Since 1984 the perioperative prophylaxis was carried out using the antibiotics Oxacillin or Halospor in artificial joint replacement of the hip. We started with 1 g Oxacillin at the very beginning of the anaesthesie. Further 0.5 g Oxacillin were administered 2 and 6 hours later. 964 hip joints operated between 1982-1988 were followed up. We observed a marked decrease of the rate of infection from 7.2% to 1.0% after the introduction of the perioperative prophylaxis.
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The objectives were to evaluate the effectiveness and safety of a single preoperative dose of intravenous tranexamic acid (TXA) in reducing perioperative blood loss and requirement for transfusion in patients undergoing hip hemiarthroplasty for femoral neck fracture. A double-blind randomized controlled trial was conducted in 140 patients with hip fracture. After randomization, 68 patients received a single dose of 1 gr of intravenous TXA at the start of the surgery (TXA group), and 72 received a placebo treatment (placebo group).
View Article and Find Full Text PDFCurr Pain Headache Rep
January 2025
Division of Perioperative Informatics, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA.
Purpose Of Review: Artificial intelligence (AI) offers a new frontier for aiding in the management of both acute and chronic pain, which may potentially transform opioid prescribing practices and addiction prevention strategies. In this review paper, not only do we discuss some of the current literature around predicting various opioid-related outcomes, but we also briefly point out the next steps to improve trustworthiness of these AI models prior to real-time use in clinical workflow.
Recent Findings: Machine learning-based predictive models for identifying risk for persistent postoperative opioid use have been reported for spine surgery, knee arthroplasty, hip arthroplasty, arthroscopic joint surgery, outpatient surgery, and mixed surgical populations.
BMJ Open
January 2025
Department of Anaesthesiology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Introduction: Surgical trauma induces a metabolic stress response, resulting in reduced insulin sensitivity and hyperglycaemia. Postoperative insulin resistance (IR) is associated with postoperative complications, and extended preoperative fasting may further aggravate the postoperative metabolic stress response. Nutritional strategies, such as carbohydrate loading (CHL), have been successfully used to attenuate postoperative IR.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Anaesthesiology, China-Japan Friendship Hospital, Beijing, Beijing, China.
Introduction: Nociception monitoring has recently gained recognition as a valuable tool for guiding intraoperative opioid administration. Several nociception monitors, including the Surgical Pleth Index, the Index of Consciousness (IoC) and the Nociception Level, have been introduced for managing intraoperative analgesia. While these technologies show promise in initial applications, the effectiveness of IoC2 in guiding pain management during anaesthesia, particularly in elderly patients who require precise opioid use, remains unclear.
View Article and Find Full Text PDFSurg Infect (Larchmt)
January 2025
New England Baptist Hospital, Boston, Massachusetts, USA.
Surgical site infection (SSI) after total hip and knee arthroplasty (THA/TKA) is a major complication leading to morbidity and mortality. Perioperative irrigation, frequently with antiseptic compounds including povidone-iodine (PI), is the standard of care in reducing SSI. Evidence supporting the value of PI versus nonantiseptic substances varies.
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