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Perioperative fluids

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https://www.readbyqxmd.com/read/28733043/perioperative-hypotension-and-discharge-outcomes-in-non-critically-injured-trauma-patients-a-single-centre-retrospective-cohort-study
#1
Nadav Sheffy, Itay Bentov, Brianna Mills, Bala G Nair, G Alec Rooke, Monica S Vavilala
BACKGROUND: There is a lack of information on the effect of age on perioperative care and outcomes after minor trauma in the elderly. We examined the association between perioperative hypotension and discharge outcome among non-critically injured adult patients. METHODS: We conducted a retrospective study of non-critically ill patients (ISS <9 or discharged within less than 24h) who received anaesthesia care for surgery and Recovery Room care at a level-1 trauma centre between 5/1/2012 and 11/30/2013...
June 24, 2017: Injury
https://www.readbyqxmd.com/read/28731875/management-of-complex-spine-surgery
#2
Massimo Lamperti, Boris Tufegdzic, Rafi Avitsian
PURPOSE OF REVIEW: The main objective of this article is to present the updated data regarding the perioperative management of patients undergoing major spine surgery in an era where the surgical techniques are changing and there is a high demand for these surgeries in older and high-risk patients. RECENT FINDINGS: Preoperative assessment and stabilization is now more structured protocol and it is based on a multidisciplinary approach to the patient. The Enhanced Recovery After Surgery (ERAS) programs and the Perioperative Surgical Home on major spine surgery are not yet fully evidence based but it seems that the use of a perioperative optimization of patients and use of a drugs' bundle is more effective than using single drugs or interventions on the postoperative pain reduction and faster recovery from surgery...
July 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28728273/-a-retrospective-study-of-the-perioperative-complications-following-whole-lung-lavage-in-the-treatment-of-pulmonary-alveolar-proteinosis
#3
Z Q Zhou, W L Guo, Y Chen, C H Zhong, S Y Li
Objective: To evaluate the safety of the procedures of whole lung lavage(WLL) for pulmonary alveolar proteinosis(PAP) in perioperative period. Methods: In this retrospective study, we collected clinical data from 78 WLL procedures of PAP patients from January 2006 to June 2016 in Guangzhou Institute of Respiratory Disease. The causes of perioperative complications were analyzed. Results: Eighteen (23.07%) of the 78 procedures developed complications, including pleural effusion(n=4), pneumonia(n=4), cardiac failure(n=2), cardiac arrhythmia (n=2), pneumothorax(n=2), atelectasis(n=1), lung edema(n=1), laryngeal edema(n=1), pleural effusion and pneumonia(n=1)...
July 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28719432/perioperative-fluid-management
#4
Brenton Alexander, Alexandre Joosten
No abstract text is available yet for this article.
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28718036/paravertebral-blocks-reduce-narcotic-use-without-affecting-perfusion-in-patients-undergoing-autologous-breast-reconstruction
#5
Elizabeth B Odom, Nili Mehta, Rajiv P Parikh, Ryan Guffey, Terence M Myckatyn
BACKGROUND: Autologous breast reconstruction offers excellent long term outcomes after mastectomy. However, maintaining adequate postoperative analgesia remains challenging. Use of paravertebral blocks (PVBs) reduces postoperative narcotic use and length of stay, and enhanced recovery protocols with mixed analgesia methods are gaining popularity, but few studies have explored the intraoperative effects of these interventions. METHODS: Patients who underwent abdominally based autologous breast reconstruction between 2010 and 2016 were compiled into a retrospective database...
July 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28710563/an-observational-study-examining-the-effects-of-a-surgically-induced-inflammatory-response-on-the-distribution-of-morphine-and-its-metabolites-into-cerebrospinal-fluid
#6
Yan Wang, Kerry B Goralski, Derek J Roberts, Kathryn Landry, Mark E Issa, Lekha Sleno, Lisa C Julien, Jeremy Wood, Richard I Hall
PURPOSE: Morphine is administered intravenously for pain management in the perioperative period. The effect of the inflammatory response to surgery on morphine distribution across the blood-brain barrier (BBB) in humans was investigated. We hypothesized that a graded surgically induced, systemic inflammatory response alters cerebrospinal fluid (CSF) levels of morphine, morphine-3-glucuronide (M3G), and morphine-6-glucuronide (M6G) through a temporary reduction in BBB drug efflux transporter function...
July 14, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28709476/erratum-to-perioperative-fluid-therapy-recommendations-for-major-abdominal-surgery-via-rica-recommendations-revisited-part-i-physiological-background-rev-esp-anestesiol-reanim-2017-64-6-328-338
#7
J Ripollés-Melchor, D Chappell, Á Espinosa, M G Mythen, A Abad-Gurumeta, S D Bergese, R Casans-Francés, J M Calvo-Vecino
No abstract text is available yet for this article.
August 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28693594/the-impact-of-phosphate-balanced-crystalloid-infusion-on-acid-base-homeostasis-palance-study-study-protocol-for-a-randomized-controlled-trial
#8
Judith-Irina Pagel, Nikolai Hulde, Tobias Kammerer, Michaela Schwarz, Daniel Chappell, Alexander Burges, Klaus Hofmann-Kiefer, Markus Rehm
BACKGROUND: This study aims to investigate the effects of a modified, balanced crystalloid including phosphate in a perioperative setting in order to maintain a stable electrolyte and acid-base homeostasis in the patient. METHODS/DESIGN: This is a single-centre, open-label, randomized controlled trial involving two parallel groups of female patients comparing a perioperative infusion regime with sodium glycerophosphate and Jonosteril® (treatment group) or Jonosteril® (comparator) alone...
July 10, 2017: Trials
https://www.readbyqxmd.com/read/28683817/the-effects-of-intravenous-lignocaine-on-depth-of-anaesthesia-and-intraoperative-haemodynamics-during-open-radical-prostatectomy
#9
Laurence Weinberg, Jae Jang, Clive Rachbuch, Chong Tan, Raymond Hu, Larry McNicol
BACKGROUND: Lignocaine is a local anaesthetic agent, which is also commonly used as a perioperative analgesic adjunct to accelerate rehabilitation and enhance recovery after surgery. Lignocaine's systemic effects on intraoperative haemodynamics and volatile anaesthetic requirements are not well explored. Therefore, we evaluated the effects of intravenous lignocaine on intraoperative volatile agent requirements and haemodynamics in patients undergoing major abdominal surgery. METHODS: We performed an analysis of 76 participants who underwent elective open radical retropubic prostatectomy...
July 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28682955/ringer-s-lactate-versus-normal-saline-in-urgent-cesarean-delivery-in-a-resource-limited-setting-a-pragmatic-clinical-trial
#10
Emmanuel Timarwa Ayebale, Arthur Kwizera, Cephas Mijumbi, Samuel Kizito, Anthony Michael Roche
BACKGROUND: Crystalloids are used routinely for perioperative fluid management in cesarean delivery. Few studies have determined the crystalloid of choice in obstetric anesthesia. We compared the effects of Ringer's lactate (RL) versus 0.9% normal saline (NS) on maternal and neonatal blood pH and 24-hour postoperative morbidity in urgent cesarean delivery in a low-resource setting. Our hypothesis was that RL would result in 30% less acidosis than NS. METHODS: This was a pragmatic prospective double-blind randomized controlled trial in the Mulago National Referral Hospital Labor Ward Theater from September 2011 to May 2012...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28678111/effectiveness-and-safety-of-batroxobin-tranexamic-acid-and-a-combination-in-reduction-of-blood-loss-in-lumbar-spinal-fusion-surgery
#11
Roopa Mn, Ajoy Prasad Shetty, Srikanth Reddy Dumpa, Balavenkat Subarmaniam, Rishi Mugesh Kanna, Rajasekeran Shanmuganathan
STUDY DESIGN: A prospective randomized double blind placebo controlled trail OBJECTIVE.: To evaluate and compare the efficacy and safety of Batroxobin (botropase),Tranexamic acid(TXA) and their combination in reduction of perioperative blood loss in lumbar spine single level fusion surgeries. SUMMARY OF BACKGROUND DATA: Spinal surgeries are associated with significant blood loss leading to perioperative anaemia and increased need for allogenic transfusion. TXA competitively inhibits plasmin and batroxobin converts fibrinogen to fibrin and theoretically their combination is synergistic ...
July 3, 2017: Spine
https://www.readbyqxmd.com/read/28673220/anaesthetic-management-of-patients-undergoing-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy-for-pseudomyxoma-peritonei-a-retrospective-audit
#12
S P Shiralkar, P Kerr, J Scott, P Sivalingam
Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to improve quality of life and survival rates in patients suffering from pseudomyxoma peritonei. The procedure is long and associated with significant intraoperative blood loss. As such, the anaesthetic management of patients undergoing this procedure can be challenging. The aim of this paper is to describe our perioperative management of pseudomyxoma peritonei patients who received CRS and to report a retrospective audit of our outcomes and complications over a six-year period at a large tertiary centre...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28671280/impact-of-obstructive-sleep-apnea-in-transsphenoidal-pituitary-surgery-an-analysis-of-inpatient-data
#13
Sei Y Chung, Michael J Sylvester, Varesh R Patel, Michael Zaki, Soly Baredes, James K Liu, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities...
July 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28660810/intravenous-fluid-and-electrolyte-administration-in-elective-gastrointestinal-surgery-mechanisms-of-excessive-therapy
#14
R G Simpson, J Quayle, N Stylianides, G Carlson, M Soop
INTRODUCTION While clinical guidelines stress the importance of the judicious perioperative intravenous fluid administration, data show that adherence to these protocols is poor. The reasons have not been identified. We therefore audited the magnitude and indications of fluid and electrolyte administration in a teaching hospital. We hypothesised that epidural analgesia is associated with excessive fluid therapy. MATERIALS AND METHODS Intravenous fluid and electrolyte administration during the day of surgery and the subsequent 2 days in consecutive patients undergoing elective gastrointestinal surgery between November 2013 and May 2014 were retrospectively audited...
July 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28650680/transurethral-resection-of-prostate-and-bleeding-a-prospective-randomized-double-blind-placebo-controlled-trial-to-see-the-efficacy-of-short-term-use-of-finasteride-and-dutasteride-on-operative-blood-loss-and-prostatic-microvessel-density
#15
Ankur Bansal, Aditi Arora
OBJECTIVE: The aim of this study was to determine the efficacy of short-duration use of finasteride and dutasteride before transurethral resection of the prostate (TURP) on intraoperative blood loss and microvessel density (MVD) of prostate stroma and suburethral tissues in benign prostatic hyperplasia (BPH). METHODS: This study includes 450 patients who were planned for TURP. They were prospectively randomized into three groups (150 patients each). Group 1 received placebo, group 2 received finasteride, 5 mg per day, and group 3 patients received dutasteride, 0...
June 26, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28648412/renal-outcome-after-radical-cystectomy-and-urinary-diversion-performed-with-restrictive-hydration-and-vasopressor-administration-in-the-frame-of-an-enhanced-recovery-program-a-follow-up-study-of-a-randomized-clinical-trial
#16
Fiona Mei Wen Wu, Fiona Burkhard, Filippo Turri, Marc Furrer, Lukas Loeffel, George Thalmann, Patrick Wuethrich
OBJECTIVE: To determine whether a restrictive perioperative fluid management in the context of an enhanced recovery after surgery program for radical cystectomy and urinary diversion affects renal function, as fluid restriction and the use of vasopressors have been linked to impaired tissue perfusion, potentially resulting in renal dysfunction. METHODS: We followed 166 patients initially included in a randomized clinical trial and equally allocated to receive a continuous norepinephrine administration combined with 1ml/kg/h initially, and after cystectomy 3ml/kg/h crystalloid infusion (intervention group, n = 83), or a standard crystalloid infusion of 6ml/kg/h throughout surgery (control group, n = 83)...
June 22, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28645586/venous-sinus-stenting-in-the-management-of-patients-with-intracranial-hypertension-manifesting-with-skull-base-cerebrospinal-fluid-leaks
#17
Rajiv R Iyer, David Solomon, Abhay Moghekar, C Rory Goodwin, Charles M Stewart, Masaru Ishii, Philippe Gailloud, Gary L Gallia
BACKGROUND: A subset of patients with skull base cerebrospinal fluid (CSF) leaks are found to have elevated intracranial pressure (ICP). In these patients, elevated ICP is thought to contribute to both the pathophysiology of the leak as well as postoperative leak recurrences. Current strategies for post-operative ICP control include medical therapy and shunting procedures. The aim of this study is to report the use of venous sinus stenting (VSS) in the management of patients with skull base CSF leaks due to elevated ICP...
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28643098/-importance-of-wound-irrigation-solutions-and-fluids-with-antiseptic-effects-in-therapy-and-prophylaxis-update-2017
#18
REVIEW
Christian Willy, Catharina Scheuermann-Poley, Marcus Stichling, Thomas von Stein, Axel Kramer
INTRODUCTION: Despite the use of modern antibiotics as well as complex perioperative, intraoperative and postoperative prophylactic measures, the rate of surgical site infections (SSI) could not be significantly reduced. The introduction of biocompatible antiseptic drugs with a high microbiocidal effect provided a successful alternative for infection prevention and therapy, particularly in a time of increasing occurrence of multi-drug resistant pathogens. Hence, questions about the risk-benefit ratio of antiseptic wound irrigation solutions, the prophylactic use of wound irrigation solutions for the reduction of SSI and the effect of negative pressure wound therapy combined with instillation (NPWTi) need to be answered...
July 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28625451/is-perioperative-administration-of-5-dextrose-effective-in-reducing-the-incidence-of-ponv-in-laparoscopic-cholecystectomy-a-randomized-control-trial
#19
Ankita Mishra, Ravinder Kumar Pandey, Ankur Sharma, Vanlalnghaka Darlong, Jyotsna Punj, Devalina Goswami, Renu Sinha, Vimi Rewari, Chandralekha Chandralekha, Virinder Kumar Bansal
STUDY OBJECTIVE: To compare the incidence of postoperative nausea and vomiting (PONV) during perioperative administration of 5% dextrose and normal saline in laparoscopic cholecystectomy. DESIGN: Prospective, randomized, double-blind trial. SETTING: Operating rooms in a tertiary care hospital of Northern India. PATIENTS: One hundred patients with American Society of Anesthesiologists status I to II undergoing laparoscopic cholecystectomy were enrolled in this study...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28620807/predictive-factors-of-maternal-hypothermia-during-cesarean-delivery-a-prospective-cohort-study
#20
François-Pierrick Desgranges, Lionel Bapteste, Céline Riffard, Marius Pop, Bérengère Cogniat, Anne-Charlotte Gagey, Pierre Boucher, Corinne Bonnard, Brigitte Paturel, Christine Mullet, Dominique Chassard, Lionel Bouvet
PURPOSE: Although perioperative hypothermia may increase maternal morbidity, active warming is infrequently performed to maintain normothermia during Cesarean delivery (CD). The aim of this prospective observational study was to determine the factors associated with maternal hypothermia in this setting. METHODS: Women scheduled for elective or emergency CD were consecutively included in this study from November 2014 to October 2015. Maternal temperature was measured using an infrared tympanic thermometer on the patient's arrival in the operating room, at skin incision, and at the end of skin suture...
June 15, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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