Articles: general-anesthesia.
-
General anesthesia providing one-lung ventilation (OLV) with double-lumen endotracheal intubation has been considered inevitable for thoracic surgery. However, with the recent trend of less invasive surgical technique and enhanced recovery after surgery, tubeless anesthesia has been performed in various thoracic surgeries. The aim of this study was to establish a feasible and safe strategy of ventilator-assisted tubeless anesthesia in video-assisted thoracoscopic surgeries (VATS) based on single-institution experiences. ⋯ No patients were converted to general anesthesia or open thoracotomy unintentionally. All patients were discharged on median 2 days postoperatively without complications. Ventilator-assisted tubeless VATS is a feasible and safe option in low-risk patients undergoing video-assisted pulmonary wedge resection.
-
Patients are administered supplemental oxygen upon emergence from general anesthesia against the risk of hypoxia. However, few studies have assessed the weaning from supplemental oxygen therapy. This study investigated the frequency and risk factors of failure to discontinue supplemental oxygen at a postanesthesia care unit (PACU). ⋯ In the analysis of more than 12,000 general anesthetics, an overall risk of failed weaning from supplemental oxygen therapy of 1:14 was observed. The identified risk factors may help determine the discontinuation of supplemental oxygen administration at PACU.
-
The requirement to change position whilst under general anaesthesia may expose patients to significant risks. We devised and implemented a concise and comprehensive patient positioning safety tool with the aim of reducing risks and improving patient safety during position changes under anaesthesia.
-
J Neurosurg Anesthesiol · Jul 2023
Meta AnalysisGeneral Anesthesia Versus Nongeneral Anesthesia for Patients With Acute Posterior Circulation Stroke Undergoing Endovascular Therapy: A Systematic Review and Meta-analysis.
There is continued controversy regarding the optimal anesthetic technique for endovascular therapy in patients with acute posterior circulation ischemic stroke. To compare the clinical outcomes general anesthesia (GA) and non-GA, we performed a systematic review and meta-analysis of randomized controlled trials and observational studies focused on the anesthetic management for endovascular therapy in patients with acute posterior circulation stroke, without language restriction. In addition, we compared clinical outcomes among the studies with different non-GA types (conscious sedation or local anesthesia). ⋯ Subgroup analysis showed that GA was associated with higher odds of mortality than conscious sedation (OR: 1.83; 95% CI, 1.30 to 2.57; I2 =0%), but there was no difference between GA and local anesthesia ( I2 =0%). Interestingly, subgroup analysis did not identify a relationship between functional independence and GA compared with local anesthesia (OR: 0.90; 95% CI, 0.64 to 1.25; P =0.919; I2 =0%). This meta-analysis demonstrates that GA is associated with worse outcomes in patients with acute posterior circulation stroke undergoing endovascular therapy based on current studies.
-
Randomized Controlled Trial
Comparison of the Stress Responses Following TAP Block and Epidural Anesthesia in Patients Undergoing Elective Laparoscopic Cholecystectomy Under General Anesthesia: Randomized Clinical Trial.
Major surgeries and the accompanied acute stress response are associated with poor immune system function and extensive immunologic changes. This study was conducted to compare postsurgery stress responses after transversus abdominis plane (TAP) blocks and epidural anesthesia in patients undergoing laparoscopic cholecystectomy under general anesthesia. ⋯ A significant decrease in the mean blood sugar, serum cortisol, CRP, and white blood cell in both groups at 6 and 24 hours after the surgery was noted. The pain score decreased 24 hours after surgery in the epidural anesthesia group and increased in the TAP block group.