Articles: postoperative.
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To examine the relationship between perioperative anxiety and postoperative pain in children and adolescents undergoing elective surgical procedures and the differences in children's perioperative anxiety and postoperative pain among subgroups of demographics. ⋯ Results of this review inform healthcare providers of the role perioperative anxiety plays on children's and adolescents' postoperative pain and indicate the need to use interventions to reduce perioperative anxiety and, therefore, optimize their postoperative pain management during the perioperative period.
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Acta Anaesthesiol Scand · Feb 2014
Observational StudyMinimal impairment in pulmonary function following laparoscopic surgery.
Pulmonary function may be impaired in connection with laparoscopic surgery, especially in the head-down body position, but the clinical importance has not been assessed in detail. The aim of this study was to assess pulmonary function after laparoscopic hysterectomy and laparoscopic cholecystectomy. We hypothesised that arterial oxygenation would be more impaired after hysterectomy performed in the head-down position than after cholecystectomy in the head-up position. ⋯ Minimal impairment in pulmonary gas exchange was found after laparoscopic surgery. Pulmonary shunt was larger after laparoscopic cholecystectomy, but no clinically significant differences in postoperative pulmonary gas exchange or spirometry were found between laparoscopic hysterectomy and laparoscopic cholecystectomy.
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Curr Opin Anaesthesiol · Feb 2014
ReviewCritical care strategies to improve neurocognitive outcome in thoracic surgery.
This review focuses on neurocognitive outcome with respect to potential pathophysiological inflammatory mechanisms of thoracic surgery and one-lung ventilation, risk factors of postoperative delirium and postoperative cognitive dysfunction (POCD) as well as anti-inflammatory strategies. ⋯ There is evidence that important key strategies improve neurocognitive outcome after thoracic surgery. This includes adequate risk stratification, the anesthetic management and postoperative critical care strategies.
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Case Reports
Near-fatal anaphylaxis caused by human serum albumin in fibrinogen and erythrocyte concentrates.
A 40-year-old man developed anaphylactic shock during surgical replacement of a prolapsed mitral valve during general anaesthesia and an attenuated reaction (Grade 2), three days later during a blood transfusion. Human serum albumin, a component of the fibrinogen concentrate used postoperatively with the erythrocyte concentrate, was identified as the trigger, confirmed by positive skin prick and intradermal tests. Any anaphylaxis during the peri-operative period should cause the clinician to perform allergy tests for identification of the culprit drug and, sometimes, culprit additive. Testing of human serum albumin, acting as hidden allergen, should be included, especially where there has been a blood transfusion.
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Randomized Controlled Trial
Effect of a Preoperative Gabapentin on Postoperative Analgesia in Patients with Inflammatory Bowel Disease Following Major Bowel Surgery: A Randomized, Placebo-Controlled Trial.
Postoperative pain management for patients with inflammatory bowel disease (IBD) can be challenging. These patients have a high tolerance to pain medication, and relative contraindications to the use of epidural analgesia, limiting the pain management options. We evaluated the effect of a single preoperative gabapentin dose on opioid consumption for patients with IBD undergoing abdominal surgery. Secondary outcomes were postoperative pain scores, opioid-related side effects, and patient's length of hospital stay. ⋯ This study examined the effect of a single preoperative administration of gabapentin in patients with IBD undergoing major bowel surgery. Our results suggest a single preoperative oral dose of gabapentin 600 mg does not reduce postoperative pain scores, opioid consumption, or opioid-related side effects.