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https://www.readbyqxmd.com/read/29784260/severe-obesity-and-sleep-disordered-breathing-as-risk-factors-for-emergence-agitation-in-pediatric-ambulatory-surgery
#1
Timothy Reynolds, Sumanna Sankaran, Wilson T Chimbira, Thuy Phan, Olubukola O Nafiu
PURPOSE: Sleep-disordered breathing (SDB) may be a critical risk factor for emergence agitation (EA). We hypothesized that SDB diagnosis is a predictor of EA in children after general anesthesia for ambulatory surgery. DESIGN: Prospective, observational, cohort study. METHODS: Children aged 4 to 17 years were assessed for the occurrence of EA. Differences in probability of EA were assessed using multivariable logistic regression analyses...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29779020/acetaminophen-reduces-acute-and-persistent-incisional-pain-after-hysterectomy
#2
Onur Koyuncu, Sedat Hakimoglu, Mustafa Ugur, Cagla Akkurt, Selim Turhanoglu, Daniel Sessler, Alparslan Turan
OBJECTIVE: Acetaminophen is effective for acute surgical pain, but whether it reduces persistent incision pain remains unknown. We tested the primary hypothesis that patients given perioperative acetaminophen have less incisional pain three months after surgery. Our secondary hypotheses were that patients randomized to acetaminophen have less postoperative pain and analgesic consumption, and better functional recovery at three months. METHODS: 140 patients having abdominal hysterectomy were randomly assigned to: 1)intravenous acetaminophen (4 g/day for 72 postoperative hours); or, 2) saline placebo...
May 15, 2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29778336/implementation-of-the-aortic-no-touch-technique-to-reduce-stroke-after-off-pump-coronary-surgery
#3
Alexander Albert, Jürgen Ennker, Yasser Hegazy, Sebastian Ullrich, Georgi Petrov, Payam Akhyari, Stefan Bauer, Eda Ürer, Ina Carolin Ennker, Artur Lichtenberg, Horst Priss, Alexander Assmann
OBJECTIVES: Despite substantial scientific effort, the relationship between stroke after coronary artery bypass grafting and the use of the aortic no-touch off-pump technique (anOPCAB) remains incompletely understood. The present study aimed to define the effect of anOPCAB on the occurrence and time point of stroke. METHODS: A total cohort of 15,042 consecutive patients underwent surgical myocardial revascularization at a single institution. After establishing anOPCAB as routine procedure, 4695 patients received surgery by 18 different surgeons using the anaortic approach...
April 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#4
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29759919/does-pepsin-play-a-role-in-etiology-of-laryngeal-nodules
#5
Hamdi Tasli, Burcu Eser, Mehmet Burak Asik, Hakan Birkent
OBJECTIVES: Vocal fold nodules (VFNs) are benign disorders affecting the superficial lamina propria of the true vocal folds. The etiology of VFNs still remains unclear but laryngeal trauma caused by vocal abuse, tobacco, alcohol, and laryngopharyngeal reflux (LPR) plays a crucial role on the pathogenesis. The aim of this study was to assess the presence of pepsin in formalin-fixed, paraffin-embedded (FEPE) specimens of VFNs to evaluate the role of LPR as a risk factor for VFNs. MATERIALS AND METHODS: A total of 28 pathology specimens of patients suffering from VFNs who had undergone laser microsurgery under general anesthesia were evaluated...
May 11, 2018: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/29758039/effects-of-palonosetron-for-prophylaxis-of-postoperative-nausea-and-vomiting-in-high-risk-patients-undergoing-total-knee-arthroplasty-a-prospective-randomized-double-blind-placebo-controlled-study
#6
Jung-Hee Ryu, Young-Tae Jeon, Byunghun Min, Jin-Young Hwang, Hye-Min Sohn
BACKGROUND: The preemptive multimodal pain protocols used in total knee arthroplasty (TKA) often cause emesis postoperatively. We investigated whether palonosetron prophylaxis reduces postoperative nausea and vomiting (PONV) in high-risk patients after TKA. METHODS: We randomized 120 female patients undergoing TKA to receive either palonosetron (0.075 mg, intravenous) or no antiemetic prophylaxis (0.9% saline, control group). All patients were given spinal anesthesia, a continuous femoral nerve block, and fentanyl-based intravenous patient controlled analgesia...
2018: PloS One
https://www.readbyqxmd.com/read/29752842/correlation-between-duration-of-preoperative-fasting-and-emergence-delirium-in-pediatric-patients-undergoing-ophthalmic-examination-under-anesthesia-a-prospective-observational-study
#7
Puneet Khanna, Kulbhushan Saini, Renu Sinha, Niseville Nisa, Shailendra Kumar, Souvik Maitra
BACKGROUND: Preoperative fasting in children can cause anxiety, which may ultimately lead to postoperative emergence delirium. However, no data are available whether duration of preoperative fasting correlates with postoperative emergence delirium. AIMS: The aim of this study was to identify if there is any correlation between the duration of preoperative fasting and emergence delirium in children undergoing ophthalmic examination under anesthesia. METHODS: In this prospective observational study, 100 children between the age group 2-6 years of American Society of Anesthesiologists physical status I or II, scheduled for examination of the eye under general anesthesia with sevoflurane were recruited...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29742589/clinical-factors-associated-with-icu-specific-care-following-supratentoral-brain-tumor-resection-and-validation-of-a-risk-prediction-score
#8
Lynze R Franko, Todd Hollon, Joseph Linzey, Christopher Roark, Venkatakrishna Rajajee, Kyle Sheehan, Magnus Teig, Shawn Hervey-Jumper, Jason Heth, Daniel Orringer, Craig A Williamson
OBJECTIVES: The postoperative management of patients who undergo brain tumor resection frequently occurs in an ICU. However, the routine admission of all patients to an ICU following surgery is controversial. This study seeks to identify the frequency with which patients undergoing elective supratentorial tumor resection require care, aside from frequent neurologic checks, that is specific to an ICU and to determine the frequency of new complications during ICU admission. Additionally, clinical predictors of ICU-specific care are identified, and a scoring system to discriminate patients most likely to require ICU-specific treatment is validated...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29733098/oxycodone-is-safe-and-effective-for-general-anesthesia
#9
Stefan Wirz, Richard K Ellerkmann, Martin Soehle, Christian-Dieter Wirtz
PURPOSE: In clinical practice, using different opioid analgesics is common during the induction and maintenance of general anesthesia and for postoperative analgesia. However, if the opioid analgesic could be limited to a single drug, we hypothesized that the risk of adverse drug interactions could be reduced, with fewer adverse effects. We examined the use of oxycodone as a single opioid in a well-defined cohort of orthopedic patients undergoing general anesthesia. METHODS: In this retrolective, monocentric investigation, we reviewed data from 83 patients who underwent general anesthesia and received intravenous oxycodone as the sole analgesic (0...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29730078/the-efficacy-and-safety-of-intravenous-glucocorticoids-in-total-hip-arthroplasty-a-systematic-review-and-meta-analysis
#10
REVIEW
Ning An, Kang Liu, Bao-Ying Fan, Dong-Hua Ma
OBJECTIVE: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the effect and safety of intravenous glucocorticoids for reducing pain scores, postoperative nausea and vomiting (PONV) and total morphine consumption for patients prepared for total hip arthroplasty (THA). METHODS: Electronic databases: PubMed (1950-September 2016), EMBASE(1974-September 2016), the Cochrane Central Register of Controlled Trials (CENTRAL, September 2016 Issue 3) and Web of Science (1950-September 2016) were systematically searched...
May 3, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29720210/endoscopic-release-of-congenital-muscular-torticollis-with-radiofrequency-in-teenagers
#11
Jun-Liang Wang, Wei Qi, Yu-Jie Liu
BACKGROUND: Congenital muscular torticollis (CMT) is due to contracture of the sternocleidomastoid muscle which may cause activity limitations of the neck, tilt of the head, craniofacial asymmetry, and deformity of the skull. The authors present their experience of arthroscopic tight fibrous band release with radiofrequency in teenagers under local anesthesia and evaluate the clinical results. METHODS: A total of 69 patients who underwent arthroscopic release of CMT with radiofrequency under local anesthesia by a single surgeon could participate in this study...
May 3, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29702358/a-medicolegal-analysis-of-malpractice-claims-involving-anesthesiologists-in-the-gastrointestinal-endoscopy-suite-2007-2016
#12
Alexander B Stone, Ethan Y Brovman, Penny Greenberg, Richard D Urman
STUDY OBJECTIVE: Gastrointestinal endoscopy cases make up the largest portion of out of operating room malpractice claims involving anesthesiologists. To date, there has been no closed claims analysis specifically focusing on the claims from the endoscopy suite. We aim to identify associated case characteristics and contributing factors. DESIGN: Retrospective review of closed claims. SETTING: Multi-institutional setting of hospitals that submit data to the Controlled Risk Insurance Company (CRICO) Comparative Benchmarking System, a database representing approximately 30% of annual malpractice cases in the United States...
April 24, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29701278/the-impact-of-general-anesthesia-on-child-development-and-school-performance-a-population-based-study
#13
Francisco J Schneuer, Jason P Bentley, Andrew J Davidson, Andrew Ja Holland, Nadia Badawi, Andrew J Martin, Justin Skowno, Samantha J Lain, Natasha Nassar
BACKGROUND: There has been considerable interest in the possible adverse neurocognitive effects of exposure to general anesthesia and surgery in early childhood. AIMS: The aim of this data linkage study was to investigate developmental and school performance outcomes of children undergoing procedures requiring general anesthesia in early childhood. METHODS: We included children born in New South Wales, Australia of 37+ weeks' gestation without major congenital anomalies or neurodevelopmental disability with either a school entry developmental assessment in 2009, 2012, or Grade-3 school test results in 2008-2014...
April 27, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29697506/association-of-neuraxial-anesthesia-with-postoperative-venous-thromboembolism-after-noncardiac-surgery-a-propensity-matched-analysis-of-acs-nsqip-database
#14
Alparslan Turan, Gausan R Bajracharya, Steve Leung, Merve Yazici Kara, Guangmei Mao, Thomas Botsford, Kurt Ruetzler, Kamal Maheshwari, Wael Ali Sakr Esa, Hesham Elsharkawy, Daniel I Sessler
BACKGROUND: Neuraxial anesthesia improves components of the Virchow's triad (hypercoagulability, venous stasis, and endothelial injury) which are key pathogenic contributors to venous thrombosis in surgical patients. However, whether neuraxial anesthesia reduces the incidence of venous thromboembolism (VTE) remain unclear. We therefore tested the primary hypothesis that neuraxial anesthesia reduces the incidence of 30-day VTE in adults recovering from orthopedic surgery. Secondarily, we tested the hypotheses that neuraxial anesthesia reduces 30-day readmission, 30-day mortality, and the duration of postoperative hospitalization...
April 23, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29696330/patient-frailty-should-be-used-to-individualize-treatment-decisions-in-primary-hyperparathyroidism
#15
Carolyn D Seib, Kathryn Chomsky-Higgins, Jessica E Gosnell, Wen T Shen, Insoo Suh, Quan-Yang Duh, Emily Finlayson
BACKGROUND: Primary hyperparathyroidism (PHPT) is a common endocrine disorder that predominantly affects patients >60 and is increasing in prevalence. Identifying risk factors for poor outcomes after parathyroidectomy in older adults will help tailor operative decision making. The impact of frailty on surgical outcomes in parathyroidectomy has not been established. METHODS: We performed a retrospective review of patients ≥40 years who underwent parathyroidectomy in the 2005-2010 ACS NSQIP...
April 25, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29696129/controlled-hypotension-during-rhinoplasty-a-comparison-of-dexmedetomidine-with-magnesium-sulfate
#16
Faranak Rokhtabnak, Soudabeh Djalali Motlagh, Mohamadreza Ghodraty, Alireza Pournajafian, Mojtaba Maleki Delarestaghi, Arash Tehrani Banihashemi, Zeinab Araghi
Objective: The current study aimed at comparing the efficacy of dexmedetomidine and magnesium sulfate to control blood pressure (BP) during rhinoplasty and the resultant effects on the quality of surgical field in terms of bleeding and visibility. Methods: The current randomized, prospective, double-blind study was conducted on 60 patients aged 18 to 50 years classified as ASA (American Society of Anesthesiologists) physical status I who were candidates for rhinoplasty...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29696106/evaluation-of-the-effect-of-aminophylline-in-reducing-the-incidence-of-acute-kidney-injury-after-cardiac-surgery
#17
Shahrbanoo Shahbazi, Peyman Alishahi, Elham Asadpour
Objectives: Acute renal failure is a common complication of major cardiovascular surgeries (One-third of patients). Adenosine release as a vascular vasodilator increases after cardiac surgery, which reduces renal and glomerular blood flow and subsequently causes kidney ischemic damage. The present study aimed at evaluating the impact of aminophylline as an adenosine receptor antagonist on renal function after cardiac surgery hoping to find an appropriate method to reduce acute kidney injury...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29687360/suspected-periprosthetic-joint-infection-after-total-knee-arthroplasty-under-propofol-versus-sevoflurane-anesthesia-a-retrospective-cohort-study
#18
Miwa Kishimoto, Hayato Yamana, Satoki Inoue, Tatsuya Noda, Manabu Akahane, Yusuke Inagaki, Hiroki Matsui, Hideo Yasunaga, Masahiko Kawaguchi, Tomoaki Imamura
PURPOSE: Periprosthetic joint infection is a serious complication of total knee arthroplasty. Though there are many factors that might increase its risk, the use of propofol for maintaining general anesthesia could theoretically increase the incidence of infection because of its lipid component that supports bacterial growth. Nevertheless, the relationship between anesthetic maintenance agents and the occurrence of periprosthetic joint infection remains uncertain. The purpose of this study was to compare the incidence of suspected early-onset periprosthetic joint infection between patients undergoing total knee arthroplasty under propofol vs sevoflurane anesthesia...
April 23, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29679123/-wide-awake-hand-surgery-based-on-application-examples
#19
P Kaiser, M Keller, J Dörler, G Schmidle
OBJECTIVE: Anesthesiologic method with low bleeding level, risk level, and complication rate for surgical procedures on the hand without a tourniquet on an unsedated patient with the possibility for functional testing during surgery. INDICATIONS: Surgical procedures of the hand can be carried out using the wide awake technique depending on the patient's suitability and preference considering individual risk factors. CONTRAINDICATIONS: Absolute contraindications are allergies to the local anesthetic or its components...
April 20, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29677057/newborn-resuscitation-skills-in-health-care-providers-at-a-zambian-tertiary-center-and-comparison-to-world-health-organization-standards
#20
Sara C Mistry, Richard Lin, Hazel Mumphansha, Laura C Kettley, Janaki A Pearson, Sonia Akrimi, David J Mayne, Wonder Hangoma, M Dylan Bould
BACKGROUND: Birth asphyxia is a leading cause of early neonatal death. In 2013, 32% of neonatal deaths in Zambia were attributable to birth asphyxia and trauma. Basic, timely interventions are key to improving outcomes. However, data from the World Health Organization suggest that resuscitation is often not initiated, or is conducted suboptimally. Currently, there are little data on the quality of newborn resuscitation in the context of a tertiary center in a lower-middle income country...
April 17, 2018: Anesthesia and Analgesia
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