Articles: general-anesthesia.
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There is controversy surrounding the influence of dexmedetomidine on the recovery of postoperative gastrointestinal dysfunction in patients under general anesthesia. The main purpose of this meta-analysis is to evaluate the effect of dexmedetomidine administration during the perioperative period on the recovery of gastrointestinal function in patients under general anesthesia. ⋯ Perioperative dexmedetomidine administration can promote the recovery of gastrointestinal function and reduce the length of hospital stay after abdominal surgery. The optimal dose and timing of dexmedetomidine and the influence on non-abdominal surgery need further investigation.
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Postoperative nausea and vomiting (PONV) are common complications after gynecological laparoscopic surgery. Pyridoxine has been recommended as a first-line drug to prevent and treat nausea and vomiting during pregnancy; however, its efficacy in preventing PONV remains unclear. ⋯ In this single center randomized trial, pyridoxine plus dexamethasone and ondansetron reduced the incidence of PONV in patients undergoing elective gynecological laparoscopic surgery under general anesthesia. These findings need to be validated in multicenter studies in diverse populations to ensure generalizability.
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Journal of anesthesia · Dec 2024
Current practice and awareness of perioperative do-not-attempt-resuscitation orders: a single-center retrospective survey and complete questionnaire survey.
We investigated whether patients who have been issued a do-not-attempt-resuscitation order (DNAR) preoperatively (hereafter, DNAR patients) are informed of the DNAR code change when they undergo anesthesia. We also conducted a survey of the awareness of medical staff regarding perioperative DNARs, and investigated the current situation at a single-center in Japan. ⋯ In clinical practice, 27% of DNAR patients were informed of DNARs code change before surgery. Perioperative advance care planning should be further promoted in clinical practice by creating guidelines and training programs regarding perioperative DNARs.
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Safe perioperative management of patients undergoing transcatheter aortic valve implantation (TAVI) is crucial. Remimazolam is a newly developed short-acting benzodiazepine. We hypothesized that combining remimazolam and flumazenil would reduce emergence time compared with sevoflurane in patients undergoing general anesthesia for TAVI. ⋯ UMIN.ac.jp ( UMIN000047892 ); first posted 30 May 2022.