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https://www.readbyqxmd.com/read/29026331/poorly-controlled-postoperative-pain-prevalence-consequences-and-prevention
#1
REVIEW
Tong J Gan
This review provides an overview of the clinical issue of poorly controlled postoperative pain and therapeutic approaches that may help to address this common unresolved health-care challenge. Postoperative pain is not adequately managed in greater than 80% of patients in the US, although rates vary depending on such factors as type of surgery performed, analgesic/anesthetic intervention used, and time elapsed after surgery. Poorly controlled acute postoperative pain is associated with increased morbidity, functional and quality-of-life impairment, delayed recovery time, prolonged duration of opioid use, and higher health-care costs...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29025297/liver-transplantation-in-patients-with-cardiac-disease
#2
Christopher L Wray
Liver transplantation (LT) is a unique surgical procedure that has major hemodynamic and cardiovascular implications. Recently, there has been significant interest focused on cardiovascular issues that affect LT patients in all phases of the perioperative period. The preoperative cardiac evaluation is a major step in the selection of LT candidates. LT candidates are aging in concordance with the general population; cardiovascular disease and their risk factors are highly associated with older age. Underlying cardiovascular disease has the potential to affect outcomes in LT patients and has a major impact on candidate selection...
October 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29019732/the-relevance-of-the-coagulation-screen-before-surgery
#3
Nuno M Borges, Jecko Thachil
Coagulation testing has long been part of the routine assessment of the preoperative patient, with the aim of identifying those with a bleeding disorder who might suffer significant perioperative bleeding. Some of the issues surrounding this involve the low prevalence of bleeding disorders in the general population, and the implications of further testing for both the patient and the health-care system. Studies suggest that this practice is not evidence based and is considered to be outdated. Most guidelines now advise against routine coagulation screens before surgery, and instead recommend taking a thorough personal and family history of bleeding in order to determine the need for further investigations...
October 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28985855/safety-of-perioperative-ketorolac-administration-in-pediatric-appendectomy
#4
Hibbut-Ur-Rauf Naseem, Robert Michael Dorman, George Ventro, David H Rothstein, Kaveh Vali
BACKGROUND: Recent studies in adults undergoing gastrointestinal surgeries show an increased rate of complications with the use of ketorolac. This calls into question the safety of ketorolac in certain procedures. We sought to evaluate the impact of perioperative ketorolac administration on outcomes in pediatric appendectomy. METHODS: The Pediatric Health Information System database was queried for patients aged 5-17 y with a primary diagnosis of appendicitis and a primary procedure of appendectomy during the period 2010-2014...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28971792/modification-of-tubeless-percutaneous-nephrolithotomy-with-a-ureteropelvic-junction-stent
#5
Tian C Zhou, Joshua M Stern
INTRODUCTION: To introduce the ureteropelvic junction stent as a safe and effective modification to tubeless percutaneous nephrolithotomy for select patients to maintain antegrade access to the collecting system. MATERIALS AND METHODS: From April 2014 to December 2015, 31 patients underwent modified tubeless percutaneous nephrolithotomy with ureteropelvic junction (UPJ) stent left in situ and an extraction string coming out the nephrostomy tract. Primary study endpoints included complications, emergency department visits, or re-admissions...
October 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28967731/new-assessment-for-advanced-age-italian-study-protocol-on-the-assessment-of-surgical-risk-in-the-over-75-year-age-group
#6
Annarita Pilleri, Giampaolo Scorcu
The role of age in the risk stratification of patients candidate for non-cardiac surgery is still today an unresolved issue. European guidelines, in contrast to American guidelines, do not attribute to age an independent role in increasing the risk, and the indices for assessment of perioperative cardiovascular risk are based on studies that were carried out on middle-aged subgroups of the population without specific attention to the elderly patient. While the indices of geriatric assessment have still not yet gained a standardized role in the risk stratification of patients candidate to non-cardiac surgery, their need is becoming increasingly urgent considering the epidemiological impact of elderly patients with multi-comorbidities who more and more in the future will undergo such interventions...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28964298/implementation-of-a-perioperative-surgical-home-protocol-for-pediatric-patients-presenting-for-adenoidectomy
#7
Vidya T Raman, Dmitry Tumin, Joshua Uffman, Arlyne K Thung, Candice Burrier, Kris R Jatana, Charles Elmaraghy, Joseph D Tobias
INTRODUCTION: The perioperative surgical home (PSH) is a patient-centered model designed to improve health, streamline the delivery of health care, and reduce the cost of care. Following the national introduction of PSH in 2014 by the ASA, adult hospitals have reported success with this model, with studies validating the benefits of PSH including reducing length of stay, lowering costs, and improving patient satisfaction. METHODS: Eligible patients, ranging in age from 16-35 months of age, were identified by the pre-admission testing (PAT) registered nurses (RNs) and faculty anesthesiologists upon review of the patient history...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28958570/measuring-the-patient-perspective-on-latissimus-dorsi-donor-site-outcomes-following-breast-reconstruction
#8
John P Browne, Ranjeet Jeevan, Andrea L Pusic, Anne F Klassen, Carmel Gulliver-Clarke, Jerome Pereira, Christopher M Caddy, Stefan J Cano
BACKGROUND: There is little evidence about the long-term donor site outcome of latissimus dorsi breast reconstruction and no patient-reported outcome measures designed specifically for the procedure. METHODS: A prospective cohort of breast cancer patients having latissimus dorsi reconstruction after a mastectomy was recruited from 270 hospitals in the United Kingdom. An 18-month follow up questionnaire containing two novel scales was sent to consenting patients...
September 13, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28957879/perioperative-management-of-cardiac-rhythm-assist-devices-in-ambulatory-surgery-and-nonoperating-room-anesthesia
#9
Lovkesh Arora, Chakradhari Inampudi
PURPOSE OF REVIEW: Patients with cardiac implantable electronic devices (CIEDs) frequently undergo various surgical procedures and in the past perioperative management involved only placing magnet over the device. New programming features, development of implantable cardiac defibrillator (ICD), cardiac resynchronization therapy, and increasing complexity of the operating room equipment have led to new sources of electromagnetic interference (EMI). A comprehensive understanding of the CIED is necessary to provide a timely and optimal care to the patients...
September 27, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28957877/heart-rate-variability-implications-for-perioperative-anesthesia-care
#10
Thomas Anthony Anderson
PURPOSE OF REVIEW: Heart rate variability (HRV) is a measure of the balance between both the parasympathetic and sympathetic nervous system and may provide useful information for anesthesia care providers. HRV may offer predictive information about critically ill and operative patients. Further, HRV collection provides real-time information of patient autonomic nervous system status and may allow tailoring of the analgesia for patients in the ICU and operating room. RECENT FINDINGS: Reduced and abnormal resting HRV predict sudden and nonsudden cardiac death...
September 27, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28953743/managing-opioid-addiction-risk-in-plastic-surgery-during-the-perioperative-period
#11
REVIEW
Daniel Demsey, Nicholas J Carr, Hance Clarke, Sharon Vipler
Opioid addiction is a public health crisis that affects all areas of medicine. Large numbers of the population across all racial and economic demographics misuse prescription opioids and use illicit opioids. The current understanding is that opioid misuse is a disease that requires treatment, and is not an issue of choice or character. Use of opioid medication is a necessary part of postoperative analgesia, but many physicians are unsure of how to do this safely given the risk of patients developing an opioid misuse disorder...
October 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28951777/hepatitis-b-in-renal-transplant-patients
#12
REVIEW
Smaragdi Marinaki, Kyriaki Kolovou, Stratigoula Sakellariou, John N Boletis, Ioanna K Delladetsima
Hepatitis B virus (HBV) poses a significant challenge for both dialysis patients and kidney transplant recipients despite its decreasing rates, especially in developed countries. The best preventive method is vaccination. Patients with chronic renal disease should ideally be vaccinated prior to dialysis, otherwise, reinforced vaccination practices and close antibody titer monitoring should be applied while on dialysis. HBV infected dialysis patients who are renal transplant candidates must be thoroughly examined by HBV-DNA, and liver enzyme testing and by liver biopsy...
September 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28948940/radical-prostatectomy-in-patients-aged-75-years-or-older-review-of-the-literature
#13
REVIEW
Philipp Mandel, Thenappan Chandrasekar, Felix K Chun, Hartwig Huland, Derya Tilki
Given the demographic trends toward a considerably longer life expectancy, the percentage of elderly patients with prostate cancer will increase further in the upcoming decades. Therefore, the question arises, should patients ≥75 years old be offered radical prostatectomy and under which circumstances? For treatment decision-making, life expectancy is more important than biological age. As a result, a patient's health and mental status has to be determined and radical treatment should only be offered to those who are fit...
September 26, 2017: Asian Journal of Andrology
https://www.readbyqxmd.com/read/28940247/enhancing-patient-safety-in-the-operating-theatre-from-the-perspective-of-experienced-operating-theatre-nurses
#14
Eydis Ingvarsdottir, Sigridur Halldorsdottir
THE STUDY'S RATIONALE: Surgical care is an extensive component of modern health care, but patient safety issues and complications of surgery have been identified as a major cause of death and disability. OBJECTIVE: The aim of this study was to identify, from the perspective of experienced operating theatre nurses (OTNs), how patient safety in the operating theatre (OT) can be enhanced. RESEARCH METHODOLOGY AND METHODS: In this phenomenological study, 14 individual interviews were conducted with a purposive sample of 11 participants: ten women and one man...
September 22, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28933805/perioperative-administration-of-buffered-versus-non-buffered-crystalloid-intravenous-fluid-to-improve-outcomes-following-adult-surgical-procedures
#15
REVIEW
Sohail Bampoe, Peter M Odor, Ahilanandan Dushianthan, Elliott Bennett-Guerrero, Suzie Cro, Tong J Gan, Michael Pw Grocott, Michael Fm James, Michael G Mythen, Catherine Mn O'Malley, Anthony M Roche, Kathy Rowan, Edward Burdett
BACKGROUND: Perioperative fluid strategies influence clinical outcomes following major surgery. Many intravenous fluid preparations are based on simple solutions, such as normal saline, that feature an electrolyte composition that differs from that of physiological plasma. Buffered fluids have a theoretical advantage of containing a substrate that acts to maintain the body's acid-base status - typically a bicarbonate or a bicarbonate precursor such as maleate, gluconate, lactate, or acetate...
September 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28930048/is-current-preoperative-frailty-assessment-adequate
#16
Gilgamesh Eamer, Jennifer A Gibson, Chelsia Gillis, Amy T Hsu, Marian Krawczyk, Emily MacDonald, Reid Whitlock, Rachel G Khadaroo
Preoperative frailty predicts adverse postoperative outcomes. Recommendations for preoperative assessment of elderly patients include performing a frailty assessment. Despite the advantages of incorporating frailty assessment into surgical settings, there is limited research on surgical health care professionals' perception and use of frailty assessment for perioperative care. We surveyed local health care employees to assess their attitudes toward and practices for frail patients. Nurses and allied health professionals were more likely than surgeons to agree frailty should play a role in planning a patient's care...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28922205/impact-of-advanced-age-on-survival-in-patients-undergoing-resection-of-hepatocellular-carcinoma-report-of-a-japanese-nationwide-survey
#17
Masaki Kaibori, Kengo Yoshii, Isao Yokota, Kiyoshi Hasegawa, Fumio Nagashima, Shoji Kubo, Masanori Kon, Namiki Izumi, Masumi Kadoya, Masatoshi Kudo, Takashi Kumada, Michiie Sakamoto, Osamu Nakashima, Yutaka Matsuyama, Tadatoshi Takayama, Norihiro Kokudo
OBJECTIVE: The impact of age on survival after hepatic resection for hepatocellular carcinoma (HCC) has not been thoroughly examined. We reviewed the data of a nationwide follow-up survey to determine the outcomes of hepatectomy for HCC in elderly patients. BACKGROUND: Management of malignant diseases in elderly patients has become a global clinical issue because of the increased life expectancy worldwide. Advancements in surgical techniques and perioperative management have reduced age-related contraindications for liver surgery...
September 15, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28921676/perioperative-passport-empowering-people-with-diabetes-along-their-surgical-journey
#18
E Page, F Akiboye, S Jackson, C Kerry, R Round, G Rayman
AIM: To determine whether a handheld 'perioperative passport' could improve the experience of perioperative care for people with diabetes and overcome some of the communication issues commonly identified in inpatient extracts. METHODS: Individuals with diabetes undergoing elective surgery requiring at least an overnight stay were identified via a customized information technology system. Those allocated to the passport group were given the perioperative passport before their hospital admission...
September 18, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28920035/anesthesia-management-of-a-patient-with-papillon-lefevre-syndrome-a-case-report
#19
Afshin Iranpour, Ata Mahmoodpoor
INTRODUCTION: Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive trait; it often requires some interventions with general anesthesia because of the accompanied complications. CASE PRESENTATION: We report a 19-year-old girl with palmoplantar hyperkeratosis who presented total loss of her teeth. She was candidate to mandibular bone graft and lower jaw dental implants under general anesthesia. CONCLUSIONS: There are only a few studies about perioperative management of these patients; however, the anesthesiologists should consider a few important issues during pre-operative and intra-operative management...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28917403/cataract-surgery-in-patients-with-late-onset-retinal-degeneration
#20
Vasileios T Papastavrou, Shyamanga Borooah, Jill M O'Brien, Neeta Ray-Chaudhuri, Baljean Dhillon, Rute V Vieira, Andrew C Browning
PURPOSE: To review the outcomes in a series of patients with long anterior lens zonular fibers associated with late-onset retinal degeneration who had phacoemulsification cataract surgery. SETTING: Newcastle Eye Centre, Newcastle upon Tyne, United Kingdom. DESIGN: Retrospective case series. METHODS: Inclusion criteria were patients with genetically confirmed late-onset retinal degeneration requiring cataract surgery...
August 2017: Journal of Cataract and Refractive Surgery
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