Articles: postoperative.
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Reg Anesth Pain Med · Sep 2016
Peripheral Nerve Block Facilitates Acute Inflammatory Responses Induced by Surgical Incision in Mice.
Anesthesia with peripheral nerve block (PNB) improves the early recovery profile of patients undergoing surgery, including the control of postoperative pain, opioid consumption, and the length of hospital stay. However, the influence of PNB on wound inflammation and the repair process has not been fully investigated. Therefore, we evaluated the effects of PNB on local inflammation of incised tissue in the acute phase of postoperative pain development. ⋯ Single PNB before incision promoted acute phase inflammation mediated by neutrophils and macrophages at the sites of incision, whereas postoperative pain was not altered. Peripheral nerve block might locally accelerate innate immune responses after surgical incision without altering the nociceptive profile.
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Reg Anesth Pain Med · Sep 2016
Review Meta AnalysisThe Impact of Neuraxial Versus General Anesthesia on the Incidence of Postoperative Surgical Site Infections Following Knee or Hip Arthroplasty: A Meta-Analysis.
Recent studies have yielded conflicting results on the association between anesthesia technique and incidence of postoperative surgical site infections (SSIs) after knee arthroplasty (KA) and hip arthroplasty (HA). Our group conducted a meta-analysis of all available studies to clarify this potential association. ⋯ Synthesis of the existing evidence supports the overall beneficial effects of neuraxial anesthesia in decreasing the development of SSI after joint arthroplasty (KA and HA). Given the limitations associated with interpretation of data from large observational trials, further investigation using prospective randomized trial design is warranted in this promising area.
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In 2010, the incidence of prolonged mechanical ventilation (> 24 hours) after isolated coronary artery bypass graft (CABG) surgery was 26.9% at the study site, The Ohio State University Wexner Medical Center, compared with the national like-hospital rate of 10.9%. ⋯ Success factors included the multidisciplinary task force and continual protocol reeducation among front-line staff.
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The impact of surgery on health is only appreciated long after hospital discharge. Furthermore, patients' perceptions of postoperative health are not routinely ascertained. The authors instituted the Systematic Assessment and Targeted Improvement of Services Following Yearlong Surgical Outcomes Surveys (SATISFY-SOS) registry to evaluate patients' postoperative health based on patient-reported outcomes (PROs). ⋯ SATISFY-SOS demonstrates the feasibility of establishing a PRO registry reflective of a busy preoperative assessment center population, without disrupting clinical workflow. Our experience suggests that patient engagement, including informed consent and multiple survey modalities, enhances PROs collection from a large cohort of unselected surgical patients. Initiatives like SATISFY-SOS could promote quality improvement, enable efficient perioperative research, and facilitate outcomes that matter to surgical patients.
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Pediatr Crit Care Me · Sep 2016
Impact of Different Diagnostic Criteria on the Reported Prevalence of Junctional Ectopic Tachycardia After Pediatric Cardiac Surgery.
Junctional ectopic tachycardia is a frequent complication after pediatric cardiac surgery. A uniform definition of postoperative junctional ectopic tachycardia has yet to be established in the literature. The objective of this study is to analyze differences in the general and age-related prevalence of postoperative junctional ectopic tachycardia according to different diagnostic definitions. ⋯ Different definitions of junctional ectopic tachycardia after pediatric cardiac surgery lead to relevant differences in the reported prevalence and age distribution pattern. A uniform definition of postoperative junctional ectopic tachycardia is needed to provide comparable study results and to improve the diagnosis of junctional ectopic tachycardia in pediatric patients.