Lactate concentration at the end of liver transplant: Early predictor of graft function or just one piece of the puzzle?

Background: The post-operative course after Liver Transplantation (LT) can be complicated by early allograft dysfunction (EAD), primary nonfunction (PNF) and death. A lactate concentration at the end of transplant of ≥5 mmol/L was recently proposed as a predictive marker of PNF, EAD, and mortality; this study aimed to validate these previous reports in a large single center cohort.

Methods: This retrospective cohort study included adult liver transplant recipients who received grafts from deceased donors at our center between June 2012 and May 2021.

Perioperative mortality in liver transplantation before and after the implementation of the organ allocation policy Share 35.

Introduction: In 2013, a new liver transplant allocation policy (Share 35) aimed to reduce waitlist-mortality was introduced in the United States. Regional organ sharing for recipients with a MELD score of ≥35 was prioritized over local allocation to those with lower MELD scores. Our aim was to assess the changes in perioperative mortality following the introduction of Share 35 as well as changes in patients' short-term 7-day survival, patients discharged alive and 1-year survival.

Wildfire Smoke Exposure Is Associated with Adverse Respiratory Events under General Anesthesia in At-risk Pediatric Patients.

Background: Increasing wildfire activity worldwide has led to exposure to poor air quality and numerous detrimental health impacts. This study hypothesized an association between exposure to poor air quality from wildfire smoke and adverse respiratory events under general anesthesia in pediatric patients.

Methods: This was a single-center retrospective double-cohort study examining two significant wildfire events in Northern California.

Perioperative outcomes for patients on chronic buprenorphine undergoing spine surgery: A case series.

Objective: Pain management following spine surgery can be challenging as patients routinely suffer from chronic pain and opioid tolerance. The increasing popularity of buprenorphine use for pain management in this population may further complicate perioperative pain management due to the limited efficacy of other opioids in the presence of buprenorphine. This study describes perioperative management and outcomes in patients on chronic buprenorphine who underwent elective inpatient spine surgery.

Perioperative Normal Saline Administration and Delayed Graft Function in Patients Undergoing Kidney Transplantation: A Retrospective Cohort Study.

Background: Perioperative normal saline administration remains common practice during kidney transplantation. The authors hypothesized that the proportion of balanced crystalloids versus normal saline administered during the perioperative period would be associated with the likelihood of delayed graft function.

Methods: The authors linked outcome data from a national transplant registry with institutional anesthesia records from 2005 to 2015.

Continuous Lumbar Plexus Block vs Continuous Lumbar Erector Spinae Plane Block for Postoperative Pain Control After Revision Total Hip Arthroplasty.

Background: Optimal pain management is key to successful recovery in revision total hip arthroplasty. Lumbar plexus blocks (LPBs) have traditionally been used for postoperative pain management. Recently, the lumbar erector spinae plane block (LESPB) has emerged as a promising regional anesthesia technique and is relatively simple to perform.

Correction: Cross-cultural adaptation of the Fresno Test for Turkish language.

[This corrects the article DOI: 10.1371/journal.pone.

Extraplexus versus intraplexus ultrasound-guided interscalene brachial plexus block for ambulatory arthroscopic shoulder surgery: A randomized controlled trial.

Background: This randomized study compared the efficacy and safety of extraplexus and intraplexus injection of local anesthetic for interscalene brachial plexus block.

Methods: 208 ASA I-II patients scheduled for elective shoulder arthroscopy under general anesthesia and ultrasound-guided interscalene brachial plexus block were randomly allocated to receive an injection of 25mL ropivacaine 0.5% either between C5-C6 nerve roots (intraplexus), or anterior and posterior to the brachial plexus into the plane between the perineural sheath and scalene muscles (extraplexus).

Cross-cultural adaptation of the Fresno Test for Turkish language.

Objective: National and international medical organizations and boards have recognized the importance of Evidence Based Medicine (EBM) and emphasized that EBM training should be included in medical education programs. Although some Turkish medical schools have developed and implemented EBM training programs, no validated Turkish language assessment tool has been available to compare the effectiveness of these training programs to national or international standards. The aim of this study is to cross-culturally adapt the Fresno Test, which is a validated English language tool utilized worldwide in the assessment of EBM training.

The effects of transmuscular quadratus lumborum blocks on postoperative pain in arthroscopic hip surgery: a cohort analysis.

Purpose: The Transmuscular Quadratus Lumborum block (TQLB) is one of the newest blocks and has been used as an effective analgesic option for various surgeries. However, it is still uncertain whether the TQLB provides beneficial analgesic outcomes for hip arthroscopic surgeries. Therefore, we aimed to investigate effects of the preoperative TQLB on postoperative pain levels and perioperative opioid consumption in patients who underwent outpatient arthroscopic hip surgery.

Preoperative Fascia Iliaca Block Does Not Improve Analgesia after Arthroscopic Hip Surgery, but Causes Quadriceps Muscles Weakness: A Randomized, Double-blind Trial.

What We Already Know About This Topic: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Ambulatory hip arthroscopy is associated with postoperative pain routinely requiring opioid analgesia. The potential role of peripheral nerve blocks for pain control after hip arthroscopy is controversial. This trial investigated whether a preoperative fascia iliaca block improves postoperative analgesia.

Postoperative Pulmonary Complications, Early Mortality, and Hospital Stay Following Noncardiothoracic Surgery: A Multicenter Study by the Perioperative Research Network Investigators.

Importance: Postoperative pulmonary complications (PPCs), a leading cause of poor surgical outcomes, are heterogeneous in their pathophysiology, severity, and reporting accuracy.

Objective: To prospectively study clinical and radiological PPCs and respiratory insufficiency therapies in a high-risk surgical population.

Design, Setting, And Participants: We performed a multicenter prospective observational study in 7 US academic institutions.

Combined preoperative femoral and sciatic nerve blockade improves analgesia after anterior cruciate ligament reconstruction: a randomized controlled clinical trial.

Study Objective: To compare preoperative femoral (FNB) with combined femoral and sciatic nerve block (CFSNB) in patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction.

Design: Prospective, randomized clinical trial.

Setting: Ambulatory surgery center affiliated with an academic medical center.

Anaesthetic techniques for risk of malignant tumour recurrence.

Background: Surgery remains a mainstay of treatment for malignant tumours; however, surgical manipulation leads to a significant systemic release of tumour cells. Whether these cells lead to metastases is largely dependent on the balance between aggressiveness of the tumour cells and resilience of the body. Surgical stress per se, anaesthetic agents and administration of opioid analgesics perioperatively can compromise immune function and might shift the balance towards progression of minimal residual disease.

Anesthesia management of patients undergoing hyperthermic isolated limb perfusion with melphalan for melanoma treatment: an analysis of 17 cases.

Background: Hyperthermic isolated limb perfusion (HILP) is used for patients with intractable or extensive in-transit metastatic melanoma of the limb to deliver high concentrations of cytotoxic agents to the affected limb and offers a treatment option in a disease stage with a poor prognosis when no treatment is given.

Methods: In a retrospective chart review of 17 cases, we studied the anesthetic and hemodynamic changes during HILP and its management.

Results: HILP was well tolerated except in one case that is described herein.

Effects of theophylline on anesthetized malignant hyperthermia-susceptible pigs.

Background: Theophylline was shown to induce contracture development in porcine malignant hyperthermia (MH) susceptible (MHS) skeletal muscles in vitro. The purpose of the current study was to investigate the in vivo effects of theophylline in MHS and MH normal (MHN) swine.

Methods: MH-trigger-free general anesthesia was performed in MHS and MHN swine.

Droperidol has comparable clinical efficacy against both nausea and vomiting.

Background: Droperidol is commonly noted to be more effective at preventing postoperative nausea (PON) than vomiting (POV) and it is assumed to have a short duration of action. This may be relevant for clinical decisions, especially for designing multiple-drug antiemetic regimens.

Methods: We conducted a post hoc analysis of a large multicentre trial.

Nausea and vomiting after office-based anesthesia.

Purpose Of The Review: Safety, quality, and patient satisfaction are not only defined by the incidences of serious adverse events but also include postoperative outcomes such as postdischarge nausea and vomiting (PDNV). PDNV has a high impact on patient recovery and may influence the cost-effectiveness of office-based surgical procedures. This article reviews the incidences and risk factors for PDNV as well as medications and concepts for prophylaxis and treatment.

The effect of postoperative fasting on vomiting in children and their assessment of pain.

Background: Mandatory postoperative food intake has been shown to increase nausea and vomiting, and so postoperative fasting has become common practice even if patients request food or drink.

Objective: We sought to investigate whether postoperative fasting reduces the incidence of postoperative vomiting in children when compared with a liberal regimen in which they are allowed to eat and drink upon request.

Methods: One hundred forty-seven children scheduled for outpatient surgery were randomized to one of two groups.

Cumulative and bolus in vitro contracture testing with 4-chloro-3-ethylphenol in malignant hyperthermia positive and negative human skeletal muscles.

In this study we evaluated the in vitro effects of 4-chloro-3-ethylphenol (CEP) using cumulative (12.5-200 micromol/L) or bolus (75 and 100 micromol/L) administrations, on muscle specimens from malignant hyperthermia (MH) susceptible and MH nonsusceptible patients, respectively. In the cumulative CEP in vitro contracture test, contractures were significantly greater in the MH susceptible compared with the MH nonsusceptible muscles in all concentrations between 25 and 100 micromol/L.

Phosphodiesterase-III-inhibition with amrinone leads to contracture development in skeletal muscle preparations of malignant hyperthermia susceptible swine.

Background And Objective: The phosphodiesterase-III (PDE-III) inhibitor enoximone-induced marked contractures in skeletal muscle specimens of malignant hyperthermia (MH) susceptible (MHS) human beings and swine. Whether this is a substance specific effect of enoximone or caused by inhibition of PDE-III remained unclear. Therefore, the effects of the PDE-III inhibitor amrinone in porcine MH normal (MHN) and MHS skeletal muscles were investigated.