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https://www.readbyqxmd.com/read/27907923/association-between-the-surgical-apgar-score-and-perioperative-complications-after-radical-prostatectomy
#1
Matthias Orberger, Jüri Palisaar, Florian Roghmann, Ludger Mittelstädt, Petra Bischoff, Joachim Noldus, Björn Löppenberg
OBJECTIVE: To evaluate whether the Surgical Apgar Score (SAS) can identify patients who are at risk for perioperative adverse events (PAE) following radical prostatectomy for prostate cancer. PATIENTS AND METHODS: At a single academic institution, 994 patients undergoing radical prostatectomy between 2010 and 2013 were analyzed retrospectively. The SAS was calculated from anesthesia records, evaluated to predict PAE within a 30-day time period postoperatively; these events were classified according to standardized classification systems...
December 2, 2016: Urologia Internationalis
https://www.readbyqxmd.com/read/27904211/post-operative-pain-management-in-shoulder-surgery-suprascapular-and-axillary-nerve-block-by-arthroscope-assisted-catheter-placement
#2
H Çağdaş Basat, D Hakan Uçar, Mehmet Armangil, Berk Güçlü, Mehmet Demirtaş
BACKGROUND: Postoperative pain management is the part of shoulder surgery to improve patient satisfaction, start rehabilitation process rapidly and decrease for hospital stay. Various treatment modalities have been used for pain management, but they have some limitations, side effects and risks. Throughout intraoperative and postoperative period, nerve blocks have been used more popularly than others because of efficacy. For the regional nerve block, local anesthetic should be infiltrated close to the nerve for maximum effect...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27902826/association-of-a-frailty-screening-initiative-with-postoperative-survival-at-30-180-and-365-days
#3
Daniel E Hall, Shipra Arya, Kendra K Schmid, Mark A Carlson, Pierre Lavedan, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason M Johanning
Importance: As the US population ages, the number of operations performed on elderly patients will likely increase. Frailty predicts postoperative mortality and morbidity more than age alone, thus presenting opportunities to identify the highest-risk surgical patients and improve their outcomes. Objective: To examine the effect of the Frailty Screening Initiative (FSI) on mortality and complications by comparing the surgical outcomes of a cohort of surgical patients treated before and after implementation of the FSI...
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27900707/fluoroscopy-guided-biodegradable-spacer-implantation-using-local-anesthesia-safety-and-efficacy-study-in-patients-with-massive-rotator-cuff-tears
#4
E Gervasi, E Maman, A Dekel, E Cautero
BACKGROUND: The management of massive rotator cuff tears (MRCTs) is challenging and associated with a high failure rates. Studies have shown that advanced age, lower American Society of Anesthesiologists physical status score and concomitant comorbidities are associated with higher risks of death and postoperative complications. This study was designed to assess the safety and efficacy of fluoroscopy-guided biodegradable spacer implantation under local anesthesia, in patients with MRCT and comorbidities completely or partially contraindicating surgeries under general anesthesia...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27898500/patterns-and-trends-of-transcatheter-aortic-valve-implantation-in-italy-insights-from-rispeva
#5
Arturo Giordano, Nicola Corcione, Giuseppe Biondi-Zoccai, Sergio Berti, Anna Sonia Petronio, Carlo Pierli, Patrizia Presbitero, Pietro Giudice, Gennaro Sardella, Antonio L Bartorelli, Roberto Bonmassari, Ciro Indolfi, Alfredo Marchese, Elvis Brscic, Alberto Cremonesi, Luca Testa, Nedy Brambilla, Francesco Bedogni
AIMS: Clinical trials have shown that transcatheter aortic valve implantation for aortic stenosis compares favorably to surgical replacement in high-risk patients and is superior to medical therapy in those at prohibitive risk. There is uncertainty however on patterns and trends in transcatheter aortic valve implantation, especially focusing on Italy. METHODS: The RISPEVA study is a prospective Italian registry including 21 institutions. Patients have been enrolled since late 2012, and data collection includes several baseline, procedural, in-hospital, and follow-up details...
November 24, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27898430/an-update-on-the-various-practical-applications-of-the-stop-bang-questionnaire-in-anesthesia-surgery-and-perioperative-medicine
#6
Mahesh Nagappa, Jean Wong, Mandeep Singh, David T Wong, Frances Chung
PURPOSE OF REVIEW: The present review aims to provide an update on the various practical applications of the STOP-Bang questionnaire in anesthesia, surgery, and perioperative medicine. RECENT FINDINGS: The STOP-Bang questionnaire was originally validated as a screening tool to identify surgical patients who are at high-risk of obstructive sleep apnea (OSA). A recent meta-analysis confirmed that STOP-Bang is validated for use in the sleep clinic, surgical, and general population...
November 24, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27888591/a-novel-approach-to-minimally-invasive-management-of-sigmoid-volvulus
#7
Alireza Tavassoli, Ghodratollah Maddah, Sadjad Noorshafiee, Maryam Salehi, Shima Imannezhad, Ehsanollah Ghorbanian
Resection is the most common treatment choice for sigmoid volvulus, a common complication in our region. A new minimally invasive technique for sigmoid resection with local anesthesia was done in this study. This method is invented to avoid general on regional anesthesia in high-risk patients. Nineteen patients were evaluated and then 14 were enrolled in this study. Sigmoidectomy with a left lower quadrant incision was performed and demographic data, the length of hospital stay, complications and procedure time were recorded...
October 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/27885426/prospective-cohort-study-assessing-chronic-pain-in-patients-following-minor-surgery-for-breast-cancer
#8
Régis Fuzier, Floriane Puel, Philippe Izard, Agnès Sommet, Sébastien Pierre
PURPOSE: Pain after tumorectomy and sentinel lymph node dissection is poorly reported in the literature. We carried out a prospective survey aimed at assessing pain three months after such minor surgery for breast cancer. METHODS: The study was approved by the local ethics committee. Most surgeries followed a standard protocol involving general anesthesia with no regional analgesia technique, laryngeal mask, sufentanil and propofol for induction, and multimodal analgesia during the postoperative period...
November 24, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27884330/factors-associated-with-adverse-events-after-emergency-laparotomy-in-cape-town-south-africa-identifying-opportunities-for-quality-improvement
#9
Richard Trafford Spence, Mark Hampton, Kent Pluke, Miriam Kahn, Nkhabe Chinyepi, Mohamed Elmusbahi, Tirsa van Wyngaard, Eugenio Panieri
BACKGROUND: Surgical outcomes research is limited in areas of the world with the greatest unmet surgical need and likely greatest variation in outcomes. Measurement alone may improve outcomes-the so-called Hawthorne effect. The purpose of this multicenter cohort study was to identify factors that are both feasible to collect and are associated with a major adverse event following a targeted procedure in Cape Town, South Africa. METHODS: A collaborative of four acute care surgical units was formed to develop a data set with minimal data burden describing outcomes after an emergency exploratory laparotomy during a 3-mo period (February-April 2015)...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27883975/evaluation-of-current-practices-in-transcatheter-aortic-valve-implantation-the-written-worldwide-tavi-experience-survey
#10
Enrico Cerrato, Luis Nombela-Franco, Tamim M Nazif, Helene Eltchaninoff, Lars Søndergaard, Henrique B Ribeiro, Marco Barbanti, Fabian Nietlispach, Peter De Jaegere, Pierfrancesco Agostoni, Ramiro Trillo, Pilar Jimenez-Quevedo, Fabrizio D'Ascenzo, Olaf Wendler, Gabriel Maluenda, Mao Chen, Corrado Tamburino, Carlos Macaya, Martin B Leon, Josep Rodes-Cabau
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been adopted worldwide as the standard treatment for severe aortic stenosis in symptomatic patients at prohibitive or high surgical risk, but there are still several areas where consensus and evidence are lacking. The purpose was to obtain a global view of current practice related to TAVI with the potential to identify the main areas of consensus and divergence between centers. METHODS: An online questionnaire was distributed in centers performing TAVI including a total of 59 questions concerning pre-procedural evaluation, procedural practices and post-procedural management...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27880971/the-risk-factors-of-postoperative-delirium-after-total-knee-arthroplasty
#11
Lih Wang, Sangyun Seok, Sungsoo Kim, Kyungtaek Kim, Seunghyun Lee, Kyungho Lee
We investigated the results of delirium which developed after total knee arthroplasty (TKA) and the risk factors for delirium in the patients who are older than 65 years. From March 2008 to March 2012, we performed a retrospective study on 296 knees of 265 patients who were treated with TKA. They were divided into two groups: 216 patients without delirium and 49 patients diagnosed with delirium by psychiatry. We analyzed the risk factors into three categories: First, the preoperative factors including gender, age, body mass index (BMI), clinical and functional knee joint score (Knee Society Knee Score and Knee Society Function Score) and the number of underlying diseases and associations with each disease; Second, the operative factors including the anesthesia method, amount of blood loss, operating time, laboratory factors, and transfusion count; Third, the postoperative factors such as start time of walking and duration of hospital stay were analyzed...
November 23, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27872956/hip-fracture-registries-utility-description-and-comparison
#12
P Sáez-López, F Brañas, N Sánchez-Hernández, N Alonso-García, J I González-Montalvo
: Hip fractures (HF) are prevalent and involve high morbidity and mortality so improving their management is important. HF registries are a good way to improve knowledge about this condition and its quality of care, while at the same time reducing clinical variability, optimizing efficiency, improving outcomes, and reducing costs. INTRODUCTION: Hip fractures (HF) are a prevalent fragility fracture secondary to osteoporosis that involves high morbidity and mortality...
November 21, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27871540/comparison-of-the-effects-of-truview-pcd%C3%A2-video-laryngoscopy-and-macintosh-blade-direct-laryngoscopy-in-geriatric-patients
#13
Muhammed M Kurnaz, Aykut Sarıtaş
STUDY OBJECTIVE: To compare the effects of Truview PCD™ video laryngoscopy (TVL) and Macintosh blade direct laryngoscopy (MDL) on hemodynamic responses observed during laryngoscopy and orotracheal intubation conditions in geriatric patients. DESIGN: Randomized prospective study. SETTING: Operating room. PATIENTS: One hundred patients in the risk group American Society of Anesthesiologists I to III aged 65 years and older underwent elective surgery under general anesthesia...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871526/risk-factors-for-failed-reactivation-of-a-labor-epidural-for-postpartum-tubal-ligation-a-prospective-observational-study
#14
Mark F Powell, Douglas D Wellons, Steve F Tran, John M Zimmerman, Michael A Frölich
STUDY OBJECTIVE: To determine specific risk factors that increase the failure rate of labor epidurals reactivated for use as a surgical block for postpartum tubal ligation. DESIGN: Prospective, observational study. SETTING: Labor and delivery suite and operating rooms at the Women and Infants Center. PATIENTS: One hundred patients undergoing postpartum tubal ligation with an existing labor epidural that is documented to be within 2 cm of initial placement...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871524/predictors-of-desaturation-during-patient-transport-to-the-postoperative-anesthesia-care-unit-an-observational-study
#15
François Labaste, Stein Silva, Léa Serin-Moulin, Etienne Lefèvre, Bernard Georges, Jean-Marie Conil, Vincent Minville
BACKGROUND: The transport of postoperative patients to the postoperative anesthesia care unit (PACU) is a high-risk period for hypoxemia. The aim of this study was to determine risk factors for hypoxemia during transfers to the PACU. METHODS: An observational, prospective, monocentric, and noninterventional study was conducted in the University Hospital of Toulouse in 2015 during a 5-week period. All patients who were transferred to PACU were included. Twenty-eight variables related to patient, surgery, and anesthesia were recorded...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27843042/low-risk-of-thromboembolic-events-after-routine-administration-of-tranexamic-acid-in-hip-and-knee-arthroplasty
#16
Rune V Madsen, Christian S Nielsen, Thomas Kallemose, Henrik Husted, Anders Troelsen
BACKGROUND: The blood-conserving effect of intravenous (IV) tranexamic acid (TXA) is well-documented for total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the risk of thromboembolic (TE) events after routine use of TXA is unclear and the safety profile is debated. This retrospective study investigates patient characteristics, occurrences, and predictors of TE events after routine administration of IV TXA in THA and TKA. METHODS: Three thousand one hundred fifty-nine THA or TKA procedures performed from 2007-2013 at our institution were included...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27833860/hemodynamic-effects-of-topical-adrenaline-during-septoplasty
#17
Ceren Günel, Sinem Sarı, Aylin Eryılmaz, Yeşim Başal
Vasoconstrictors agents is used in septal surgery, in attempt to improve haemostasis and thereby improve the surgical field. We aimed to compare the effect of lignocaine with adrenaline injection and alone lignocaine injection with topical adrenalin on perioperative hemodynamic effect, hemorrhage and postoperative pain. Patients undergoing surgery were randomised into two groups: group I in whom infiltration was performed with lignocaine (2 %) with adrenaline (1:100,000), group II in whom infiltration was performed with lignocaine (2 %) injection with topical adrenalin application (1:10,000)...
December 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/27825646/the-risk-of-postoperative-nausea-and-vomiting-between-surgical-patients-received-propofol-and-sevoflurane-anesthesia-a-matched-study
#18
Hideki Matsuura, Satoki Inoue, Masahiko Kawaguchi
OBJECTIVES: The current consensus guidelines for managing postoperative nausea and vomiting (PONV) suggest that one of anesthetic risk factors is the use of volatile anesthetics. However, in clinical settings, it is rare to perceive propofol to be superior to volatile anesthetics for the prevention of PONV. To assess whether PONV is related to the type of anesthetic delivered, we compared the incidence and duration of PONV between propofol anesthesia and sevoflurane anesthesia. METHODS: We performed a retrospective review of an institutional registry containing 21606 general anesthesia cases conducted following ethics board approval...
November 4, 2016: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
https://www.readbyqxmd.com/read/27812971/efficacy-and-safety-of-dexmedetomidine-as-an-adjuvant-in-epidural-analgesia-and-anesthesia-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#19
REVIEW
Xu Zhang, Dong Wang, Min Shi, YuanGuo Luo
BACKGROUND AND OBJECTIVE: Several clinical trials have examined and indicated the usefulness of epidural dexmedetomidine therapy. However, there has been no systematic analysis of the findings of these trials to date. We undertook this systematic review and meta-analysis to investigate the efficacy and safety of epidural dexmedetomidine adjunctive therapy in different surgical procedures. MATERIALS AND METHODS: We searched EMBASE, PubMed, the Cochrane Library, and the Clinical Trials...
November 4, 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27811597/predictors-of-at-home-arterial-oxygen-desaturation-events-in-ambulatory-surgical-patients
#20
Chuck Biddle, Charles Elam, Laura Lahaye, Gordon Kerr, Laura Chubb, Brad Verhulst
OBJECTIVES: Little is known about the early recovery phase occurring at-home after anesthesia and surgery in ambulatory surgical patients. We studied quantitative oximetry and quality-of-life metrics in the first 48 hours after same-day orthopedic surgery examining the association between the recovery metrics and specific patient and procedural factors. METHODS: We used the STOP-Bang score to quantify patient risk for obstructive sleep apnea in 50 adult patients at 2 centers using continuous portable oximetry and patient journaling...
November 2, 2016: Journal of Patient Safety
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