Articles: postoperative.
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Randomized Controlled Trial Multicenter Study
The effect of opioid-free anaesthesia on the quality of recovery after endoscopic sinus surgery: A multicentre randomised controlled trial.
It remains to be determined whether opioid-free anaesthesia (OFA) is consistently effective for different types of surgery. ⋯ OFA can provide good intraoperative analgesia and postoperative recovery quality as effectively as conventional opioid anaesthesia in patients undergoing ESS. OFA can be an alternative option in the pain management of ESS.
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Acta Anaesthesiol Scand · Aug 2023
Association between postoperative thrombocytopenia and outcomes after traumatic brain injury surgery: A cohort study.
It is well known that thrombocytopenia occurs in patients with traumatic brain injury (TBI), and its incidence increases with the severity of injury. We aimed to determine whether postoperative thrombocytopenia in patients with TBI is associated with poor clinical outcomes. ⋯ Patients with TBI who experienced postoperative thrombocytopenia were more likely to have a poor short-term prognosis. In addition, we found that the rate of platelet growth over time varied significantly between the survival and non-survival groups. Patients with TBI who experienced a greater early increase in platelet count had a lower mortality rate.
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Anesthesia and analgesia · Aug 2023
Opioid-Sparing Multimodal Analgesia Use After Cesarean Delivery Under General Anesthesia: A Retrospective Cohort Study in 729 US Hospitals.
Optimizing analgesia after cesarean delivery is essential to quality of patient recovery. The American Society of Anesthesiologists and the Society for Obstetric Anesthesia and Perinatology recommend multimodal analgesia (MMA). However, little is known about clinical implementation of these guidelines after cesarean delivery under general anesthesia (GA). We performed this study to describe the use of MMA after cesarean delivery under GA in the United States and determine factors associated with use of MMA, variation in analgesia practice across hospitals, and trends in MMA use over time. ⋯ Variation in osMMA utilization was observed after cesarean delivery under GA in this cohort of US hospitals. While increasing trends in utilization of osMMA and OosMMA are encouraging, there is need for increased attention to postoperative analgesia practices after GA for cesarean delivery given low percentage of patients receiving osMMA and OosMMA.
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Journal of anesthesia · Aug 2023
Prevalence of preoperative opioid usage and its impact on postoperative outcomes: a retrospective cohort study.
Preoperative opioid treatment increases postoperative adverse events. This study was aimed to analyze preoperative opioid prevalence in countries with low opioid consumption. Additionally, the effect of low opioid usage on postoperative outcomes was also investigated. ⋯ Preoperative opioid usage was one-tenth of the United States average. Despite its low prevalence and small dosage, preoperative opioid usage was associated with poor postoperative outcomes. Dedicated perioperative interventions to prevent opioid-associated adverse events should be developed even in countries with low opioid consumption.