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Intraoperative monitorering

Ryan J Hendrix, Aneel Damle, Chloe Williams, Ariana Harris, Spiro Spanakis, Donald H Lambert, Laura A Lambert
BACKGROUND: Recent data have demonstrated multiple benefits of intra- and postoperative fluid restriction in major abdominal surgery; however, data regarding the outcomes of fluid restriction in cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) are limited. This study evaluates the safety and short-term clinical outcomes of restricted intraoperative fluid therapy in CRS/HIPEC. METHODS: This was a single-institution, retrospective review of all CRS/HIPEC procedures performed at the University of Massachusetts Medical School between January 2009 and July 2017...
December 4, 2018: Annals of Surgical Oncology
Jagdeep Sharma, Ruchi Gupta, Anita Kumari, Lakshmi Mahajan, Jasveer Singh
Aim: There are limited data comparing levobupivacaine, ropivacaine, and bupivacaine in paediatric patients. So, this study was performed to evaluate the caudal effectiveness of all the three drugs in paediatric patients undergoing infraumbilical surgeries and associated complications with these drugs. Material and Methods: 90 patients of ASA grade I and II posted for elective infraumbilical surgeries were randomly divided into three groups of 30 each. A standardized anaesthetic protocol was used...
2018: Anesthesiology Research and Practice
Bon-Nyeo Koo, Min A Kwon, Sang-Hyun Kim, Jong Yeop Kim, Young-Jin Moon, Sun Young Park, Eun-Ho Lee, Min Suk Chae, Sung Uk Choi, Jeong-Hyun Choi, Jin-Young Hwang
Considering the functional role of red blood cells (RBC) in maintaining a proper supply of oxygen to the tissues, RBC transfusion can be a life-saving intervention in situations of severe bleeding or anemia. RBC transfusion is often inevitable to address intraoperative massive bleeding; it is a key component of safe perioperative patient management. Unlike general medical resources, packed RBCs (pRBCs) have limited availability because their supply relies entirely on voluntary donations. Besides, excessive utilization of pRBCs may aggravate prognosis or increase the risk of developing infectious diseases...
December 5, 2018: Korean Journal of Anesthesiology
Le Zhou, Gianlorenzo Dionigi, Alessandro Pontin, Antonella Pino, Ettore Caruso, Che-Wei Wu, Hui Sun, Ralph P Tufano, Hoon Yub Kim
We evaluate the role of intraoperative neuromonitoring (IONM) in thyroidectomy performed for Graves' disease (GD) with an emphasis on recurrent laryngeal nerve (RLN) management and completeness of resection. The study is a retrospective series comprising 55 thyroidectomy (control group) versus 82 procedures with intermittent IONM (I-IONM) and 72 by means of continuous IONM (C-IONM). In the control group the laryngeal nerves have been identified by visualization solely. In the I-IONM group both vagal nerve (VN) and RLN have been localized and monitored during thyroid resection...
March 2019: Journal of Clinical & Translational Endocrinology
Weiwei Zhang, Mujian Teng, Baochi Liu, Qiling Liu, Xin Liu, Yanhui Si, Lei Li
Objective: This study is aimed at examining the impact of repeated intraportal autologous bone marrow transfusion (ABMT) in patients with decompensated liver cirrhosis after splenectomy. Methods: A total of 25 patients with decompensated liver cirrhosis undergoing splenectomy were divided into ABMT and control groups. The portal vein was cannulated intraoperatively using Celsite Implantofix through the right gastroomental vein. Both groups were given a routine medical treatment...
2018: Gastroenterology Research and Practice
Susanne Koch, Claudia Spies
PURPOSE OF REVIEW: To summarize recent recommendations on intraoperative electroencephalogram (EEG) neuromonitoring in the elderly aimed at the prevention of postoperative delirium and long-term neurocognitive decline. We discuss recent perioperative EEG investigations relating to aging and cognitive dysfunction, and their implications on intraoperative EEG neuromonitoring in elderly patients. RECENT FINDINGS: The incidence of postoperative delirium in elderly can be reduced by monitoring depth of anesthesia, using an index number (0-100) derived from processed frontal EEG readings...
November 29, 2018: Current Opinion in Anaesthesiology
Sherif Assaad, Wolf B Kratzert, Albert C Perrino
PURPOSE OF REVIEW: Excessive accumulation of extravascular lung water (EVLW) resulting in pulmonary edema is the most feared complication following thoracic surgery and lung transplant. ICUs have long relied on chest radiography to monitor pulmonary status postoperatively but the increasing recognition of the limitations of bedside plain films has fueled development of newer technologies, which offer earlier detection, quantitative assessments, and can aide in preoperative screening of surgical candidates...
November 29, 2018: Current Opinion in Anaesthesiology
Eleanor McCabe-Lankford, Margarita Peterson, Bryce McCarthy, April J Brown, Brad Terry, Laura Galarza-Paez, Nicole Levi-Polyachenko
BACKGROUND: Reproduction of the perfusion used in therapy (hyperthermic intraperitoneal chemotherapy) procedures preclinically represents a valuable asset for investigating new therapeutic agents that may improve patient outcomes. This article provides technical descriptions of our execution of closed and open "coliseum" abdominal perfusion techniques in a mouse model of peritoneal carcinomatosis of colorectal cancer. MATERIALS AND METHODS: BALB/c mice presenting with disseminated colorectal cancer (CT26-luciferin cells) underwent 30-min perfusions mimicking either the closed perfusion or the coliseum perfusion technique...
January 2019: Journal of Surgical Research
(no author information available yet)
OBJECTIVEHemifacial spasm (HFS) is characterized by involuntary tonic and/or clonic contractions of facial nerve muscles. Fully endoscopic microvascular decompression (E-MVD) for HFS has not been widely adopted. This paper aims to illustrate the safety and efficacy of the fully endoscopic technique for HFS treatment.METHODSThe authors conducted a single-center retrospective study of 27 patients (28 separate E-MVD cases; 1 patient had bilateral E-MVD) diagnosed with HFS who underwent fully E-MVD from January 2013 to October 2016...
October 1, 2018: Journal of Neurosurgery
(no author information available yet)
OBJECTIVEThe purpose of this study was to evaluate the technical feasibility, accuracy, and relevance on surgical outcome of D-wave monitoring combined with somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) during resection of intradural extramedullary (IDEM) spinal tumors.METHODSClinical and intraoperative neurophysiological monitoring (IONM) data obtained in 108 consecutive patients who underwent surgery for IDEM tumors at the Institute for Scientific and Care Research "ASMN" of Reggio Emilia, Italy, were prospectively entered into a database and retrospectively analyzed...
November 1, 2018: Journal of Neurosurgery. Spine
Woo Hyung Lee, Chul-Kee Park, Hee-Pyoung Park, Sung-Min Kim, Byung-Mo Oh, Keewon Kim, Young-Doo Choi, Han Gil Seo
BACKGROUND: Dexmedetomidine (DEX) is used as an adjunct to total intravenous anesthesia. However, its effect on intraoperative neurophysiological monitoring (IOM) during brain tumor surgery remains controversial. The aim of this study was to explore the effect of DEX on IOM during brain tumor surgery. METHODS: Seventy eight consecutive patients (DEX group, n=40; control group, n=38), who underwent brain tumor surgery with IOM, were retrospectively reviewed. The outcomes included the predictability, laterality of alterations, and stimulation parameters of transcranial motor-evoked potentials (tcMEPs) and somatosensory-evoked potentials (SSEPs)...
November 26, 2018: World Neurosurgery
N U Farrukh Hameed, Bin Wu, Fangyuan Gong, Jie Zhang, Hong Chen, Jinsong Wu
Two techniques, the translongitudinal cerebral fissure and transfrontal cortical approach, can be employed to resect posterior cingulate gyrus tumors. We demonstrate the transcortical technique comprising of multimodal imaging guidance and awake brain mapping which enabled maximum safe resection of dominant cingulate gyrus glioma. The patient, a 49-yr-old female, came to clinic after experiencing headache for a month. Initial magnetic resonance imaging (MRI) scans revealed a nonenhancing lesion of the left posterior cingulate gyrus...
November 28, 2018: Operative Neurosurgery (Hagerstown, Md.)
Marla B Ferschl, John Feiner, Lan Vu, Devon Smith, Mark D Rollins
BACKGROUND: Minimally invasive fetal surgery is commonly performed to treat twin-to-twin transfusion syndrome with selective fetoscopic laser photocoagulation and twin-reversed arterial perfusion sequence using radiofrequency ablation. Although an increasing number of centers worldwide are performing these procedures, anesthetic management varies. Both neuraxial anesthesia and monitored anesthesia care with local anesthesia are used at different institutions. We sought to determine the efficacy and outcomes of these 2 anesthetic techniques for fetal procedures at our institution...
November 21, 2018: Anesthesia and Analgesia
Jan Coburger, Christian Rainer Wirtz
PURPOSE: Fluorescence guided surgery by 5-aminolevulinic acid (5-ALA) and intraoperative MRI (iMRI) are currently the most important intraoperative imaging techniques in high grade glioma (HGG) surgery. Few comparative studies exist for these techniques. This review aims to systematically compare 5-ALA and iMRI assisted surgery based on the current literature and discuss the potential impact of a combined use of both techniques. METHODS: A systematic literature search based on preferred reporting items for systematic reviews and meta-analysis was performed concerning accuracy of tumor detection; extent of resection; neurological deficits (ND); Quality of life (QoL); usability and combined use of both techniques...
November 28, 2018: Journal of Neuro-oncology
Luciano Mastronardi, Ettore Di Scipio, Guglielmo Cacciotti, Raffaelino Roperto, Carlo Giacobbo Scavo
BACKGROUND AND OBJECTIVE: Goals of small vestibular schwannoma (VS) microneurosurgery are as follows: radical resection, facial nerve (FN) preservation, and hearing preservation (HP). Microsurgical advances make HP possible in many patients with preoperative socially useful hearing (SUH). We evaluated postoperative HP in VS with maximum diameter < 2 cm monitored with two different auditory brainstem response (ABR) techniques. MATERIALS AND METHODS: Twenty-eight consecutive non-randomized patients with SUH suffering from small VS underwent keyhole microneurosurgery by retrosigmoid (RS) approach...
November 27, 2018: Acta Neurochirurgica
Marco Ranucci, Luigi Barile, Federico Ambrogi, Valeria Pistuddi
BACKGROUND: Hypotension during surgery is linked to postoperative complications. Recently, a new hemodynamic algorithm intended to predict hypotensive events (hypotension probability indicator, HPI) has been developed. The aim of the present study is to test the discrimination and calibration properties of the HPI. METHODS: The intraoperative files of 23 patients undergoing cardiac and major vascular surgery receiving the HPI-based hemodynamic monitoring were retrospectively investigated for prediction of hypotensive events (mean arterial pressure < 65 mmHg)...
November 22, 2018: Minerva Anestesiologica
Clemens Neudorfer, Stefan Hunsche, Martin Hellmich, Faycal El Majdoub, Mohammad Maarouf
BACKGROUND/AIMS: Technological advancements had a serious impact on the evolution of robotic systems in stereotactic neurosurgery over the last three decades and may turn robot-assisted stereotactic neurosurgery into a sophisticated alternative to purely mechanical guiding devices. OBJECTIVES: To compare robot-assisted and conventional frame-based deep brain stimulation (DBS) surgery with regard to accuracy, precision, reliability, duration of surgery, intraoperative imaging quality, safety and maintenance using a standardized setup...
November 27, 2018: Stereotactic and Functional Neurosurgery
Philipp Riss, Daniela Dunkler, Andreas Selberherr, Lindsay Brammen, Julian Heidtmann, Christian Scheuba
BACKGROUND: Most criteria require a parathyroid hormone (PTH) decline of ≥50% within 10 minutes after excision of the gland during surgery for primary hyperparathyroidism. The aim was to evaluate a model allowing earlier prediction of cure. METHODS: One thousand eighteen patients with primary hyperparathyroidism were included. A ≥50% decline from baseline within 10 minutes after excision intraoperatively predicted complete removal of hypersecreting tissue. The data were reanalyzed regarding a criterion, requiring a ≥50% decline after 5 minutes...
November 26, 2018: Head & Neck
S Terada, S Irikoma, A Yamashita, T Murakoshi
BACKGROUND: Epidural morphine is widely used for postoperative analgesia after cesarean delivery. However, respiratory depression can occur after neuraxial administration of morphine. Previous reports describing respiratory depression in obstetric patients have relied on intermittent visual counting of the respiratory rate. In this study, we estimated the incidence of respiratory depression in patients who had received epidural morphine after cesarean delivery, using a continuous respiratory rate monitoring system with a finger sensor...
October 26, 2018: International Journal of Obstetric Anesthesia
Toshihiro Onohara, Ryoichi Kyuragi, Kentaro Inoue, Shohei Yoshida, Takuya Matsumoto, Tadashi Furuyama
OBJECTIVES: Little is known about late-onset primary malignant neoplasms after repair of abdominal aortic aneurysms (AAAs), despite malignancy being one of the primary causes of late death. We investigated the incidence and prognostic factors related to the occurrence of malignancy after AAA repair. METHODS: We performed a retrospective analysis of 589 patients who underwent AAA repair, including 264 endovascular AAA repairs (EVAR) and 325 open surgical repairs (OSR); 482 patients had no history of previous malignancy or concomitant malignancy, 72 had previous malignancy, and 35 had concomitant malignancy in remission at the time of AAA repair...
November 23, 2018: Annals of Vascular Surgery
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