Articles: postoperative.
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Several studies have suggested that the level of pancreatic division during distal pancreatectomy (DP) has an impact on postoperative pancreatic fistula (POPF) occurrence. The purpose of this study was thus to investigate the level of pancreatic division as a potential risk factor for POPF after DP for non-pancreatic ductal adenocarcinoma lesions (non-PDAC) in the era of parenchyma-sparing resection. ⋯ Clinically relevant POPF and postoperative diabetes do not appear to be affected by pancreatic division level. The intention to prevent POPF or pancreatogenic diabetes should not influence the decision on level of pancreatic division during DP.
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Reg Anesth Pain Med · May 2019
Effectiveness of intravenous acetaminophen for postoperative pain management in hip and knee arthroplasties: a population-based study.
The significance of intravenous over oral acetaminophen (APAP) as part of multimodal analgesic protocols is contested, particularly when considering its relatively high price and use in a surgical cohort such as total hip or knee arthroplasty (THA/TKA), which generally tolerates oral medications. This study aims to elucidate APAP's effectiveness in a large, population-based patient sample. ⋯ These results do not support the routine use of intravenous APAP in patients undergoing lower joint arthroplasty, especially since oral APAP shows more beneficial outcome patterns.
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Lobar atelectasis (or collapse) is an exceedingly common, rather predictable, and potentially pathogenic companion to many forms of acute illness, postoperative care, and chronic debility. Readily diagnosed by using routine chest imaging and bedside ultrasound, the consequences from lobar collapse may be minor or serious, depending on extent, mechanism, patient vulnerability, abruptness of onset, effectiveness of hypoxic vasoconstriction, and compensatory reserves. Measures taken to reduce secretion burden, assure adequate secretion clearance, maintain upright positioning, reverse lung compression, and sustain lung expansion accord with a logical physiologic rationale. Both classification and logical approaches to prophylaxis and treatment of lobar atelectasis derive from a sound mechanistic knowledge of its causation.
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J Minim Invasive Gynecol · May 2019
Observational StudyLaparoscopic Superior Hypogastric Blocks for Postoperative Pain Management in Hysterectomies: A New Technique for Superior Hypogastric Blocks.
To evaluate the effect of intraoperative superior hypogastric blocks on postoperative pain management. ⋯ Intraoperative SHP block is a preferable modality for postoperative analgesia in patients undergoing hysterectomy. The surgical laparoscopic modified anterior approach we describe is an uncomplicated and easily applicable method. More effective results would be seen if used together with wound site local anesthetic infiltration or abdominal wall plane blocks. (Clinical trial registration no. NCT03427840.).
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Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established treatment for patients with Parkinson disease. One adverse event is the development of postoperative confusion. The aim of this study was to report the incidence and associated factors of postoperative confusion after STN DBS surgery. ⋯ The incidence of postoperative confusion in this cohort was 26.5%. After analysis of confounding factors, the Charlson comorbidity index was significantly associated with postoperative confusion.