Articles: postoperative.
-
To evaluate the relationship between plasma N-terminal prohormone B-type natriuretic peptide (NT-proBNP) and weaning outcomes, and the ability of NT-proBNP level to predict weaning success, in cancer patients with pulmonary complications undergoing noncardiac major surgeries. ⋯ Measuring NT-proBNP at the end of a spontaneous breathing trial may assist in predicting weaning success, as a noninvasive, quantitative and repeatable indicator of cardiac stress in patients with postsurgical respiratory failure.
-
Total hip and knee arthroplasty (THA and TKA) are frequently performed surgical procedures with excellent long-term functional outcomes. However, pain is pronounced in the early post-operative phase, especially after TKA. Glucocorticoids have proven to relieve post-operative pain, but a higher dose might be needed, as compared with the lower dose recommended to reduce post-operative nausea and vomiting (PONV). Prior to this PhD study, procedure-specific data were limited on the effects of high-dose glucocorticoid on post-operative pain and recovery in THA and TKA. So, the following question remained to be answered: does high-dose glucocorticoid added to a multimodal analgesic regime reduce pain and improve recovery after THA and TKA? ⋯ This PhD thesis render new knowledge by demonstrating - for the first time - detailed procedure-specific beneficial effects of a single pre-operative dose of MP, 125 mg IV, on acute post-operative analgesia in THA, and on acute post-operative analgesia and on other immediate recovery aspects in TKA. Noteworthy, these benefits were observed with MP added to a comprehensive multimodal oral analgesic regime consisting of paracetamol, celecoxib and gabapentin - and in TKA also to an intra-operative local infiltration analgesia regimen. However, current data in hip and knee surgery preclude firm safety conclusions, and call for large-scale studies to definitively clarify the risk-benefit ratio, before final recommendations can be made. Also, the shortage of dose-finding data calls for studies to define the minimal effective dose to provide post-operative analgesia.
-
There is limited knowledge on how diabetes and other comorbidities influence the survival of patients undergoing curative esophageal cancer surgery. ⋯ This study revealed no strongly increased risk for mortality in patients with diabetes or other comorbidities selected for esophageal cancer surgery.
-
Randomized Controlled Trial
Perioperative Auto-titrated Continuous Positive Airway Pressure Treatment in Surgical Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial.
In those with moderate or severe sleep apnoea, perioperative auto-titrated CPAP improves oxygen saturation and reduces postoperative AHI.
pearl -
Am J Geriatr Psychiatry · Oct 2013
Does preoperative risk for delirium moderate the effects of postoperative pain and opiate use on postoperative delirium?
To investigate whether preoperative risk for delirium moderates the effect of postoperative pain and opioids on the development of postoperative delirium. ⋯ High levels of postoperative pain and using high opioid doses increased risk for postoperative delirium for all patients. The highest incidence of delirium was among patients who had high preoperative risk for delirium and also had high postoperative pain and used high opioid doses.