Journal of clinical anesthesia
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Multicenter Study Observational Study
Patient/anesthesiologist intersubjective experiences and intravenous supplementation during elective cesarean delivery: A prospective patient-reported outcome study.
This prospective, observational study investigated the impact of patient/anesthesiologist interactions and socioeconomic factors on administering intravenous analgesics and anxiolytics during elective Cesarean delivery under spinal anesthesia. The study explored the role of emotional experiences and psychosocial characteristics on intraoperative administration of intravenous adjuncts. ⋯ The study revealed a substantial gap between patient requests for analgesics and their administration, as well as an overreliance on anxiolysis compared to analgesia. Unconscious attitudes related to patient factors and subjective physician perceptions played a role in medication decisions. The findings emphasize the need for better pain assessment and management training, and awareness of implicit biases in healthcare settings. Future research should investigate optimal communication strategies and address unconscious attitudes to improve patient-centered care.
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Randomized Controlled Trial Multicenter Study
Personalized perioperative blood pressure management in patients having major non-cardiac surgery: A bicentric pilot randomized trial.
We hypothesize that personalized perioperative blood pressure management maintaining intraoperative mean arterial pressure (MAP) above the preoperative mean nighttime MAP reduces perfusion-related organ injury compared to maintaining intraoperative MAP above 65 mmHg in patients having major non-cardiac surgery. Before testing this hypothesis in a large-scale trial, we performed this bicentric pilot trial to determine a) if performing preoperative automated nighttime blood pressure monitoring to calculate personalized intraoperative MAP targets is feasible; b) in what proportion of patients the preoperative mean nighttime MAP clinically meaningfully differs from a MAP of 65 mmHg; and c) if maintaining intraoperative MAP above the preoperative mean nighttime MAP is feasible in patients having major non-cardiac surgery. ⋯ It seems feasible to determine the effect of personalized perioperative blood pressure management maintaining intraoperative MAP above the preoperative mean nighttime MAP on postoperative complications in a large multicenter trial.