Journal of anesthesia
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Journal of anesthesia · Dec 2022
Randomized Controlled TrialUsefulness and accuracy of a handheld ultrasound device for epidurssal landmark and depth assessment by anesthesiology residents.
The aim of this study was to assess the usefulness and accuracy of a handheld ultrasound device (Accuro, Rivanna Medical, Charlottesville, VA, USA) for epidural landmark and depth assessment when epidural anesthesia is performed by residents. ⋯ Although there was no significant difference in time from Tuohy needle puncture to loss of resistance, Accuro reduced the number of Tuohy needle redirects and accurately indicated the depth to the epidural space. Accuro may be useful for identifying the needle insertion point and estimating depth to the epidural space when residents perform epidural anesthesia.
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Journal of anesthesia · Dec 2022
Association of the placenta accreta spectrum score and estimated blood loss in placenta accreta spectrum patients with placenta previa: a retrospective cohort study.
The placenta accreta spectrum (PAS) score calculated by the scoring system may predict patients with PAS. We aim to find the relationship between estimated blood loss and the PAS score. Further, find the inflection point, identify PAS patients with placenta previa who were at risk for major bleeding. ⋯ There was a non-linear relationship between estimated intraoperative blood loss and PAS score. When the PAS score was greater than 9, hemorrhage, the risk of major bleeding, the need for transfusions, and the placement of an abdominal aortic balloon all increase significantly.
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Journal of anesthesia · Dec 2022
Comparison of total intravenous with inhalational anesthesia in terms of postoperative delirium and complications in older patients: a nationwide population-based study.
Postoperative delirium incidences are increasing in older adults. A Cochrane Review found no significant difference in the incidence of postoperative delirium between total intravenous anesthesia (TIVA) and inhalational anesthesia (IA). This study evaluated the differences in postoperative delirium and morbidity between patients who underwent either TIVA or IA. ⋯ This study demonstrated that TIVA was related to a slightly decreased postoperative delirium and incidence of morbidity compared to IA.