BMC anesthesiology
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Observational Study
Neuromuscular block in patients 80 years and older: a prospective, controlled study.
An increasing number of patients older than 80 years are undergoing anesthesia, but little information is available regarding pharmacodynamic effects of myorelaxants in this population. This study aims to compare the time course of rocuronium neuromuscular block in patients ≥ 80 years with those of younger adults. ⋯ Compared to younger adults rocuronium shifted in patients ≥ 80 years from a rapid onset, intermediate acting compound to a slower onset, long-acting compound.
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Randomized Controlled Trial
Impact of dexmedetomidine supplemented analgesia on delirium in patients recovering from orthopedic surgery: A randomized controlled trial.
Dexmedetomidine promotes normal sleep architecture; the drug also improves analgesia. We therefore tested the hypothesis that supplementing intravenous analgesia with dexmedetomidine reduces delirium in older patients recovering from orthopedic surgery. ⋯ Supplementing sufentanil intravenous analgesia with low-dose dexmedetomidine did not significantly reduce delirium, but improved analgesia and sleep quality without provoking adverse events.
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Observational Study
The relationship between the effect-site concentration of propofol and sedation scale in children: a pharmacodynamic modeling study.
Continuous infusion of propofol has been used to achieve sedation in children. However, the relationship between the effect-site concentration (Ce) of propofol and sedation scale has not been previously examined. The objective of this study was to investigate the relationship between the Ce of propofol and the University of Michigan Sedation Scale (UMSS) score in children with population pharmacodynamic modeling. ⋯ We quantified the pharmacodynamic relationship between the Ce of propofol and UMSS score, and this finding may be helpful to predict the sedation score at the target Ce of propofol in children.
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Malnutrition in intensive care unit (ICU) patients is associated with adverse clinical outcomes. The modified nutrition risk in the critically ill score (mNUTRIC) was proposed as an appropriate nutritional assessment tool in critically ill patients, but it has not been fully demonstrated and widely used. Our study was conducted to identify the nutritional risk in ICU patients using the mNUTRIC score and explore the relationship between 28-day mortality and high mNUTRIC scores. ⋯ Patients admitted to the ICU were at high risk of malnutrition, and a high mNUTRIC score was associated with increased ICU length of stay and higher mortality. More large prospective studies are needed to demonstrate the validity of this score.
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Comparative Study Observational Study
Optimal angle of needle insertion for spinal anesthesia in patients with spondylolisthesis: an ultrasonographic study.
Spondylolisthesis is a common degenerative spinal deformity. At the level of spondylolisthesis, the anatomy of the interlaminar space may differ from normal spine, in which case optimal angle of the needle insertion for spinal anesthesia may change. This study compared the optimal angle of needle insertion during spinal anesthesia in patients with and without lumbar spondylolisthesis using ultrasound. ⋯ In patients with spondylolisthesis, caudad angulation of the spinal needle can aid successful spinal puncture at spondylolisthesis level, both in the midline and paramedian approaches.