Articles: postoperative.
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To identify and describe the characteristics of existing practices for postoperative weight bearing and management of tibial plateau fractures (TPFs), identify gaps in the literature, and inform the design of future research. ⋯ Postoperative rehabilitation for TPFs most commonly involves significant non-weight bearing time before full weight bearing is recommended at 9-12 weeks. Partial weight bearing protocols and brace use were varied. Type of rehabilitation may be an important factor influencing recovery, with future high quality prospective studies required to determine the impact of different protocols on clinical and radiological outcomes.
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Ischemic myocardial damage accompanying coronary artery bypass graft surgery remains a clinical challenge. We investigated whether xenon anesthesia could limit myocardial damage in coronary artery bypass graft surgery patients, as has been reported for animal ischemia models. ⋯ In postoperative cardiac troponin I release, xenon was noninferior to sevoflurane in low-risk, on-pump coronary artery bypass graft surgery patients. Only with xenon was cardiac troponin I release less than with total intravenous anesthesia. Xenon anesthesia appeared safe and feasible.
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J. Cardiothorac. Vasc. Anesth. · Dec 2017
Randomized Controlled TrialIntravenous Acetaminophen Does Not Decrease Persistent Surgical Pain After Cardiac Surgery.
The authors investigated the hypothesis that perioperative acetaminophen reduces incisional pain at 30 and 90 days. ⋯ IV acetaminophen did not reduce the incidence or intensity of incisional pain at 30 days and 90 days after surgery.
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Review Meta Analysis
Effects of Single Nucleotide Polymorphisms on Surgical and Post-surgical Opioid Requirements - A Systematic Review and Meta-analysis.
There is great heterogeneity in the way individuals respond to medications. Inherited differences, such as single nucleotide polymorphisms (SNP), can influence the efficacy and toxicity of drugs. This meta-analysis aims to collate data from studies investigating the effect of SNPs on postoperative and/or intraoperative opioid requirements. ⋯ Investigation of single changes in 1 gene can only yield limited information regarding genetic effects on opioid requirements. Rapid development of whole genome sequencing enables information on all genetic modifications that may affect analgesic response to be collected. The information collected must include data on the individual's metabolic enzymes, as well as information on drug receptors and enzymes responsible for drug degradation, so that a personal profile can be built up which will predict individual response to drugs, and guide clinicians on the type and dosage of drug to use.
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J. Thorac. Cardiovasc. Surg. · Dec 2017
Diaphragmatic fenestration for refractory chylothorax after congenital cardiac surgery in infants.
Medically refractory chylous pleural effusion after congenital heart surgery is associated with significant morbidity and mortality, especially in infants. We reviewed our experience with diaphragmatic fenestration procedure in this group of patients. ⋯ Diaphragmatic fenestration is an effective and safe strategy for management of persistent chylous effusions after congenital cardiac surgery.