Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Meta AnalysisHigh-Dose versus Low-Dose Corticosteroids in COVID-19 Patients: a Systematic Review and Meta-analysis.
The clinical efficacy of corticosteroids remains unclear. The primary aim of this systematic review and meta-analysis was to evaluate the use of high-dose versus low- dose corticosteroids on the mortality rate of COVID-19 patients. ⋯ The meta-analysis demonstrated high-dose corticosteroids did not reduce mortality rate. However, high-dose corticosteroids did not pose higher risk of hyperglycemia and infection rate for COVID-19 patients. Due to the inconclusive trial sequential analysis, substantial heterogeneity and low level of evidence, future large-scale randomized clinical trials are warranted to improve the certainty of evidence for the use of high-dose compared to low-dose corticosteroids in COVID-19 patients.
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Randomized Controlled TrialThe Effects of Programmed Intermittent Paravertebral Bolus Infusion on Postoperative Analgesia in Patients Undergoing Video-Assisted Thoracoscopic Surgery: A Prospective, Randomized, Controlled Study.
To compare the effects of programmed intermittent bolus infusion (PIBI), continuous thoracic paravertebral infusion (CTPI), and continuous intravenous infusion (CII) on postoperative analgesia in patients undergoing video-assisted thoracoscopic surgery (VATS). ⋯ PIBI outperformed CTPI and CII in inducing analgesia for postoperative pain in patients undergoing VATS.
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Randomized Controlled TrialSugammadex Versus Neostigmine for Neuromuscular Block Reversal and Postoperative Pulmonary Complications in Patients Undergoing Resection of Lung Cancer.
This study aimed to compare the effect of sugammadex and neostigmine on neuromuscular block reversal and the incidence of postoperative pulmonary complications in patients undergoing lung cancer resection. ⋯ Administration of sugammadex provided faster recovery of rocuronium-induced neuromuscular block when compared with neostigmine. Moreover, for patients undergoing lung cancer resection, administration of sugammadex could reduce the incidence of postoperative pulmonary complications and duration of postoperative hospital stay.
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Pain Trajectories After Valve Surgeries Performed via Midline Sternotomy Versus Mini-Thoracotomy.
Controlling moderate-to-severe pain remains a major challenge after cardiothoracic surgery. Several outcomes have been compared extensively after valve surgery performed via midline sternotomy versus mini-thoracotomy, but postoperative pain (POP) was not adequately examined. Therefore, the authors tested the hypothesis that there is no difference in POP trajectories in patients undergoing valve surgery via midline sternotomy versus mini-thoracotomy. ⋯ Midline sternotomies are associated with higher odds of having an acute worsening or stationary versus a rapidly improving pain trajectory compared to mini-thoracotomies. Therefore, the choice of incision may play an important role in determining POP trajectory after valve surgery.