Data_Sheet_1_Outcomes after surgery in patients with and without recent influenza: a nationwide population-based study.docx

BackgroundThe influence of recent influenza infection on perioperative outcomes is not completely understood.MethodUsing Taiwan’s National Health Insurance Research Data from 2008 to 2013, we conducted a surgical cohort study, which included 20,544 matched patients with a recent history of influenza and 10,272 matched patients without. The main outcomes were postoperative complications and mortality. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for the complications and for mortality in patients with a history of influenza within 1–14 days or 15–30 days compared with non-influenza controls.ResultsCompared with patients who had no influenza, patients with influenza within preoperative days 1–7 had increased risks of postoperative pneumonia (OR 2.22, 95% CI 1.81–2.73), septicemia (OR 1.98, 95% CI 1.70–2.31), acute renal failure (OR 2.10, 95% CI 1.47–3.00), and urinary tract infection (OR 1.45, 95% CI 1.23–1.70). An increased risk of intensive care admission, prolonged length of stay, and higher medical expenditure was noted in patients with history of influenza within 1–14 days.ConclusionWe found that there was an association between influenza within 14 days preoperatively and the increased risk of postoperative complications, particularly with the occurrence of influenza within 7 days prior to surgery.</p

A forest plot showing a comparison of intracuff lidocaine (alkalinized and non-alkalinized) used and the control groups, as well as the incidence of POST at 1 h.

<p>A forest plot showing a comparison of intracuff lidocaine (alkalinized and non-alkalinized) used and the control groups, as well as the incidence of POST at 1 h.</p

A forest plot showing a comparison of intracuff lidocaine (alkalinized and non-alkalinized) used and the control groups, as well as the incidence of POST at 24 h.

<p>A forest plot showing a comparison of intracuff lidocaine (alkalinized and non-alkalinized) used and the control groups, as well as the incidence of POST at 24 h.</p

A flowchart showing the selection of the randomized controlled trials for our meta-analysis.

<p>A flowchart showing the selection of the randomized controlled trials for our meta-analysis.</p

The effect of intracuff lidocaine (alkalinized and non-alkalinized) used on the POST pain score at 1 h.

<p>The effect of intracuff lidocaine (alkalinized and non-alkalinized) used on the POST pain score at 1 h.</p

Effect of Intracuff Lidocaine on Postoperative Sore Throat and the Emergence Phenomenon: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

<div><p>Background</p><p>Postoperative sore throat and other airway morbidities are common and troublesome after endotracheal tube intubation general anesthesia (ETGA). We propose lidocaine as endotracheal tube (ETT) cuff inflation media to reduce the postintubation-related emergence phenomenon.</p><p>Methods</p><p>We searched PubMed, EMBASE, and Cochrane databases systematically for randomized controlled trials (RCTs) that have investigated the outcome of intracuff lidocaine versus air or saline in patients receiving ETGA. Using a random-effects model, we conducted a meta-analysis to assess the relative risks (RRs) and mean difference (MD) of the incidence and intensity of relevant adverse outcomes.</p><p>Results</p><p>We reviewed nineteen trials, which comprised 1566 patients. The incidence of early- and late-phase postoperative sore throat (POST), coughing, agitation, hoarseness, and dysphonia decreased significantly in lidocaine groups, with RRs of 0.46 (95% confidence interval [CI]: 0.31 to 0.68), 0.41 (95% CI: 0.25 to 0.66), 0.43 (95% CI: 0.31 to 0.62), 0.37 (95% CI: 0.25 to 0.55), 0.43 (95% CI: 0.29 to 0.63), and 0.19 (95% CI: 0.08 to 0.5), respectively, when compared with the control groups. The severity of POST also reduced significantly (mean difference [MD] -16.43 mm, 95% CI: -21.48 to -11.38) at 1 h and (MD -10.22 mm, 95% CI: -13.5 to -6.94) at 24 h. Both alkalinized and non-alkalinized lidocaine in the subgroup analyses showed significant benefits in emergence phenomena prevention compared with the control.</p><p>Conclusion</p><p>Our results indicate that both alkalinized and non-alkalinized intracuff lidocaine may prevent and alleviate POST and postintubation-related emergence phenomena.</p></div

Intracuff Lidocaine for Preventing Other Complications.

<p>NA = Not applicable</p><p>Intracuff Lidocaine for Preventing Other Complications.</p