British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Deep neuromuscular block does not improve surgical conditions in patients receiving sevoflurane anaesthesia for laparoscopic renal surgery.
Deep neuromuscular block does not improve surgical conditions for laparoscopic renal surgery.
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Review Meta Analysis
Epidural analgesia, intrapartum hyperthermia, and neonatal brain injury: a systematic review and meta-analysis.
Epidural analgesia is associated with intrapartum hyperthermia, and chorioamnionitis is associated with neonatal brain injury. However, it is not known if epidural hyperthermia is associated with neonatal brain injury. This systematic review and meta-analysis investigated three questions: (1) does epidural analgesia cause intrapartum hyperthermia, (2) is intrapartum hyperthermia associated with neonatal brain injury, and (3) is epidural-induced hyperthermia associated with neonatal brain injury? ⋯ Epidural analgesia is a cause of intrapartum hyperthermia, and intrapartum hyperthermia of any cause is associated with neonatal brain injury. Further work is required to establish if epidural-induced hyperthermia is a cause of neonatal brain injury.
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Randomized Controlled Trial
Nociception-monitor-guided opioid administration in radical retropubic prostatectomy: a randomised controlled trial.
This RCT investigated the effect of opioid titration by three different nociception monitoring devices or clinical signs during general anaesthesia. ⋯ NCT03380949.
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Review Practice Guideline
Improving perioperative brain health: an expert consensus review of key actions for the perioperative care team.
Delirium and postoperative neurocognitive disorder are the commonest perioperative complications in patients more than 65 yr of age. However, data suggest that we often fail to screen patients for preoperative cognitive impairment, to warn patients and families of risk, and to take preventive measures to reduce the incidence of perioperative neurocognitive disorders. As part of the American Society of Anesthesiologists (ASA) Perioperative Brain Health Initiative, an international group of experts was invited to review published best practice statements and guidelines. ⋯ The actions focus on education, cognitive and delirium screening, non-pharmacologic interventions, pain control, and avoidance of antipsychotics. Strategies for effective implementation are discussed. Anaesthetists should be key members of multidisciplinary perioperative care teams to implement these recommendations.
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Letter Randomized Controlled Trial
A randomised pilot trial of combined cognitive and physical exercise prehabilitation to improve outcomes in surgical patients.