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Tests before elective surgery

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https://www.readbyqxmd.com/read/28510737/total-haemoglobin-mass-but-not-haemoglobin-concentration-is-associated-with-preoperative-cardiopulmonary-exercise-testing-derived-oxygen-consumption-variables
#1
J M Otto, J O M Plumb, D Wakeham, E Clissold, L Loughney, W Schmidt, H E Montgomery, M P W Grocott, T Richards
Background: Cardiopulmonary exercise testing (CPET) measures peak exertional oxygen consumption ( V˙O2peak ) and that at the anaerobic threshold ( V˙O2 at AT, i.e. the point at which anaerobic metabolism contributes substantially to overall metabolism). Lower values are associated with excess postoperative morbidity and mortality. A reduced haemoglobin concentration ([Hb]) results from a reduction in total haemoglobin mass (tHb-mass) or an increase in plasma volume. Thus, tHb-mass might be a more useful measure of oxygen-carrying capacity and might correlate better with CPET-derived fitness measures in preoperative patients than does circulating [Hb]...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28492701/short-term-intensive-training-attenuates-the-exercise-induced-interaction-of-mono-1-2-cells-and-platelets-after-coronary-bypass-in-cardiac-patients
#2
Shu-Chun Huang, Mei-Kuen Wong, Pyng-Jing Lin, Feng-Chun Tsai, Jaw-Ji Chu, Meng-Yu Wu, Tieh-Cheng Fu, Jong-Shyan Wang
The interaction between platelets and monocytes plays a critical role in the pathogenesis and progression of cardiovascular diseases. This study investigated how short-term intensive training (SIT) influences monocyte subset characteristics and exercise-induced monocyte and platelet aggregates (MPAs) following elective coronary bypass (CABG) in cardiac patients. Forty-nine patients hospitalised for CABG were randomised into SIT (N=26) and conventional training (CT, N=23) groups. The SIT subjects underwent supervised aerobic training at 80~120 % of the ventilatory anaerobic threshold based on sub-maximal exercise tests performed 7 days post-CABG for 20 sessions with two sessions/day and 30 min/session, which were completed within four weeks after surgery...
May 11, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28441911/the-effects-of-a-data-driven-maximum-surgical-blood-ordering-schedule-on-preoperative-blood-ordering-practices
#3
C L Woodrum, M Wisniewski, D J Triulzi, J H Waters, L H Alarcon, M H Yazer
OBJECTIVES: The maximum surgical blood ordering schedule (MSBOS) provides guidelines for pre-operative pre-transfusion testing for elective surgical procedures. This study compared blood ordering and utilization during the period when the MSBOS was created by achieving consensus between the blood bank and the various surgical specialties, and after the introduction of an MSBOS created by using department-specific red blood cell (RBC) transfusion data (data driven MSBOS, dMSBOS). METHODS: The dMSBOS was created by analyzing 12 months of RBC transfusion data for each procedure across a regional health system...
April 25, 2017: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/28437263/a-randomised-trial-to-evaluate-preoperative-oral-carbohydrate-administration-on-insulin-resistance-in-off-pump-coronary-artery-bypass-patients
#4
Bora Lee, Sarah Soh, Jae-Kwang Shim, Ha Y Kim, Hyelin Lee, Young-Lan Kwak
BACKGROUND: In fasting cardiac surgery patients, preoperative carbohydrate (CHO) drink intake attenuated insulin resistance and improved cardiac metabolism, although its beneficial effects were not evident after cardiac surgery possibly due to cardiopulmonary bypass-related extreme systemic inflammation. OBJECTIVE: We aimed to evaluate whether preoperative CHO intake affected insulin resistance and free-fatty acid (FFA) concentrations in off-pump coronary revascularisation...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28403412/reduced-hemidiaphragmatic-paresis-with-extrafascial-compared-with-conventional-intrafascial-tip-placement-for-continuous-interscalene-brachial-plexus-block-a-randomized-controlled-double-blind-trial
#5
E Albrecht, I Bathory, N Fournier, A Jacot-Guillarmod, A Farron, R Brull
Background.: The incidence of hemidiaphragmatic paresis with continuous interscalene brachial plexus block (CISB) can approach 100%. We tested the hypothesis that extrafascial placement of the catheter tip reduces the rate of hemidiaphragmatic paresis compared with intrafascial tip placement for CISB while providing effective analgesia. Methods.: Seventy patients undergoing elective major shoulder surgery under general anaesthesia were randomized to receive an ultrasound-guided CISB plexus block for analgesia with the catheter tip placed either within (intrafascial group) or immediately outside (extrafascial group) the brachial plexus sheath midway between the levels of C5 and C6...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28401341/vancomycin-prophylaxis-for-total-joint-arthroplasty-incorrectly-dosed-and-has-a-higher-rate-of-periprosthetic-infection-than-cefazolin
#6
Michael M Kheir, Timothy L Tan, Ibrahim Azboy, Dean D Tan, Javad Parvizi
BACKGROUND: In total joint arthroplasty (TJA), vancomycin is used as perioperative antibiotic prophylaxis in patients with penicillin allergy or in patients colonized with methicillin-resistant Staphylococcus aureus (MRSA). Although vancomycin dosing should be weight-based (15 mg/kg), not all surgeons are aware of this; a fixed 1-g dose is instead frequently administered. QUESTIONS/PURPOSES: (1) Is there a difference in the risk of periprosthetic joint infection (PJI) in patients receiving vancomycin or cefazolin prophylaxis after primary TJA? (2) What proportion of patients is adequately dosed with vancomycin? (3) Compared with actual fixed dosing, does weight-based dosing result in a greater proportion of patients staying above the recommended 15-mg/L level at the beginning and end of surgery? (4) Are patients overdosed with vancomycin at greater risk of developing nephrotoxicity and acute kidney injury? METHODS: A single-institution, retrospective study was performed on 1828 patients undergoing primary TJAs who received vancomycin prophylaxis between 2008 and 2014...
April 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28391235/is-postoperative-decrease-of-serum-albumin-an-early-predictor-of-complications-after-major-abdominal-surgery-a-prospective-cohort-study-in-a-european-centre
#7
Ismail Labgaa, Gaëtan-Romain Joliat, Amaniel Kefleyesus, Styliani Mantziari, Markus Schäfer, Nicolas Demartines, Martin Hübner
OBJECTIVE: To test postoperative serum albumin drop (ΔAlb) as a marker of surgical stress response and early predictor of clinical outcomes. DESIGN: Prospective cohort study (NCT02356484). Albumin was prospectively measured in 138 patients undergoing major abdominal surgery. Blood samples were collected before surgery and on postoperative days 0, 1 2 and 3. ΔAlb was compared to the modified estimation of physiologic ability and surgical stress (mE-PASS) score and correlated to the performances of C reactive protein (CRP), procalcitonin (PCT) and lactate (LCT)...
April 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28372652/dose-ranging-effects-of-pregabalin-on-pain-in-patients-undergoing-laparoscopic-hysterectomy-a-randomized-double-blinded-placebo-controlled-clinical-trial
#8
Zahra Asgari, Safoura Rouholamin, Masoomeh Nataj, Mahdi Sepidarkish, Reihaneh Hosseini, Maryam Razavi
OBJECTIVE: The study aimed to investigate the preemptive analgesia efficacy of different concentrations (75, 150 and 300mg) of preemptive pregabalin for the postoperative pain management after laparoscopic hysterectomy. DESIGN: Prospective, randomized, placebo-controlled, double-blind study. SETTING: The Gynecology and Obstetrics Center of Arash Hospital, Tehran, Iran, from October 2013 to November 2014. PATIENTS: A total of 96 women with American Association of Anesthesiologist (ASA) physical status I and II underwent elective laparoscopic hysterectomy surgery...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28372647/the-suppressive-effects-of-landiolol-administration-on-the-occurrence-of-postoperative-atrial-fibrillation-and-tachycardia-and-plasma-il-6-elevation-in-patients-undergoing-esophageal-surgery-a-randomized-controlled-clinical-trial
#9
Yuta Horikoshi, Toru Goyagi, Ryohei Kudo, Sahoko Kodama, Takashi Horiguchi, Toshiaki Nishikawa
STUDY OBJECTIVE: To determine whether perioperative landiolol administration suppresses postoperative atrial fibrillation (AF) and the plasma cytokines elevation in patients undergoing esophageal cancer surgery. DESIGN: A prospective, randomized controlled trial. SETTING: Akita University Hospital, Akita, Japan, from April 2012 to January 2015. PATIENTS: Forty American Society of Anesthesiologists grade I-II patients undergoing elective esophagectomy...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28304142/biomarkers-and-anastomotic-leakage-in-colorectal-surgery-c-reactive-protein-trajectory-is-the-gold-standard
#10
Stephen R Smith, Peter Pockney, Ryan Holmes, Fiona Doig, John Attia, Elizabeth Holliday, Rosemary Carroll, Brian Draganic
BACKGROUND: Anastomotic leakage is a feared complication following colorectal surgery. Early prediction results in improved clinical outcome, but accurate predictive factors remain elusive. Many biomarkers have been studied with respect to diagnosis of anastomotic leakage but the concept of trajectory testing, using biomarkers, has not been assessed with regards to early diagnosis of anastomotic leak. METHODS: C-reactive protein (CRP), procalcitonin (PCT), white cell count (WCC) and gamma-glutamyl transferase were assessed for predictive utility in diagnosing anastomotic leakage with emphasis on identifying an association with change in their levels or trajectory...
March 17, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28298790/effect-of-periradial-administration-of-papaverine-on-radial-artery-diameter
#11
P S Nagaraja, Naveen G Singh, N Manjunatha, Rushikesh Chintamanrao Desai
BACKGROUND: Radial artery cannulation is a skillful procedure. An experienced anesthesiologist might also face difficulty in cannulating a feeble radial pulse. AIM: The purpose of the study was to determine whether periradial subcutaneous administration of papaverine results in effective vasodilation and improvement in the palpability score of radial artery. SETTINGS AND DESIGN: Prospective, double-blinded trial. METHODOLOGY: Thirty patients undergoing elective cardiac surgery were enrolled in the study...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28257309/patient-centered-anesthesia-triage-system-predicts-asa-physical-status
#12
F Kayser Enneking, Nila S Radhakrishnan, Kent Berg, Saharsh Patel, Judith M Wishin, Terrie Vasilopoulos
BACKGROUND: The purpose of this study was to validate a patient-centered anesthesia triage system (PCATS) by examining its association with, and predictive value of, ASA physical status (PS) classification. ASA PS classification is a widely used indicator of health status and the predictor of risk of perioperative complications. Thus, ASA PS is a good triage point such that healthy surgical patients (ASA PS I and II) undergoing low-complexity surgery are assessed by telephone, whereas less-healthy patients (ASA PS III and IV) or those patients undergoing highly complex surgery are seen in person at a presurgical clinic...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28256333/-the-effect-of-two-different-glycemic-management-protocols-on-postoperative-cognitive-dysfunction-in-coronary-artery-bypass-surgery
#13
Pinar Kurnaz, Zerrin Sungur, Emre Camci, Nukhet Sivrikoz, Gunseli Orhun, Mert Senturk, Omer Sayin, Emin Tireli, Hakan Gurvit
INTRODUCTION: Postoperative cognitive dysfunction (POCD) is an adverse outcome of surgery that is more common after open heart procedures. The aim of this study is to investigate the role of tightly controlled blood glucose levels during coronary artery surgery on early and late cognitive decline. METHODS: 40 patients older than 50 years undergoing elective coronary surgery were randomized into two groups. In the "Tight Control" group (GI), the glycemia was maintained between 80 and 120mgdL(-1) while in the "Liberal" group (GII), it ranged between 80-180mgdL(-1)...
February 27, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28250481/comparison-of-oral-dexmedetomidine-versus-oral-midazolam-as-premedication-to-prevent-emergence-agitation-after-sevoflurane-anaesthesia-in-paediatric-patients
#14
M Kavya Prabhu, Sripada G Mehandale
BACKGROUND AND AIMS: Sevoflurane is the most often used inhalational agent in paediatric anaesthesia, but emergence agitation (EA) remains a major concern. Oral midazolam and parenteral dexmedetomidine are known to be effective in controlling EA. We attempted to elucidate whether oral dexmedetomidine is better than midazolam in controlling EA. METHODS: Prospective double-blinded study involving ninety patients aged 1-10 years, undergoing elective surgeries of <2 h of expected duration under sevoflurane general anaesthesia, randomised to receive either midazolam (Group A) or dexmedetomidine (Group B) as oral premedication was carried out to record level of sedation before induction, haemodynamic parameters and recovery time...
February 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28247661/-internal-drainage-in-cancer-patients-optimizing-treatment-of-stent-related-symptoms
#15
A G Martov, D V Ergakov, A B Novikov, N G Muzhetskaya, G L Esen'yan
INTRODUCTION: The so-called stent-related symptoms caused mainly by detrusor overactivity due to distal ("cystic") curl of the internal stent are common among patients with this type of drainage. The need for long-term stenting makes the quality of life of cancer patients one of the challenging problems of modern urology. The aim of this study was to optimize treatment of stent-related symptoms in cancer patients with internal long-term stents by complementing the treatment regimen with m-anticholinergic solifenacin...
April 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28243862/preoperative-exercise-capacity-is-associated-with-the-prevalence-of-postoperative-delirium-in-elective-cardiac-surgery
#16
Masato Ogawa, Kazuhiro P Izawa, Seimi Satomi-Kobayashi, Aki Kitamura, Yasunori Tsuboi, Kodai Komaki, Rei Ono, Yoshitada Sakai, Hiroshi Tanaka, Yutaka Okita
BACKGROUND: Postoperative delirium (POD) is a critical complication that is closely associated with mortality and major morbidity in elective cardiac surgery. The identification of patients at risk for POD is crucial but has not been fully explored. AIMS: The aim of this study was to determine the predictive value of the assessment of preoperative exercise capacity for POD. METHODS: We enrolled 313 consecutive patients (mean age, 68.6 ± 14...
February 28, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28242146/prevalence-and-implications-of-abnormal-respiratory-patterns-in-cardiac-surgery-a-prospective-cohort-study
#17
Dmitry Ponomarev, Oksana Kamenskaya, Asya Klinkova, Irina Loginova, Vladimir Lomivorotov, Igor Kornilov, Vladimir Shmyrev, Aleksander Chernavskiy, Giovanni Landoni, Aleksander Karaskov
OBJECTIVE: To investigate the prevalence and impact of abnormal respiratory patterns in cardiac surgery patients. DESIGN: Prospective cohort study. SETTING: Tertiary hospital. PARTICIPANTS: Patients scheduled for elective coronary artery bypass graft surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Pulmonary function tests were performed in 454 patients before surgery...
December 7, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28208943/role-of-prophylactic-tranexamic-acid-in-reducing-blood-loss-during-elective-caesarean-section-a-randomized-controlled-study
#18
Sj Dhivya Lakshmi, Reena Abraham
INTRODUCTION: Obstetric haemorrhage accounts for 20-25% of maternal mortality and morbidity. Anti-fibrinolytics are being widely used in field of surgery. It is also used to reduce heavy menstrual blood loss. AIM: To analyse the effectiveness of Tranexamic Acid (TXA) in reducing blood loss during elective caesarean section. MATERIALS AND METHODS: This interventional, randomized, parallel group study was done in the Department of Obstetrics and Gynaecolgy, PSG IMSR, Coimbatore, from June 2014 to May 2015...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28134961/somatic-dysfunction-in-the-diagnosis-of-uncommon-ectopic-pregnancies-surgical-correlation-and-comparison-with-related-pathologic-findings
#19
Daniel Martingano, Hannah Canepa, Setareh Fararooy, Dmitriy Rybitskiy, Sam Shahem, Francis X Martingano, George Aglialoro
BACKGROUND: Ectopic pregnancies occur when the implantation of a fertilized ovum occurs outside the endometrial cavity. Such pregnancies occur in approximately 1.5% to 2.0% of all pregnancies and cause 6% of maternal deaths. OBJECTIVES: To evaluate osteopathic structural examination (OSE) findings in patients with ectopic pregnancies of uncommon locations and to establish the utility of these findings in the diagnosis of these ectopic pregnancies. METHODS: In this prospective case series, a focused OSE was performed on each patient with an ectopic pregnancy at her initial presentation after the patient history but before other diagnostic or laboratory tests were performed and surgical treatment was initiated...
February 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28108076/safety-and-effectiveness-of-alveolar-recruitment-maneuvers-and-positive-end-expiratory-pressure-during-general-anesthesia-for-cesarean-section-a-prospective-randomized-trial
#20
D Aretha, F Fligou, P Kiekkas, C Messini, E Panteli, E Zintzaras, M Karanikolas
INTRODUCTION: During cesarean section, the supine position reduces functional residual capacity and worsens lung compliance. We tested the hypothesis that alveolar recruitment maneuvers and positive end-expiratory pressure improve lung compliance in women undergoing general anesthesia for cesarean section. METHODS: Ninety women undergoing cesarean section were randomly assigned to one of two groups in a prospective, double-blind trial. In the alveolar recruitment maneuver group, pressure-control ventilation was used and inspiratory time was increased to 50% after delivery; positive end-expiratory pressure was increased to 20cmH2O and peak airway inspiratory pressure gradually increased to 45-50cmH2O...
May 2017: International Journal of Obstetric Anesthesia
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