of esophageal Doppler in low-risk patients undergoing major colorectal surgery. ⋯ PVI offers an entirely non-invasive alternative for goal-directed fluid therapy in this group of patients.
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Clinical Trial Observational Study
Outpatient laparoscopic sleeve gastrectomy: first 100 cases.
The development of outpatient surgery was one of the major goals of public health policy in 2010. The purpose of this observational prospective study was to evaluate the feasibility of laparoscopic sleeve gastrectomy (SG) in an ambulatory setting. ⋯ Laparoscopic SG in an ambulatory setting is feasible with a dedicated anesthesiological approach and an expert surgical team. Appropriate patient selection is important for ensuring safety and quality of care within the outpatient program.
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The aim of this study was to establish the incidence of acute kidney injury (AKI) in patients undergoing elective hip and knee arthroplasty. ⋯ We identified stage 3 or higher CKD as a major risk factor for developing postoperative AKI. Preexisting CKD raised the risk of developing AKI 4-fold. We recommend that all patients undergoing lower limb arthroplasty should have renal function assessed preoperatively. In the perioperative period, renal function should be monitored in all patients. This is of particular importance in patients with estimated glomerular filtration rate <60.
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Back injuries are a highly reported category of occupational injury in the health care setting. The daily clinical activities of an anesthesia provider, including lifting, pushing stretchers, transferring patients, and bending for procedures, are risk factors for developing low back pain. The purpose of this study is to investigate the prevalence of work related low back pain in anesthesia providers. ⋯ Nearly half of all anesthesia providers sampled suffer from low back pain subjectively attributed to their clinical practice. This leads to changes in work flow and missed days of work. The results of this study suggest a deficiency in the effectiveness of anesthesia training programs in teaching proper techniques to prevent musculoskeletal injuries.
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Comparative Study Observational Study
Correlation of probability scores of placenta accreta on magnetic resonance imaging with hemorrhagic morbidity.
To evaluate the hypothesis that assigning grades to magnetic resonance imaging (MRI) findings of suspected placenta accreta will correlate with hemorrhagic outcomes. We chose a single-center, retrospective, observational design. ⋯ In cases of suspected placenta accreta, probability scores for antenatal placental MRI may not be associated with increasing degrees of hemorrhage. Continued research is warranted to determine the effectiveness of assigning probability scores for antenatal accreta imaging studies, combined with clinical indices of suspicion, in assisting with antenatal multidisciplinary team planning for operative management of this morbid condition.