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geriatric anaesthesia

WeiBing Wang, YuanHai Li, AiJiao Sun, HongPing Yu, JingChun Dong, Huang Xu
BACKGROUND: Unilateral spinal anesthesia (USpA) has been reported to potentiate spinal anaesthesia and is used in geriatric patients. The purpose of this study was to determine the median effective dose (ED50 ) of 0.5% hypobaric bupivacaine and 0.5% hypobaric ropivacaine USpA for geriatric patients (age ≥ 70 years) undergoing elective hip replacement surgery. METHODS: A total of 60 geriatric patients (age ≥ 70 years) undergoing elective hip replacement surgery were enrolled in this study...
December 2017: Der Anaesthesist
Victoria Cui, Catherine M Tedeschi, Vanessa L Kronzer, Sherry L McKinnon, Michael S Avidan
INTRODUCTION: Postoperative delirium can be a serious consequence of major surgery, associated with longer hospital stays, readmission, cognitive and functional deterioration and mortality. Delirium is an acute, reversible disorder characterised by fluctuating course, inattention, disorganised thinking and altered level of consciousness. Delirium occurring in the hours immediately following anaesthesia and delirium occurring in the postoperative period of 1-5 days have been described as distinct clinical entities...
July 10, 2017: BMJ Open
Kathrine Mauchaza, Farai D Madzimbamuto, Seymour Waner
INTRODUCTION: The prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) in Africa is sparsely documented. In Zimbabwe there is no routine patient or specimen screening for MRSA. The aim of this study was to document the presence and epidemiology of MRSA in Zimbabwe. METHOD: The study was done in one private sector laboratory with a national network that serves both public and private hospitals. The sample population included in-patients and outpatients, all ages, both genders, all races and only one positive specimen per patient was counted...
June 2016: Ghana Medical Journal
M Schuers, M Timsit, A Gillibert, A Fred, N Griffon, J Bénichou, S J Darmoni, P Staccini
BACKGROUND: To evaluate the impact of the pharmaceutical patient record use in emergency, geriatric and anaesthesia and intensive care departments, an experimentation was launched in 2013 in 55 hospitals. The purpose of the study was to assess the opinions of physicians and pharmacists about the benefits and usability of the patient pharmaceutical record. METHODS: An e-mailed self-administered questionnaire was sent to all the pharmacists, anaesthesiologists, geriatricians and emergency physicians of the 55 hospitals involved in the patient pharmaceutical record experimentation...
September 2016: Revue D'épidémiologie et de Santé Publique
Anjana Sahu, Indirani H Kumar
A 70-year-old female patient, known case of hypertension and incomplete Left bundle branch block (LBBB), posted for bipolar hemiarthroplasty. A geriatric patient with LBBB and systemic hypertension is a fatal combination; it may precipitate into complete AV dissociation during anaesthesia and surgical stress. We are reporting this interesting case as our patient had developed complete Atrioventricular (AV) dissociation when scheduled earlier for surgery and got postponed. We had given combined spinal epidural anaesthesia and managed successfully without any complication...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
T S Wildes, A C Winter, H R Maybrier, A M Mickle, E J Lenze, S Stark, N Lin, S K Inouye, E M Schmitt, S L McKinnon, M R Muench, M R Murphy, R T Upadhyayula, B A Fritz, K E Escallier, G P Apakama, D A Emmert, T J Graetz, T W Stevens, B J Palanca, R Hueneke, S Melby, B Torres, J M Leung, E Jacobsohn, M S Avidan
INTRODUCTION: Postoperative delirium, arbitrarily defined as occurring within 5 days of surgery, affects up to 50% of patients older than 60 after a major operation. This geriatric syndrome is associated with longer intensive care unit and hospital stay, readmission, persistent cognitive deterioration and mortality. No effective preventive methods have been identified, but preliminary evidence suggests that EEG monitoring during general anaesthesia, by facilitating reduced anaesthetic exposure and EEG suppression, might decrease incident postoperative delirium...
June 15, 2016: BMJ Open
Najma Siddiqi, Jennifer K Harrison, Andrew Clegg, Elizabeth A Teale, John Young, James Taylor, Samantha A Simpkins
BACKGROUND: Delirium is a common mental disorder, which is distressing and has serious adverse outcomes in hospitalised patients. Prevention of delirium is desirable from the perspective of patients and carers, and healthcare providers. It is currently unclear, however, whether interventions for preventing delirium are effective. OBJECTIVES: To assess the effectiveness of interventions for preventing delirium in hospitalised non-Intensive Care Unit (ICU) patients...
March 11, 2016: Cochrane Database of Systematic Reviews
S Murthy, D L Hepner, Z Cooper, A M Bader, M D Neuman
As the population of the world is rapidly ageing, the amount of surgery being performed in older patients is also increasing. Special attention is required for the anaesthetic and perioperative management of these patients. The clinical and non-clinical issues specific to older surgical patients are reviewed, with a special emphasis on areas of debate related to anaesthesia care in this group. These issues include the role of frailty and disability in preoperative assessment, choice of anaesthesia technique for hip fracture, postoperative delirium, and approaches to shared decision-making before surgical procedures...
December 2015: British Journal of Anaesthesia
Ramachandran Ramani
PURPOSE OF REVIEW: Connectivity is a technique that uses functional MRI (fMRI) to explore global brain function in healthy and diseased states. Connectivity is now being studied as a part of global brain function in major national and international studies. It is, therefore, timely to review its relevance to anaesthesia. RECENT FINDINGS: Dynamic connectivity in the brain, which transcends anatomical boundaries, links functionally related regions. Clinical manifestations in neuropsychiatric diseases such has Alzheimer's disease and schizophrenia can be explained on the basis of altered connectivity patterns in the brain...
October 2015: Current Opinion in Anaesthesiology
R Griffiths, S M White, I K Moppett, M J Parker, T J S Chesser, M L Costa, A Johansen, H Wilson, A J Timperley
Concise guidelines are presented for the preparation and conduct of anaesthesia and surgery in patients undergoing cemented hemiarthroplasty for hip fracture. The Working Party specifically considered recent publications highlighting complications occurring during the peri-operative period. The advice presented is based on previously published advice and clinical studies.
May 2015: Anaesthesia
Y-S Kim, B-G Lim, H Kim, M-H Kong, I-O Lee
BACKGROUND: Intravenous or volatile agents reduce respiratory function, which can result in respiratory complications in geriatric patients. We hypothesised that there would be no differences in lung function between anaesthesia established using either drug. METHODS: Elderly patients were randomly assigned to receive either propofol with remifentanil (n = 48) or desflurane (DES) with remifentanil (n = 52) for knee surgery. Spirometry tests including forced expiratory volume in 1 s (FEV1 ), forced vital capacity (FVC), forced mid-expiratory flow (FEF25-75), and FEV1 /FVC ratio were performed preoperatively, and 30 min, 60 min, and 24 h after awakening...
July 2015: Acta Anaesthesiologica Scandinavica
Yun Zhi Lee, Ruth Qianyi Lee, Kyu Kyu Thinn, Keah How Poon, Eugene Hern Liu
INTRODUCTION: Postoperative nausea and vomiting (PONV), and postoperative pain are common during the early postoperative period. In addition to these problems, elderly patients risk developing postoperative confusion. This study aimed to identify the risk factors associated with these problems, and the extent of these problems, in a Singapore inpatient surgical population. METHODS: Over a period of six weeks, we surveyed 707 elective surgical inpatients aged ≥ 18 years who received general anaesthesia and/or regional anaesthesia...
January 2015: Singapore Medical Journal
Alf Kozian, Moritz A Kretzschmar, Thomas Schilling
PURPOSE OF REVIEW: The mean age of patients presenting for thoracic surgery is rising steadily, associated with an increased demand for thoracic surgical treatments by geriatric patients. With increasing age, physiologic changes and comorbidities have to be considered. Thoracic anesthesia for elderly patients requires greater specific knowledge. RECENT FINDINGS: Respiratory mechanics change progressively during aging, and the pharmacology of different drugs is also altered with increasing age...
February 2015: Current Opinion in Anaesthesiology
Peter Koch, Aki Pietsch, Melanie Harling, Susanne Behl-Schön, Albert Nienhaus
BACKGROUND: Work-related musculoskeletal pain- particularly back pain - is an important individual and socioeconomic problem. The Back College for the insurance holders of the Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW) is based on a multimodal concept and has been evaluated with respect to pain relief and continuing in the nursing profession. METHODS: In a retrospective cohort study, the participants in the Back College from 2009 to 2011 were surveyed in writing...
2014: Journal of Occupational Medicine and Toxicology
Veronica Boyle, Boaz Shulruf, Phillippa Poole
AIM: Medical schools must select and educate to meet anticipated health needs. Factors influencing career choice include those of the student and their background as well as subsequent experience. Women have comprised over 50% of medical classes for over 20 years. This study describes gender patterns of current specialty interest among medical students at the University of Auckland, and models the predictive effect of gender compared to other career influencing factors. METHOD: The study analysed career intention survey data from 711 graduating medical students (response rate, 79%) from 2006 to 2011...
September 12, 2014: New Zealand Medical Journal
R Owczuk, W Wenski, P Twardowski, A Dylczyk-Sommer, W Sawicka, M A Wujtewicz, A Marciniak, A Polak-Krzemińska, T Jasiński, M Wujtewicz
BACKGROUND: Ondansetron was effectively used to prevent spinal anesthesia-induced hypotension in the general population and women anesthetised for cesarean section. The aim of this study was to test the hypothesis that blocking type 3 serotonin receptors with intravenous ondansetron administration reduces hypotension and bradycardia induced by spinal anesthesia in elderly patients. METHODS: Fifty-three patients participated in the study with 26 in the ondansetron group (received 8 mg intravenous ondansetron) and 27 in the placebo group (received 0...
June 2015: Minerva Anestesiologica
S Bala Bhaskar, Sukhminder Jit Singh Bajwa
No abstract text is available yet for this article.
May 2014: Indian Journal of Anaesthesia
D Conti, P Ballo, R Boccalini, A Boccherini, S Cantini, A Venni, S Pezzati, S Gori, F Franconi, A Zuppiroli, A Pedullà
Patient sex is known to influence the response to general and regional anaesthesia and recovery after surgery. However, most studies come from analyses carried out on middle-aged patients. As most of the patients admitted to the post-anaesthesia recovery room in our institution are elderly, we took the opportunity to investigate the association between sex and incidence of early adverse events in this older population of patients after major surgery. Consecutive patients undergoing general, orthopaedic, urological and gynaecological surgery, admitted to the recovery room of our institution over a 15-month period, were retrospectively studied...
July 2014: Anaesthesia and Intensive Care
Moningi Srilata, Padmaja Durga, Gopinath Ramachandran
BACKGROUND AND AIMS: Several changes in the management protocols of anaesthesia for geriatric patients were introduced into clinical practice to improve the outcome. Very few studies have evaluated the impact of these management protocols. The aim of our study was to evaluate impact of some of the changes in the peri-operative management protocols of geriatric patients undergoing elective orthopaedic lower limb surgeries on the outcomes. METHODS: A retrospective chart review of thirty-eight surgical patients from 1999 (Group 1999) before the introduction of changes and 107 patients from 2007 (Group 2007) after establishing changes was performed and data of peri-operative variables were collected and analysed...
March 2014: Indian Journal of Anaesthesia
E Dubljanin-Raspopović, L Marković-Denić, K Ivković, U Nedeljković, S Tomanović, M Kadija, G Tulić, M Bumbasirević
Hip fractures are the most serious consequence of falling in older people with osteoporosis. Early ambulation is one of the main goals of inpatient rehabilitation aimed at reducing negative effects of immobilization, and promoting functional recovery. Recognizing the role of different factors that are associated with time to ambulation time after hip fracture surgery may help decrease morbidity and mortality rates. The aim of this study was to examine the impact of postoperative pain time to ambulation following hip fracture surgery...
2013: Acta Chirurgica Iugoslavica
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