Purpose: There has been interest to investigate optimal anesthetic techniques for primary total shoulder arthroplasty (TSA). In this study, we investigate if there are differences in postoperative complications in patients receiving (1) regional alone; (2) general alone; and (3) regional plus general anesthesia for primary TSA.
Methods: Patients undergoing primary TSA from 2014 to 2018 were identified in a national database. Patients were stratified into 3 cohorts: general anesthesia, regional anesthesia, and general anesthesia combined with regional anesthesia. Thirty-day complications were assessed using bivariate and multivariate analyses.
Results: Of 13,386 total patients undergoing TSA, 9079 patients (67.8%) had general anesthesia, 212 (1.6%) had regional anesthesia, and 4095 (30.6%) had general anesthesia combined with regional anesthesia. There were no significant differences in postoperative complications between the general anesthesia group and the regional anesthesia group. Following adjustment, an increased risk of extended length of hospital stay was seen in the combined general and regional anesthesia group compared to those who only had general anesthesia (p = 0.001).
Conclusion: General versus regional versus general plus regional anesthesia have no difference in postoperative complications in patients receiving primary total shoulder arthroplasty. However, addition of regional anesthesia to general anesthesia is associated with increased length of stay.
Level Of Evidence: III.
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http://dx.doi.org/10.1007/s00590-023-03494-1 | DOI Listing |
Importance: Delirium is common after cardiac surgery and associated with adverse outcomes. Intraoperative benzodiazepines may increase postoperative delirium but restricting intraoperative benzodiazepines has not yet been evaluated in a randomized trial.
Objective: To determine whether an institutional policy of restricted intraoperative benzodiazepine administration reduced the incidence of postoperative delirium.
Riga-Fede disease (RFD) is a rare, benign condition marked by traumatic ulceration on the tongue's ventral side in infants. It arises from friction between the tongue and lower incisors during sucking, potentially worsening into a keratinized lesion if the cause is not addressed. This report details the case of a 1-year-6-month-old male with hydrocephalus, cleft palate, corpus callosum dysgenesis, neuropsychomotor developmental delay, and tracheostomy and gastrostomy needs.
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Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Background Currently, there is no data on the prevalence of urethral stricture illness in India. For short-segment bulbar urethral stricture, end-to-end anastomosis is the gold standard of care. The purpose of this study was to find where the direct vision internal urethrotomy (DVIU) exists in today's era.
View Article and Find Full Text PDFJ Med Life
December 2024
Department of Anesthesiology and Intensive Care, Faculty of Medicine Universitas Padjadjaran Bandung, Indonesia.
Enhanced Recovery After Surgery (ERAS) is a recovery method developed to minimize pain and improve post-operative healing in patients. Brain tumor resection using the ERAS concept is relatively new. This case series evaluates the implementation of the ERAS protocol in three female patients diagnosed with supratentorial brain tumors.
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Background: Trapeziectomy and abductor pollicis longus hammock ligamentoplasty may be performed in the surgical management of trapeziometacarpal joint osteoarthritis (TMC OA). Several anaesthesia techniques are available for TMC joint surgery, including wide-awake local anaesthesia no tourniquet (WALANT), regional anaesthesia, and general anaesthesia (GA). The aim of this study was to compare the clinical outcomes of trapeziectomy and abductor pollicis longus hammock ligamentoplasty performed under WALANT versus GA.
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