Preoperative assessment of postoperative delirium: a cross-sectional study of patients and anesthesiologists in Canada.

Purpose: We sought to evaluate 1) patient- and anesthesiologist-reported rates of postoperative delirium (POD) risk discussion during preoperative meetings, 2) patients' and anesthesiologists' ratings of the importance of POD, and 3) predictors of patient-reported discussion of POD risk during preoperative meetings.

Methods: In this multicentre two-part cross-sectional survey study, patients ≥ 65 yr scheduled to undergo elective noncardiac surgery completed a five-minute survey after preoperative anesthesia consultation. Patients were asked about their perception of POD importance, and whether they discussed or were assessed for POD risk.

The Routine Use of the Pulmonary Artery Catheter Should Be Abandoned.

The pulmonary artery catheter (PAC) is the most common method of measuring cardiac output in cardiac surgery. However, its use has always been questioned in terms of survival benefit, specifically with regard to the accuracy of its measurements and its invasive nature, with the potential for serious complications. In this review we aimed to develop a clear understanding of the pitfalls of the use of PAC, and discuss its risks and available alternatives.

Airway management of an open penetrating neck injury.

Although penetrating neck injuries (PNIs) represent a small subset of patients presenting to the emergency department (ED), they can result in significant morbidity and mortality. The approach to airway management in PNI varies widely according to clinical presentation and local practice, such that global management statements are lacking. Although rapid sequence intubation (RSI) may be safe in most patients with PNI, the high-risk subset (10%) of patients with laryngotracheal injury require particularly judicious airway management.

What epidural opioid results in the best analgesia outcomes and fewest side effects after surgery?: a meta-analysis of randomized controlled trials.

Background: Epidural opioids are widely used for central neuraxial blockade and postoperative analgesia. However, differences in analgesic efficacy and side effect rates among individual opioids remain controversial.

Methods: We conducted a random-effects meta-analysis of randomized controlled trials that compared at least 2 continuous epidural infusions for acute postoperative analgesia over at least 24 hours.