Articles: anesthesia.
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Journal of critical care · Dec 2024
Review Meta AnalysisFluid infusion prior to intubation or anesthesia: A meta-analysis of randomized controlled trials.
The results of current randomized controlled trials (RCTs) vary regarding the effectiveness of rehydration prior to anesthesia induction. Our objective was to determine the effectiveness of pre-induction rehydration in patients undergoing tracheal intubation or surgical procedures. ⋯ Pre-induction rehydration can reduce the occurrence of hypotensive events, but only in pre-surgical patients, and does not decrease the use of vasoactive medications.
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Randomized Controlled Trial Multicenter Study Comparative Study
Short-term outcomes in infants following general anesthesia with low-dose sevoflurane/dexmedetomidine/remifentanil versus standard dose sevoflurane (The TREX trial).
The Trial Remifentanil DEXmedetomidine (TREX) trial aimed to determine whether, in children less than 2 yr old, low-dose sevoflurane/dexmedetomidine/remifentanil anesthesia is superior to standard-dose sevoflurane anesthesia in terms of global cognitive function at 3 yr of age. The aim of the current secondary analyses was to compare incidence of intraoperative hypotension and bradycardia, postoperative pain, time to recovery, need for treatment of intraoperative hypotension and bradycardia, incidence of light anesthesia and need for treatment, need for postoperative pain medications, and morbidity and mortality outcomes at 5 days between the two arms. ⋯ These early postoperative results suggest that in children less than 2 yr of age receiving greater than 2 h of general anesthesia, the low-dose sevoflurane/dexmedetomidine/remifentanil anesthesia technique and the standard sevoflurane anesthesia technique are broadly clinically similar, with no clear evidence to support choosing one technique over the other.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Meta AnalysisAmino Acid Infusion for Perioperative Functional Renal Protection: A Meta-analysis.
Acute kidney injury (AKI) is a common perioperative complication. To date, no single intervention has been proven effective for AKI prevention in this setting. However, intravenous amino acids (AA) administration may recruit renal functional reserve and, thereby, attenuate the perioperative loss of the glomerular filtration rate. ⋯ This meta-analysis suggests that AA administration likely decreased the perioperative incidence of AKI.
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Paediatric anaesthesia · Dec 2024
Randomized Controlled TrialAnesthetic-sparing effect of dexmedetomidine during total intravenous anesthesia for children undergoing dental surgery: A randomized controlled trial.
Dexmedetomidine, an α2-adrenergic agonist, reduces propofol and remifentanil requirements when used as an adjunct to total intravenous anesthesia in adults, but studies in a pediatric population are sparse. This study investigates the magnitude of dose-sparing effects of a postinduction dexmedetomidine bolus on propofol and remifentanil requirements during pediatric surgery. ⋯ Dexmedetomidine 1 mcg/kg reduced the propofol and remifentanil requirements during maintenance of anesthesia in children when administered as a postinduction bolus.
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Curr Opin Anaesthesiol · Dec 2024
ReviewBeyond adverse events in anesthesiology: 'unanticipated events' and strategies for improved reporting.
Patient safety in anesthesiology has advanced significantly over the past several decades. The current process of improving care is often based on studying adverse events (AEs) and near misses. However, there is a wealth of information not captured by focusing solely on these events, potentially resulting in missed opportunities for care improvements. ⋯ Consistent reporting and monitoring for trends related to UEs could allow departments to identify risks and mitigate harm before it occurs. We review various proposed methods to expand data collection, and recommend anesthesia practices pursue UE tracking through department-specific reporting interfaces.