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https://www.readbyqxmd.com/read/27913269/the-structure-organisation-and-perioperative-management-of-ambulatory-surgery-and-anaesthesia-in-france-methodology-of-the-sfar-opera-study
#1
Pierre Albaladejo, Frédéric Aubrun, Charles-Marc Samama, Laurent Jouffroy, Marc Beaussier, Dan Benhamou, Pauline Romegoux, Kristina Skaare, Jean Luc Bosson, Claude Ecoffey
The organization of health care establishments and perioperative care are essential for ensuring the quality of care and safety of patients undergoing outpatient surgery. In order to correctly inventory these organizations and practices, in 2013-2014, the French Society of Anaesthesia and Intensive Care organized an extensive practical survey in French ambulatory surgery units entitled the "OPERA" study (Organisation PERiopératoire de l'anesthésie en chirurgie Ambulatoire). From among all of the ambulatory surgery centres listed by the Agences Régionales de Santé [Regional Health Agencies, France], 206 public and private centres were randomly selected...
November 29, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27912105/pre-operative-walking-activity-in-youth-with-cerebral-palsy
#2
Kristen Nicholson, Nancy Lennon, Robert Hulbert, Chris Church, Freeman Miller
BACKGROUND: No data are available regarding level of walking activity for youth with cerebral palsy (CP) before undergoing orthopeadic surgery. The goals of this study were to quantify pre-operative walking activity, and determine whether pre-operative values are different from previously defined levels of walking activity in youth with CP. PROCEDURES: This study retrospectively evaluated pre-operative walking activity in youth with spastic CP, GMFCS levels I-IV...
November 29, 2016: Research in Developmental Disabilities
https://www.readbyqxmd.com/read/27905219/early-24-hour-blood-pressure-response-to-roux-en-y-gastric-bypass-in-obese-patients
#3
Julie S Pedersen, Christian Borup, Morten Damgaard, Vindhya D Yatawara, Andrea K Floyd, Niels Gadsbøll, Peter K Bonfils
Recently, it has been proposed, that the blood pressure (BP) lowering effect of gastric bypass surgery not only is explained by the obtained weight loss, but that the anatomical rearrangement of the gut after 'malabsorptive' surgical techniques, such as the laparoscopic Roux-en-Y gastric bypass (LRYGB), may affect BP through a change in a putative 'entero-renal' axis. If so one could anticipate a reduction in BP even before a noticeable weight loss was obtained. The purpose of the present study was to investigate the very early BP response to LRYGB surgery...
December 1, 2016: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/27902825/association-between-the-amount-of-vaginal-mesh-used-with-mesh-erosions-and-repeated-surgery-after-repairing-pelvic-organ-prolapse-and-stress-urinary-incontinence
#4
Bilal Chughtai, Matthew D Barber, Jialin Mao, James C Forde, Sharon-Lise T Normand, Art Sedrakyan
Importance: Mesh, a synthetic graft, has been used in pelvic organ prolapse (POP) repair and stress urinary incontinence (SUI) to augment and strengthen weakened tissue. Polypropylene mesh has come under scrutiny by the US Food and Drug Administration. Objective: To examine the rates of mesh complications and invasive reintervention after the placement of vaginal mesh for POP repair or SUI surgery. Design, Setting, and Participants: This investigation was an observational cohort study at inpatient and ambulatory surgery settings in New York State...
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27891288/massive-ascites-in-a-renal-transplant-patient-after-laparoscopic-fenestration-of-a-lymphocele
#5
Shohei Kawaguchi, Takahiro Nohara, Takashi Shima, Satoko Matsuyama, Chikako Nose, Junya Yamahana, Yoshifumi Kadono, Chikashi Seto, Masahiko Kawabata, Atsushi Mizokami
Retroperitoneal lymphocele is a common complication of renal transplantation. Here, we report the case of a 67-year-old woman with massive ascites after fenestration surgery for a lymphocele that developed following renal transplantation. She had been on continuous ambulatory peritoneal dialysis for 9 years. Living donor renal transplantation was performed and an intrapelvic lymphocele subsequently developed. The lymphocele did not resolve after aspiration therapy; therefore, laparoscopic fenestration was performed...
2016: Case Reports in Transplantation
https://www.readbyqxmd.com/read/27890310/same-day-total-hip-arthroplasty-performed-at-an-ambulatory-surgical-center-90-day-complication-rate-on-549-patients
#6
Gregg R Klein, Jason M Posner, Harlan B Levine, Mark A Hartzband
BACKGROUND: There is an increasing interest in outpatient total hip arthroplasty (THA), as there are perceived benefits to the patient, insurer, and overall healthcare system. However, the safety of outpatient total joint arthroplasty has not been studied. METHODS: Five hundred forty-nine patients who underwent mini-posterior THA at a freestanding independent ambulatory surgical center (ASC) were reviewed. All patients were discharged to home on the day of surgery...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27890061/preoperative-screening-for-sleep-disordered-breathing-in-children-a-systematic-literature-review
#7
Erin E Bauer, Rebecca Lee, Yasmine N Campbell
Clinicians frequently underestimate or do not assess sleep-disordered breathing (SDB) in children in ambulatory surgical centers. Identifying the disorder and obtaining information relevant to anesthesia management can be assisted by the use of a standard questionnaire during preoperative assessment. We wanted to determine whether a preoperative screening tool increases clinician awareness of SDB in children and leads to a decrease in perioperative respiratory adverse events. We reviewed 21 articles to identify reliable screening tools for pediatric SDB in ambulatory surgical centers and selected six articles for the review...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27878804/assessment-of-cardiovascular-risk-in-patients-undergoing-total-joint-alloplasty-the-crash-joint-study
#8
Pawel Legosz, Marcin Kotkowski, Anna E Platek, Pawel Maldyk, Bartosz Krzowski, Anna Rys, Karolina Semczuk, Filip M Szymanski, Krzysztof J Filipiak
BACKGROUND: Risk assessment is of particular importance for patients undergoing surgical interventions. Orthopedic procedures, especially total joint alloplasty are major procedure associated with high perioperative risk, as well as one of the highest rates of complications. The aim of the present study was to establish the prevalence of classical and non-classical cardiovascular risk factors in patients undergoing total hip or knee alloplasty. METHODS: The CRASH-JOINT (Cardiovascular Risk Assessment ScHeme in JOINT alloplasty) was a prospective, epidemiological study performed in consecutive patients scheduled for total joint (hip or knee) replacement surgery...
November 23, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27872995/nt-probnp-as-marker-of-ventricular-dilatation-and-pulmonary-regurgitation-after-surgical-correction-of-tetralogy-of-fallot-a-mri-validation-study
#9
Annalisa Paolino, Tarique Hussain, Antonio Pavon, Maria Nieves Velasco, Sergio Uribe, Antonio Ordoñez, Israel Valverde
The goal of this study is to evaluate whether NT-proBNP plasma levels may help as a screening biomarker for monitoring right ventricular dilatation, pulmonary regurgitation and the onset of heart failure in patients with repaired Tetralogy of Fallot. Our single-centre observational prospective study involved 43 patients (15.1 years, SD = 8) with corrected Tetralogy of Fallot. Data collection included: clinical parameters (electrocardiogram, chest X-ray, NYHA scale, time since last surgery), biochemistry (NT-proBNP levels) and MRI values (ventricular volumetry, pulmonary flow assessment)...
November 21, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27871578/children-with-heart-disease-risk-stratification-for-non-cardiac-surgery
#10
Angela K Saettele, Jacob L Christensen, Kelly L Chilson, David J Murray
STUDY OBJECTIVE: Children with congenital or acquired heart disease have an increased risk of anesthesia related morbidity and mortality. The child's anesthetic risk is related to the severity of their underlying cardiac disease, associated comorbidities, and surgical procedure. The goal of this project was to determine the ease of use of a preoperative risk stratification tool for assigning pediatric cardiac staff and to determine the relative frequency that children with low, moderate, and high risk cardiac disease present for non-cardiac surgery at a tertiary pediatric hospital...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871557/effect-of-adjunctive-dexmedetomidine-on-postoperative-intravenous-opioid-administration-in-patients-undergoing-thyroidectomy-in-an-ambulatory-setting
#11
Kristin Long, Joseph Ruiz, Spencer Kee, Alicia Kowalski, Farzin Goravanchi, Jeff Cerny, Katy French, Mike Hernandez, Nancy Perrier, Elizabeth Rebello
STUDY OBJECTIVE: Two of the most feared complications for patients undergoing thyroid surgery are pain and postoperative nausea and vomiting. Thyroidectomy is considered high risk for postoperative nausea and vomiting, and recent studies have looked at adjuncts to treat pain, limit narcotic use, "fast-track" the surgical process, and enhance recovery without compromising the patient's safety. One such perioperative medication of interest is dexmedetomidine (Dex), a centrally acting α-2 agonist that has been associated with reducing pain and postoperative opioid consumption...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871521/functional-outcome-and-cost-effectiveness-of-outpatient-vs-inpatient-care-for-complex-hind-foot-and-ankle-surgery-a-retrospective-cohort-study
#12
Justin Oh, Anahi Perlas, Johnny Lau, Rajiv Gandhi, Vincent W S Chan
STUDY OBJECTIVE: To compare the postoperative functional outcome and the total cost associated with outpatient vs inpatient care following complex hind-foot and ankle surgery. DESIGN: Retrospective, cohort study. SETTING: Tertiary care center. PATIENTS: Forty patients, American Society of Anesthesiologists 1-3, of either sex undergoing elective complex hind-foot and ankle surgery (fusion, osteotomy, or multiple ligament repair)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871518/continuous-ambulatory-adductor-canal-catheters-for-patients-undergoing-knee-arthroplasty-surgery
#13
Neil A Hanson, Phoebe H Lee, Stanley C Yuan, Daniel S Choi, Cindy Jo Allen, David B Auyong
STUDY OBJECTIVE: To determine after knee arthroplasty surgery the feasibility of discharging patients home on postoperative day 1 with continuous adductor canal blocks. DESIGN: Retrospective case series. SETTING: Outpatient setting after hospital discharge. PATIENTS: Patients undergoing knee arthroplasty surgery from October 2013 to August 2014. INTERVENTIONS: All patients received continuous adductor canal catheters for postoperative analgesia and were discharged to home on postoperative day 1...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871514/cost-impact-of-unexpected-disposition-after-orthopedic-ambulatory-surgery-associated-with-category-of-anesthesia-provider
#14
Robert L Ohsfeldt, Thomas R Miller, John E Schneider, Cara M Scheibling
STUDY OBJECTIVE: To provide estimates of the costs and health outcomes implications of the excess risk of unexpected disposition for nurse anesthetist (NA) procedures. DESIGN: A projection model was used to apply estimates of costs and health outcomes associated with the excess risk of unexpected disposition for NAs reported in a recent study. SETTING: Ambulatory and inpatient surgery. PATIENTS: Base-case model parameters were based on estimates taken from peer-reviewed publications when available, or from other sources including data for all hospital stays in the United States in 2013 from the Healthcare Cost and Utilization Project Web site...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870808/description-and-results-of-a-comprehensive-care-protocol-for-overnight-stay-spine-surgery-in-adults
#15
Drew A Bednar
STUDY DESIGN: This is a prospective cohort study. OBJECTIVE: To define the probability of successful morning-after discharge after adult spine surgery achieved with a standard care protocol as applied to patients with a large variety of common degenerative spine disorders. SUMMARY OF BACKGROUND DATA: Qualifying criteria for ambulatory or overnight-stay adult spine surgery are not well defined in either the spine or anesthesia literature. Most reports simply go to ASA risk classification or surgical technique alternatives and do not present a clearly defined patient care and case management protocol...
November 18, 2016: Spine
https://www.readbyqxmd.com/read/27870667/the-role-of-dedicated-musculoskeletal-urgent-care-centers-in-reducing-cost-and-improving-access-to-orthopaedic-care
#16
Travis J Anderson, Peter L Althausen
OBJECTIVES: Over the past few years, the United States has seen the rapid growth of dedicated musculoskeletal urgent care centers owned and operated by individual orthopaedic practices. In June of 2014, our practice opened the first dedicated orthopaedic urgent care in the region staffed by physician assistants and supervised by orthopaedic surgeons. Our hypothesis is that such centers can safely improve orthopaedic care for ambulatory orthopaedic injuries, decrease volume for overburdened emergency departments (EDs), reduce wait times and significantly decrease the cost of care while improving access to orthopaedic specialists...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27868292/patterns-of-reflux-in-gastroesophageal-reflux-disease-in-pediatric-population-of-new-south-wales
#17
Sarath Kumar Narayanan, Ralph Clinton Cohen, Jonathan Saul Karpelowsky
This study is to determine the association of ambulatory pH monitoring (24hr pH) with symptoms of gastroesophageal reflux and its other investigations. The clinical and epidemiological profiles of subjects referred for reflux disorders are also studied. Symptoms or group of symptoms, profiles and prior investigations of 1259 consecutive pediatric subjects (with 1332 24hr pH studies performed) referred for evaluation of reflux disorders between 1988 and 2012 were retrospectively studied. Chi-square or fisher exact test was used for hypothesis testing, student t-test for the comparison of means and the Wilcoxon rank-sum test for comparing medians of continuous variables...
November 21, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/27865327/indwelling-pleural-catheters-a-clinical-option-in-trapped-lung
#18
REVIEW
Luca Bertolaccini, Andrea Viti, Simona Paiano, Carlo Pomari, Luca Rosario Assante, Alberto Terzi
Malignant pleural effusion (MPE) symptoms have a real impact on quality of life. Surgical approach through video-assisted thoracic surgery provides a first step in palliation. In patients unfit for general anesthesia, awake pleuroscopy represents an alternative. Sclerosing agents can be administered at the bedside through a chest tube. Ideal treatment of MPE should include adequate long-term symptom relief, minimize hospitalization, and reduce adverse effects. Indwelling pleural catheter (IPC) allows outpatient management of MPE through periodic ambulatory fluid drainage...
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27861435/intramuscular-fentanyl-and-ketorolac-associated-with-superior-pain-control-after-pediatric-bilateral-myringotomy-and-tube-placement-surgery-a-retrospective-cohort-study
#19
Paul A Stricker, Wallis T Muhly, Ellen C Jantzen, Yue Li, Abbas F Jawad, Alexander S Long, Marcia Polansky, Scott D Cook-Sather
BACKGROUND: Bilateral myringotomy and pressure equalization tube insertion (BMT) is the most common surgery in children. Multiple anesthetic techniques for BMT have been proposed, but that which reliably promotes ideal recovery remains unclear. We sought to assess associations between anesthetic regimens that included single-agent (fentanyl or ketorolac) or dual-agent (fentanyl and ketorolac) analgesic therapy and the primary outcome of maximal postanesthesia care unit (PACU) pain score...
November 17, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27853667/resection-of-beak-type-thoracic-ossification-of-the-posterior-longitudinal-ligament-from-a-posterior-approach-under-intraoperative-neurophysiological-monitoring-for-paralysis-after-posterior-decompression-and-fusion-surgery
#20
Shiro Imagama, Kei Ando, Zenya Ito, Kazuyoshi Kobayashi, Tetsuro Hida, Kenyu Ito, Yoshimoto Ishikawa, Mikito Tsushima, Akiyuki Matsumoto, Satoshi Tanaka, Masayoshi Morozumi, Masaaki Machino, Kyotaro Ota, Hiroaki Nakashima, Norimitsu Wakao, Yoshihiro Nishida, Yukihiro Matsuyama, Naoki Ishiguro
Study Design Prospective clinical study. Objective Posterior decompression and fusion surgery for beak-type thoracic ossification of the posterior longitudinal ligament (T-OPLL) generally has a favorable outcome. However, some patients require additional surgery for postoperative severe paralysis, a condition that is inadequately discussed in the literature. The objective of this study was to describe the efficacy of a procedure we refer to as "resection at an anterior site of the spinal cord from a posterior approach" (RASPA) for severely paralyzed patients after posterior decompression and fusion surgery for beak-type T-OPLL...
December 2016: Global Spine Journal
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