There was no significant advantage of the sTAP block over local infiltration or no intervention for postoperative pain control in pediatric patients undergoing non-laparoscopic major abdominal surgeries.
Background: Delayed extubation after cardiac surgery is associated with high morbidity and mortality, increased intensive care unit length of stay, and healthcare cost. Acute type A aortic dissection (ATAAD) generally results in prolonged mechanical ventilation due to the complexity of surgical management and some postoperative complications. This study aimed to elucidate the perioperative risk factors for delayed extubation in patients undergoing ATAAD surgery. Methods: A retrospective cohort study including 239 patients who were diagnosed with ATAAD and underwent emergency surgery from October 2004 to January 2018 was performed. The potential perioperative risk factors for delayed extubation were collected. This study defined delayed extubation as the time to commence extubation being greater than 48 hours. The clinical data were analyzed with univariate and multivariate analyses to identify risk factors for delayed extubation following ATAAD surgery. Results: The incidence of delayed extubation was 48.5% (n=116). Multiple logistic regression analysis showed perioperative risk factors for delayed extubation included preoperative cardiac tamponade [odds ratio (OR) 3.94, 95% confidence interval (CI) 1. 39-11.17, P=0.010], central arterial cannulation (ascending aorta and proximal aortic arch) for cardiopulmonary bypass (CPB) (OR 4.
BackgroundThe quality of patients’ recovery following surgery and anesthesia has been a matter of focus and concern over the past decade. The Quality of Recovery-40 (QoR-40) questionnaire was developed and validated for post-anesthesia patient evaluation. The QoR-40, however, is English-based and was tested and validated in Caucasian patients, a population that is culturally and behaviorally different from the Thai population. The objective of this study was to translate and modify the original English-language QoR-40 into the Thai language and evaluate the Quality of Recovery-35 Thai version for measuring health outcomes in Thai patients after surgery and anesthesia.MethodsTranslation was performed according to internationally recognized translation standards to ensure the integrity of the translated version. Consistent with the recommendations of 25 anesthesiologists, five questions from the original QoR-40 were excluded. The 35-item questionnaire was then translated into the Thai language and renamed the Quality of Recovery-35 Thai version (Thai QoR-35). Overall, 43 outpatients and 53 inpatients rated their health and recovery status using three patient evaluation tools: 100-mm Visual Analogue Scale–Recovery (VAS-R), six-item Activities of Daily Living (ADL) questionnaire, and Thai QoR-35.ResultsOverall, 90 % of patients took <10 min to complete the Thai QoR-35 questionnaire. The Thai QoR-35 and VAS-R showed good convergent validity (r = 0.84, P < 0.001). Discrimination validity was supported by a significant difference in mean scores for recovery among the Thai QoR-35, VAS-R, and ADL when compared between outpatients and inpatients (P < 0.01) and also between baseline and postoperative values (P < 0.001). The Thai QoR-35 also demonstrated good reliability with high internal consistency at three time points (Cronbach’s alpha = 0.88, 0.89, 0.91, respectively; P < 0.01) and a split-half reliability coefficient of 0.65 (P < 0.001).ConclusionThai QoR-35 is a valid, reliable tool for evaluating quality of recovery in Thai patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-016-0229-7) contains supplementary material, which is available to authorized users.
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