Journal of clinical anesthesia
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Review Meta Analysis
Association of preoperative vitamin D deficiency with the risk of postoperative delirium and cognitive dysfunction: A meta-analysis.
Despite vitamin D deficiency (VDD) associated with cognitive dysfunction in the general population, the impacts of preoperative VDD on postoperative delirium (POD) and cognitive dysfunction (POCD) remain to be clarified. ⋯ Our results demonstrated that preoperative vitamin D deficiency was associated with postoperative cognitive impairment. Given the prediction interval, more future studies are needed to elucidate associations between VDD and POD/POCD.
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The American Society of Anesthesiologists Physical Status (ASA-PS) is a grading system routinely adopted worldwide by physicians to classify patients' overall health status. Concerns have been raised surrounding the subjectiveness of this system, potentially leading to poor inter-rater agreement/reliability. We hypothesized that physicians are overconfident when assigning ASA-PS scores and that presenting them with the ASA-PS definitions/examples would improve accuracy. We therefore evaluated participants' accuracy and self-reported confidence on the ASA-PS Classification System (1) while assigning ASA-PS according to their baseline knowledge/judgment; and (2) after a single exposure to the ASA-PS definitions/examples. ⋯ Physicians tend to disagree and be overconfident when assigning ASA-PS scores. A brief consultation of the ASA-PS definitions/examples improves the accuracy for both anesthesiologists and non-anesthesiologists.
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Although combined thoracic paravertebral blockade (TPVB)-general anesthesia (GA) could improve pain control compared to GA alone after thoracoscopic lung cancer surgery, it has not been established whether this improvement in pain control could reduce associated adverse outcomes. Thus, this study aimed to explore the association between TPVB usage and adverse outcomes after thoracoscopic lung cancer surgery. ⋯ The usage of TPVB may be a feasible and adjustable approach to reduce the rates of PPCs and POAF and associated LOS in thoracoscopic lung cancer surgery.