Impact of sugammadex and neostigmine on outcome after major orthopaedic surgery: A population-based analysis.

Background: Residual neuromuscular blockade after surgery remains a major concern given its association with pulmonary complications. However, current clinical practices with and the comparative impact on perioperative risk of various reversal agents remain understudied.

Objective: We investigated the use of sugammadex and neostigmine in the USA, and their impact on postoperative complications by examining national data.

Does the impact of peripheral nerve blocks vary by age and comorbidity subgroups? A nationwide population-based study.

Introduction: A large body of literature suggests that peripheral nerve blockade (PNB) is associated with improved perioperative outcomes in total hip and knee joint arthroplasty patients. However, it is unclear to what extent this association exists across patient subgroups based on age and health status.

Methods: Patients who underwent total joint arthroplasty were identified from the Premier Healthcare database (2006-2019).

The Perioperative Use of Benzodiazepines for Major Orthopedic Surgery in the United States.

Background: Despite numerous indications for perioperative benzodiazepine use, associated risks may be exacerbated in elderly and comorbid patients. In the absence of national utilization data, we aimed to describe utilization patterns using national claims data from total hip/knee arthroplasty patients (THA/TKA), an increasingly older and vulnerable surgical population.

Methods: We included data on 1,863,996 TKAs and 985,471 THAs (Premier Healthcare claims data, 2006-2019).

Association of perioperative midazolam use and complications: a population-based analysis.

Introduction: The benzodiazepine midazolam is the main sedative used in the perioperative setting, resulting in anxiolysis and a reduction in anesthetic dose requirements. However, benzodiazepine use is also associated with potentially serious side effects including respiratory complications, and postoperative delirium (POD). A paucity of population level data exists on current perioperative midazolam use in adult orthopedic surgery and its effects on complications.

General Versus Regional Anaesthesia for Lower Limb Arthroplasty and Associated Patient Satisfaction Levels: A Prospective Service Evaluation in the Oxford University Hospitals.

Introduction Lower limb arthroplasty is performed under general anaesthesia (GA) or regional anaesthesia (RA). There is increasing evidence of the surgical and anaesthetic benefits of RA. National Institute for Health and Care Excellence (NICE) guidelines advise using either but highlight a lack of data comparing outcomes of RA and GA for these procedures.

Peripheral nerve block anesthesia/analgesia for patients undergoing primary hip and knee arthroplasty: recommendations from the International Consensus on Anesthesia-Related Outcomes after Surgery (ICAROS) group based on a systematic review and meta-analysis of current literature.

Background: Evidence-based international expert consensus regarding the impact of peripheral nerve block (PNB) use in total hip/knee arthroplasty surgery.

Methods: A systematic review and meta-analysis: randomized controlled and observational studies investigating the impact of PNB utilization on major complications, including mortality, cardiac, pulmonary, gastrointestinal, renal, thromboembolic, neurologic, infectious, and bleeding complications.Medline, PubMed, Embase, and Cochrane Library including Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, were queried from 1946 to August 4, 2020.

Audiovisual distraction as an anxiety-minimising adjuvant to regional anaesthesia in adult limb surgery: a service evaluation using patient reported experience measures.

Audiovisual distraction (AVD) is an expanding anxiety-minimising technique for patients undergoing surgery under regional anaesthesia (RA). We evaluated patient satisfaction with AVD in the setting of conscious RA for limb surgery using patient reported experience measures (PREMs). Service evaluation using PREMs, via standardised post-operative patient questionnaire, in a single tertiary referral centre for orthopaedic and plastic surgery over an 18-month period.

The Impact of Immunization and Use of Oseltamivir on Influenza-Related Hospitalizations: A Population-Based Study.

Background: As the COVID-19 pandemic continues into flu season, it is critical to minimize hospitalizations to maximize capacity and preserve critical care resources. We sought to identify risk factors for influenza-related hospitalization, specifically the role of immunization and oseltamivir prescriptions.

Methods: Patients with influenza diagnoses were identified from the MarketScan database (2014-2018).

Depth to the airway lumen at the level of the cricothyroid membrane measured by ultrasound.

Background: Knowing the likely depth to the airway before emergency cricothyroidotomy may improve success in cases where it cannot be measured. Our aim was to measure the depth to the airway at the cricothyroid membrane by ultrasound in a large group of adult patients.

Method: Prospective, observational study in two centres, Oxford and Gloucester.

Liposomal bupivacaine infiltration at the surgical site for the management of postoperative pain.

Background: Despite multi-modal analgesic techniques, acute postoperative pain remains an unmet health need, with up to three quarters of people undergoing surgery reporting significant pain. Liposomal bupivacaine is an analgesic consisting of bupivacaine hydrochloride encapsulated within multiple, non-concentric lipid bi-layers offering a novel method of sustained-release analgesia.

Objectives: To assess the analgesic efficacy and adverse effects of liposomal bupivacaine infiltration at the surgical site for the management of postoperative pain.

Liposomal bupivacaine peripheral nerve block for the management of postoperative pain.

Background: Postoperative pain remains a significant issue with poor perioperative pain management associated with an increased risk of morbidity and mortality. Liposomal bupivacaine is an analgesic consisting of bupivacaine hydrochloride encapsulated within multiple, non-concentric lipid bi-layers offering a novel method of sustained release.

Objectives: To assess the analgesic efficacy and adverse effects of liposomal bupivacaine infiltration peripheral nerve block for the management of postoperative pain.

Neuromuscular blockade in the elderly patient.

Neuromuscular blockade is a desirable or even essential component of general anesthesia for major surgical operations. As the population continues to age, and more operations are conducted in the elderly, due consideration must be given to neuromuscular blockade in these patients to avoid possible complications. This review considers the pharmacokinetics and pharmacodynamics of neuromuscular blockade that may be altered in the elderly.

Audiovisual distraction as a useful adjunct to epidural anesthesia and sedation for prolonged lower limb microvascular orthoplastic surgery.

Lower limb orthopedic operations are frequently performed under regional anesthesia, which allows avoidance of potential side effects and complications of general anesthesia and sedation. Often though, patients feel anxious about being awake during operations. To decrease intraoperative anxiety, we use multimedia equipment consisting of a tablet device, noise-canceling headphones, and a makeshift frame, where patients can listen to music, watch movies, or occupy themselves in numerous ways.

Reconstruction of complex orbital exenteration defects: a single center's experience with a five-year follow-up.

Background: Orbital exenteration presents a challenge to the reconstructive surgeon. Defects may be treated with split skin grafts, local advancement flaps, or free flap coverage. There are few published series showing the long-term outcomes of reconstruction.