British journal of anaesthesia
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Randomized Controlled Trial
Remifentanil and perioperative glycaemic response in cardiac surgery: an open-label randomised trial.
This study investigated whether remifentanil infusion decreased intraoperative hyperglycaemia and insulin resistance compared with intermittent fentanyl administration in patients undergoing elective cardiac surgery. ⋯ NCT02349152.
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Review
Perioperative considerations for transgender women undergoing routine surgery: a narrative review.
A transgender woman is a person assigned male sex at birth who identifies as a woman. With the numbers of transgender identity on the rise, encountering a transgender woman requiring routine surgery is becoming more common in anaesthetic practice. The perioperative period can be challenging for transgender women, but these challenges can be mitigated by a skilled and sensitive perioperative team. ⋯ Whilst there are anaesthetic issues relevant to both transgender women and men, there are many issues unique to transgender women. This article focuses only on considerations for the perioperative care of the transgender woman. This narrative review provides an overview of the factors influencing the safe care of the transgender woman presenting for routine surgery, including the potential social and pharmacological factors to consider, and anatomical changes to be aware of from previous gender confirming or feminisation surgeries that can influence clinical decision-making.
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Elevated red cell distribution width (RDW) has been associated with worse outcomes in several medical patient populations. The aim of this study was to investigate the association of increased preoperative RDW and short- and long-term mortality after noncardiac surgery. ⋯ Increased preoperative RDW is associated with increased long-term mortality after noncardiac surgery. RDW could be a composite biomarker of pre-existing chronic inflammation and poor nutritional status. Future studies should clarify if this is a modifiable risk factor for improved surgical outcomes.