BACKGROUND: Neuraxial anesthesia is often viewed as superior to general anesthesia but may delay discharge. Comparisons do not typically use multimodal analgesics and nerve blockade. Combining nerve blockade with general anesthesia may reduce pain, opioid consumption, and nausea. We hypothesized that general anesthesia (with nerve blocks) would lead to earlier readiness for discharge, compared to spinal anesthesia (with nerve blocks). METHODS: All patients underwent ambulatory foot and ankle surgery, with a predicted case duration of 1–3 hours. All patients received popliteal and adductor canal nerve blocks using bupivacaine and dexamethasone. No intraoperative opioids were administered. All patients received ondansetron, dexamethasone, ketamine, and ketorolac. Patients, data collectors, and the data analyst were not informed of group assignment. Patients were randomized to spinal or general anesthesia with concealed allocation. Spinal anesthesia was performed with mepivacaine and accompanied with propofol sedation. After general anesthesia was induced with propofol, a laryngeal mask airway was inserted, followed by sevoflurane and propofol. Time until ready for discharge, the primary outcome, was compared between groups after adjusting for age and surgery time using multivariable unconditional quantile regression. Secondary outcomes compared at multiple timepoints were adjusted for multiple comparisons using the Holm–Bonferroni step-down procedure. RESULTS: General anesthesia patients were ready for discharge at a median of 39 minutes earlier (95% confidence interval, 2–75; P = .038) versus spinal anesthesia patients. Patients in both groups met readiness criteria for discharge substantially before actual discharge. Pain scores at rest were higher among general anesthesia patients 1 hour after leaving the operating room (adjusted difference in means, 2.1 [95% confidence interval, 1.0–3.2]; P
https://ift.tt/2L6VTxX
Αρχειοθήκη ιστολογίου
-
►
2020
(289)
- ► Φεβρουαρίου (28)
-
►
2019
(9071)
- ► Δεκεμβρίου (19)
- ► Σεπτεμβρίου (54)
- ► Φεβρουαρίου (3642)
- ► Ιανουαρίου (3200)
-
▼
2018
(39872)
- ► Δεκεμβρίου (3318)
- ► Σεπτεμβρίου (3683)
-
▼
Μαΐου
(3439)
-
▼
Μαΐ 30
(131)
- Obturators versus flaps after maxillary oncologica...
- Unravelling the molecular signatures in HNSCC: Is ...
- Targeting myeloid-derived suppressor cells for can...
- An independent relation of atopic dermatitis to ex...
- Interleukin 17A exacerbates ER-stress-mediated inf...
- Seafood allergy: A comprehensive review of fish an...
- Helminth-induced regulatory T cells and suppressio...
- Dendritic cells, T cells and lymphatics: dialogues...
- Pediatric Residents’ Assessment of Atopic Dermatit...
- Development of Food Protein-Induced Enterocolitis ...
- Pilot study of the CAPS (Clinical extent, Area, Pr...
- Different Treatments With the TRV Reposition Chair
- Audit of the Spanish EURECCA Esophagogastric Cance...
- Thykamine Safety and Efficacy Study in Mild-to-Mod...
- ctDNA as a Biomarker for Treatment Response in HNSCC
- Re: “High Thyroid Cancer Mortality Rate in Japan: ...
- No-Scar Transoral Thyroglossal Duct Cyst Excision ...
- The impact of cold on the respiratory tract and it...
- Reconstrucción de defectos orofaríngeos tras cirug...
- Monophasic Synovial Sarcoma of Tongue: A Rarest of...
- Robot Assisted Trans Axillary Thyroidectomy: A Sub...
- Successful treatment of primary bone marrow Hodgki...
- Bike Safety for the Whole Family
- Trichophyton erinacei Transmitted to a Pregnant Wo...
- Lentigo Maligna—Challenges, Observations, Imiquimo...
- Prevalence of Skin Cancer Examination Among Indoor...
- Lentigo Maligna Treated With Off-Label Neoadjuvant...
- Adolescents’ Perspectives on Atopic Dermatitis Tre...
- Multidisciplinary management of oculo-auriculo-ver...
- Deconstructive SCNT reveals novel Treg subsets
- Saturated fatty acids, obesity and the NLRP3 infla...
- Ketamine Anesthesia Does Not Improve Depression Sc...
- Epitope mapping and kinetics of CD4 T cell immunit...
- Tear Off the Masks: Identity and Imposture in Twen...
- Political knowledge: Measurement, misinformation a...
- The Saga of History 492: The Transformation of Wor...
- Flexible scintillator autoradiography for tumor ma...
- The link between interoceptive processing and anxi...
- How effective and cost-effective are behaviour cha...
- Sociolinguistics, translation and interpreting
- Changes in environmental tobacco smoke (ETS) expos...
- Diagnostic accuracy for the extent and activity of...
- Franchising the disenfranchised? The paradoxical s...
- Sequencing of prostate cancers identifies new canc...
- Visual attention mechanisms in happiness vs. trust...
- The behavioural variant frontotemporal dementia ph...
- Genome-wide association analyses identify 44 risk ...
- Socioeconomic segregation in secondary schools: ev...
- What Does a Red Meat Allergy Have to Do With Anest...
- Automated Assessment of Existing Patient’s Revised...
- Pain Medicine Board Review
- Assessing the Association Between Blood Loss and P...
- Phentolamine Reverses Epinephrine-Enhanced Skin An...
- Intraoperative Methadone in Same-Day Ambulatory Su...
- Mixing Studies in Patients With Prolonged Activate...
- Opening the Black Box: Understanding the Science B...
- Reversing Cholinergic Bronchoconstriction by Commo...
- The Effect of Labor Epidural Analgesia on Breastfe...
- Readiness for Discharge After Foot and Ankle Surge...
- In Response
- Opioid Use Disorders: Perioperative Management of ...
- The Use of Hydroxyethyl Starch 130/0.4 in Surgery ...
- Efficacy of Malignant Hyperthermia Association of ...
- TIP SHEET: Johns Hopkins Researchers Well Represen...
- Supraglottoplasty surgery types 1–3: A practical c...
- Is the evidence of local allergic rhinitis growing?
- Multidisciplinary management of oculo-auriculo-ver...
- Development and Assessment of a Transoral Robotic ...
- Follicular dendritic cell sarcoma presenting as a ...
- Maxillary sinus schwannoma
- Unusual presentation of Henöch-Schonlein purpura
- Toe walking after three: how serious could it be?
- A 3-month-old infant with atypical Kawasaki disease
- Denosumab causing severe, refractory hypocalcaemia...
- Subcutaneous oedema of upper limbs heralding an ag...
- Lactation ketoacidosis: case presentation and lite...
- Myeloid sarcoma of the small intestine in a patien...
- Left ventricular mural thrombus despite treatment ...
- Facilitated subcutaneous immunoglobulin treatment ...
- Congenital limb deficiency requiring transfemoral ...
- Renal cell carcinoma with sarcomatoid transformati...
- Giant cell lesion of the jaw as a presenting featu...
- Endometrial metastasis of primary malignant melano...
- Superior sagittal sinus thrombosis in a case of Mi...
- A chronic alcoholic man with high fever, neck rigi...
- Unusual case of cerebral demyelination and bilater...
- Scleral dellen following strabismus surgery
- Severe Babesia microti infection presenting as mul...
- Acute Kidney Injury after Liver Transplantation
- OPTICAL OR TRANSBRONCHIAL BIOPSY TO DIAGNOSE ACUTE...
- Donating Another Person’s Kidney: Avoiding the Dis...
- Diagnosis of Acute Cellular Rejection Using Probe-...
- Invited author's reply to "Optimal culture methods...
- Optimal culture methods and microbial contaminatio...
- Domino Liver Transplant in Maple Syrup Urine Disea...
- Hyperfiltration-mediated injury in the remaining k...
- A comparison of the incidence of supraventricular ...
- Safety of moderate-to-deep sedation performed by s...
- Validation of the Brief Developmental Assessment i...
- In Vivo Observation of Structural Changes in Neoco...
-
▼
Μαΐ 30
(131)
- ► Φεβρουαρίου (2693)
- ► Ιανουαρίου (3198)
-
►
2017
(41099)
- ► Δεκεμβρίου (3127)
- ► Σεπτεμβρίου (2173)
-
►
2016
(13807)
- ► Δεκεμβρίου (700)
- ► Σεπτεμβρίου (600)
- ► Φεβρουαρίου (1350)
- ► Ιανουαρίου (1400)
-
►
2015
(1500)
- ► Δεκεμβρίου (1450)
Ετικέτες
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου