Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
The effect of sevoflurane compared to propofol maintenance on post-surgical quality of recovery in patients undergoing an ambulatory gynecological surgery: A prospective, randomized, double-blinded, controlled, clinical trial.
TIVA does not offer better quality recovery than sevoflurane maintenance in ambulatory gynecological surgery.
pearl -
To review research highlights of manuscripts published in 2016 that pertain to all aspects of the clinical practice of anesthesiology. ⋯ This recent body of evidence will both help inform anesthesiologists of the developing trends in anesthesiology and will also pose new challenges for further studies.
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To determine the appropriate mean arterial pressure (MAP) control level for elderly patients with hypertension during the perioperative period. ⋯ For elderly hypertensive patients, controlling intraoperative MAP levels to 80 to 95mmHg can reduce postoperative AKI after major abdominal surgery.
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Editorial Comment
Dexamethasone: The wonder drug in perioperative medicine.
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The use of neuromuscular blockade agents (NMBA), had been associated with significant residual post-operative paralysis and morbidity. There is a lack of clinical evidence on incidence of postoperative complications within the post-anesthesia care unit (PACU) in patients exposed to intraoperative NMBA's. This study aims to estimate the incidence of post-operative complications associated with use of NMBAs and assessing its association with healthcare resource utilization. ⋯ This study documents that incidence of major PACU complications after non-cardiac surgery was 2.1%, with the most frequent complications being re-intubation and ICU admission. Patients receiving NMBA reversal were at a lower risk of re-intubation and unplanned ICU admission, justifying routine use of reversals. Complete NMBA reversals are crucial in reducing preventable patient harm and healthcare utilization.