Perioperative Medicine最新文献

{"title":"Effect of preoperative oral carbohydrate on the postoperative recovery quality of patients undergoing daytime oral surgery: a randomized controlled trial.","authors":"Weixiang Tang, Gaige Meng, Chen Yang, Yue Sun, Weiwei Zhong, Yao Lu","doi":"10.1186/s13741-024-00459-8","DOIUrl":"https://doi.org/10.1186/s13741-024-00459-8","url":null,"abstract":"<p><strong>Background: </strong>Preoperative oral carbohydrate intake can improve the postoperative recovery of fasting patients in many kinds of surgeries; however, the effect of carbohydrates on patients undergoing daytime oral surgery is still unclear. This study was designed to evaluate the effect of preoperative oral carbohydrate intake on the quality of recovery of patients undergoing daytime oral surgery using the quality of recovery-15 (QoR-15) questionnaire.</p><p><strong>Methods: </strong>Ninety-two patients scheduled for daytime oral surgery were randomly allocated to the midnight fasting group (F group, n = 45) or the carbohydrate-Outfast loading group (O group, n = 47). Participants in the F group fasted from midnight the day before surgery. Patients in the O group also fasted but received the Outfast drink (4 ml/kg) 2-3 h before the induction of anesthesia. QoR-15 questionnaire, patient well-being, and satisfaction were assessed before anesthesia induction and 24 h after surgery. Perioperative blood glucose, postoperative exhaust time, and adverse events were also recorded.</p><p><strong>Results: </strong>The QoR-15 scores were significantly higher in the O group than in the F group preoperatively and postoperatively. Seven parameters representing patient well-being evaluated on a numeric rating scale (NRS, 0-10) were lower in the O group than in the F group postoperatively, except for the hunger and sleep quality scores. Patient satisfaction scores on a 5-point scale were higher in the O group than in the F group preoperatively and postoperatively. Meanwhile, the postoperative exhaust time was significantly shorter in the O group compared to the F group, while there were no significant differences in blood glucose concentrations between two groups.</p><p><strong>Conclusions: </strong>Preoperative oral carbohydrate intake could improve postoperative recovery quality, well-being, and satisfaction of patients undergoing daytime oral surgery 24 h after surgery, and may serve as a treatment option for patients undergoing daytime oral surgery.</p><p><strong>Trial registration: </strong>This trial was registered in the Chinese Clinical Trial Registry (ChiCTR2100053753) on 28/11/2021.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"102"},"PeriodicalIF":2.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of virtual reality hypnosedation on perioperative pain and anxiety in port implantation under local anesthesia: a randomized controlled pilot trial (VIP Trial).","authors":"Kira C Steinkraus, Hannah Feldmann, Lisa S Hunold, Sandra Graf, Colette Dörr-Harim, Nadir Nasir, Christoph W Michalski, Felix J Hüttner","doi":"10.1186/s13741-024-00454-z","DOIUrl":"10.1186/s13741-024-00454-z","url":null,"abstract":"<p><strong>Background: </strong>This monocentric randomized controlled pilot trial investigates the impact of virtual reality (VR) hypnosedation on perioperative anxiety, pain, patient satisfaction, and medication usage during port implantation under local anesthesia.</p><p><strong>Methods: </strong>A total of 120 patients undergoing elective port implantation between January 2022 and August 2023 were enrolled and randomized in a 1:1 ratio to either a VR hypnosedation group or a control group. The VR group used a commercially available VR headset with the HypnoVR application, providing various environments, musical backgrounds, and a guiding voice, while the control group underwent the procedure without VR. Patients with ASA > 3, chronic pain, cognitive issues, and contraindications against VR use were excluded. The main outcomes measured were perioperative pain and anxiety scores, with secondary outcomes including perioperative medication usage. Due to the nature of the interventions, blinding of patients and physicians was not feasible. Statistical analysis was primarily descriptive and exploratory, focusing on estimating effect sizes for future trials.</p><p><strong>Results: </strong>The study found no significant differences in immediate postoperative pain with 1.43 ± 1.63 vs. 1.6 ± 2.05 (p = 0.62) or anxiety scores 30.65 ± 9.13 vs. 31.78 ± 13.34 (p = 0.60) between the no VR and VR group, respectively. Additionally, there was a trend to less usage of certain medications, particularly remifentanil (mean dose of 200 mg vs. 100 mg (p = 0.12)) and novaminsulfon (mean dose of 1250 mg vs. 900 mg (p = 0.26)) in the VR group vs. no VR group, respectively. However, these differences were not statistically significant and therefore no definitive conclusions can be drawn regarding medication usage based on this data.</p><p><strong>Conclusion: </strong>While VR hypnosedation did not significantly reduce perioperative pain or anxiety in this pilot trial, the observed trends in reduced medication usage suggest potential benefits. These findings warrant further investigation in larger, confirmatory trials to better understand the role of VR in enhancing patient comfort and potentially reducing reliance on pharmacological interventions during surgical procedures.</p><p><strong>Trial registration: </strong>German Clinical Trials Register: DRKS00028508; registration date 15 March 2022; Universal Trial Number: U1111-1275-4995.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"101"},"PeriodicalIF":2.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of intra-operative red blood cell transfusion on the systemic immune index and recovery in patients undergoing cesarean section: a large propensity score-matched study.","authors":"Yilu Zhou, Zhiqiang Liu, Zhendong Xu","doi":"10.1186/s13741-024-00457-w","DOIUrl":"10.1186/s13741-024-00457-w","url":null,"abstract":"<p><strong>Background: </strong>Post-partum hemorrhage (PPH) is a leading cause of maternal death worldwide. However, the effect of blood transfusion in patients undergoing cesarean section remains unclear.</p><p><strong>Materials and methods: </strong>The analysis was based on the retrospective evaluation of the pre- and post-operative data for 1231 patients who underwent a cesarean section at our hospital between January 2016 and June 2020. Patients were classified into the blood transfusion group (BT) and the no blood transfusion group (NBT) based on their intra-operative blood transfusion status.</p><p><strong>Results: </strong>After propensity score matching, 322 patients were included in both groups and between-group differences in length of hospital stay (LOS), perioperative systemic inflammation indicators, and post-operative complications were evaluated. The LOS was longer in the BT (median, 6.6 days) than the NBT (median, 4.2 days) group (P = 0.026). The post-operative complication rate was higher for the BT than NBT group, as follows: vomiting, 3.2% vs. 4.9%, P = 0.032; fever, 5.41% vs. 2.24%, P = 0.032; wound complications, 15.44% vs. 10.45%, P = 0.028; and intestinal obstructions, 5.88% vs. 2.75%, P = 0.034. Systemic inflammation indicators increased significantly, from the pre-operative baseline, for both groups at post-operative day (POD) 1 and POD3. On multivariate analysis, intra-operative blood transfusion was associated with a longer LOS (hazard ratio, 1.52; 95% confidence interval, 1.07-2.25).</p><p><strong>Conclusion: </strong>Intraoperative blood transfusion for cesarean section was associated with increased levels of systemic inflammation indicators, higher post-operative complication rates, and prolonged hospital stay.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"100"},"PeriodicalIF":2.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the incidence of hyperoxia and the effectiveness of Oxygen Reserve Index-guided FiO2 titration in hyperoxia prevention.","authors":"Pelin Uzun Sarıtaş, Aykut Sarıtaş, Merve Çetin Poyraz, Gaye Aydın","doi":"10.1186/s13741-024-00456-x","DOIUrl":"https://doi.org/10.1186/s13741-024-00456-x","url":null,"abstract":"<p><strong>Background: </strong>Although pulse oximetry technology, which is considered the standard of care to ensure optimum oxygenation, is indispensable in clinical practice, especially in the detection of hypoxemia, it has some limitations in the detection of hyperoxemia. Oxygen Reserve Index can provide clinicians with a crucial pathway in detecting and preventing hyperoxia, noninvasively. Our aim in this study is to determine the hyperoxia detection ability of ORi and to investigate the effectiveness of ORi and SpO₂-guided FiO₂ titration in preventing hyperoxia.</p><p><strong>Methods: </strong>This prospective randomized study was conducted in the operating theater of Health Sciences University İzmir Tepecik Training and Research Hospital from September 1, 2020, to December 1, 2022. Patients undergoing major abdominal surgery were divided into two groups: the control group and the SpO2 + ORi group. FiO2 titration was performed in the SpO2 + ORi group to maintain the ORi between 0.00 and 95% < SpO2 ≤ 98%. Parameters were recorded before induction, 10 min after intubation, and every hour during the operation.</p><p><strong>Results: </strong>A positive linear relationship of 75.8% (r = 0.758) was found between PaO2 and ORi in the ORi + SpO2 group (p < 0.001). Moderate hyperoxemia was observed in 31.6% of patients in the control group, while it was not observed in the ORi + SpO2 group at the 3rd hour. PaO2 values decreased significantly over time in the ORi + SpO2 group with FiO2 titration (p < 0.001).</p><p><strong>Conclusion: </strong>The combined use of SpO2 and ORi has been demonstrated to successfully guide FiO2 titration for optimal oxygenation and reduce hyperoxemia.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"99"},"PeriodicalIF":2.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of preoperative stroke on 1-year mortality and days at home alive after major surgery: an observational cohort study.","authors":"Matilda Widaeus, Alva Cedermark, Max Bell","doi":"10.1186/s13741-024-00453-0","DOIUrl":"10.1186/s13741-024-00453-0","url":null,"abstract":"<p><strong>Objective: </strong>The lifetime risk of stroke is one in four people. As the population aged over 60 constantly expands, the impact of stroke on perioperative care is of increasing concern. This study investigates the effect of preoperative stroke on short- and long-term outcomes, hypothesizing that it decreases both 1-year mortality and days alive and at home up to 30 days after surgery (DAH30).</p><p><strong>Methods: </strong>This cohort study investigated 290,306 adult patients with (7214) and without (283,092) preoperative stroke undergoing major non-cardiovascular, non-ambulatory surgery at 23 hospitals in Sweden between 2007 and 2014. Data were pre- and postoperatively matched with quality registers. Using logistic regression, significant independent risk factors influencing the risk of 1-year mortality and impeded DAH30 were identified with adjusted odds ratios calculated.</p><p><strong>Results: </strong>Preoperative stroke was associated with higher 1-year mortality and lower DAH30, even after full adjustment for other co-morbid and surgical factors.</p><p><strong>Conclusions: </strong>This large cohort showed preoperative stroke to impact both the patient-centered short-term outcome DAH30 and 1-year mortality. These findings should be considered in perioperative planning.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"97"},"PeriodicalIF":2.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is pericapsular nerve group block superior to other regional analgesia techniques following total hip arthroplasty? a systematic review and network meta-analysis.","authors":"Lang Wan, Hua Huang, Fumin Zhang, Yanbing Li, Yantao Zhou","doi":"10.1186/s13741-024-00455-y","DOIUrl":"10.1186/s13741-024-00455-y","url":null,"abstract":"<p><strong>Background: </strong>A systematic review and network meta-analysis (NMA) to compare the safety and efficacy of pericapsular nerve group block (PENGB) with other regional analgesia techniques in patients undergoing total hip arthroplasty (THA).</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science, and the Cochrane Library for relevant research from inception to May, 2024. Randomized controlled trials (RCTs) comparing PENGB with other regional analgesia techniques in patients undergoing THA were included. The primary outcome was resting pain scores at 6 h after surgery. The NMA was made by using Stata 15.1 software. Potential risk of bias was assessed by using CINeMA. Sensitivity and subgroup analyses were performed on the primary outcome.</p><p><strong>Results: </strong>A total of 11 RCTs including 766 patients were eligible for inclusion. For postoperative resting and movement pain scores within 24 h analysis, PENGB + periarticular local anesthetic infiltration (PLAI) was found to be significantly more effective than other treatments and its Surface under the cumulative ranking curve (SUCRA) was the lowest. Moreover, PENGB + PLAI was ranked the best in reducing opioid consumption within 24 h and the length of hospital stay. PENGB was found to have significantly lower incidence of quadriceps motor block and postoperative nausea and vomiting (PONV).</p><p><strong>Conclusions: </strong>PENGB is more likely to reduce the incidence of quadriceps motor block and PONV in patients undergoing THA, but PENGB + PLAI is superior to other regional analgesia techniques (PLAI, PENGB, fascia iliaca compartment block, and quadratus lumborum block) in improving postoperative pain and shortening the length of hospital stay.</p><p><strong>Trial registration number: </strong>CRD42024538421.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"96"},"PeriodicalIF":2.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of rapid response system in mortality and complications post-orthopedic surgery: a retrospective cohort study.","authors":"Hey-Ran Choi, In-Ae Song, Tak Kyu Oh","doi":"10.1186/s13741-024-00458-9","DOIUrl":"10.1186/s13741-024-00458-9","url":null,"abstract":"<p><strong>Background: </strong>Rapid response systems (RRSs) are used in hospitals to identify and treat deteriorating patients. However, RRS implementation and outcomes in orthopedic and surgical patients remain controversial. We aimed to investigate whether the RRS affects mortality and complications after orthopedic surgery.</p><p><strong>Methods: </strong>The National Health Insurance Service of South Korea provided the data for this population-based cohort study. Individuals who were admitted to the hospital that implemented RRS were categorized into the RRS group and those admitted to a hospital that did not implement the RRS were categorized into the non-RRS group. In-hospital mortality and postoperative complications were the endpoints.</p><p><strong>Results: </strong>A total of 931,774 adult patients were included. Among them, 93,293 patients underwent orthopedic surgery in a hospital that implemented RRS and were assigned to the RRS group, whereas 838,481 patients were assigned to the non-RRS group. In multivariable logistic regression analysis, the RRS group was not associated with in-hospital mortality after orthopedic surgery compared with the non-RRS group (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.80, 1.08; P = 0.350). However, the RRS group was associated with a 14% lower postoperative complication rate after orthopedic surgery than the non-RRS group (OR 0.86, 95% CI 0.84, 0.86; P < 0.001).</p><p><strong>Conclusions: </strong>The RRS was not associated with in-hospital mortality following orthopedic surgery in South Korea. However, RRS deployment was related to a decreased risk of postoperative complications in patients undergoing orthopedic surgery.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"98"},"PeriodicalIF":2.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of preoperative red blood cell width and postoperative 30-day mortality in patients undergoing non-cardiac surgery: a retrospective cohort study using propensity-score matching.","authors":"Wei Wei, Bishan Feng, Zimiao Chen, Xiaojie Liu, Mengjing Xiao, Haofei Hu","doi":"10.1186/s13741-024-00451-2","DOIUrl":"10.1186/s13741-024-00451-2","url":null,"abstract":"<p><strong>Background: </strong>In terms of predicting surgery mortality, it is controversial whether red blood cell width works independently. In non-cardiac surgery patients older than 18 years, we intend to examine the relationship between red blood cell width and postoperative 30-day mortality.</p><p><strong>Methods: </strong>In this retrospective cohort study, 90,785 Singapore General Hospital patients were matched by propensity score between January 1, 2012 and October 31, 2016. It was determined that red blood cell width at baseline and mortality within 30 days after surgery were the independent and dependent variables. We used a non-parametric multivariate logistic regression to balance the confounders among 7807 patients with high RDW and 7807 patients with non-high RDW in the propensity score matching. We investigated the association between RDW and 30-day mortality after surgery using the doubly robust estimation method.</p><p><strong>Results: </strong>Cohorts matched according to propensity score, the risk of 30-day mortality after surgery increased by 114.6.0% among the high RDW group (OR = 2.146, 95% CI 1.645-2.799, P < 0.00001). In the crude model, there was a significant association between RDW and 30-day mortality after surgery (OR = 1.877, 95% CI 1.476-2.388, P < 0.00001). In the propensity-score adjusted model, the risk of 30-day mortality after surgery in the high RDW group compared to the control group was not as high as in the non-adjusted model (OR = 1.867, 95% CI 1.467-2.376, P < 0.00001). Compared to non-high RDW group, the risk of 30-day mortality after surgery increased by 117.0% and 127.7% among high RDW group in the original cohort (OR 2.170, 95% CI 1.754-2.683, P < 0.00001) and the weighted cohort (OR 2.272, 95% CI 2.009-2.580, P < 0.00001), respectively.</p><p><strong>Conclusions: </strong>According to the results of this observational, propensity score-matched cohort study, uncontrolled high RDW before surgery is associated with an increased risk of death within 30 days after surgery, that is to say, patients over the age of 18 with high preoperative RDW who undergo non-cardiac surgery have a worse postoperative prognosis than those with normal RDW.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"95"},"PeriodicalIF":2.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of single bolus versus bolus followed by infusion of tranexamic acid with blood loss in adolescent idiopathic scoliosis surgery.","authors":"Mohd Shahnaz Hasan, Mew Har Leong, Zheng-Yii Lee, Chee Kidd Chiu, Chris Yin Wei Chan, Mun Keong Kwan, Siti Nadzrah Yunus","doi":"10.1186/s13741-024-00452-1","DOIUrl":"10.1186/s13741-024-00452-1","url":null,"abstract":"<p><strong>Background: </strong>Adolescent idiopathic scoliosis (AIS) corrective surgery may involve significant blood loss and blood transfusion requirements. Antifibrinolytic agents such as tranexamic acid (TXA) have been used to reduce blood loss, but its optimal dose is uncertain. The objective of this study is to determine the estimated blood loss and rate of blood transfusion between two groups of AIS patients receiving TXA as a single bolus versus bolus followed by infusion in scoliosis surgery.</p><p><strong>Methods: </strong>This was a retrospective analysis of a single bolus versus bolus followed by infusion of TXA in AIS surgery. AIS patients undergoing posterior spinal fusion (PSF) from December 2018 to September 2019 at a tertiary university hospital were identified. Inclusion criteria were patients aged between 10 and 21 years who received either a single bolus of 30 mg/kg TXA (Group A) or a single bolus of 30 mg/kg followed by continuous infusion of 10 mg/kg/h of TXA (Group B). Patient demographics, operative data, estimated blood loss, blood transfusion rate, and complications were recorded.</p><p><strong>Results: </strong>A total of 129 AIS patients were included. All operative surgeries were performed by two senior consultants. The mean age was 14.8 ± 3.4 years old, and 89.1% were female. The Cobb angle, number of fusion levels, number of screws, length of skin incision, and duration of surgery were comparable between the two groups. There was no difference in the total estimated blood loss between the two groups: 723.3 ± 279.4 mL (range: 175.0-1607.0 mL) in Group A and 819.4 ± 302.6 mL (range: 330.0-1556.0 mL) in Group B (p = 0.065). There were no complications, and none received blood transfusion.</p><p><strong>Conclusion: </strong>TXA when administered as a single bolus or bolus followed by infusion in AIS patients undergoing PSF surgery was associated with similar estimated total surgical blood loss and blood transfusion requirement.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"94"},"PeriodicalIF":2.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreasing the pressure of endotracheal tube cuff slowly with a constant speed can decrease coughing incidence during extubation: a randomized clinical trial.","authors":"Zhuan Zhang, Ning Li, Hu Li, Xinqi Zhang, Chao Chen, Bo Yuan, Hao Wu, Yanlong Yu","doi":"10.1186/s13741-024-00450-3","DOIUrl":"10.1186/s13741-024-00450-3","url":null,"abstract":"<p><strong>Background: </strong>To discuss whether decreasing the pressure of endotracheal tube cuff slowly with a constant speed can decrease the incidence of coughing during extubation.</p><p><strong>Methods: </strong>Ninety patients undergoing elective noncardiac surgery under general anesthesia with endotracheal intubation were randomly divided into two groups: group P, the pilot balloon was connected to a syringe and an aneroid manometer through a three-way stopcock, respectively, and the decrease of cuff pressure was controlled at 3 cmH₂O/s during deflating before extubation; group C, the pressure in endotracheal tube cuff was decreased suddenly with a syringe extracting the air from the cuff rapidly at once exactly before extubation. The incidence of coughing during extubation period was recorded. Mean arterial pressure (MAP) and heart rate (HR) were recorded before general anesthesia induction (T0), just before cuff deflation (T1), immediately after deflation (T2), at 1 min (T3), 3 min (T4), and 5 min after extubation (T5). The occurrence of adverse reactions was also recorded.</p><p><strong>Results: </strong>The initiation of coughing during extubation period occurs at immediately the time of balloon deflation. Compared with group C, the incidence of coughing was significantly decreased (P = 0.001), MAP and HR were significantly decreased at T2-T4 and T2-T5, respectively (P < 0.05 for all), and the incidence of pharyngolaryngeal discomfort after extubation was significantly reduced (P = 0.021) in group P.</p><p><strong>Conclusions: </strong>Decreasing the pressure of endotracheal tube cuff slowly with a constant speed can significantly reduce the incidence of coughing during extubating period, stabilize hemodynamics, and reduce the incidence of adverse reactions.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"93"},"PeriodicalIF":2.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}