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Ambulatory surgery

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https://www.readbyqxmd.com/read/29318355/an-enhanced-recovery-after-surgery-eras-protocol-for-ambulatory-anorectal-surgery-reduced-postoperative-pain-and-unplanned-returns-to-care-after-discharge
#1
Aaron B Parrish, Sean M O'Neill, Steven R Crain, Tara A Russell, Deepak K Sonthalia, Vu T Nguyen, Armen Aboulian
BACKGROUND: Ambulatory surgery for anorectal procedures has been proven to be safe and effective. Specific perioperative pathways combining multiple interventions have been shown to optimize recovery and outcomes associated with inpatient colorectal surgery. However, there are no major studies describing and evaluating a standardized protocol for ambulatory anorectal surgery. The purpose of this study was to evaluate the outcomes of a modified enhanced recovery after surgery (ERAS) protocol for ambulatory anorectal surgery...
January 9, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29317347/using-virtual-reality-to-control-preoperative-anxiety-in-ambulatory-surgery-patients-a-pilot-study-in-maxillofacial-and-plastic-surgery
#2
L Ganry, B Hersant, M SidAhmed-Mezi, G Dhonneur, J P Meningaud
INTRODUCTION: Preoperative anxiety may lead to medical and surgical complications, behavioral problems and emotional distress. The most common means of prevention are based on using medication and, more recently, hypnosis. The aim of our study was to determine whether a virtual reality (VR) program presenting natural scenes could be part of a new therapy to reduce patients' preoperative anxiety. MATERIALS AND METHODS: Our prospective pilot study consisted of a single-blind trial in skin cancer surgery at the Henri Mondor Teaching Hospital in France...
January 6, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29310966/improving-the-anesthetic-process-by-a-fuzzy-rule-based-medical-decision-system
#3
Juan Albino Mendez, Ana Leon, Ayoze Marrero, Jose M Gonzalez-Cava, Jose Antonio Reboso, Jose Ignacio Estevez, José F Gomez-Gonzalez
OBJECTIVE: The main objective of this research is the design and implementation of a new fuzzy logic tool for automatic drug delivery in patients undergoing general anesthesia. The aim is to adjust the drug dose to the real patient needs using heuristic knowledge provided by clinicians. A two-level computer decision system is proposed. The idea is to release the clinician from routine tasks so that he can focus on other variables of the patient. METHODS: The controller uses the Bispectral Index (BIS) to assess the hypnotic state of the patient...
January 5, 2018: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29304735/effect-of-single-dose-dexmedetomidine-on-postoperative-recovery-after-ambulatory-ureteroscopy-and-ureteric-stenting-a-double-blind-randomized-controlled-study
#4
I I Shariffuddin, W H Teoh, S Wahab, C Y Wang
BACKGROUND: Ambulatory surgery has recently gain popularity, as it is a good method of optimizinghospital resources utilization. To support ambulatory surgery, anaesthetic goals nowrevolve around patients' early recovery with minimal pain and nausea, expedientdischarge home and prompt resumption of activities of daily living. In this study, weevaluated the effect of a single pre-induction dose of dexmedetomidine on anaestheticrequirements, postoperative pain and clinical recovery after ambulatory ureteroscopy andureteric stenting under general anaesthesia...
January 5, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29304180/the-effect-of-facility-characteristics-on-patient-safety-patient-experience-and-service-availability-for-procedures-in-non-hospital-affiliated-outpatient-settings-a-systematic-review
#5
Nancy F Berglas, Molly F Battistelli, Wanda K Nicholson, Mindy Sobota, Richard D Urman, Sarah C M Roberts
BACKGROUND: Over recent decades, numerous medical procedures have migrated out of hospitals and into freestanding ambulatory surgery centers (ASCs) and physician offices, with possible implications for patient outcomes. In response, states have passed regulations for office-based surgeries, private organizations have established standards for facility accreditation, and professional associations have developed clinical guidelines. While abortions have been performed in office setting for decades, states have also enacted laws requiring that facilities that perform abortions meet specific requirements...
2018: PloS One
https://www.readbyqxmd.com/read/29299520/the-efficacy-of-lavender-aromatherapy-in-reducing-preoperative-anxiety-in-ambulatory-surgery-patients-undergoing-procedures-in-general-otolaryngology
#6
Michael Wotman, Joshua Levinger, Lillian Leung, Aron Kallush, Elizabeth Mauer, Ashutosh Kacker
Background: Preoperative anxiety is a common problem in hospitals and other health care centers. This emotional state has been shown to negatively impact patient satisfaction and outcomes. Aromatherapy, the therapeutic use of essential oils extracted from aromatic plants, may offer a simple, low-risk and cost-effective method of managing preoperative anxiety. The purpose of this study was to evaluate the efficacy of lavender aromatherapy in reducing preoperative anxiety in ambulatory surgery patients undergoing procedures in general otolaryngology...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29295799/profound-prolonged-bradycardia-and-hypotension-after-interscalene-brachial-plexus-block-with-bupivacaine
#7
Mathew Nelson, Alexandra Reens, Lara Reda, David Lee
BACKGROUND: Interscalene brachial plexus blocks have been a routinely performed method of anesthesia for shoulder surgery that decreases the need for general anesthesia, length of stay, and recovery time. We describe a case of bupivacaine toxicity after an interscalene block. CASE REPORT: The patient was a 66-year-old man who presented to our Emergency Department by emergency medical services from an ambulatory surgery center where he had undergone rotator cuff surgery, with bradycardia and hypotension...
December 30, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29288921/outcome-of-magnetic-resonance-guided-focused-ultrasound-surgery-mrgfus-for-figo-class-1-fibroids
#8
Roy Mashiach, Yael Inbar, Jaron Rabinovici, Aya Mohr Sasson, Aviva Alagem-Mizrachi, Ronit Machtinger
OBJECTIVE: Intracavitary uterine fibroids and fibroids that distort the uterine cavity are associated with excessive vaginal bleeding and infertility. While intracavitary fibroids smaller than 4 cm are usually treated safely by operative hysteroscopy, larger fibroids may require multiple surgeries or more extensive surgery with possible damage to the integrity of the uterine wall. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a noninvasive approach for treating uterine fibroids, mainly the intramural type...
December 14, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29286264/the-2017-seventh-world-congress-of-pediatric-cardiology-cardiac-surgery-week-in-review-ambulatory-pediatric-cardiology
#9
Devyani Chowdhury
The Seventh World Congress of Pediatric Cardiology was held in Barcelona in July, 2017. The central philosophy of the congress was "bridging together" all major specialties in the field. This article summarises the highlights of the meeting as it relates to ambulatory paediatric cardiology. There is a now a more unified approach to children with CHD, including assessment of neuro-developmental outcomes. The new World Heart Foundation criteria for the diagnosis of rheumatic fever remain controversial.
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29284847/evaluation-of-preoperative-flupirtine-in-ambulatory-functional-endoscopic-sinus-surgery-a-prospective-double-blind-randomized-controlled-trial
#10
Anjan Das, Hirak Biswas, Anindya Mukherjee, Sandip Roy Basunia, Subinay Chhaule, Tapobrata Mitra, Partha Sarathi Halder, Subrata Kumar Mandal
Background: Functional endoscopic sinus surgery (FESS) is the mainstay therapeutic management for nasal pathologies. We evaluated flupirtine, a centrally acting analgesic, for producing perfect perioperative conditions in FESS for adults in a day-care setting. Materials and Methods: Sixty-two patients (25-40 years) scheduled for FESS under general anesthesia were randomly divided into Group F (n = 31) receiving preoperative flupirtine (100 mg) and Group C (n = 31) receiving identical-looking placebo capsule per oral 60 min before induction of anesthesia...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284842/randomized-comparison-of-isoflurane-versus-sevoflurane-and-desflurane-for-maintenance-of-ambulatory-anesthesia
#11
Pranjali Kurhekar, Krishnagopal Vinod, J Shesha Dhiviya Krishna, M Sethuraman Raghuraman
Background: Ambulatory surgeries demand safe anesthesia with faster recovery which makes it expensive due to the cost of inhalational anesthetic agents such as sevoflurane and desflurane. Isoflurane is inexpensive agent but can cause delayed recovery. The aim of this study was to evaluate cost-benefit ratio of all three agent with respect to recovery and safety profile. Materials and Methods: Patients posted for elective ambulatory surgeries were divided into three groups...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284832/application-of-discharge-criteria-for-home-readiness-using-bispectral-and-supraglottic-airway-devices-in-day-care-surgery-without-using-muscle-relaxants
#12
Joginder Pal Attri, Manjit Singh, Hemchandra Bhatt, Kamal Jyoti, Harjinder Kaur
Introduction: The availability of rapid and short-acting intravenous and volatile anesthetics has facilitated early recovery that is why nowadays ambulatory surgery is becoming more common. If the criteria used to discharge patients from the Postanesthesia Care Unit (PACU) are met in the operating room (OR), it would be appropriate to consider bypassing the PACU and transferring the patient directly to the step-down unit. This process is known as "fast-tracking" after ambulatory surgery...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29280884/postoperative-nausea-and-vomiting-with-plastic-surgery-a-practical-advisory-to-etiology-impact-and-treatment
#13
Michele A Manahan, Debra J Johnson, Karol A Gutowski, Steven C Bonawitz, Warren A Ellsworth, Marta Zielinski, Robert W Thomsen, C Bob Basu
Ambulatory surgery is common in plastic surgery, where many aesthetic and reconstructive procedures can be performed in hospitals, ambulatory surgery centers, or office-based surgery facilities. Outpatient surgery offers advantages to both the patient and the surgeon by increasing accessibility, flexibility, and convenience; lowering cost; and maintaining high-quality care. To optimize a patient's experience and comfort, postoperative nausea and vomiting (PONV) should be prevented. However, in those patients who develop PONV, it must be appropriately managed and treated...
January 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29280779/breast-cancer-does-type-of-hospital-where-you-get-surgery-affect-survival
#14
Jenny J Lin, Natalia Egorova, Rebeca Franco, Nina A Bickell
Under the Affordable Care Act (ACA), more women are insured with Medicaid, which should improve healthcare access. We sought to determine whether there are survival differences among patients with breast cancer undergoing surgery at facilities with varying proportions of Medicaid patients. We used New York State (NYS) Vital Statistics death records data linked with NYS discharge inpatient and ambulatory surgery databases to examine 90-day survival after surgery from 2008 to 2013. We used all Medicaid discharges to calculate and create quintiles of facilities based on Medicaid volume...
December 22, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29276105/grip-strength-measurement-for-frailty-assessment-in-patients-with-vascular-disease-and-associations-with-comorbidity-cardiac-risk-and-sarcopenia
#15
Thomas E Reeve, Rebecca Ur, Timothy E Craven, James H Kaan, Matthew P Goldman, Matthew S Edwards, Justin B Hurie, Gabriela Velazquez-Ramirez, Matthew A Corriere
OBJECTIVE: Frailty is associated with adverse events, length of stay, and nonhome discharge after vascular surgery. Frailty measures based on walking-based tests may be impractical or invalid for patients with walking impairment from symptoms or sequelae of vascular disease. We hypothesized that grip strength is associated with frailty, comorbidity, and cardiac risk among patients with vascular disease. METHODS: Dominant hand grip strength was measured during ambulatory clinic visits among patients with vascular disease (abdominal aortic aneurysm [AAA], carotid stenosis, and peripheral artery disease [PAD])...
December 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29275894/ambulatory-surgery-under-local-anesthesia-for-parathyroid-adenoma-feasibility-and-outcome
#16
A Benhami, E Chuffart, N Christou, S Liva-Yonnet, M Mathonnet
The aim of this study was to evaluate the results of ambulatory parathyroid resection performed under local anesthesia (LA). MATERIAL AND METHODS: Outpatients undergoing parathyroid adenoma resection by a focused approach under LA were included. Results were evaluated by intraoperative serum parathormone levels (ioPTH) and the balance of phosphate and calcium postoperatively, at 3 months, 1 year and at the point date. The quality of ambulatory care was evaluated by the number of cancelled interventions, the number of patients hospitalized after surgery or during the first postoperative month...
December 21, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29274661/perioperative-celecoxib-and-postoperative-opioid-use-in-hand-surgery-a-prospective-cohort-study
#17
Jeffrey G Stepan, Daniel A London, Daniel A Osei, Martin I Boyer, Agnes Z Dardas, Ryan P Calfee
PURPOSE: Prescription opioid abuse is an epidemic in the United States; multimodal analgesia has been suggested as a potential solution to decrease postoperative opioid use. The primary aim of this study was to determine the effect of perioperative celecoxib on opioid intake. Secondary goals were to determine whether perioperative administration of celecoxib decreased postoperative patient-reported pain and whether patient demographic characteristics could predict postoperative pain and opioid intake...
December 21, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29274521/returns-to-specialization-evidence-from-the-outpatient-surgery-market
#18
Elizabeth L Munnich, Stephen T Parente
Technological changes in medicine have created new opportunities to provide surgical care in lower cost, specialized facilities. This paper examines patient outcomes in ambulatory surgery centers (ASCs), which were developed as a low-cost alternative to outpatient surgery in hospitals. Because we are concerned that selection into ASCs may bias estimates of facility quality, we use predicted changes in federally set Medicare facility payment rates as an instrument for ASC utilization to estimate the effect of location of treatment on patient outcomes...
December 9, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/29250223/california-study-of-ablation-caabl-early-utilization-after-index-hospitalization-for-non-valvular-atrial-fibrillation
#19
Uma Srivatsa, Beate Danielsen, Ezra Amsterdam, Yingbo Yang, Dali Fan, Nayereh Pezeshkian, Richard H White
Background: Catheter ablation (ABL) for non-valvular AF (NVAF) is recommended for symptomatic patients refractory to medical therapy and its success is related to the duration of the arrhythmia prior to intervention.Our aim was to assess the early utilization and the factors that prompted ABL in patients hospitalized for new onset NVAF. Methods: Using de-identified administrative discharge records for hospitalizations and emergency department (ED) visits, we determined the patients who had a first-time (since 1991) health record diagnosis of AF between2005 - 2011...
June 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29245349/secondary-hypertension-due-to-isolated-interrupted-aortic-arch-in-a-45-year-old-person-a-case-report
#20
Jian Mei Zhou, Xin Wen Liu, Yi Yang, Bo Zhong Wang, Jian An Wang
RATIONALE: Though it is rare, isolated interrupted aortic arch (IAA) could lead to hypertension. Surgical repair is the only effective curative method to treat IAA conditions and patients with IAA can hardly survive to adulthood with medication alone. We report an IAA case that of a 45-year-old male patient who survived for 45 years without surgical treatment. PATIENT CONCERNS: A 45-year-old man was referred to the hospital presenting with abnormal blood pressure level...
December 2017: Medicine (Baltimore)
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