Opioid use has risen dramatically in the past three decades. In the USA, opioid overdose has become a leading cause of unintentional death, surpassing motor vehicle accidents. A patient's first exposure to opioids may be during the perioperative period, a time where anesthesiologists have a significant role in pain management. Almost all patients in the USA receive opioids during a surgical encounter. Opioids have many undesirable side effects, including potential for misuse, or opioid use disorder. Anesthesiologists and surgeons employ several methods to decrease unnecessary opioid use, opioid-related adverse events, and side effects in the perioperative period. Multimodal analgesia, enhanced recovery pathways, and regional anesthesia are key tools as we work towards optimal opioid stewardship and the ideal of effective analgesia without undesirable sequelae.
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http://dx.doi.org/10.1186/s13741-018-0097-4 | DOI Listing |
Int J Surg
January 2025
Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, Jiangsu, China.
Background: Type A aortic dissection (TAAD) remains a significant challenge in cardiac surgery, presenting high risks of adverse outcomes such as permanent neurological dysfunction and mortality despite advances in medical technology and surgical techniques. This study investigates the use of quantitative electroencephalography (QEEG) to monitor and predict neurological outcomes during the perioperative period in TAAD patients.
Methods: This prospective observational study was conducted at the hospital, involving patients undergoing TAAD surgery from February 2022 to January 2023.
Cochrane Database Syst Rev
January 2025
Liverpool Reviews and Implementation Group, Department of Health Data Science, University of Liverpool, Liverpool, UK.
Rationale: Postpartum haemorrhage, defined as a blood loss of 500 mL or more within 24 hours of birth, is the leading global cause of maternal morbidity and mortality. Uterine fibroids are non-cancerous growths that develop in or around the uterus, and affect an increasing number of women. Caesarean myomectomy is the surgical removal of fibroids during a caesarean section.
View Article and Find Full Text PDFPak J Med Sci
January 2025
Qing Wang Orthopedics Department 2, First people's Hospital of Yong Kang, Yongkang, Zhejiang Province 321300, P.R. China.
Objective: To evaluate the efficacy of supra-inguinal fascia iliaca compartment block (S-FICB) in patients undergoing proximal femoral nail antirotation (PFNA) internal fixation surgery for intertrochanteric fracture (ITF).
Methods: Retrospective analysis of 95 patients with ITF undergoing PFNA internal fixation surgery in the First People's Hospital of Yong Kang from March 2021 to August 2023 was performed. Among them, 49 patients received general anesthesia (GA; GA group) and 46 patients received S-FICB combined with general anesthesia (S-FICB group).
J Int Med Res
January 2025
Cardiovascular Surgery, University Hospital of Lausanne, Lausanne, Switzerland.
Objective: The definition of coronary artery bypass graft (CABG)-associated myocardial infarction (MI) is controversial because the postoperative increases in cardiac enzyme activities are multifactorial in origin.
Methods: We performed a retrospective case-control study of patients who experienced perioperative MI (cardiac enzyme release, electrocardiographic changes, dysfunction on echocardiography) and those without ischemia to identify risk factors and enzyme activity thresholds.
Results: The estimated incidence of CABG-associated MI was 2.
Thorac Cancer
January 2025
Department of Thoracic Surgery, University and Hospital Trust-Ospedale Borgo Trento, Verona, Italy.
In early-stage lung cancer, lung function appears to be less compromised after segmentectomy than lobectomy, though the advantage seems modest. We aimed to re-assess postoperative lung function in surgical patients, with a particular focus on the diffusion capacity for carbon monoxide (DL). We evaluated all patients who underwent either lobectomy or segmentectomy for T1a-c lung cancer at our center between March 2016 and March 2023.
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