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surgery in patients with obstructive sleep apnea

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https://www.readbyqxmd.com/read/29134423/perioperative-respiratory-complications-current-evidence-and-strategy-discussed-in-2017-ja-symposium
#1
K Hirota, M Yamakage, S Hashimoto, T Asai, S Isono
Respiratory management during general anesthesia aims to safely secure the airway and maintain adequate ventilation to deliver oxygen to the vital organs, maintaining homeostasis even during surgery. Despite its clinical importance, anesthesiologists often encounter difficulties in properly managing respiration during the perioperative period, leading to severe respiratory complications. In this year's JA symposium, 5 editorial board members of Journal of Anesthesia (JA) who are experts in the field of respiratory management in anesthesia discussed the following topics: quitting smoking before surgery: exposure to passive smoke is damaging to children, ventilator-associated pneumonia, high inspiratory oxygen concentration and lung injury, aspiration pneumonia, and postoperative respiratory management strategy in patients with obstructive sleep apnea...
November 13, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29122706/mid-to-long-term-outcomes-of-laparoscopic-sleeve-gastrectomy-in-indian-population-3-7-year-results-a-retrospective-cohort-study
#2
Harshit Garg, Sandeep Aggarwal, Mahesh Chandra Misra, Pratyusha Priyadarshini, Ashish Swami, Lokesh Kashyap, Richa Jaiswal
INTRODUCTION: Few studies have addressed the mid to long term impact of Laparoscopic Sleeve Gastrectomy (LSG) on weight loss and obesity associated co-morbidities, particularly in Indian population. The aim of this study is to assess the efficacy of LSG in morbid obesity over 3-7 years follow up. MATERIALS AND METHODS: Data of all patients who underwent LSG between January 2008 and March 2015 and completed their at least 1 year follow up till March 2016 was retrospectively reviewed using a prospectively collected database...
November 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29120929/risk-factors-for-opioid-induced-respiratory-depression-and-failure-to-rescue-a-review
#3
Kapil Gupta, Arun Prasad, Mahesh Nagappa, Jean Wong, Lusine Abrahamyan, Frances Chung
PURPOSE OF REVIEW: The primary objective of this review is to identify the risk factors for opioid-induced respiratory depression (OIRD) in the postoperative period. RECENT FINDINGS: In the postoperative period, OIRD has often been reported resulting in morbidity and mortality. The risk factors which predispose surgical patients to increased risk of OIRD are not clearly defined. A literature search was performed for adult surgical patients who were prescribed opioids during their hospital stay and any available reports on postoperative respiratory depression/respiratory events...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29117883/admission-criteria-for-children-with-obstructive-sleep-apnea-after-adenotonsillectomy-considerations-for-cost
#4
David F Smith, Charlene P Spiceland, Stacey L Ishman, Branden M Engorn, Christopher Donohue, Paul S Park, James R Benke, Tiffany Frazee, Robert H Brown, Nicholas M Dalesio
STUDY OBJECTIVES: Postoperative respiratory complications (PRCs) are common among children with obstructive sleep apnea (OSA) after adenotonsillectomy. We analyzed postoperative admission guidelines to determine which optimally balanced patient safety and cost. METHODS: Retrospective study of children aged 12 years or younger undergoing adenotonsillectomy for OSA after polysomnography at a tertiary academic care center over 2 years. Demographics, medical history, and hospital course were collected...
November 1, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29113702/mandibular-advancement-for-adult-obstructive-sleep-apnea-a%C3%A2-systematic-review-and-meta-analysis
#5
REVIEW
Michael W Noller, Christian Guilleminault, Christopher J Gouveia, Douglas Mack, Charles Vivian, Jose Abdullatif, Stefano Mangili, Stanley Yung Liu, Soroush Zaghi, Macario Camacho
OBJECTIVES: Patients with mandibular insufficiency can be predisposed to obstructive sleep apnea (OSA). The objective of this study was to systematically review the international literature for mandibular advancement surgeries (MAS) as treatment for adult OSA, and then to perform a meta-analysis. METHODS: Four authors searched five databases from the inception of each database through April 5, 2017. The PRISMA statement was followed. RESULTS: 972 studies were screened, 84 were downloaded, and 11 (57 patients) met criteria...
October 13, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29110581/outcomes-of-drug-induced-sleep-endoscopy-directed-surgery-for-pediatric-obstructive-sleep-apnea
#6
Shan He, Nithin S Peddireddy, David F Smith, Angela L Duggins, Christine Heubi, Sally R Shott, Stacey L Ishman
Objectives To determine the effectiveness of pediatric drug-induced sleep endoscopy (DISE)-directed surgery for children with infant obstructive sleep apnea (OSA) or OSA after adenotonsillectomy. Study Design Case series with chart review. Setting Tertiary care pediatric hospital. Subjects and Methods We included 56 children undergoing DISE from October 2013 to September 2015 who underwent subsequent surgery to address OSA. The primary outcome was successful response to DISE-directed surgery based on the postoperative obstructive Apnea-Hypopnea Index (oAHI)...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29108917/subcranial-and-orthognathic-surgery-for-obstructive-sleep-apnea-in-achondroplasia
#7
Srinivas M Susarla, Gerhard S Mundinger, Hitesh Kapadia, Mark Fisher, James Smartt, Christopher Derderian, Amir Dorafshar, Richard A Hopper
PURPOSE: Obstructive sleep apnea (OSA) is a common problem in patients with achondroplasia. The purpose of this study was to assess changes in airway volumes following various degrees of facial skeletal advancement. METHODS: This was a retrospective evaluation of patients with achondroplasia who underwent facial skeletal advancement for obstructive sleep apnea. Patients were treated with either an isolated Le Fort III distraction (LF3) or Le Fort II distraction with or without subsequent Le Fort I and bilateral sagittal split osteotomies (LF2 ± LF1/BSSO)...
October 5, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29108893/bariatric-surgery-as-a-treatment-for-heart-failure-review-of-the-literature-and-potential-mechanisms
#8
Tammy L Kindel, Jennifer L Strande
Heart failure due to severe obesity is a complex disease due to multiple mechanisms, including increased body mass, inflammation, and impaired cardiac metabolism that is complicated by obesity-associated co-morbidities, such as type 2 diabetes and obstructive sleep apnea. Bariatric surgery significantly improves cardiac geometry, function, and symptoms related to obesity cardiomyopathy. There is a consistently positive impact of bariatric surgery on diastolic function with the potential to significantly improve systolic function as measured by ejection fraction in patients with advanced heart failure...
October 2, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29106880/utility-of-screening-questionnaire-and-polysomnography-to-predict-postoperative-outcomes-in-children
#9
Hiromi Kako, Jennifer Tripi, Hina Walia, Dmitry Tumin, Mark Splaingard, Kris R Jatana, Joseph D Tobias, Vidya T Raman
INTRODUCTION: The prevalence of pediatric obstructive sleep apnea (OSA) has increased concurrently with the increasing prevalence of obesity. We have previously validated a short questionnaire predicting the occurrence of OSA on polysomnography (PSG). This follow-up study assessed the utility of the questionnaire in predicting postoperative outcomes. METHODS: Children undergoing surgery and completing a sleep study were prospectively screened for OSA using a short questionnaire...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29106863/clinical-variables-determining-the-success-of-adenotonsillectomy-in-children-with-down-syndrome
#10
Maíra da Rocha, Renata Caroline Mendonça Ferraz, Vitor Guo Chen, Gustavo Antonio Moreira, Reginaldo Raimundo Fujita
OBJECTIVES: To evaluate the evolution of polysomnographic parameters of children with Down syndrome and obstructive sleep apnea syndrome submitted to adenotonsillectomy and the interaction of comorbidities on therapeutic outcome. METHODS: Ninety patients with Down syndrome and habitual snoring were identified between 2005 and 2015 in a Pediatric Otorhinolaryngology Clinic. Parent's complaints were evaluated by the test of equality of two proportions. Wilcoxon test was used to examine pre- and post-operative polysomnographic differences...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29106778/evolution-of-soft-palate-surgery-techniques-for-obstructive-sleep-apnea-patients-a-comparative-study-for-single-level-palatal-surgeries
#11
Mohamed S Rashwan, Filippo Montevecchi, Giovanni Cammaroto, Mohamed Badr El Deen, Nagi Iskander, Diaa El Hennawi, Mohammed El Tabbakh, Giuseppe Meccariello, Riccardo Gobbi, Francesco Stomeo, Claudio Vicini
OBJECTIVES: to compare the results of tissue preservation techniques of soft palate surgeries including expansion sphincter pharyngoplasty (ESP) and barbed reposition pharyngoplasty (BRP) for patients suffering from obstructive sleep apnea (OSA) with the traditional uvulopalatopharyngoplasty (UPPP). DESIGN: interventional comparative study. SETTING: Morgagni- Pierantoni Hospital. PARTICIPANTS: seventy five patients were included in the study, divided into three groups with 25 patients per group: UPPP, ESP or BRP...
November 6, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29102064/modified-z-palatoplasty-with-one-layer-closure-in-one-stage-multilevel-surgery-for-severe-obstructive-sleep-apnea
#12
Ethan I Huang, Chia-Ling Kuo, Yu-Ting Chou, Yu-Ching Lin, Shu-Yi Huang
OBJECTIVE: The meticulous two-layer closure is a step to complete the modified Z-palatoplasty, which has been reported to serve as an effective element in multilevel sleep surgery for patients with severe obstructive sleep apnea, especially with Friedman anatomical stages II and III diseases. A single layer closure-the suture closure as originally described in uvulopalatopharyngoplasty by Fujita et al., is an alternative of the two-layer closure, featured by simplicity while its efficacy has not been completely proved in patients with severe obstructive sleep apnea...
October 25, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29099950/sleep-quality-after-modified-uvulopalatopharyngoplasty-results-from-the-skup3-randomized-controlled-trial
#13
Sundman Joar, Friberg Danielle, Bring Johan, Lowden Arne, Nagai Roberta, Browaldh Nanna
Study Objectives: To investigate whether uvulopalatopharyngoplasty (UPPP) improves sleep quality in patients with Obstructive Sleep Apnea (OSA) using the Functional Outcomes of Sleep Questionnaire (FOSQ) and the Karolinska Sleep Questionnaire (KSQ). Methods: Randomized controlled trial used to compare modified UPPP, with controls at baseline and after six months. The controls received delayed surgery and a six-month postoperative follow-up. All operated patients were offered a 24-month follow-up...
November 1, 2017: Sleep
https://www.readbyqxmd.com/read/29094197/let-s-know-from-our-patients-ppops-score-for-palate-surgery-evaluation-a-pilot-study
#14
Mohamed S Rashwan, Filippo Montevecchi, Elisabetta Firinua, Sandeep Dachuri, Hayfa Obaidat, Riccardo Gobbi, Giovanni Cammaroto, Simona Nuzzo, Claudio Vicini
AIM: To introduce a questionnaire that can be used to assess the post-operative perception of the patients after palatal surgery. The questionnaire was named: Palate Post-Operative Problems Score (PPOPS). STUDY DESIGN: Pilot study. PATIENTS AND METHODS: The study was performed at Morgagni-Pierantoni hospital, Forli. Forty patients suffering from obstructive sleep apnea (OSA) who performed either expansion sphincter pharyngoplasty (ESP) or barbed reposition pharyngoplasty (BRP) in our hospital were divided into two groups, 20 patients per group...
November 1, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29094076/friedman-tongue-position-and-cone-beam-computed-tomography-in-patients-with-obstructive-sleep-apnea
#15
Rebecca Harvey, Louise O'Brien, Sharon Aronovich, Anita Shelgikar, Paul Hoff, John Palmisano, Jeffrey Stanley
Objective: Evaluate the correlation between Friedman Tongue Position (FTP) and airway cephalometrics in patients with obstructive sleep apnea (OSA). Study Design: Retrospective review of adult patients with OSA undergoing Cone Beam Computed Tomography (CBCT). Methods: Collected data included age, sex, body mass index, apnea hypopnea index, FTP, and airway cephalometric parameters. Data analyses were performed using ANOVA, dichotomous t-testing, and linear regression...
October 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29068965/single-stage-repair-of-palatal-fistula-and-velopharyngeal-incompetence-by-the-new-l-flap
#16
Mohammad Waheed El-Anwar, Ezzeddin Elsheikh, Sherif Askar
OBJECTIVE: To describe and assess the results of use of the new L-shaped posterior pharyngeal flap for repair of both palatal fistula and velopharyngeal incompetence. METHODS: This study included 10 patients who were diagnosed to have soft palate fistula and persistent velopharyngeal insufficiency (VPI). L-shaped superiorly based pharyngeal flap was harvested from oropharynx and inserted into the soft palate closing the fistula after fistula trimming. The palatal part of the flap (transverse limb) was spread 1 cm horizontally and 1 cm in the anteroposterior direction in soft palate at fistula site closing it without tension...
October 24, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29050058/-ambulant-anesthesia-limits-and-possibilities
#17
Harald Hofer, Frank Vescia
The number of operations carried out on an outpatient basis is increasing in Germany. This trend has been observed for years. The prerequisite is an infrastructure that is in line with guidelines. The competence of the anesthetist must not be restricted to that of a standard specialist anesthetist, but the physician should have experience in ambulatory anesthesia. Well-adjusted comorbidities of the patient are generally not a contraindication for an outpatient procedure. The heavily overweight patient can also be operated on an outpatient basis if he is compliant, comorbidities are well adjusted and intensive postoperative care is ensured...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29049120/a-contemporary-medicolegal-analysis-of-outpatient-medication-management-in-chronic-pain
#18
Christopher R Abrecht, Ethan Y Brovman, Penny Greenberg, Ellen Song, James P Rathmell, Richard D Urman
BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO)...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049073/postoperative-outcomes-in-obstructive-sleep-apnea-patients-undergoing-cardiac-surgery-a-systematic-review-and-meta-analysis-of-comparative-studies
#19
Mahesh Nagappa, George Ho, Jayadeep Patra, Jean Wong, Mandeep Singh, Roop Kaw, Davy Cheng, Frances Chung
BACKGROUND: Obstructive sleep apnea (OSA) is a common comorbidity in patients undergoing cardiac surgery and may predispose patients to postoperative complications. The purpose of this meta-analysis is to determine the evidence of postoperative complications associated with OSA patients undergoing cardiac surgery. METHODS: A literature search of Cochrane Database of Systematic Reviews, Medline, Medline In-process, Web of Science, Scopus, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL until October 2016 was performed...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28988235/readmissions-and-emergency-department-visits-after-bariatric-surgery-at-saudi-arabian-hospital-the-rates-reasons-and-risk-factors
#20
Anwar Ahmed, Doaa AlBuraikan, Bashayr ALMuqbil, Wijdan AlJohi, Wala Alanazi, Budor AlRasheed
BACKGROUND: Saudi Arabian hospital readmissions and emergency department (ED) visits following bariatric surgery and discharge have never been investigated. This study aimed to evaluate the rates and reasons of hospital readmissions and ED visits related to surgical weight loss interventions at the King Abdulaziz Medical City - Riyadh. METHODS: We conducted a retrospective cohort study on 301 patients who underwent bariatric surgery between January 2011 and July 2016...
October 7, 2017: Obesity Facts
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