Journal of clinical anesthesia
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Observational Study
Chewing gum for 1 h does not change gastric volume in healthy fasting subjects. A prospective observational study.
Chewing gum for one hour does not change gastric fluid volume.
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Review Comparative Study
Cognitive impairment and postoperative outcomes in patients undergoing primary total hip arthroplasty: A systematic review.
Total hip arthroplasty (THA) is a common surgical procedure in the elderly. Varying degrees of cognitive impairment (CI) are frequently seen in this patient population. To date, there has been no systematic review of the literature specifically examining the impact of CI on outcomes after elective THA. The aim of this systematic review was to identify studies that compare the postoperative outcomes of patients with and without CI after undergoing elective primary THA. ⋯ We demonstrate that there are strong associations between patients with pre-existing CI undergoing THA and increased POD, hospital mortality, hospital complications, and hospital LOS. We report good quality evidence linking complications after THA to preexisting CI. Screening for CI can improve care and better predict the risk of developing postoperative complications such as delirium. Further investigations can address perioperative factors that can help reduce complications and show the utility of more widespread assessment of preoperative cognitive impairment.
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Incidence of insufficient intraoperative neuromuscular paralysis. A retrospective registry analysis.
Muscular tone that inhibits anesthetic or surgical care characterizes insufficient neuromuscular block. The incidence of insufficient neuromuscular block is unknown, therefore we developed novel electronic search strategies to identify occurrences of insufficient neuromuscular block. Our primary goal was to determine the incidence of intraoperative insufficient neuromuscular block in abdominal and neurovascular surgery. Our secondary goal was to assess factors independently associated with insufficient block. ⋯ Our results suggest that episodes of insufficient block occur in over a quarter of operations that are generally thought to require muscle relaxation. Without neuromuscular monitoring, it is difficult to separate inadequate anesthesia from inadequate neuromuscular block, and both presumably contributed in many cases.
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Letter Case Reports
Anesthetic management of an adult patient with Morquio A syndrome.