Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2023
Review Meta AnalysisEffects of magnesium, phosphate, or zinc supplementation in ICU patients - a systematic review and meta-analysis.
Low-serum levels of magnesium, phosphate, and zinc are observed in many intensive care unit (ICU) patients, but clinical equipoise exists regarding supplementation strategies. We aimed to assess the desirable and undesirable effects of supplementation with magnesium, phosphate, or zinc in adult ICU patients. ⋯ In adult ICU patients, the certainty of evidence for the effects of supplementation with magnesium, phosphate, or zinc was very low. High-quality trials are needed to assess the value of supplementation strategies in these patients.
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Acta Anaesthesiol Scand · Mar 2023
Glycemic profile and quality of recovery after emergency abdominal surgery - a prospective explorative cohort study.
Associations between degrees of postoperative hyperglycemia and morbidity has previously been established. There may be an association between the glycemic profile and patient-reported recovery, and this may be a target for perioperative quality improvements. We aimed to investigate the association between metrics of the 30-day glycemic profile and patient-reported recovery in nondiabetic patients after major abdominal surgery. ⋯ We did not find an association between the remaining metrics and patient-reported recovery. Alterations in the glycemic profile are frequent and prolonged during the first postoperative month after major surgery probably due to peripheral insulin resistance. Our findings indicate that high-glycemic variation is associated with poorer patient-reported recovery and might represent a proxy for care improvements in the postoperative period.
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Acta Anaesthesiol Scand · Mar 2023
Observational StudyThe effect of ketamine and fentanyl on haemodynamics during intubation in prehospital and retrieval medicine.
Ketamine use for rapid sequence intubation (RSI) is frequent in pre-hospital and retrieval medicine (PHARM) and is associated with potentially deleterious haemodynamic changes, which may be ameliorated by concurrent use of fentanyl. ⋯ The addition of fentanyl to ketamine for RSI was not associated with an alteration of the odds of post-induction haemodynamic stability, although the doses used were low. These findings justify further study into the optimal dosing of fentanyl during RSI in pre-hospital and retrieval medicine.
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Acta Anaesthesiol Scand · Mar 2023
Randomized Controlled TrialPosterior quadratus lumborum block versus epidural analgesia for postoperative pain management after open radical cystectomy: a randomized clinical trial.
In open abdominal surgery, continuous epidural analgesia is commonly used method for postoperative analgesia. However, ultrasound (US)-guided fascial plane blocks may be a reasonable alternative. ⋯ Opioid consumption did not differ significantly between posterior QLB and an epidural infusion with ropivacaine for the first 2 postoperative days following RC.
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Acta Anaesthesiol Scand · Mar 2023
Frequency of blood lactate elevation following esophagectomy and its association to postoperative complications.
Esophagectomy is a major surgical intervention and a cornerstone in the treatment of esophageal cancer. There is clinical experience that blood lactate concentration often is elevated in the period following esophagectomy, but the incidence and clinical consequences are sparsely studied. ⋯ In conclusion, elevated blood lactate in the immediate time following esophagectomy showed a weak association to intensive care and length of stay but not anastomotic leak.