Articles: postoperative.
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Thoracic Surgery PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: To study the prevalence of post-operative pyrexia after thoracic endovascular aortic repair ( TEVAR ) and discuss the appropriate management. ⋯ The following authors have nothing to disclose: Randolph Wong, Calvin Ng, Rainbow Lau, Micky Kwok, Simon Chow, Innes Wan, Song Wan, Simon Yu, Malcolm UnderwoodNo Product/Research Disclosure Information.
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Observational Study
Outcome by mode of anaesthesia for hip fracture surgery. An observational audit of 65 535 patients in a national dataset.
Large observational studies of accurate data can provide similar results to more arduous and expensive randomised controlled trials. In 2012, the National Hip Fracture Database extended its dataset to include 'type of anaesthesia' data fields. We analysed 65 535 patient record sets to determine differences in outcome. ⋯ Mortality within 24 hours after surgery was significantly higher among patients receiving cemented compared with uncemented hemiarthroplasty (1.6% vs 1.2%, p = 0.030), suggesting excess early mortality related to bone cement implantation syndrome. If these data are accurate, then either there is no difference in 30-day mortality between general and spinal anaesthesia after hip fracture surgery per se, and therefore future research should focus on how to make both types of anaesthesia safer, or there is a difference, but mortality is not the correct outcome to measure after anaesthesia, and therefore future research should focus on differences between general and spinal anaesthesia. These could include more anaesthesia-sensitive outcomes, such as hypotension, pain, postoperative confusion, respiratory infection and mobilisation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2014
[New oral anticoagulantsRegional anaesthesia and new oral anticoagulants].
New oral anticoagulants (NOAC) are increasingly applied after hip and knee replacement and in patients with non-vavular atrial fibrillation. Patients with cardiac disease benefit from regional anaesthesia, especially catheter-provided postoperative pain relief, but are at higher risk for puncture-related haematoma when NOAC are applied simultaneously. ⋯ The respective time intervals are prolonged in patients with renal insufficiency, especially when Dabigatran is applied, until 36 to 72 h. In general, high risk patients with NOAC undergoing surgery benefit from an interdicsciplinary approach and from less traumatic techniques such as spinal anaesthesia or superficial peripheral nerve blocks.
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In this case series, we describe transient postoperative facial nerve palsy in patients after awake craniotomy using selective scalp nerve blocks. In a 1-year period, 7 of the 42 patients receiving scalp nerve blocks at our institutions developed this complication. ⋯ The exact cause of transient postoperative facial nerve palsy after auriculotemporal nerve block is unknown and likely multifactorial. This technique may need to be refined to avoid such complications.