Articles: postoperative.
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Minerva anestesiologica · Jun 2019
Meta Analysis Comparative StudyInhalation versus intravenous anesthesia for adults undergoing heart valve surgery: a systematic review and meta-analysis.
Many studies have found that volatile anesthetics are associated with improved clinical outcomes for adults undergoing coronary artery bypass grafting. However, the effect of volatile anesthetics for adults after heart valve surgery has been unclear. So we conducted a meta-analysis of randomized controlled trials (RCTs) to explore whether the choice of an anesthetic regimen might influence patients' outcomes after valve surgery. ⋯ Among patients undergoing heart valve surgery, the use of inhalation anesthesia compared with TIVA failed to demonstrate superiority for survival and major postoperative complications, and the evidence was insufficient to draw firm conclusions due to the limited sample size. A determination of equivalence or superiority between these two anesthetic regimens requires further researches.
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Clinical transplantation · Jun 2019
Comparative StudyComparison of methods of providing analgesia after pancreas transplant: IV opioid analgesia versus transversus abdominis plane block with liposomal bupivacaine or continuous catheter infusion.
Current practices emphasize a multimodal approach to perioperative analgesia due to higher efficacy and decreased opioid usage. Analgesia for pancreas transplant (PT) has traditionally been managed with intravenous (IV) opioids, and reports of transversus abdominis plane (TAP) blocks are limited in this population. ⋯ Compared with IV opioid analgesia, TAP block interventions were associated with lower overall use of opioids and a faster time to intestinal function following pancreas transplant.
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The purpose of this study was to provide a systematic and comprehensive review of the existing literature regrading postoperative ossification of posterior longitudinal ligament (OPLL) progression. ⋯ The lack of high-level evidence makes it difficult to draw definite conclusions and further research and long-term follow-up clinical studies are needed to better understand postoperative OPLL progression.
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Best Pract Res Clin Anaesthesiol · Jun 2019
ReviewPostoperative ward monitoring - Why and what now?
The postoperative ward is considered an ideal nursing environment for stable patients transitioning out of the hospital. However, approximately half of all in-hospital cardiorespiratory arrests occur here and are associated with poor outcomes. ⋯ It seems tempting to apply continuous monitoring to every patient on the ward, but inherent challenges such as artifacts and alarm fatigue need to be considered. This review looks to the future where a continuous, smarter, and portable platform for monitoring of vital signs on the hospital ward will be accompanied with a central monitoring platform and machine learning-based pattern detection solutions to improve safety for hospitalized patients.