Articles: post-operative.
-
Anesthesia and analgesia · Jan 2024
Meta AnalysisAnalgesic Effects of Regional Analgesic Techniques in Pediatric Inguinal Surgeries: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.
Various regional analgesic techniques have been used in pediatric inguinal surgery to facilitate postoperative recovery. However, each technique's relative performance was undetermined owing to the lack of quantitative analysis. ⋯ The quadratus lumborum and transversus abdominis plane blocks had the longest time to the first rescue analgesic and the least rescue analgesic requirement for pediatric inguinal surgeries. Specifically, the quadratus lumborum block had the longest analgesic duration in inguinal hernia repair, and the caudal block was found to be the only regional analgesia that extended the time to the first rescue analgesic in pediatric orchidopexy. Most included randomized controlled trials had some concern or a high risk of bias, and future studies should focus on providing high-quality evidence to further clarify the analgesic effects of regional analgesia for pediatric inguinal surgeries.
-
Critical care medicine · Jan 2024
High Mechanical Power and Driving Pressures are Associated With Postoperative Respiratory Failure Independent From Patients' Respiratory System Mechanics.
High mechanical power and driving pressure (ΔP) have been associated with postoperative respiratory failure (PRF) and may be important parameters guiding mechanical ventilation. However, it remains unclear whether high mechanical power and ΔP merely reflect patients with poor respiratory system mechanics at risk of PRF. We investigated the effect of mechanical power and ΔP on PRF in cohorts after exact matching by patients' baseline respiratory system compliance. ⋯ High mechanical power and ΔP are associated with PRF independent of patient's baseline respiratory system compliance. Our findings support utilization of these parameters for titrating mechanical ventilation in the operating room and ICU.
-
Case Reports
Three Episodes of Postanesthesia Paradoxical Vocal Cord Motion Disorder in the Same Patient: A Case Report.
Postanesthesia paradoxical vocal cord motion disorder (PVCMD) is often benign. However, if not recognized, PVCMD can lead to unnecessary treatments. Our patient had 3 different surgeries over a period of 20 months. ⋯ The third episode of PVCMD occurred after a cervical fusion surgery. Prevertebral edema from surgery further compromised the airways. Our case demonstrates the challenges of identifying and managing perioperative PVCMD, especially when surgical complications confound the airway management.