Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2021
Ketamine for postoperative pain treatment in spinal surgery. A protocol for a systematic review with meta-analysis and trial sequential analysis.
Post-operative pain treatment with ketamine has been demonstrated to have post-operative opioid-sparing and anti-hyperalgesic effects. However, evidence regarding the beneficial and harmful effects and the optimal dose and timing of perioperative treatment with ketamine for patients undergoing spinal surgery is unclear. The objective of this systematic review is to assess the analgesic, serious and non-serious adverse effects of perioperative pain treatment with ketamine for patients undergoing spinal surgery. ⋯ This systematic review will assess the beneficial and harmful effects of perioperative pain treatment with ketamine for patients undergoing spinal surgery and have the potential to inform best practice and advance research.
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Acta Anaesthesiol Scand · Jan 2021
Randomized Controlled TrialContinuous intravenous infusion of enoxaparin controls thrombin formation more than standard subcutaneous administration in critically ill patients. A sub-study of the ENOKSI thromboprophylaxis RCT.
Standard subcutaneous low-molecular-weight heparin (LMWH) thromboprophylaxis yields low anti-factor Xa activity in patients in the intensive care unit (ICU). The aim of the study was to assess coagulation status in ICU patients randomized to receive enoxaparin thromboprophylaxis either as a standard subcutaneous bolus (SCB) or continuous intravenous infusion (CII) for 3 consecutive days after the initiation of LMWH thromboprophylaxis. ⋯ Enoxaparin thromboprophylaxis administered by CII inhibited more prominently FXa and preserved better the AT level, compared with standard subcutaneous care.
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Acta Anaesthesiol Scand · Jan 2021
Randomized Controlled TrialPost-operative opioid-related adverse events with intravenous oxycodone compared to morphine: a randomized controlled trial.
The value of intravenous oxycodone compared to morphine remains controversial. The purpose of this trial was to compare opioid-related adverse events (ORAES) of intravenous oxycodone and morphine after total hip arthroplasty. ⋯ This study demonstrates that IV oxycodone did not significantly reduce ORAEs within the first 24 hours compared to similar ratio of IV morphine.
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Acta Anaesthesiol Scand · Jan 2021
ReviewAcetate- versus lactate-buffered crystalloid solutions: Protocol for a systematic review with meta-analysis and trial sequential analysis.
Buffered crystalloid solutions are increasingly recommended as first-line resuscitation fluids. However, guidelines do not distinguish between different types of buffered solutions. The aim of the outlined systematic review is to summarize and assess the effects of acetate- vs lactate-buffered crystalloid solutions on patient-important outcomes. ⋯ The outlined systematic review will provide important data on how patient-important outcomes are affected by intravenous administration of acetate- vs lactate-buffered crystalloid solutions in hospitalized patients.
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Acta Anaesthesiol Scand · Jan 2021
Multicenter StudyRisk factors for long-term cognitive impairment in ICU survivors: a multicenter, prospective cohort study.
To describe the incidence of and risk factors for impaired cognitive function in intensive care unit (ICU) survivors. We hypothesized that age, severity of illness, and days in coma, delirium, mechanical ventilation in the ICU would be associated with impaired cognitive function. ⋯ In this multicenter study of adult ICU survivors, cognitive impairment was frequent and severe in those assessed at 6 months. Higher age was a risk factor for cognitive impairment, but events related to the ICU stay were not associated with poorer cognitive performance at 6 months.