A Study of the dosage and duration for levobupivacaine infusion by the caudal ‐epidural route in infants aged 3‐6 months
ConclusionThis study examines the pharmacokinetics of levobupivacaine after a loading dose (given over 5 minutes) followed by a maintenance infusion in infants 3 ‐6 months. The study allows the development of a pharmacokinetic model, combining levobupivacaine and α1‐acid glycoprotein data. Modelling indicates that unbound levobupivacaine quickly reaches steady state once the infusion is started. Simulations suggest that it may be possible to continue the infusion beyond 48 hours.This article is protected by copyright. All rights reserved.
DiscussionAn in situ repair by a combination of the nice knot with an anchor or a transosseous nice knot configuration can theoretically be used as a repair technique for an acromioclavicular dislocation. In comparison with existing techniques, this model shows favorable results for translation.Level of evidenceIII, controlled laboratory study.
ConclusionWith this local –regional nerve-blocking protocol, opioid use after ARCR was unexpectedly low, and a large proportion of patients recovered without any post-surgical opioids. The correlation seen between opioid use and age may not be clinically significant, given the low use of post-operative opioids overall. The se results may be useful in guiding post-operative opioid prescribing after ARCR, as well as in lowering costs associated with ARCR.
This study evaluates parathyroidectomy outcomes in elderly patients.MethodsPrimary hyperparathyroidism patients having parathyroidectomy as listed in the 2005 –2017 ACS-NSQIP database were separated by age: ≤60, 61–79 and ≥80. Outcomes included complications, 30-day mortality, return to the OR, operating times, and hospital length of stay (LOS). Multivariable logistic regression was used to compare patients 61–79 and ≥80 to those ≤60. Patien ts ≤60 and ≥80 were propensity score matched using gender, race, BMI, smoking status, steroid use, modified frailty index (mFI), ASA class, procedur...
PERCUTANEOUS REPAIR and replacement increasingly are being used to treat valvular heart disease. Adoption of these catheter-based techniques necessitates standardized methods for evaluating new or residual regurgitation after percutaneous valve repair or replacement. The American Society of Echocardiography guidelines document, “Guidelines for the Evaluation of Valvular Regurgitation After Percutaneous Valve Repair or Replacement,” addresses this need and provides a framework for evaluating regurgitation using echocardiography, invasive hemodynamic assessment, and cardiac magnetic resonance (CMR) imaging.
CONCLUSIONS: LA repair of PUH is feasible for patients with a raised BMI and does not result in higher postoperative pain scores or the need for higher doses of LA. PMID: 31951146 [PubMed - as supplied by publisher]
ConclusionHartmann ’s reversal remains challenging but can have low complication and mortality rates if performed on selected patients in a reference center. An ASA of 3 was the only predictor of mortality.
A tracheal pouch is a rare complication of successful repair of a congenital tracheoesophageal fistula (TEF). An 18-month-old child with a repaired congenital TEF was scheduled for esophageal dilation to treat his esophageal stricture. Migration of the distal end of the endotracheal tube into a previously undetected tracheal pouch caused an abrupt failure to ventilate at the end of surgery. Given our experience, we recommend to screen the trachea of every patient with corrected TEF for a tracheal pouch when they are scheduled for another procedure requiring general anesthesia.
Condition: Inguinal Hernia Interventions: Other: Transversus abdominis plane block; Other: Local anesthetic infiltration; Other: Intravenous dexketoprofen Sponsor: Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital Completed
WEANING a patient from mechanical ventilation and early extubation of the trachea in the pediatric postcardiac surgical population normally are performed within 24 hours. Fast-track cardiac anesthesia strives to achieve endotracheal extubation within 1 to 6 hours after cardiac surgery, and ultrafast-track extubation is defined as immediate post-surgical weaning from mechanical ventilation and endotracheal extubation.1 It is not possible to fast-track all post-cardiac surgical patients. Studies indicate that from 1980 onward, between 65% and 88% of all pediatric cardiac surgical patients beyond the neonatal age group are ab...
RIB FRACTURES are a frequent occurrence in trauma victims.1 Patients with a “flail chest” pattern of injury, defined as 2 fractures per rib in 3 (or more) consecutive ribs, often struggle with hypoxemic respiratory failure related to inefficient ventilatory mechanics, inability to expectorate, underlying pulmonary contusion, and subsequent pneumonia. The operative indic ations for rib fracture repair have not been established and are considered to be an issue of debate.2