Articles: general-anesthesia.
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Acta clinica Croatica · Sep 2022
ReviewTHE EFFECT OF REGIONAL VS. GENERAL ANESTHESIA ON THE IMMUNE RESPONSE IN BREAST CANCER SURGERY: A NARRATIVE REVIEW OF THE LITERATURE.
For breast cancer patients, surgery remains the cornerstone in treatment. Perioperative and postoperative period is associated with impaired immune function that can have profound implications for cancer patients in terms of tumor recurrence and metastases. The three main factors include surgery and related neuroendocrine stress response, anesthetic drugs, including opioid analgesics and postoperative pain. ⋯ The level of NK cells' cytotoxicity is inversely proportional to the stage and spread of cancer. Regional anesthesia and its potential beneficial effects on the perioperative immune response and long-term outcome after surgery has been investigated as an alternative to general anesthesia in patients undergoing breast cancer surgery. In this paper, we present a review of literature aimed to assess the impact of regional anesthesia techniques on the immune response in patients undergoing breast cancer surgery and how it compares to general anesthesia.
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Several retrospective studies using administrative or single-center data have failed to show any difference between general anesthesia using propofol versus inhaled volatiles on long-term survival after breast cancer surgery. Although randomized controlled trials are ongoing, validated data from national clinical registries may advance the reliability of existing knowledge. ⋯ Among patients undergoing breast cancer surgery under general anesthesia, no association was observed between the choice of propofol or an inhaled volatile maintenance and overall survival.
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Paediatric anaesthesia · Sep 2022
Observational StudyThe Association Between Carotid Flow Time and Fluid Responsiveness in Children Under General Anesthesia.
Fluid administration in children undergoing surgery requires precision, however, determining fluid responsiveness can be challenging. Ultrasound has been used widely in the emergency department and intensive care units as a noninvasive, bedside manner of determining volume status, but the intraoperative period presents unique challenges as often the chest and abdomen are inaccessible for ultrasound. We investigate whether carotid artery ultrasound, specifically carotid flow time, can be used to determine fluid responsiveness in children under general anesthesia. ⋯ Flow time increases with initiation of positive pressure ventilation and after administration of a fluid bolus. FTc may serve as an indicator of fluid status but does not predict fluid responsiveness in children under general anesthesia.
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Ulus Travma Acil Cer · Sep 2022
Randomized Controlled TrialThe use of STOP-BANG questionnaire and other difficult airway determinants in difficult airway prediction and correlation.
The primary objective of this study was to evaluate the use of STOP-BANG questionnaire in prediction of difficult airway. The secondary aim of this study is to evaluate the correlation of the questionnaire and other difficult airway determinant tests in predicting difficult airway. ⋯ In our study, the STOP-BANG questionnaire was found to be important in predicting the difficult airway and this test was found to be usable like other difficult airway parameters.