BMC anesthesiology
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Multicenter Study Observational Study
Regional anaesthesia is associated with less patient satisfaction compared to general anaesthesia following distal upper extremity surgery: a prospective double centred observational study.
Patient satisfaction is a well-established indicator to evaluate the quality of medical care and there is an increasing support for the use of patient-reported experience measures (PREMs) to evaluate satisfaction. To anesthetize the upper limb for surgery, both general and regional plexus anaesthesia are appropriate techniques. However, the best technique in the anaesthesiologist's perspective might not necessarily result in the highest patient satisfaction. The aim of this study is to investigate patient satisfaction following general and regional anaesthesia, and to identify areas where anaesthesiologists can focus on improving patient care. ⋯ Following regional plexus anaesthesia, a third of the patients are not "fully satisfied". To optimize patient satisfaction following regional anaesthesia techniques, we advocate stronger focus on patient counselling preoperatively, addressing the issues of block failure and prolonged postoperative sensory and motor block.
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Randomized Controlled Trial
Continuous Adductor Canal Block used for postoperative pain relief after medial Unicondylar Knee Arthroplasty: a randomized, double-blind, placebo-controlled trial.
Peripheral nerve block and local infiltration analgesia (LIA) provide good analgesia after knee replacement. This study evaluated the additional analgesic efficacy of continuous adductor canal block (ACB) added to single-dose LIA after medial unicondylar knee arthroplasty (UKA). We hypothesized ACB would lower pain scores and facilitate postoperative ambulation. ⋯ Continuous adductor canal block added to single-dose LIA offered better analgesia and facilitated ambulation without motor weakness after medial UKA.
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Several studies have investigated the effects of dexamethasone on post-operative cognitive dysfunction (POCD) or post-operative delirium (POD); however, their conclusions have been inconsistent. Thus, we conducted a meta-analysis to determine the effects of dexamethasone on POCD and POD in adults following general anaesthesia. ⋯ This meta-analysis revealed that prophylactic dexamethasone did not reduce the incidence of POCD and POD. Trials of alternative preventive strategies for POCD and POD, as well as a better understanding of the pathophysiology of those complex syndromes, are still needed to make progress in this field.
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Observational Study
Analysis of pre- and intraoperative clinical for successful operating room extubation after living donor liver transplantation: a retrospective observational cohort study.
Early extubation after liver transplantation is safe and accelerates patient recovery. Patients with end-stage liver disease undergo sarcopenic changes, and sarcopenia is associated with postoperative morbidity and mortality. We investigated the impact of core muscle mass on the feasibility of immediate extubation in the operating room (OR) after living donor liver transplantation (LDLT). ⋯ Our study could improve the accuracy of predictions concerning immediate post-transplant extubation in the OR by introducing preoperative PMI into predictive models for patients who underwent elective LDLT.
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To assess the validity of central and pulmonary veno-arterial CO2 gradients to predict fluid responsiveness and to guide fluid management during liver transplantation. ⋯ Central and the Pulmonary CO2 gaps cannot be used as valid tools to predict fluid responsiveness or to guide fluid management during liver transplantation. CO2 gaps also do not correlate well with the changes in PPV or CO.