Articles: general-anesthesia.
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Surgery and general anaesthesia have the potential to disturb the body's circadian timing system, which may affect postoperative outcomes. Animal studies suggest that anaesthesia could induce diurnal phase shifts, but clinical research is scarce. We hypothesised that surgery and general anaesthesia would result in peri-operative changes in diurnal sleep-wake patterns in patients. ⋯ Disruption started from one night before surgery and did not normalise until 6 days after surgery. We conclude that there is a peri-operative phase advance in midpoint of sleep, confirming our hypothesis that surgery and general anaesthesia disturb the circadian timing system. Patients had decreased subjective sleep quality, worse sleep efficiency and increased daytime fatigue.
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Paediatric anaesthesia · Jan 2022
Unplanned admission to pediatric intensive care after general anesthesia: A seven-year retrospective cohort study in a tertiary children's hospital.
Thorough preoperative risk assessment and planning is key to improving patient safety in the perioperative period. Analysis of unplanned ICU admissions after general anesthesia has been validated as a measure of patient safety and its use as a quality initiative is recommended in many countries. ⋯ "Anesthesia-related" was the leading reason for unplanned ICU admissions, of which the majority required only observation or transient respiratory support. All but one patient who died demonstrated no changes in the PCPC scale, presenting favorable outcome overall.
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Multicenter Study Comparative Study
Chronic subdural hematoma drainage under local anesthesia with sedation versus general anesthesia and its outcome.
Burr hole drainage is the criterion standard treatment for chronic subdural hematoma (CSDH), a common neurosurgical condition. However, apart from the surgical technique, the method of anesthesia also has a significant impact on postoperative patient outcome. Currently, there are limited studies comparing the use of local anesthesia with sedation (LA sedation) versus general anesthesia (GA) in the drainage of CSDH. The objective of this study was to compare the morbidity and mortality outcomes of using LA sedation versus GA in CSDH burr hole drainage. ⋯ This study demonstrates that CSDH drainage under LA sedation is safe and efficacious, with a significantly lower risk of postoperative mortality and morbidity when compared with GA.
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Case Reports Comparative Study
Investigation of asleep versus awake motor mapping in resective brain surgery.
To develop an asleep motor mapping paradigm for accurate detection of the corticospinal tract during glioma surgery and compare outcomes with awake patients undergoing glioma resection. ⋯ In this small patient series, asleep motor mapping using commonly available motor evoked potential hardware appears to be safe and efficacious in regard to EOR and functional outcomes.