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Tests before elective surgery

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https://www.readbyqxmd.com/read/27907814/platelet-function-one-and-three-months-after-coronary-bypass-surgery-in-relation-to-once-or-twice-daily-dosing-of-acetylsalicylic-acid
#1
Torbjörn Ivert, Magnus Dalén, Charlotte Ander, Ragnhild Stålesen, Per Näsman, Marie Lordkipanidzé, Paul Hjemdahl
INTRODUCTION: Current guidelines recommend acetylsalicylic acid (ASA) treatment after coronary artery bypass grafting (CABG) to reduce thrombotic vein graft occlusion. The optimal dosage of ASA is not known. MATERIALS AND METHODS: Forty-two patients undergoing elective CABG were randomized to receive either ASA 75mg or 160mg once daily (OD) or 75mg twice daily (BID) after the operation. Platelet function testing was performed before, and one and three months after the operation...
November 21, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27906721/preoperative-evaluation-and-preparation-of-the-morbidly-obese-patient
#2
Andreas B Böhmer, Frank Wappler
PURPOSE OF REVIEW: This review aims to familiarize with the most current findings regarding preoperative evaluation and preparation of morbidly obese patients prior to elective, noncardiac surgery. In the light of the increasing number of surgical patients being morbidly obese, the knowledge of evidence-based preoperative evaluation strategies is profound for a rational approach. RECENT FINDINGS: Preoperative evaluation should be carried out with sufficient time before the day of surgery to allow modification of the perioperative management...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27887662/the-effects-of-water-lubrication-of-tracheal-tubes-on-post-intubation-airway-complications-study-protocol-for-a-randomized-controlled-trial
#3
Eugene Kim, Seong Mi Yang, So Jeong Yoon, Jae-Hyon Bahk, Jeong-Hwa Seo
BACKGROUND: Water is known to have lubricating properties, thus it is used for lubrication of tracheal tubes to reduce airway injuries caused by intubation. However, there is no definite evidence to substantiate the beneficial effects of lubricating tracheal tubes using water for attenuating airway injuries. Moreover, the lubrication pretreatment may cause contamination of the tube, leading to respiratory infections. Therefore, this trial aims to assess whether no pretreatment of tracheal tubes does not increase post-intubation airway complications as compared with water lubrication of tubes...
November 25, 2016: Trials
https://www.readbyqxmd.com/read/27866310/prediction-of-difficult-laryngoscopy-using-spirometry-a-pilot-study
#4
Serkan Dogru, Tugba Karaman, Aynur Sahin, Hakan Tapar, Serkan Karaman, Semih Arici, Mustafa Suren, Ziya Kaya, Battal Tahsin Somuk
Prediction of difficult laryngoscopy is still the uncovered secret of anesthetic practice. This pilot study is aimed to assess the efficacy of spirometry measurements in predicting difficult laryngoscopy compared with conventional airway assessment techniques. We enrolled 202 adults, ages 18-40 years, with an American Society of Anaesthesiologists score of I or II, scheduled for elective surgery and undergoing general anesthesia. Spirometry was used for lung capacity measurements before the operation. The Mallampati classification, neck circumference, sternomental distance, thyromental distance, maximum mouth-opening measurement, and upper lip bite test of the subjects were measured...
November 19, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27861701/preparing-family-caregivers-to-recognize-delirium-symptoms-in-older-adults-after-elective-hip-or-knee-arthroplasty
#5
Margaret J Bull, Lesley Boaz, Mehdi Maadooliat, Mary E Hagle, Lynn Gettrust, Maureen T Greene, Sue Baird Holmes, Jane S Saczynski
OBJECTIVES: To test the feasibility of a telephone-based intervention that prepares family caregivers to recognize delirium symptoms and how to communicate their observations to healthcare providers. DESIGN: Mixed-method, pre-post quasi-experimental design. SETTING: A Midwest Veterans Affairs Medical Center and a nonprofit health system. PARTICIPANTS: Forty-one family caregiver-older adult dyads provided consent; 34 completed the intervention...
November 11, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27828786/the-effect-of-prior-tetanic-stimulation-on-train-of-four-monitoring-in-paediatric-patients-a-randomised-open-label-controlled-trial
#6
Ricardo V Carlos, Hans Donald de Boer, Marcelo Luis Abramides Torres, Maria José Carvalho Carmona
BACKGROUND: In clinical research, neuromuscular monitoring must present a stable response for a period of 2 to 5 min before administration of a neuromuscular blocking agent. The time required to reach this stable response may be shortened by applying a 5-s tetanic stimulus. OBJECTIVES: The aim of this study was to test whether tetanic stimulation interferes with onset and recovery times after a single dose of rocuronium 0.6 mg kg followed by spontaneous recovery...
November 8, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27826645/surgery-alters-parameters-of-vitamin-d-status-and-other-laboratory-results
#7
N Binkley, D Coursin, D Krueger, P Iglar, J Heiner, R Illgen, M Squire, J Lappe, P Watson, K Hogan
: Fracture liaison services often perform laboratory testing, but these results may be altered by surgery. In 40 hip arthroplasty patients, many laboratory parameters of bone health relevance were reduced by 8-22% on the first post-operative day. Laboratory results obtained in the immediate post-surgery interval do not reliably ascertain baseline status. INTRODUCTION: As secondary causes of osteoporosis are common, fracture liaison services often perform laboratory testing in the immediate post-fracture interval...
November 8, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27799175/evaluation-of-clinical-practice-in-perioperative-patient-blood-management
#8
D M Baron, P G H Metnitz, T Fellinger, B Metnitz, A Rhodes, S A Kozek-Langenecker
BACKGROUND: Several guidelines have been published to facilitate implementation of patient blood management (PBM). This study was performed to evaluate clinical practices in PBM. METHODS: An online survey based on the guidelines for the management of severe perioperative bleeding from the European Society of Anaesthesiology (ESA) was conducted among ESA members. We assessed characteristic data of participating physicians, preoperative assessment of bleeding risk and anaemia, intraoperative transfusion practices, specific pharmacologic treatment of significant bleeding, and clinical use of PBM algorithms...
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27761038/a-comparison-of-the-effect-of-two-doses-of-oral-melatonin-with-oral-midazolam-and-placebo-on-pre-operative-anxiety-cognition-and-psychomotor-function-in-children-a-randomised-double-blind-study
#9
Madhuri S Kurdi, Sindhu Priya Muthukalai
BACKGROUND AND AIMS: Melatonin (MT), a naturally occurring pituitary hormone has a sleep promoting effect. There are very few studies on pre-operative oral MT (0.2-0.5 mg/kg) in children. We planned a study to assess the efficacy of oral MT in two doses and compare it with oral midazolam and placebo for pre-operative anxiolysis, sedation, maintenance of cognition and psychomotor skills, parental separation behaviour and venepuncture compliance. METHODS: This prospective double-blind randomised study was conducted after ethical committee approval on 100 children aged 5-15 years, American Society of Anaesthesiologists physical status I and II undergoing elective surgery at our hospital from January 1, 2014, to December 31, 2014...
October 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27761033/role-of-melatonin-in-attenuation-of-haemodynamic-responses-to-laryngoscopy-and-intubation
#10
Priyamvada Gupta, Durga Jethava, Ruchika Choudhary, Dharam Das Jethava
BACKGROUND AND AIMS: Laryngoscopy and endotracheal intubation are considered as potent stimuli which lead to an increase in heart rate and blood pressure. Melatonin (N-acetyl-5-methoxytryptamine) has been studied for pre-operative anxiolysis and sedation in Intensive Care Unit. We made a hypothesis that melatonin can provide haemodynamic stability during laryngoscopy and intubation when given 120 min before the procedure. METHODS: Sixty American Society of Anesthesiologists physical status Grade I and II patients of either gender, 20-45 years old, 40-65 kg body weight, scheduled to undergo elective surgical procedures under general anaesthesia were assigned into two equal groups - Group C (control) and Group M (melatonin)...
October 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27749339/comparison-of-seer-sonorheometry-with-rotational-thromboelastometry-and-laboratory-parameters-in-cardiac-surgery
#11
Julie L Huffmyer, Lucas G Fernandez, Cyrus Haghighian, Abdullah S Terkawi, Danja S Groves
BACKGROUND: The Quantra Hemostasis Analyzer is a novel diagnostic device that uses an ultrasound-based technology, sonic estimation of elasticity via resonance (SEER) sonorheometry, to characterize the dynamic changes in viscoelastic properties of a blood sample during coagulation. Cardiac surgery utilizing cardiopulmonary bypass (CPB) is associated with a significant impact on the coagulation system and can result in perioperative coagulopathy. The aim of this study was to correlate SEER sonorheometry results to corresponding rotational thromboelastometry (ROTEM) and laboratory parameters obtained before, during, and after CPB...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27746523/palonosetron-and-granisetron-in-postoperative-nausea-vomiting-a-randomized-double-blind-prospective-study
#12
Amrita A Gugale, Pradnya Milind Bhalerao
BACKGROUND: Postoperative nausea and vomiting (PONV) is a common occurrence after laparoscopic surgeries. A number of pharmacological agents (antihistamines, butyrophenones, dopamine receptor antagonists) have been tried of which the 5-hydroxytryptamine type 3 receptor antagonists are devoid of most side effects and highly effective in prevention and treatment of PONV. Thus, we evaluated the effectiveness of granisetron and palonosetron in prevention of PONV after laparoscopic surgeries under general anesthesia...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27716157/effects-of-a-fixed-low-dose-ropivacaine-with-different-volume-and-concentrations-on-interscalene-brachial-plexus-block-a-randomized-controlled-trial
#13
Wenwen Zhai, Xuedong Wang, Yulan Rong, Min Li, Hong Wang
BACKGROUND: Ultrasound guidance has reduced the amount of local anesthetics to achieve a successful block. Previous studies of the relationship between the volume or concentration of local anesthetics and the effects of the block were based on relatively high doses of local anesthetics. We tested the hypothesis that providing low dose of ropivacaine at three combinations of volumes and concentrations for ultrasound-guided interscalene brachial plexus block would produce different effects in the aspect of onset time, pain control and the incidence of side effects...
September 30, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27665096/using-preoperative-unsupervised-cluster-analysis-of-chronic-rhinosinusitis-to-inform-patient-decision-and-endoscopic-sinus-surgery-outcome
#14
Choaib Adnane, Taoufik Adouly, Amine Khallouk, Sami Rouadi, Redallah Abada, Mohamed Roubal, Mohamed Mahtar
The purpose of this study is to use unsupervised cluster methodology to identify phenotype and mucosal eosinophilia endotype subgroups of patients with medical refractory chronic rhinosinusitis (CRS), and evaluate the difference in quality of life (QOL) outcomes after endoscopic sinus surgery (ESS) between these clusters for better surgical case selection. A prospective cohort study included 131 patients with medical refractory CRS who elected ESS. The Sino-Nasal Outcome Test (SNOT-22) was used to evaluate QOL before and 12 months after surgery...
September 24, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27664889/preoperative-cancer-cachexia-and-short-term-outcomes-following-surgery
#15
Meredith C Mason, Jose M Garcia, Shubhada Sansgiry, Annette Walder, David H Berger, Daniel A Anaya
BACKGROUND: Cancer cachexia is an important measure of physiologic reserve associated with worse survival and represents an actionable factor for the cancer population. However, the incidence of cachexia in surgical cancer patients and its impact on postoperative outcomes are currently unknown. METHODS: A prospective cohort study enrolling patients having elective cancer surgery (2012-2014) at a Veterans Affairs tertiary referral center. Preoperative cancer cachexia (weight loss ≥5% over 6-mo period before surgery) was the predictor of interest...
October 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27664886/assessing-surgeon-behavior-change-after-anastomotic-leak-in-colorectal-surgery
#16
Vlad V Simianu, Anirban Basu, Rafael Alfonso-Cristancho, Richard C Thirlby, Abraham D Flaxman, David R Flum
BACKGROUND: Recency effect suggests that people disproportionately value events from the immediate past when making decisions, but the extent of this impact on surgeons' decisions is unknown. This study evaluates for recency effect in surgeons by examining use of preventative leak testing before and after colorectal operations with anastomotic leaks. MATERIALS AND METHODS: Prospective cohort of adult patients (≥18 y) undergoing elective colorectal operations at Washington State hospitals participating in the Surgical Care and Outcomes Assessment Program (2006-2013)...
October 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27651988/is-there-any-effect-of-pneumoperitoneum-pressure-on-coagulation-and-fibrinolysis-during-laparoscopic-cholecystectomy
#17
Turgut Donmez, Sinan Uzman, Dogan Yildirim, Adnan Hut, Huseyin Imam Avaroglu, Duygu Ayfer Erdem, Erdinc Cekic, Fazilet Erozgen
BACKGROUND: Laparoscopic cholecystectomies (LC) are generally performed in a 12 mmHg-pressured pneumoperitoneum in a slight sitting position. Considerable thromboembolism risk arises in this operation due to pneumoperitoneum, operation position and risk factors of patients. We aim to investigate the effect of pneumoperitoneum pressure on coagulation and fibrinolysis under general anesthesia. MATERIAL AND METHODS: Fifty American Society of Anesthesiologist (ASA) I-III patients who underwent elective LC without thromboprophlaxis were enrolled in this prospective study...
2016: PeerJ
https://www.readbyqxmd.com/read/27648469/enhanced-recovery-after-surgery-in-a-single-high-volume-surgical-oncology-unit-details-matter
#18
Timothy L Fitzgerald, Catalina Mosquera, Nicholas J Koutlas, Nasreen A Vohra, Kimberly V Edwards, Emmanuel E Zervos
Benefits of ERAS protocol have been well documented; however, it is unclear whether the improvement stems from the protocol or shifts in expectations. Interdisciplinary educational seminars were conducted for all health professionals. However, one test surgeon adopted the protocol. 394 patients undergoing elective abdominal surgery from June 2013 to April 2015 with a median age of 63 years were included. The implementation of ERAS protocol resulted in a decrease in the length of stay (LOS) and mortality, whereas the difference in cost was found to be insignificant...
2016: Surgery Research and Practice
https://www.readbyqxmd.com/read/27632347/adrb2-gly16gly-genotype-cardiac-output-and-cerebral-oxygenation-in-patients-undergoing-anesthesia-for-abdominal-aortic-aneurysm-surgery
#19
Jonatan Myrup Staalsø, Kim Zillo Rokamp, Niels D Olesen, Lars Lonn, Niels H Secher, Niels V Olsen, Teit Mantoni, Ulf Helgstrand, Henning B Nielsen
BACKGROUND: Gly16arg polymorphism of the adrenergic β2-receptor is associated with the elevated cardiac output (Q) in healthy gly16-homozygotic subjects. We questioned whether this polymorphism also affects Q and regional cerebral oxygen saturation (SCO2) during anesthesia in vascular surgical patients. METHODS: One hundred sixty-eight patients (age 71 ± 6 years) admitted for elective surgery were included. Cardiovascular variables were determined before and during anesthesia by intravascular pulse contour analysis (Nexfin) and SCO2 by cerebral oximetry (INVOS 5100C)...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27603225/effect-of-lean-processes-on-surgical-wait-times-and-efficiency-in-a-tertiary-care-veterans-affairs-medical-center
#20
Nakul P Valsangkar, Andrew C Eppstein, Rick A Lawson, Amber N Taylor
Importance: There are an increasing number of veterans in the United States, and the current delay and wait times prevent Veterans Affairs institutions from fully meeting the needs of current and former service members. Concrete strategies to improve throughput at these facilities have been sparse. Objective: To identify whether lean processes can be used to improve wait times for surgical procedures in Veterans Affairs hospitals. Design, Setting, and Participants: Databases in the Veterans Integrated Service Network 11 Data Warehouse, Veterans Health Administration Support Service Center, and Veterans Information Systems and Technology Architecture/Dynamic Host Configuration Protocol were queried to assess changes in wait times for elective general surgical procedures and clinical volume before, during, and after implementation of lean processes over 3 fiscal years (FYs) at a tertiary care Veterans Affairs medical center...
September 7, 2016: JAMA Surgery
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