Articles: general-anesthesia.
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Background and Objectives: The most recent guidelines and recommendations regarding treatments of dental caries in children are shifting towards evidence-based minimal or non-invasive approaches aiming to preserve the vitality of teeth and potentially reduce the need for dental general anesthesia. This study investigated the treatment recommendations of dentists actively practicing pediatric dentistry in Germany regarding different patient cases with caries in primary teeth. Materials and Methods: The questionnaire was distributed on paper or online to pediatric dentists and general dentists practicing pediatric dentistry. ⋯ The dentist's age, experience, and educational background did not significantly correlate to choosing "not recommended" treatment options. Conclusions: A child's pain and cooperation level greatly impact the treatment decisions made by dentists, with a risk of too invasive treatment options in low-severity cases. Substantial disparities in treatment recommendations for caries in primary teeth persist among dental practitioners regardless of their age, experience, and educational background.
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Minerva anestesiologica · Nov 2024
Comparison of remimazolam and propofol on postoperative subjective quality of recovery in patients undergoing general anesthesia: a meta-analysis of randomized controlled trials.
Remimazolam, a recently approved drug for surgical sedation and general anesthesia, has been compared with propofol in previous studies regarding its efficacy as a general anesthetic. However, the question of whether remimazolam demonstrates non-inferiority to propofol in postoperative subjective quality of recovery (QoR) among patients under general anesthesia has not been definitively answered. ⋯ Remimazolam is similar to propofol in terms of postoperative subjective QoR for patients receiving general anesthesia.
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This study evaluates the efficiency and cost-effectiveness of an oncological outpatient neurosurgery protocol using enhanced recovery after surgery principles in a European healthcare setting. Additionally, it assesses the impact of incorporating hospital at home (HaH) for perioperative follow-up on program efficiency and costs. ⋯ Outpatient neurosurgery with HaH follow-up offers substantial cost savings without compromising care quality in a public health setting. Inpatient care's higher costs are largely due to bed utilization, while the integration of HaH does not add significant costs, making it a viable alternative for postoperative management.
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In oral maxillofacial surgery, the nasal tracheal tube is mostly used to provide a better surgical field for oral, head and neck operations. Postoperative sore throat and hoarseness are common following tracheal intubation, with an incidence of 11-55%. Then, we previously reported advantage technique of fiberoptic scope to decrease the risk which the tip of the tube is visualized as the tube is advanced which helps avoid impingement of the tube. However, the extent to which this technique causes postoperative complications is unknown compared to traditional technique. The aim of this study was retrospectively to determine the effect of postoperative sore throat following nasotracheal intubation by tip of the tube is visualized by fiberoptic scope. ⋯ We found that postoperative sore throat and recovery were not influenced by observative fiberoptic scope for nasotracheal intubation.
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To improve the management level of general anesthesia during bronchoscopy in the children with diffuse alveolar hemorrhage (DAH). A retrospective study was conducted in the children with DAH who had performed bronchoscopy under general anesthesia with spontaneous respiration by face mask ventilation initially from June 2021 to June 2022 in our hospital. (1) Thirty-four children who had underwent 38 bronchoscopy procedures were included. (2) General anesthesia induction was performed by bolus of propofol intravenous in all the procedures. For maintaining anesthesia, combination use of propofol and remifentanil intravenously infusion were given in 31 procedures (81.6%) and propofol intravenously infusion alone was given in the rest 7 procedures (18.4%). ⋯ Intraoperative hypercapnia also occurred in 16 procedures (42.1%). Two procedures (5.3%) were complicated by severe pulmonary hemorrhage. General anesthesia with spontaneous respiration by face mask ventilation is feasible and relatively safe for the children with DAH undergoing bronchoscopy, whereas the anesthetic protocol still needs to be improved.