Author(s): Hajibandeh, S; Antoniou, S A; Torella, F; Antoniou, G A

Source: British journal of anaesthesia; Jan 2017; vol. 118 (no. 1); p. 11-21

Publication Date: Jan 2017

Publication Type(s): Journal Article
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Abstract:To investigate the role of perioperative beta-blocker use in vascular and endovascular surgery.   We performed a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards. The review protocol was registered with International Prospective Register of Systematic Reviews (registration number:CRD42016038111). We searched electronic databases to identify all randomized controlled trials and observational studies investigating outcomes of patients undergoing vascular and endovascular surgery with or without perioperative beta blockade. We used the Cochrane tool and the Newcastle-Ottawa scale to assess the risk of bias of trials and observational studies, respectively. Random-effects models were applied to calculate pooled outcome data. We identified three randomized trials, five retrospective cohort studies, and three prospective cohort studies, enrolling a total of 32,602 patients. Our analyses indicated that perioperative use of beta-blockers did not reduce the risk of all-cause mortality [odds ratio (OR) 1.10, 95% confidence interval (CI) 0.59-2.04, P = 0.77], cardiac mortality (OR 2.62, 95% CI 0.86-8.05, P = 0.09), myocardial infarction (OR 0.89, 95% CI 0.59-1.35, P = 0.58), unstable angina (OR 1.34, 95% CI 0.41- 4.38, P = 0.63), stroke (OR 2.45, 95% CI 0.89-6.75, P = 0.08), arrhythmias (OR 0.76, 95% CI 0.41-1.43, P = 0.40), congestive heart failure (OR 1.12, 95% CI 0.77-1.63, P = 0.56), renal failure (OR 1.48, 95% CI 0.90-2.45, P = 0.13), composite cardiovascular events (OR 0.88, 95% CI 0.55-1.40, P = 0.58), rehospitalisation (OR 0.86, 95% CI 0.48-1.52, P = 0.60), and reoperation (OR 1.17, 95% CI 0.42-3.27, P = 0.77) in vascular surgery. Beta-blockers do not improve perioperative outcomes in vascular and endovascular surgery.           © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.Database: Medline

Source: Journal of clinical anesthesia; Nov 2016; vol. 34 ; p. 270-271

Publication Type(s): Journal Article

Author(s): Tran, Steven; Krige, Anton
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Abstract:The benefits of cardiopulmonary exercise testing have been well established. Certain patient groups present challenges for conducting such a test. We were presented with a patient with a permanent tracheostomy at the preoperative assessment clinic. We describe our technique in overcoming the problem of connecting him to the testing machine, as this is normally done with the aid of a tight-fitting face mask. We used a cuffed tracheostomy tube together with some widely available tubing from theaters to connect the patient to the gas analyzer. The test was only stopped because of excessive secretions from the patient, and we had already established enough data to tell us that the patient was fit enough to proceed to surgery. As more patients present with tracheostomies, we feel that this case would be a useful reference in managing and assessing such patients.  

​Citation: International journal of obstetric anesthesia, Feb 2016, vol. 25, p. 91-92 (February 2016)
 
Author(s): Bhatia, K, Kochhar, P, Clegg, I, Maguire, S
 
Source: Medline

Citation: International Journal of Obstetric Anesthesia, May 2015, vol./is. 24/2(194-195), 0959-289X;1532-3374 (01 May 2015)

Author(s): Wai C., Bhatia K., Clegg I.

Publication Type: Journal: Letter

Source: EMBASE