BMC anesthesiology
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Observational Study
Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery.
Accurate determination of cardiopulmonary exercise test (CPET) derived parameters is essential to allow for uniform preoperative risk assessment. The objective of this prospective observational study was to evaluate the inter-observer agreement of preoperative CPET-derived variables by comparing a self-preferred approach with a systematic guideline-based approach. ⋯ Inter-observer agreement of numerical values of CPET-derived parameters can be improved by using a systematic guideline-based approach. Effort-independent variables such as the V̇E/V̇CO2-slope and the OUES might be useful to further improve uniformity in preoperative risk assessment in addition to, or in case V̇O2VAT and V̇O2peak are not determinable.
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Postoperative nausea and vomiting is common in patients receiving microvascular decompression. In the current study, we examined whether postoperative nausea and vomiting is associated with reduced intraocular pressure (IOP) after microvascular decompression, a measure that reflects intracranial pressure. ⋯ In patients undergoing microvascular decompression surgery, postoperative IOP reduction is associated with postoperative vomiting.
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Complications of peribulbar anaesthesia include retrobulbar haemorrhage, globe perforation and brainstem anaesthesia. Therefore, this study took measurements relating the proximity of medial canthus to the optic nerve and also the safe angle between orbit and globe using 200 multiplanar reconstructed computed tomography (CT) images of the orbit. The principal results show that in 1.5% of the sample, the optic nerve is within 20 mm of the medial canthus, with a minimum distance of 15 mm. ⋯ We have shown that there are a minority of patients with unusual orbital anatomy. This places them at a theoretical higher risk of complications. These cases are not currently predicted by measured data.
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Randomized Controlled Trial
Effect of additional equipotent fentanyl or sufentanil administration on recovery profiles during propofol-remifentanil-based anaesthesia in patients undergoing gynaecologic laparoscopic surgery: a randomized clinical trial.
In clinical practice, sufentanil has a stronger sedative effect on patients than fentanyl at equivalent doses. This study hypothesized that, at equivalent doses, patients undergoing gynaecologic laparoscopic surgery (GLS) receiving fentanyl would have an earlier emergence from anaesthesia (EA), a shorter time to extubation (TE), and a better degree of wakefulness. Therefore, this study evaluated the effects of equipotent doses of fentanyl and sufentanil on the quality of emergence in patients undergoing GLS. ⋯ The majority of patients scheduled for GLS were able to rapidly and smoothly emerge from anaesthesia. After surgery, similar outcomes, including EA, TE, the incidence of endotracheal tube tolerance, the rate of leaving the surgical bed voluntarily, RSS scores, VRS scores, and adverse events in the PACU, were achieved for the patients between the two anaesthetic protocols.
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Observational Study
The duration of chronic low back pain is associated with acute postoperative pain intensity in lumbar fusion surgery: a prospective observational study.
Pre-existing chronic pain has been associated with severe postoperative pain. In this study, we sought to prospectively analyse the association between the duration of chronic low back pain and the intensity of acute postoperative pain after lumbar fusion surgery. ⋯ The longer the duration of chronic pain was, the higher the incidence of moderate to severe acute postoperative pain was and the greater the amount of analgesics required after surgery.