Although previous case series have suggested that SGB offers an effective intervention for PTSD, this study did not demonstrate any appreciable difference between SGB and sham treatment on psychological or pain outcomes. Future studies should examine if differences in treatment methods or patient population could allow individuals with PTSD to benefit from SGB, but current evidence does not support widespread or indiscriminant clinical use of the procedure for PTSD.
Objective
The purpose of this study was to describe the preoperative and postoperative experiences of spine surgery from the patient’s perspective to help inform behavioral health services provided before, during, and after hospitalization.
Setting
Single urban academic tertiary care hospital.
Methods
Semistructured interviews with 14 adults who underwent spine surgery. Interview transcriptions were analyzed using content analysis by three investigators to identify emergent themes.
Results
Three broad domains with associated themes emerged from the analysis: 1) preoperative experience—preparation, worries, and expectations; 2) recovery process—activity and pain management strategies; and 3) postoperative support in recovery—family and social support.
Conclusions
The results of this qualitative descriptive study can be used to guide future perioperative behavioral health services for patients undergoing spinal surgery. Establishing realistic expectations of spine surgery and a comprehensive pain management plan are essential for adequate preoperative preparation. Furthermore, family involvement in the preoperative preparation for surgery is important for support of the patient during the recovery process.
We tested whether positive end-expiratory pressure (PEEP) increases right internal jugular vein (RIJV) cross-sectional area (CSA) in 45 ASA physical status I and II adults. All patients received a standardized IV fluid bolus, induction of general anesthesia, tracheal intubation, and mechanical ventilation. We evaluated the CSA of the RIJV using ultrasound without PEEP (control) and with PEEP (10 cm H(2)O) in the supine, level position. Addition of PEEP increased RIJV CSA 0.42 + or - 0.41 cm(2) (mean + or - SD, median 0.34 cm(2), P < 0.001), which represented a 41% mean increase in CSA.
The purpose of this study was to evaluate the plasma potassium (K+) response after administration of tromethamine (THAM) or sodium bicarbonate (NaHCO3) in an acidotic rabbit model. Eighteen healthy, adult female New Zealand White rabbits were subjected to severe hypoxia until a base deficit of -10 mEq/L resulted. Rabbits were then randomized to receive THAM solution, NaHCO3, or no drug (control). The drug was administered over 2 min in quantities calculated to correct a base deficit of 10 or greater. Plasma K+ and sodium (Na+) were measured for 45 min after drug administration. No difference in K+ response was noted after THAM, NaHCO3, or no drug. In contrast, THAM resulted in significantly lower Na+ concentrations when compared to the NaHCO3 or the control group (P < 0.05). In this rabbit model, alkalinization after THAM administration results in K+ changes similar to those after NaHCO3. THAM should be considered when treating acidosis in patients where hypernatremia is a concern.
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