Abstract:
BACKGROUND:Childhood and adolescent obesity increased in recent decades, and caregivers face an increasing number of obese pediatric surgical patients. Some clinical and pharmacogenetic data suggest that obese patients have altered pain sensitivity and analgesic requirements. OBJECTIVE:To test the primary hypothesis that increased BMI in pediatric patients is associated with increased pain during the initial 48 postoperative hours. Secondarily, we tested whether BMI is associated with increased opioid consumption during the same period. DESIGN:Retrospective single-center cohort study. SETTING:Pediatric surgical wards in a tertiary medical center. PATIENTS:A total of 808 opioid naïve patients aged 8 to 18 years having elective non-cardiac surgery with hospital stay of at least 48 h in the Cleveland Clinic between 2010 and 2015. INTERVENTIONS:None. MEASUREMENTS:Using U.S. Centers for Disease Control definitions for childhood weight classifications, we retrospectively evaluated the association between body mass index (BMI) percentile and time-weighted average pain scores and opioid consumption. We used multivariable linear regression to test for an association with postoperative pain scores, and multivariable gamma regression to test for an association with postoperative opioid consumption (in mg morphine equivalents Kg-1). RESULTS:BMI was not associated with postoperative pain after general, orthopedic, or neuro-spinal surgeries. Pain increased by 0.07 [98.75% CI: (0.01, 0.13), Padj < 0.05] points per 5 percentile increase in BMI after neuro-cranial surgery. Higher BMI was associated with a decrease in postoperative opioid consumption (mean change [95% CI] -2.12% [-3.12%, -1.10%] in morphine equivalents Kg-1 per 5 percentile increase in BMI, P < 0.001). CONCLUSION:We found no clinically important increase in pain scores or opioid consumption in association with higher BMI in patients 8 to 18 years of age recovering from elective non-cardiac surgery.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Cohen B,Tanios MA,Koyuncu O,Yilmaz HO,Raza S,Mukhdomi J,Artis AS,Seif J,Chhabada S,Turan Adoi
10.1016/j.jclinane.2020.109729subject
Has Abstractpub_date
2020-06-01 00:00:00pages
109729eissn
0952-8180issn
1873-4529pii
S0952-8180(19)31126-2journal_volume
62pub_type
杂志文章abstract:STUDY OBJECTIVE:To determine the effect of alkalinization of mepivacaine on onset of caudal anesthesia. DESIGN:Randomized, blind study. SETTING:Colon-Rectal Surgery Service of the Tertiary Center at Cleveland Clinic Foundation. PATIENTS:Young, healthy adults undergoing anal surgery. INTERVENTIONS:Addition of bicarb...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0952-8180(92)90134-m
更新日期:1992-07-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the consequences of opioid use for postoperative pain management and the degree to which these consequences may be reduced or minimized with opioid-sparing or opioid-replacement techniques. DESIGN:Literature review relating to the economics of postoperative pain management. Comparisons betw...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s0952-8180(02)00372-0
更新日期:2002-08-01 00:00:00
abstract:STUDY OBJECTIVES:To test the effect of stellate ganglion block on tympanic membrane temperatures. DESIGN:Prospective, observational study. SETTING:Department of Anesthesia, Yamanashi Medical University, Yamanashi, Japan. SUBJECTS:7 healthy male volunteers. INTERVENTIONS:Stellate ganglion block, 6 ml of 1% mepivacai...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(98)00092-0
更新日期:1998-12-01 00:00:00
abstract:PURPOSE:The aim of this study was to evaluate the effect of neuraxial blocks on surgical blood losses and on the number of patients requiring blood transfusion. METHODS:A search of the American National Library of Medicine's PubMed up to November 12, 2004, was performed. Twenty-four studies could be kept for analysis....
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,meta分析
doi:10.1016/j.jclinane.2005.08.013
更新日期:2006-03-01 00:00:00
abstract::A young, healthy adult man exhibited naloxone-reversible, prolonged apnea after a 4-hour infusion of remifentanil, which was used as the opioid component of a general endotracheal anesthetic. Clinical experience and pharmacokinetic simulations indicate that the apnea was clearly atypical. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.05.024
更新日期:2007-02-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the effects of tympanometric changes on the frequency of postoperative nausea and vomiting (PONV). DESIGN:Prospective, observational study. SETTING:University hospital. PATIENTS:49 ASA physical status I, nonpremedicated children undergoing elective strabismus surgery. INTERVENTIONS:Fr...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.05.027
更新日期:2007-03-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluated a department's long-term (6.5-year) success of achieving an overall and individual incidence of anesthesiologists working late of approximately 20% of days when not on call to work late, if necessary, and providing care in operating rooms. DESIGN:Historical cohort study, January 2014 throu...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2020.110151
更新日期:2020-12-02 00:00:00
abstract:OBJECTIVE:When dexmedetomidine is used in patients undergoing spinal anesthesia, high incidence of bradycardia in response to parasympathetic activation is reported. Therefore, we aimed to evaluate the effectiveness of atropine premedication for preventing the incidence of bradycardia and the hemodynamic effect on pati...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2016.07.012
更新日期:2016-12-01 00:00:00
abstract::We report a case of recurrent ST-segment elevations totaling 7 times over 3 hours during subtotal gastrectomy and the early postoperative period in a patient with no history of coronary artery disease. Possible contributing factors include cold stimulus, epidural anesthesia, and inadequate depth of anesthesia. The fir...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2004.08.013
更新日期:2005-08-01 00:00:00
abstract:STUDY OBJECT:To investigate the changes in hemodynamics and hypnotic levels during propofol infusion and tracheal intubation with and without fentanyl. DESIGN:Randomized, double-blinded study. SETTING:Teaching hospital. PATIENTS:40 ASA physical status I adult patients scheduled for elective surgery. INTERVENTIONS:P...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(01)00375-0
更新日期:2002-03-01 00:00:00
abstract:STUDY OBJECTIVES:To investigate the hypothesis that the combination of ondansetron and droperidol would be more effective than droperidol alone in reducing nausea and vomiting. DESIGN:Randomized, doubleblind study. SETTING:Magee-Womens Hospital, Pittsburgh, Pennsylvania. PATIENTS:160 healthy, ASA physical status I a...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(97)00188-8
更新日期:1998-02-01 00:00:00
abstract::"A professor is a gentleman with a different point of view." This characteristic and sarcastic statement was often recited by August Bier (1861-1949) and can also be aptly applied to him. As the father of spinal and intravenous regional neural blockade, Bier had a tremendous impact on surgery and anesthesia. It took h...
journal_title:Journal of clinical anesthesia
pub_type: 传,历史文章,杂志文章
doi:10.1016/s0952-8180(00)00202-6
更新日期:2000-11-01 00:00:00
abstract::Posterior reversible encephalopathy syndrome refers to a neuroradiologic disorder in which seizure activity (multiple seizures are more common than single events) is commonly the initial presenting symptom. We describe a case of posterior reversible encephalopathy syndrome in a previously healthy parturient who presen...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.07.004
更新日期:2007-03-01 00:00:00
abstract:STUDY OBJECTIVES:To evaluate the efficacy and safety of granisetron-droperidol combination for the prevention of postoperative nausea and vomiting (PONV) after middle ear surgery. DESIGN:Prospective, randomized, double-blind study. SETTING:University hospital. PATIENTS:150 ASA physical status I patients (108 females...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验,收录出版
doi:10.1016/s0952-8180(99)00011-2
更新日期:1999-03-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether our institutional insulin management (modified Atlanta) protocol is efficient and safe in controlling blood glucose levels in the perioperative period in surgical patients undergoing tumor hepatectomy. DESIGN:Retrospective study. SETTING:Large community hospital. PATIENTS:20 cons...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2008.09.006
更新日期:2009-08-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the accuracy and precision of estimation of partial pressure of carbon dioxide (Pa(CO2)) using end-tidal or transcutaneous CO2 (TcP(CO2)) measurements during mechanical ventilation in the elderly patient. DESIGN:A prospective, observational study was conducted. SETTINGS:The study was done ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.02.007
更新日期:2006-09-01 00:00:00
abstract::Horner's syndrome is a complication of epidural analgesia and anesthesia, encountered more commonly in pregnant women than in other patients. Previous reports described the appearance of Horner's syndrome following epidural injection of concentrated local anesthetic solutions. We report unilateral Horner's syndrome oc...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(03)00017-5
更新日期:2003-05-01 00:00:00
abstract::A potentially life-threatening arrhythmia appeared on the preinduction electrocardiogram of an asymptomatic young woman prior to spine surgery. The patient was evaluated by electrophysiology and had a rare accessory pathway, a Mahaim Fiber. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2010.09.010
更新日期:2011-09-01 00:00:00
abstract::We present a case in which an anemic patient with religious objections to blood transfusion experienced three episodes of severe myocardial ischemia during the perioperative period. The first episode of ischemia was successfully treated by discontinuing isoflurane and resolving the hypotension. The second and third ep...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(96)00086-4
更新日期:1996-08-01 00:00:00
abstract::Informed consent is a cornerstone and routine component of the ethical practice of modern medicine. Its full theoretical application to specific clinical situations, however, presents a number of ethical dilemmas for health care providers. Obstetric anesthesia, in particular, presents many unique challenges to the pro...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s0952-8180(02)00505-6
更新日期:2003-12-01 00:00:00
abstract:STUDY OBJECTIVE:To establish a useful ultrasonic approach to the epidural space so as to optimize pre-puncture diagnostics. DESIGN:Prospective study. SETTING:University clinic. PATIENTS:60 participants (19 to 34 years of age), 40 healthy volunteers (20 male, 20 female) and 20 parturients. INTERVENTIONS:Ultrasound s...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s0952-8180(01)00245-8
更新日期:2001-05-01 00:00:00
abstract::We present the case report of a 49-year-old gentleman with a history of adenoid cystic carcinoma of the left nare status post curative bifrontal craniotomy, left lateral rhinotomy and medial maxillectomy, adjuvant radiotherapy, and orbital exenteration for optic neuropathy, complicated by medial wall dehiscence. His c...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.05.005
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Cardiac arrest is associated with very high mortality and causes neurological dysfunction in the survivors. Therapeutic hypothermia is one of the recommended modality in the postarrest management. However, recent findings question its benefit in postarrest management. This meta-analysis has been conceptualiz...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jclinane.2016.03.001
更新日期:2016-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the safety and efficacy of monitored anesthesia care (MAC) in patients who undergo a novel treatment for hepatocellular cancer in which procedure-related hemodynamic instability is problematic. DESIGN:Nonrandomized open study. SETTING:University cancer center operating room. PATIENTS:Nine...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s0952-8180(97)00031-7
更新日期:1997-05-01 00:00:00
abstract:STUDY OBJECTIVE:Evaluate feasibility of 1-day OR management course for anesthesiology residents and determine if course content increases trust in OR management science. DESIGN:Pre- and post-course survey evaluations. SETTING:OR management course. PATIENTS:University of Florida anesthesiology residents. INTERVENTIO...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2018.12.045
更新日期:2019-08-01 00:00:00
abstract::Presented here is a case of unilateral pulmonary edema following acute subglottic edema after removal of an endotracheal tube. A 3-year-old boy, diagnosed as having nondiphtheric croup and pectus excavatum deformity, was scheduled for repair of a cleft lip. No complication occurred during the operation. After removal ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(90)90049-9
更新日期:1990-01-01 00:00:00
abstract::Administration of vecuronium by infusion is an increasingly common technique, both in the operating room and in the intensive care unit (ICU), for patients requiring prolonged neuromuscular blockade and mechanical ventilation. The major advantage of vecuronium over older neuromuscular blocking agents is its rapid excr...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(90)90107-e
更新日期:1990-07-01 00:00:00
abstract::A 37-year-old patient undergoing operative hysteroscopy developed noncardiogenic pulmonary edema after fluid absorption of 6 L of Ringer's lactate distension solution. No electrolyte or neurologic sequelae were associated with this fluid absorption. A subsequent 35-year-old patient having similar surgery in which a de...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2003.03.010
更新日期:2004-02-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the hemodynamic effects of two different concentrations of pentastarch hydroxyethyl starch (HES; 200/0.5) solutions with a 4% human albumin solution for fluid resuscitation. DESIGN:Open-label, randomized, controlled study. SETTING:Medical-surgical intensive care unit. PATIENTS:34 consecuti...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2008.05.022
更新日期:2008-11-01 00:00:00
abstract:STUDY OBJECTIVE:To determine if intrathecal opioid decreases time to extubation after coronary artery bypass surgery without compromising postoperative analgesia. DESIGN:Prospective randomized trial. SETTING:Veterans Affairs Hospital. PATIENTS:21 ASA physical status III and IV men scheduled for elective coronary byp...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(97)00081-0
更新日期:1997-08-01 00:00:00