Journal of clinical anesthesia
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Randomized Controlled Trial
Pre-operative breathing training based on video learning reduces emergence delirium in preschool children: A randomized clinical trial.
Emergence delirium is a common complication in preschool children after general anesthesia and may result in undesirable complications. This study aimed to determine whether breathing training after watching an informative video during the pre-operative visit could reduce the incidence of emergence delirium in preschool children after otorhinolaryngologic surgery under general anesthesia. ⋯ We concluded that breathing training based on video learning during the pre-operative visit in preschool children undergoing otorhinolaryngologic surgery could significantly decrease the incidence of emergence delirium.
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The combination of dural puncture epidural (DPE) technique and programmed intermittent epidural bolus (PIEB) is a novel alternative labor analgesia regimen providing rapid analgesia onset and improved analgesia quality. However, the optimum PIEB settings for using the DPE technique remain unclear. ⋯ The optimum PIEB interval time between 8 mL boluses of ropivacaine 0.1% and sufentanil 0.3 μg/mL when using the DPE technique was approximately 41 min.
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In the last few decades, an opioid related health crisis has been a challenging problem in many countries around the world, especially the United States. Better understanding of the association of pre-admission opioid abuse and/or dependence (POAD) on specific major complications in traumatic brain injury (TBI) patients can aid the medical team in improving patient care management and outcomes. ⋯ POAD TBI patients have a lower in-hospital mortality, shorter duration of hospitalization and a lower risk of acute myocardial infarction, while they are more likely to have respiratory failure, delirium, sepsis, malnutrition, and acute renal failure compared to TBI patients without POAD. Prospective study is warranted to further confirm these findings.
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Median nerve block can provide excellent analgesia during open surgery for trigger thumb in children. However, no data on the 90% minimum effective volume (MEV90) and concentration (MEC90) of ropivacaine for ultrasound-guided median nerve block in pediatric patients have been reported. ⋯ For ultrasound-guided median nerve block in children aged 1-3 years old with trigger finger undergoing open surgery, the MEV90 of 0.2% ropivacaine is 1.44 ml (95% CI 1.043 ml, 1.466 ml), and the MEC90 of 1.5 ml of ropivacaine is 0.195% (95% CI 0.159%, 0.197%).
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Observational Study
Chronic arterial hypertension and nocturnal non-dipping predict postinduction and intraoperative hypotension: A secondary analysis of a prospective study.
Postinduction and intraoperative hypotension are associated with organ injury in non-cardiac surgery patients. Automated ambulatory blood pressure monitoring can identify chronic arterial hypertension and nocturnal blood pressure non-dipping. We tested the hypotheses that: a) chronic arterial hypertension and nocturnal non-dipping are independent risk factors for postinduction and intraoperative hypotension; and b) adding information on chronic arterial hypertension and nocturnal non-dipping improves hypotension prediction models based on readily available preoperative clinical information. ⋯ Chronic arterial hypertension and nocturnal non-dipping are independent risk factors for postinduction and intraoperative hypotension in non-cardiac surgery patients. Adding information on chronic arterial hypertension and nocturnal non-dipping moderately improved hypotension prediction models based on preoperative clinical information.