Articles: surgery.
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Retrospective Controlled Cohort. ⋯ In postoperative PSF for AIS patients receiving LB via ESPB, those who did not receive a PCA had lower opioid consumption without worse pain scores or mobility and had a lower LOS. Adding LB via ESPB to postoperative pain regimens effectively replaces a PCA by providing the same pain control and reducing overall opioid consumption and LOS.
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Retrospective database review. ⋯ Level II.
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Clinical trials and validation studies demonstrate promising hypotension prediction capability by the Hypotension Prediction Index (HPI). Most studies that evaluate HPI derive it from invasive blood pressure readings, but a direct comparison with the noninvasive alternative remains undetermined. Such a comparison could provide valuable insights for clinicians in deciding between invasive and noninvasive monitoring strategies. ⋯ Noninvasive HPI is reliably accessible to clinicians during noncardiac surgery, showing comparable accuracy in HPI probabilities and the potential for additional response time.
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Leadership is a skill that all surgeons are confronted with in some capacity. Surprisingly in the US most training programs do not offer a structured program in leadership and there certainly are no metrics used to assess leadership competency. As a response to this, at The Society for Clinical Vascular Surgery (SCVS) a panel of leaders in vascular surgery both national and international, along with leadership experts discussed some of the salient issues in this space. This document is the result of this discussion and serves as a good framework for understanding needs and current shortcomings of leadership training.
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J Clin Monit Comput · Oct 2024
Wire-in-needle versus conventional syringe-on-needle technique for ultrasound-guided central venous catheter insertion in the internal jugular vein: the WIN randomized trial.
There are different techniques for ultrasound-guided central venous catheter (CVC) insertion. When using the conventional syringe-on-needle technique, the syringe needs to be removed from the needle after venous puncture to pass the guidewire through the needle into the vein. When, alternatively, using the wire-in-needle technique, the needle is preloaded with the guidewire, and the guidewire-after venous puncture-is advanced into the vein under real-time ultrasound guidance. We tested the hypothesis that the wire-in-needle technique reduces the time to successful guidewire insertion in the internal jugular vein compared with the syringe-on-needle technique in adults. ⋯ The wire-in-needle technique-compared with the syringe-on-needle technique-did not reduce the time to successful guidewire insertion in the internal jugular vein. Clinicians can consider either technique for ultrasound-guided CVC insertion in adults.