Journal of clinical anesthesia
-
Evidence suggests that administering appropriate volumes of perioperative fluid replacement therapies can decrease the incidence of postoperative nausea and vomiting (PONV). However, the relative effects of colloids and crystalloids on PONV are still unclear. The objective of this systematic review was to determine whether administering colloids to adults undergoing noncardiac surgery significantly reduces PONV incidence and rescue antiemetic use, compared with administering crystalloids. ⋯ Colloid administration reduced the incidence of PONV in adults undergoing elective, noncardiac, major surgery under general anesthesia for >3 h. However, clinical studies performed in larger cohorts are required to determine the impact of colloids on PONV.
-
The repetitive hypoxic and hypercapnia events of obstructive sleep apnea (OSA) are believed to adversely affect cardiopulmonary function, which make them vulnerable to a higher incidence of postoperative complications. The primary aim of this systematic review and meta-analysis was to examine the association of OSA and the composite endpoints of postoperative cardiac or cerebrovascular complications in adult undergoing non-cardiac surgery. ⋯ CRD42019136564.
-
Randomized Controlled Trial
Comparison of the ED50 of intrathecal hyperbaric ropivacaine co-administered with or without intrathecal dexmedetomidine for cesarean section: A prospective, double-blinded, randomized dose-response trial using up-down sequential allocation method.
Studies have showed that intrathecal dexmedetomidine as supplements to local anesthetics can improve the quality of the spinal anesthesia and reduce the local anesthetic requirement of spinal anesthesia for cesarean section. However, the magnitude of this effect has not been fully quantified. Therefore, we conducted the present study to investigate the ED50 of intrathecal hyperbaric ropivacaine with or without dexmedetomidine for cesarean section in healthy parturients. ED50 values obtained were compared to estimate the effect of intrathecal dexmedetomidine versus placebo on ropivacaine requirement. ⋯ Under the conditions of the present study, intrathecal dexmedetomidine (5 μg) reduced the ED50 of intrathecal hyperbaric ropivacaine by approximately 18% for cesarean section in healthy parturients under combined spinal-epidural anesthesia.
-
There are few cognitive screening tools appropriate for fast-paced settings with limited staffing, and particularly in preoperative evaluation clinics. The Society for Perioperative Assessment and Quality Improvement (SPAQI) convened experts in neuropsychology, geriatric medicine, and anesthesiology to conduct a review of the literature and compile a comprehensive list of cognitive screening tools used within primary care and preoperative settings. This Recommendations Statement: 1. summarizes a review of the literature on existing cognitive screening tools used within preoperative settings; 2. discusses factors to consider when selecting cognitive screening tools in a preoperative environment; and 3. includes a work flow diagram to guide use of these screening measures. ⋯ Most had adequate sensitivity and specificity to detect cognitive impairment/dementia. While information on the psychometric properties of these tools is limited, the tools discussed are appropriate for lay examiners, are short in duration, and accessible for free or at a low cost. We describe factors that must be considered prior to instrument selection.
-
Randomized Controlled Trial
Comparison of ultrasound guided Erector Spinae Plane Block and quadratus lumborum block for postoperative analgesia in laparoscopic cholecystectomy patients; a prospective randomized study.
Erector Spinae Plane Block (ESPB) is a recently described block. Both ESPB and Quadratus Lumborum block type II (QLB-II) have been reported to provide effective postoperative analgesia in patients undergoing laparoscopic cholecystectomy (LC). In this study, we compared the postoperative analgesic effects of ESPB and QLB-II in patients undergoing LC. ⋯ While ESPB and QLB-II are not significantly different, they improve analgesia quality in patients undergoing LC.