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Fast track anesthesia

Luiz Eduardo Imbelloni, Geraldo Borges de Morais Filho
BACKGROUND: The fast-track concept refers to all phases of perioperative care: Preoperative, intraoperative, and postoperative strategies. Although most research has focused on adherence to medication, adherence also encompasses numerous health-related behaviors. The aim of this prospective study was to determine the attitudes and awareness among health professionals involved in the treatment of elderly patients with fractures of the femur and the results of 400 patients. METHODS: The postoperative protocol acceleration was presented to various hospital departments through four seminars...
September 2016: Anesthesia, Essays and Researches
Antonio Siniscalchi, Lorenzo Gamberini, Tommaso Bardi, Cristiana Laici, Elisa Gamberini, Letizia Francorsi, Stefano Faenza
AIM: To evaluate the potential benefits and risks of the use of epidural anaesthesia within an enhanced recovery protocol in this specific subpopulation. METHODS: A retrospective review was conducted, including all cirrhotic patients who underwent open liver resection between January 2013 and December 2015 at Bologna University Hospital. Patients with an abnormal coagulation profile contraindicating the placement of an epidural catheter were excluded from the analysis...
September 18, 2016: World Journal of Hepatology
A G Nazarenko, N A Konovalov, A V Krut'ko, T N Zamiro, I B Geroeva, R R Gubaidullin, N E Khoreva, A N Komarov, M A Stepanyan, M V Konstantinova, A M Kazachonok, R A Onoprienko, V A Korolishin, T N Kubynina, M A Martynova
TOPICALITY: The fast track technology means a complex of targeted measures involving rational preoperative preparation, minimally invasive surgery, regional anesthesia and short-acting anesthetics, and early postoperative rehabilitation. Elucidating the possibility of applying the fast track technology in neurosurgery, in particular in spinal surgery, is extremely topical. This is associated with the epidemiological data and the fact that minimally invasive techniques used in neurosurgery are highly expensive...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Zvonimir Krajcer, Venkatesh G Ramaiah, Meredith Huetter, Larry E Miller
OBJECTIVE: To assess the feasibility, safety, and clinical utility of a fast-track endovascular aneurysm repair (EVAR) protocol. BACKGROUND: Despite recent advances in EVAR technology and techniques, considerable opportunity exists to further improve EVAR efficiency and outcomes. METHODS: Eligible patients underwent elective EVAR with the Ovation Prime stent graft. Successful completion of the fast-track protocol required bilateral percutaneous access, avoidance of general anesthesia and intensive care unit admission, and next-day discharge...
July 12, 2016: Catheterization and Cardiovascular Interventions
Ramón Eizaga Rebollar, María V García Palacios, Javier Morales Guerrero, Luis M Torres Morera
We report the case of a 17-month-old child who underwent laparotomy under general anesthesia and caudal block. Electrocardiogram ST-T changes were observed after local anesthetic injection. The prompt use of Intralipid 30% was successful in normalizing ECG alterations. Our experience is consistent with previous literature, mainly carried out in adults. Thereby, we conduct a brief review of the subject in pediatrics. As a major conclusion, we strongly recommend the "fast-track" lipid rescue as soon as this severe complication is detected...
August 2016: Journal of Clinical Anesthesia
Basavana Goudra, Preet Mohinder Singh, Gowri Gouda, Ashish C Sinha
BACKGROUND: Peroral endoscopic myotomy (POEM) is a novel method of treating achalasia of the esophagus. Very little data are available to guide the anesthesia providers caring for these patients. The anesthetic challenges are primarily related to the risk of pulmonary aspiration. There is also a potential risk of pneumomediastinum, pneumoperitoneum, subcutaneous, or submucosal emphysema, as a result of carbon dioxide tracking into the soft tissues surrounding the esophagus and lower esophageal sphincter...
May 2016: Anesthesia, Essays and Researches
Paulo Sérgio da Silva, Márcio Portugal Trindade Cartacho, Casimiro Cardoso de Castro, Marcello Fonseca Salgado Filho, Antônio Carlos Aguiar Brandão
OBJECTIVE: To evaluate the influence of pulmonary hypertension in the ultra-fast-track anesthesia technique in adult cardiac surgery. METHODS: A retrospective study. They were included 40 patients divided into two groups: GI (without pulmonary hypertension) and GII (with pulmonary hypertension). Based on data obtained by transthoracic echocardiography. We considered as the absence of pulmonary hypertension: a pulmonary artery systolic pressure (sPAP) <36 mmHg, with tricuspid regurgitation velocity <2...
July 2015: Revista Brasileira de Cirurgia Cardiovascular
M Alyami, P Lundberg, G Passot, Olivier Glehen, E Cotte
BACKGROUND: Urinary retention following colorectal surgery is a known and costly morbidity. Increasing effort is being made to streamline patient recovery following colon resection, though the ideal timing and duration of urinary catheterization (UC) and its effect on urinary retention (UR) and urinary tract infection (UTI) remain controversial. METHODS: Our program prospectively enrolled patients undergoing elective segmental colon resection through our "fast track" protocol, in which UC is completely avoided unless required for fluid management or to facilitate dissection...
July 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Kianoush Saberi, Mehrdad Salehi, Mehrzad Rahmanian, Ali Reza Bakhshandeh, Mohammad Mahlabani
Facing a patient with acute intermittent porphyria (AIP), there is narrow safety margin which circumscribe all the therapeutic actions including choice of drugs. This would become even more complicated when it comes to a stressful and drug-dependent process like a cardiopulmonary bypass. According to author's researches, no specific AIP case of tricuspid valve (TV) replacement is reported recently. Furthermore, fast-track anesthesia was safely used in this 37-year-old male known the case of AIP, who was a candidate for TV replacement and removing the port catheter...
April 2016: Annals of Cardiac Anaesthesia
Nuria Martín, Ricard Valero, Paola Hurtado, Isabel Gracia, Carla Fernández, Jordi Rumià, Francesc Valldeoriola, Enrique J Carrero, Francisco Javier Tercero, Nicolás de Riva, Neus Fàbregas
BACKGROUND: A 24-h-stay in the post-anesthesia care unit (PACU) is a common postoperative procedure after deep brain stimulation surgery (DBS). OBJECTIVE: We evaluated the impact of a fast-track (FT) postoperative care protocol. METHODS: An analysis was performed on all patients who underwent DBS in 2 periods: 2006, overnight monitored care (OMC group), and 2007-2013, FT care (FT group). RESULTS: The study included 19 patients in OMC and 95 patients in FT...
March 19, 2016: Neurocirugía
I I Zatevakhin, I N Pasechnik, R R Gubaidullin, E A Reshetnikov, M N Berezenko
AIM: To discuss the main aspects of multimodal method of accelerated postoperative rehabilitation (fast track surgery). MATERIAL AND METHODS: The program of accelerated rehabilitation consists of minimization of surgical treatment's stressful influence on patient's organism in all stages of perioperative period. The method implies use of efficient preoperative management, minimally invasive operations, regional anesthesia and short-acting anesthetics, early postoperative rehabilitation...
2015: Khirurgiia
Maxim Roy, Nathalie Morissette, Martin Girard, Nicholas Robillard, Pierre Beaulieu
PURPOSE: We report a case of awake paralysis due to residual neuromuscular blockade (NMB) in the intensive care unit (ICU) in a patient following fast-track cardiac surgery. As a result of this case, we performed a prospective quality assurance audit to investigate the incidence of residual paralysis in the ICU in a similar population of cardiac surgery patients. CLINICAL FEATURES AND AUDIT METHODS: A 73-yr-old woman (69 kg) underwent coronary artery bypass surgery under anesthesia induced with intravenous sufentanil 25 µg, midazolam 5 mg, ketamine 25 mg, and rocuronium 100 mg (followed by two additional 50-mg doses during surgery) and maintained with sevoflurane...
June 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Henrik Kehlet, Eske Kvanner Aasvang
Regional anesthesia for knee and hip arthroplasty may have favorable outcome effects compared with general anesthesia by effectively blocking afferent input, providing initial postoperative analgesia, reducing endocrine metabolic responses, and providing sympathetic blockade with reduced bleeding and less risk of thromboembolic complications but with undesirable effects on lower limb motor and urinary bladder function. Old randomized studies supported the use of regional anesthesia with fewer postoperative pulmonary and thromboembolic complications, and this has been supported by recent large non-randomized epidemiological database cohort studies...
2015: F1000Research
Moataz Salah, Hisham Hosny, Maged Salah, Hoda Saad
INTRODUCTION: Ultra-fast track anaesthesia aims at immediate extubation of cardiac surgical patients at the end of the operation. This study compares the effect of ultrafast track anesthesia versus continued postoperative mechanical ventilation on the intensive care unit length of stay. METHODS: Fifty-two elective adult patients were randomly allocated into ultrafast track anaesthesia and conventional groups by computer-generated random numbers. Redo operations, pre-operative intubation, uncontrolled diabetes, shock/left ventricular ejection fraction < 45%, pulmonary artery systolic pressure >55mmHg, creatinine clearance -1, haemodynamic instability, or those with concerns of postoperative bleeding were excluded...
2015: Heart, Lung and Vessels
J Ripollés-Melchor, R Casans-Francés, A Abad-Gurumeta, A Suárez-de-la-Rica, J M Ramírez-Rodríguez, F López-Timoneda, J M Calvo-Vecino
INTRODUCTION: The aim of this study was to determine the interest in ERAS protocols, and the extent to which clinicians are familiar with and apply these protocols during perioperative care. MATERIALS AND METHODS: Free access survey hosted on the Spanish Society of Anesthesiology and Critical Care; Spanish Association of Surgeons and Spanish Society of Enteral and Parenteral nutrition and ERAS Spain (GERM) websites conducted between September and December 2014. RESULTS: The survey was answered by 272 professionals (44...
August 2016: Revista Española de Anestesiología y Reanimación
I I Zatevakhin, I N Pasechnik, R R Gubaidullin, E A Reshetnikov, M N Berezenko
AIM: To discuss the main aspects of multimodal method of accelerated postoperative rehabilitation (fast track surgery). MATERIAL AND METHODS: The program of accelerated rehabilitation consists of minimization of surgical treatment's stressful influence on patient's organism in perioperative period. The method implies use of efficient preoperative management, minimally invasive operations, regional anesthesia and short-acting anesthetics, early postoperative rehabilitation...
2015: Khirurgiia
Zvonimir Krajcer, Venkatesh Ramaiah, Meredith Huetter
BACKGROUND: Considerable technological advancements have recently been made with endovascular stent grafts for the treatment of abdominal aortic aneurysm (AAA). However, there is opportunity to further improve the efficiency of endovascular aneurysm repair (EVAR), which may yield better patient outcomes and lower perioperative treatment costs. METHODS/DESIGN: The Least Invasive Fast-Track EVAR (LIFE) registry was developed to determine the clinical utility and cost effectiveness of the Ovation® Prime stent graft when used under least invasive conditions using a defined fast-track protocol...
2015: BMC Cardiovascular Disorders
Yang-nian Wei, Nian-feng Li, Xiao-yong Cai, Bang-yu Lu, Fei Huang, Shi-fa Mo, Hong-chang Zhang, Ming-dong Wang, Fa-sheng Wu
OBJECTIVE: To investigate the clinical effect of fast-track surgery combined with Chinese medicine treatment in devascularization operation for cirrhotic esophageal varices. METHODS: Seventy-two patients with cirrhotic esophageal varices were selected from January 2009 to June 2013, and randomly assigned to a conventional group and a fast-track group (fast-track surgery combined with Chinese medicine treatment) using a randomized digital table, 36 cases in each group...
October 2015: Chinese Journal of Integrative Medicine
Stephen Aniskevich, Sher-Lu Pai
Historically, patients undergoing liver transplantation were left intubated and extubated in the intensive care unit (ICU) after a period of recovery. Proponents of this practice argued that these patients were critically ill and need time to be properly optimized from a physiological and pain standpoint prior to extubation. Recently, there has been a growing movement toward early extubation in transplant centers worldwide. Initially fueled by research into early extubation following cardiac surgery, extubation in the operating room or soon after arrival to the ICU, has been shown to be safe with proper patient selection...
September 18, 2015: World Journal of Hepatology
Chirojit Mukherjee, David Holzhey, Meinhard Mende, Axel Linke, Udo X Kaisers, Joerg Ender
OBJECTIVE: The purpose of the study was to report the anesthetic management and immediate procedural success in the initial 20 patients undergoing percutaneous transapical mitral valve replacement. DESIGN: Retrospective review of collected data. SETTING: University-affiliated heart center. PARTICIPANTS: Twenty patients with mitral regurgitation or stenosis due to a degenerated valve or ring in the mitral position. INTERVENTIONS: TEE-guided transapical mitral valve replacement under general anesthesia and early extubation by means of an established fast-track protocol...
August 2015: Journal of Cardiothoracic and Vascular Anesthesia
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