Articles: postoperative.
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Case Reports Observational Study
Postoperative awake paralysis in the intensive care unit after cardiac surgery due to residual neuromuscular blockade: a case report and prospective observational study.
We report a case of awake paralysis due to residual neuromuscular blockade (NMB) in the intensive care unit (ICU) in a patient following fast-track cardiac surgery. As a result of this case, we performed a prospective quality assurance audit to investigate the incidence of residual paralysis in the ICU in a similar population of cardiac surgery patients. ⋯ Postoperative residual paralysis after fast-track cardiac surgery was common in our institution and likely contributed to the reported case of postoperative awake paralysis. We suggest that an NMB not be administered after intubation in fast-track patients. If given, however, it must be well communicated to the ICU team upon ICU admission. We further recommend routine assessment of neuromuscular function before sedation is weaned prior to extubation.
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Minerva anestesiologica · May 2016
An evaluation of the efficacy of solifenacin and darifenacin for prevention of catheter related bladder discomfort: a prospective, randomized, placebo controlled, double blind study.
Urinary catheterization during surgical interventions causes postoperative catheter related bladder discomfort (CRBD). Antimuscarinic agents are the mainstay of treatment for overactive bladder (OAB). As the symptoms of CRBD mimic to OAB, so we designed this study to assess the efficacy of solifenacin and darifenacin for prevention of CRBD. ⋯ Pretreatment with oral solifenacin or darifenacin reduces catheter-related bladder discomfort with no clinically relevant significant side effects.
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Multicenter Study Observational Study
Risk prediction model for respiratory complications after lung resection: An observational multicentre study.
Patients undergoing lung surgery are at risk of postoperative pulmonary complications (PPCs). Identifying those patients is important to optimise individual perioperative management. The Clinical Prediction Rule for Pulmonary Complications (CPRPCs) after thoracic surgery, developed by the Memorial Sloan-Kettering Cancer Center, might be an ideal predictor. The hypothesis was that CPRPC performs well for the prediction of PPCs. ⋯ In this external validation, the CPRPC performed poorly despite its simplicity. The CPRPC was not a useful scale in our cohort. In contrast, we used a more accurate score to predict the occurrence of PPCs in our cohort. It is based on age, smoking status and predicted postoperative forced expiratory volume in 1 s. We propose that our formula should be externally validated.