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Tests before elective surgery

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https://www.readbyqxmd.com/read/29779961/patient-satisfaction-with-the-consent-discussion-is-not-improved-by-showing-patients-their-computed-tomography-or-angiography-images-before-they-undergo-vascular-surgery
#1
Dominic LeBlanc, Adam H Power, Guy DeRose, Audra Duncan, Luc Dubois
OBJECTIVE: Patient-based decision aids and other multimedia tools have been developed to help enrich the preoperative discussion between surgeon and patient. Use of these tools, however, can be time-consuming and logistically challenging. We investigated whether simply showing patients their images from preoperative computed tomography (CT) or angiography would improve patients' satisfaction with the preoperative discussion. We also examined whether this improved the patient's understanding and trust and whether it contributed to increased preoperative anxiety...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29756691/cerebrovascular-autoregulation-impairments-during-cardiac-surgery-with-cardiopulmonary-bypass-are-related-to-postoperative-cognitive-deterioration-prospective-observational-study
#2
Birute Kumpaitiene, Milda Svagzdiene, Edmundas Sirvinskas, Virginija Adomaitiene, Vytautas Petkus, Rolandas Zakelis, Solventa Krakauskaite, Romanas Chomskis, Arminas Ragauskas, Teodoro F Dagi, Rimantas Benetis
BACKGROUND: Post-operative cognitive dysfunction (POCD) occurs in approximately 33-83% of patients after cardiac surgery with cardiopulmonary bypass (CPB). Recent clinical data suggest that real-time, intraoperative monitoring of patient- specific cerebrovascular autoregulation (CA) may help to prevent POCD by detecting individual critical limits for mean arterial pressure (MAP) outside which CA is impaired. Objectives of the study were to detect the episodes of impaired CA during cardiac surgery with CPB, and to investigate the association between CA impairment and POCD...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29730103/value-of-routine-preoperative-tests-for-coagulation-before-elective-cranial-surgery-results-of-an-institutional-audit-and-a-nationwide-survey-of-neurosurgical-centers-in-pakistan
#3
Naveed Zaman Akhunzada, Muhammad Bilal Tariq, Saad Akhtar Khan, Sidra Sattar, Wajeeha Tariq, Muhammad Shahzad Shamim, Samie Asghar Dogar
Routine preoperative blood testing has become a dogma. The general practice is to order preoperative work up as a knee jerk response rather than individualize it for each patient. The fact that the bleeding brain tends to swell, which coupled with limited options for proximal control, packing and overall hemostasis, leads to an over emphasis on preoperative coagulation profile. MATERIAL AND METHODS: This is a retrospective review of the medical records of patients admitted at Aga Khan University Hospital from January 2010 to December 2015 for an elective craniotomy...
May 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29696127/effect-of-oral-clonidine-on-shoulder-tip-pain-and-hemodynamic-response-after-laparoscopic-cholecystectomy-a-randomized-double-blind-study
#4
Hamid Mirhosseini, Mohamad Hossein Avazbakhsh, Meysam Hosseini Amiri, Ahmad Entezari, Reza Bidaki
Background: Shoulder tip pain is a common problem after laparoscopic cholecystectomy. There are a few clinical trial studies on the effect of clonidine on post laparoscopic shoulder pain (PLSP). This study aimed at evaluating the effect of oral clonidine on PLSP in semi-sitting position and post-operative hemodynamic response of patients undergoing LC surgery. Methods: This randomized controlled clinical trial was conducted on 60 patients, who were candidates for elective laparoscopic cholecystectomy surgery under general anesthesia, and were randomly allocated to clonidine and placebo groups...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29684984/effects-of-preoperative-oral-carbohydrate-administration-on-patient-well-being-and-satisfaction-in-thyroid-surgery
#5
A Ram Doo, Hyunsup Hwang, Min-Jong Ki, Jun-Rae Lee, Dong-Chan Kim
Background: Although the positive effects of preoperative oral carbohydrate administration on clinical outcomes following major surgery have been reported continuously, there are few investigations of them in minor surgical patients. The present study was designed to examine the effects of preoperative oral carbohydrate administration on patient well-being and satisfaction in patients undergoing thyroidectomy. Methods: Fifty adults aged 20-65 years and scheduled for elective thyroidectomy in first schedule in the morning were allocated to one of two groups...
April 24, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29652271/prophylactic-preoperative-levosimendan-for-off-pump-coronary-artery-bypass-grafting-in-patients-with-left-ventricular-dysfunction-single-centered-randomized-prospective-study
#6
Pushkar Mahendra Desai, Manjula S Sarkar, Sanjeeta R Umbarkar
Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients. Aim and Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29629058/effect-of-propofol-and-isoflurane-on-gas-exchange-parameters-following-one-lung-ventilation-in-thoracic-surgery-a-double-blinded-randomized-controlled-clinical-trial
#7
Shima Sheybani, Alireza Sharifian Attar, Sogol Golshan, Shadi Sheibani, Majid Rajabian
Background: The use of anesthetic drugs with minimal inhibitory effects on the hypoxic pulmonary vasoconstriction (HPV) could have a decisive role in preventing the hypoxemia during one-lung ventilation (OLV). Objective: The aim of this study was to compare the effects of propofol and isoflurane on the changes in gas exchange parameters following OLV in thoracic surgery. Methods: This double-blinded randomized controlled clinical trial was conducted on patients who were candidates for elective right thoracotomy referred to the central operating room of Ghaem Hospital in Mashhad, Iran, during February 2016-2017...
February 2018: Electronic Physician
https://www.readbyqxmd.com/read/29628593/comparison-of-esmolol-and-dexmedetomidine-for-suppression-of-hemodynamic-response-to-laryngoscopy-and-endotracheal-intubation-in-adult-patients-undergoing-elective-general-surgery-a-prospective-randomized-controlled-double-blinded-study
#8
Sandeep Sharma, Om Prakash Suthar, M L Tak, Abhilasha Thanvi, Naveen Paliwal, Rakesh Karnawat
Context: Laryngoscopy and endotracheal intubation lead to strong sympathetic response which may precipitate arrhythmias, myocardial ischemia and cerebrovascular accidents in patients with preexisting cardiovascular disease. Aims: This study was aimed to compare the effect of dexmedetomidine and esmolol on hemodynamic response to laryngoscopy and endotracheal intubation in patients undergoing elective surgery under general anesthesia. Settings and Design: This was a prospective, randomized controlled double-blinded study...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29559753/clinical-evaluation-of-measuring-the-act-during-elective-cardiac-surgery-with-two-different-devices
#9
Florian Falter, Nabeel Razzaq, Martin John, Jens Fassl, Markus Maurer, Sean Ewing, Ross Hofmeyr
Unfractionated heparin is the mainstay of anticoagulation during cardiac surgery on cardiopulmonary bypass (CPB) due to its low cost, quick onset, and ease of reversal. Since over 30 years, the activated clotting time (ACT) has been used to assess the level of heparin activity both before and after CPB. We compared two different methods of measuring the ACT: i-STAT, which uses amperometric detection of thrombin cleavage, and Hemochron Jr, which is based on detecting viscoelastic changes in blood. We included 402 patients from three institutions (Papworth Hospital, Cambridge, UK; Groote Schuur, Cape Town, South Africa; University Hospital Basel, Basel, Switzerland) undergoing elective cardiac surgery on CPB in our study...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29555590/a-high-sensitivity-electrochemiluminescence-based-elisa-for-the-measurement-of-the-oxidative-stress-biomarker-3-nitrotyrosine-in-human-blood-serum-and-cells
#10
Annie R Knight, Emma L Taylor, Roman Lukaszewski, Karina Tveen Jensen, Helen E Jones, Jane E Carré, Michail N Isupov, Jennifer A Littlechild, Stephen J Bailey, Emily Brewer, Timothy J McDonald, Andrew R Pitt, Corinne M Spickett, Paul G Winyard
The generation of 3-nitrotyrosine, within proteins, is a post-translational modification resulting from oxidative or nitrative stress. It has been suggested that this modification could be used as a biomarker for inflammatory diseases. Despite the superiority of mass spectrometry-based determinations of nitrotyrosine, in a high-throughput clinical setting the measurement of nitrotyrosine by an enzyme-linked immunosorbent assay (ELISA) is likely to be more cost-effective. ELISAs offer an alternative means to detect nitrotyrosine, but many commercially available ELISAs are insufficiently sensitive to detect nitrotyrosine in healthy human serum...
May 20, 2018: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/29516670/the-effectiveness-of-age-appropriate-pre-operative-information-session-on-the-anxiety-level-of-school-age-children-undergoing-elective-surgery-in-jordan
#11
Abeer Shaheen, Omayyah Nassar, Inaam Khalaf, Suha Al-Oballi Kridli, Samiha Jarrah, Suhaila Halasa
BACKGROUND: Undergoing surgery is an anxious experience for children. Applying anxiety reduction age-appropriate programs by nurses would be beneficial in reducing anxiety to children. AIM: To test the effectiveness of age-appropriate preoperative information session in reducing anxiety levels of school-age children undergoing elective surgery in Jordan. DESIGN: The study used a quasi-experimental design. METHODS: One hundred and twenty-six children were recruited from an educational hospital in Amman from January to June 2012 and were randomly assigned to intervention and control groups...
March 8, 2018: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/29505442/the-association-between-timing-of-routine-preoperative-blood-testing-and-a-composite-of-30-day-postoperative-morbidity-and-mortality
#12
Kurt Ruetzler, Peirong Lin, Jing You, Yehoshua Schacham, Amanda J Naylor, Daniel I Sessler, Leif Saager
BACKGROUND: Laboratory testing is a common component of preanesthesia evaluation and is designed to identify medical abnormalities that might otherwise remain undetected. While blood testing might optimally be performed shortly before surgery, it is often done earlier for practical reasons. We tested the hypothesis that longer periods between preoperative laboratory testing and surgery are associated with increased odds of having a composite of 30-day morbidity and mortality. METHODS: We obtained preoperative data from 2,320,920 patients in the American College of Surgeons National Surgical Quality Improvement Program who were treated between 2005 and 2012...
March 1, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29470237/primary-shoulder-hemiarthroplasty-what-can-be-learned-from-359-cases-that-were-surgically-revised
#13
Daniel J Hackett, Jason E Hsu, Frederick A Matsen
BACKGROUND: Primary shoulder hemiarthroplasty is used to address a range of glenohumeral disorders, including fracture, arthritis, avascular necrosis, and capsulorrhaphy arthropathy; some patients with hemiarthroplasties undergo revision surgery for persistent pain or residual shoulder dysfunction. The literature does not clarify the features of the hemiarthroplasties having repeat surgery in a way that can guide surgeons' efforts to minimize the need for revision. To help address this gap, we analyzed the characteristics of patients from our region for whom we performed surgical revision of a prior humeral hemiarthroplasty QUESTIONS/PURPOSES: (1) What are the common characteristics of shoulder hemiarthroplasties having a revision? (2) What are the common characteristics of the subset of revised shoulder hemiarthroplasties that were performed for fracture? (3) What are characteristics of the subset of all revised hemiarthroplasties that were associated with glenoid bone erosion? METHODS: Data for 983 patients for whom we performed a surgical revision of any type of shoulder arthroplasty between January 1991 and January 2017 were identified in our longitudinally maintained institutional arthroplasty revision database...
May 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29453331/a-prospective-cohort-evaluation-of-the-cortisol-response-to-cardiac-surgery-with-occurrence-of-early-postoperative-cognitive-decline
#14
Sandro Glumac, Goran Kardum, Nenad Karanović
BACKGROUND A recent study reported that patients with higher cortisol levels on the 1st postoperative morning after cardiac surgery exhibited an increased risk of early postoperative cognitive decline (POCD). Therefore, we conducted the current study to gain further insight into the stress response to a surgical procedure as a potential risk factor for early POCD after cardiac surgery. MATERIAL AND METHODS This prospective cohort study enrolled 125 patients undergoing elective cardiac surgery with or without cardiopulmonary bypass (CPB)...
February 17, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29452296/development-and-persistence-of-suspected-neuropathic-pain-after-total-knee-arthroplasty-in-individuals-with-osteoarthritis
#15
Matthew Fitzsimmons, Eloise Carr, Linda Woodhouse, Geoff P Bostick
BACKGROUND: Despite the effectiveness of total knee arthroplasty (TKA) for osteoarthritis (OA), up to 20% will report knee pain 1 year after surgery. One possible reason is the development of neuropathic pain before or after TKA. OBJECTIVE: To longitudinally describe suspected neuropathic pain in patients pre- and post-TKA and to explore relations between pre-TKA suspected neuropathic pain and post-TKA outcomes. DESIGN: Prospective observational study...
February 13, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29439725/natural-progress-of-d-dimer-following-total-joint-arthroplasty-a-baseline-for-the-diagnosis-of-the-early-postoperative-infection
#16
Yong Seuk Lee, Young-Kyun Lee, Seung Bum Han, Chang Hyun Nam, Javad Parvizi, Kyung-Hoi Koo
BACKGROUND: Early detection followed by prompt intervention is essential for the treatment of periprosthetic joint infection (PJI). D-dimer, a fibrin degradation product, characteristically changes rapidly during early postoperative period and has a short half-life. The aim of this prospective study was to measure postoperative change of D-dimer level after joint arthroplasty in conjunction with ESR and CRP. METHODS: ESR, CRP, and D-dimer levels were measured on the day before surgery, postoperative days 1, 2, 3, and 5 and weeks 2 and 6 in 65 patients who underwent elective primary total hip arthroplasty (38 hips in 38 patients) or total knee arthroplasty (27 knees in 27 patients)...
February 13, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29434802/an-investigation-of-the-mechanism-of-dexmedetomidine-in-improving-postoperative-cognitive-dysfunction-from-the-perspectives-of-alleviating-neuronal-mitochondrial-membrane-oxidative-stress-and-electrophysiological-dysfunction
#17
Jie Chen, Na Shen, Xiaohui Duan, Yaning Guo
The aim of this study was to investigate the mechanism of dexmedetomidine in improving postoperative cognitive dysfunction from the perspectives of alleviating neuronal mitochondrial membrane oxidative stress and electrophysiological dysfunction. A total of 120 patients undergoing elective surgery under general anesthesia from June 2013 to May, 2016 were selected as the subjects of the study and randomly divided into the propofol + remifentanil and dexmedetomidine groups. The Rey Auditory Verbal Learning Test (AVLT) and Beck Depression Inventory (BDI) were performed at day 1 before operation and at day 1, 3, 5 and 15 after operation...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29397124/simplified-algorithm-for-the-prevention-of-postoperative-nausea-and-vomiting-a-before-and-after-study
#18
G Dewinter, W Staelens, E Veef, A Teunkens, M Van de Velde, S Rex
BACKGROUND: Poor adherence to guidelines aimed at reducing the incidence of postoperative nausea and vomiting (PONV) is well known. In a before-and-after study, we tested the effectiveness of a simplified algorithm for PONV prophylaxis on the incidence of PONV. METHODS: In the first audit, we examined the adherence to our institutional guidelines for PONV prevention. In response to the results of this audit, we introduced a simplified algorithm for PONV prevention [female patients receiving triple prophylaxis (dexamethasone and ondansetron plus either a target-controlled infusion with propofol or droperidol) and male patients receiving double prophylaxis, dexamethasone, and ondansetron]...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29397122/the-surgical-safety-checklist-and-patient-outcomes-after-surgery-a-prospective-observational-cohort-study-systematic-review-and-meta-analysis
#19
T E F Abbott, T Ahmad, M K Phull, A J Fowler, R Hewson, B M Biccard, M S Chew, M Gillies, R M Pearse
BACKGROUND: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. METHODS: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29357913/screening-of-methicillin-resistant-staphylococcus-aureus-nasal-colonization-among-elective-surgery-patients-in-referral-hospital-in-indonesia
#20
Erni J Nelwan, Robert Sinto, Decy Subekti, Randy Adiwinata, Lia Waslia, Tonny Loho, Dodi Safari, Djoko Widodo
OBJECTIVE: Methicillin-resistant Staphylococcus aureus (MRSA) colonization is associated with serious surgical site infection in high-risk patients. High prevalence of MRSA colonization was reported in many settings, nonetheless local data is required. The purpose of this study is to identify the prevalence and risk factor of MRSA nasal carriage in adult patients in National Referral Hospital in Indonesia before underwent elective surgical procedure. RESULTS: From 384 patients, 16...
January 22, 2018: BMC Research Notes
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