BMC anesthesiology
-
Randomized Controlled Trial
Target blood pressure management during cardiopulmonary bypass improves lactate levels after cardiac surgery: a randomized controlled trial.
Hyperlactatemia is associated with a poor prognosis in cardiac surgery patients. This study explored the impact of target blood pressure management during cardiopulmonary bypass (CPB) on blood lactate levels after cardiac surgery. ⋯ Maintaining a relatively higher MAP during CPB deceased the blood lactate level at the end of surgery, reduced epinephrine consumption, and shortened the time to extubation and length of stay in the ICU after surgery.
-
Pain control after hepatectomy is usually achieved by opioids. There are significant individual differences in the amount of opioids used after hepatectomy, and the metabolism of opioids is liver-dependent. The purpose of our study was to explore the possible risk factors for opioid consumption during the first 48 h after surgery. ⋯ Age younger than 60 years, major hepatic resection, an open approach and a longer operation are factors more likely to cause patients to require higher doses of sufentanil after hepatectomy, and the early identification of such patients can increase the efficacy of perioperative pain management.
-
Observational Study
Remimazolam for induction of anesthesia in elderly patients with severe aortic stenosis: a prospective, observational pilot study.
Remimazolam, a novel benzodiazepine, has been reported to cause less hypotension than propofol during induction of anesthesia. Therefore, remimazolam might be a valuable option in elderly patients with severe aortic stenosis who are considered to be the most vulnerable to hemodynamic instability. We aimed to evaluate the feasibility and hemodynamic effects of remimazolam as an induction agent in elderly patients with severe aortic stenosis. ⋯ Remimazolam could be used as an induction agent with timely bolus vasopressors in elderly patients with severe aortic stenosis.
-
Frailty is a multidimensional condition characterized by loss of functional reserve, which results in increased vulnerability to adverse outcomes following surgery. Anesthesiologists can reduce adverse outcomes when risk factors are recognized early and dedicated care pathways are operational. As the frail elderly population is growing, we investigated the perspective on the aging population, familiarity with the frailty syndrome and current organization of perioperative care for elderly patients among Dutch anesthesiologists. ⋯ This survey demonstrated that the increasing number of frail elderly patients is perceived as important and relevant for anesthetic management. Opportunities lie in improving the organization and effectuation of perioperative care by more consistent involvement of anesthesiologists.
-
Postoperative pulmonary embolism (PE) is a serious thrombotic complication in the patients with otolaryngologic cancers. We investigated the risk factors associated with postoperative PE after radical resection of head and neck cancers. ⋯ The intraoperative hypotension, oliguria, and operation time > 4 h are risk factors associated with postoperative PE after radical resection of head and neck cancers. Improving intraoperative hemodynamics management to ensure adequate blood pressure and urine output may reduce the occurrence of such complications.