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Fasting And surgery

Caroline A Dufault
Perioperative nurses care for patients undergoing a wide range of surgical procedures. One fast-growing surgical specialty is spine surgery performed using minimally invasive techniques. Patients may be candidates for minimally invasive spine surgery based on their presenting signs and symptoms and medical imaging test results. Open anterior and posterior surgical approaches to spine surgery are how surgeons traditionally have performed these procedures. However, new technology has enabled a minimally invasive lateral approach to the spine...
August 2018: AORN Journal
Daniel Wood, Nicholas Lightfoot
AIM: Patients presenting for elective surgery frequently omit one or more regular medications. There is evidence that withholding some medication classes may lead to harm in the peri-operative period. We aim to quantify medication non-compliance in an adult, elective surgical population and identify the reasons for this non-compliance. METHOD: Data was collected over a four-week period at an elective surgical facility on adult patients presenting for surgery. Surgery and anaesthesia type, the names of regular medications and reasons for omission were recorded...
August 17, 2018: New Zealand Medical Journal
C H Pham, Z J Collier, A B Webb, W L Garner, T J Gillenwater
OBJECTIVE: "NPO at midnight" is a standard preoperative practice intended to reduce aspiration risk but can result in prolonged feeding interruptions in critically ill burn patients. Postoperative hyperalimentation in the form of a "catch-up" tube feeding protocol is routine. A retrospective review of our perioperative fasting practices and "catch-up" enteral feeding protocols was performed. METHODS: Patients admitted to the Burn ICU from July 1st, 2015 to August 31st, 2016 were reviewed...
August 13, 2018: Burns: Journal of the International Society for Burn Injuries
Mohammad Irfan Akhtar, Mona Momeni, Andrea Szekely, Mohammad Hamid, Mohamed R El Tahan, Steffen Rex
OBJECTIVE: To describe global practices for on-table extubation (OTE) in pediatric cardiac anesthesia in European and non-European countries. DESIGN: Multiple-choice, web-based survey with 34 questions addressing organizational data, existence of OTE programs, inclusion and exclusion criteria for OTE, and intraoperative and immediate postoperative management. SETTING: Online survey endorsed by the European Association of Cardiothoracic Anesthesiologists...
July 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
B A Tudor-Drobjewski, P Marhofer, O Kimberger, W D Huber, G Roth, L Triffterer
BACKGROUND: Preoperative fasting is a major cause of perioperative discomfort in paediatric anaesthesia and leads to postoperative insulin resistance, thus potentially enhancing the inflammatory response to surgery. Addressing these problems by preoperative carbohydrate intake has not been a well-defined approach in children. METHODS: We randomised 120 children scheduled for gastroscopy under general anaesthesia to either a control group of standard preoperative fasting or a study group receiving a carbohydrate beverage (PreOp™; Nutricia, Erlangen, Germany)...
September 2018: British Journal of Anaesthesia
A R Schmidt, K P Buehler, Ch Both, R Wiener, R Klaghofer, M Hersberger, M Weiss, A Schmitz
BACKGROUND: The paediatric preoperative fasting time of 2 h for clear fluids, as suggested by guidelines, is often exceeded. Shorter preoperative fasting has been proposed to avoid potential outcomes such as dehydration, ketoacidosis, reduced arterial blood pressure, and patient discomfort. The aim of this study was to investigate whether liberal clear fluid intake until premedication significantly reduces actual fasting time and impacts gastric pH and residual volume. METHODS: Children (1-16 yr old, ASA I or II) undergoing elective procedures with general anaesthesia requiring tracheal intubation were randomised for clear fluid intake until premedication with midazolam (liberal) or 2 h fluid fasting (standard)...
September 2018: British Journal of Anaesthesia
Guodong Zhao, Zizheng Wang, Minggen Hu, Sai Chou, Xin Ma, Xiangjun Lv, Zhiming Zhao, Yong Xu, Zhipeng Zhou, Rong Liu
BACKGROUNDS: Retroperitoneoscopic surgery has shown advantages in urological surgery. However, its application in pancreatic surgery for neoplasm is rare. Robotic surgical system with its magnified view and flexible instruments may provide a superior alternative to conventional laparoscopic system in retroperitoneoscopic surgery. We aimed to evaluate the safety, feasibility, and short-term outcomes in a series of patients treated by robotic retroperitoneoscopic pancreatic surgery. CASE PRESENTATION: Between March 2016 and May 2016, four patients with solitary pancreatic neuroendocrine neoplasms were treated with robotic retroperitoneoscopic surgery...
August 16, 2018: World Journal of Surgical Oncology
Antonia Dastamani, Maria Güemes, Catherine Pitfield, Kate Morgan, Mansoor Rajab, Christof Rottenburger, Jamshed Bomanji, Paolo De Coppi, Mehul Dattani, Pratik Shah
BACKGROUND: A long-acting somatostatin analogue (lanreotide) is used in the management of a diazoxide-unresponsive diffuse form of congenital hyperinsulinism (CHI). However, no reports of its use in patients with the focal form of CHI exist. Case 1: A 1-month-old boy diagnosed with diazoxide-unresponsive CHI due to a paternal heterozygous ABCC8 gene mutation showed partial response to octreotide. 18F-DOPA-PET/CT scan revealed a focal lesion in the pancreatic head. Surgical removal of the lesion was unsuccessful...
August 16, 2018: Hormone Research in Pædiatrics
Michael C Grant, Melinda M Gibbons, Clifford Y Ko, Elizabeth C Wick, Maxime Cannesson, Michael J Scott, Matthew D McEvoy, Adam B King, Christopher L Wu
Enhanced recovery after surgery protocols for bariatric surgery are increasingly being implemented, and reports suggest that they may be associated with superior outcomes, reduced length of hospital stay, and cost savings. The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery. We have conducted an evidence review to select anesthetic interventions that positively influence outcomes and facilitate recovery after bariatric surgery...
August 14, 2018: Anesthesia and Analgesia
Christos Liaskos, Chrysi Koliaki, Kleopatra Alexiadou, Georgia Argyrakopoulou, Nicholas Tentolouris, Theodoros Diamantis, Andreas Alexandrou, Nicholas Katsilambros, Alexander Kokkinos
PURPOSE: We aimed to compare the effects of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on postprandial glucose and lipid metabolism in addition to weight loss and fasting metabolic profile, in non-diabetic patients undergoing bariatric surgery. METHODS: Seventy-one patients were consecutively recruited and studied preoperatively, 3 and 6 months after surgery. Of these, 28 underwent RYGB (7 males, age 38 ± 9 years, BMI 46.9 ± 5.0 kg/m2 ), and 43 SG (9 males, age 38 ± 9 years, BMI 50...
August 15, 2018: Obesity Surgery
Haiwei Shi, Long Xiao, Zhifang Wang
Curative effect of artificial femoral head replacement on hip joint function and complications of elderly patients with femoral intertrochanteric fracture were investigated. Eighty patients who were operated for femoral intertrochanteric fractures operation were randomly divided into observation group (n=40) and control group (n=40). The observation group was treated with artificial femoral head replacement, while the control group received internal proximal femur locking plate fixation. In the observation group, the operation time was shorter than that in the control group (P<0...
August 2018: Experimental and Therapeutic Medicine
Nian-Cun Qiu, Wei Li, Miao-E Liu, Xiao-Xia Cen, Cheng-Xiang Shan, Wei Zhang, Qing Liu, Yang Wang, Ya-Ting Zhu, Ming Qiu
OBJECTIVE: The present study compared the therapeutic effects of great curvature plication with duodenal-jejunal bypass (GCP-DJB) and the commonly used sleeve gastrectomy (SG) in rats with type 2 diabetes mellitus (T2DM). METHODS: The rats were randomly divided into three groups: Control group (n = 6), SG group (n = 6), and GCP-DJB group (n = 6). Body weight, daily food intake, fasting blood glucose level, fasting insulin level, insulin resistance index, and fasting serum concentrations of glucagon-like peptide-1 (GLP-1), peptide tyrosine tyrosine (PYY), and bile acid were measured...
August 15, 2018: Obesity Surgery
Kang Min Kim, Jae Gun Kwak, Beatrice Chia-Hui Shin, Eung Re Kim, Ji-Hyun Lee, Eun Hee Kim, Jin Tae Kim, Woong-Han Kim
Background: Early extubation after cardiovascular surgery has some clinical advantages, including reduced hospitalization costs. Herein, we review the results of ultra-fast-track (UFT) extubation, which refers to extubation performed on the operating table just after the operation, or within 1-2 hours after surgery, in patients with congenital cardiac disease. Methods: We performed UFT extubation in patients (n=72) with a relatively simple congenital cardiac defect or who underwent a simple operation starting in September 2016...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Farshad Roghani-Dehkordi, Omid Hashemifard, Masoumeh Sadeghi, Rohollah Mansouri, Mehdi Akbarzadeh, Asieh Dehghani, Mojtaba Akbari
BACKGROUND: Trans-radial and trans-ulnar accesses have been practiced and recommended as default and alternative techniques for coronary angiography and angioplasty in recent years. In this study, we present new innovative approaches using more distal access points, i.e. trans-snuff box and trans-palmar approaches. METHODS: We conducted dorsal hand access (trans-snuff box) for angiography and/or angioplasty on 235 patients, and trans-palmar access (superficial palmar branch of ulnar artery) on 175 patients in 3 hospitals in Isfahan City, Iran...
March 2018: ARYA Atherosclerosis
Matthew L Carlson, James B Smadbeck, Michael J Link, Eric W Klee, George Vasmatzis, Lisa A Schimmenti
OBJECTIVES: 1) Describe the genetic alterations discovered in a series of sporadic vestibular schwannomas (VS). 2) Identify if more clinically aggressive variants possess different genetic alterations compared to more indolent-behaving VS. METHODS: Fresh frozen tumor and matched peripheral blood leukocytes from 23 individuals with sporadic VS were analyzed using whole-exome sequencing, tumor whole transcriptome expression profiling (mRNA-Seq), and tumor mate-pair analysis...
August 13, 2018: Otology & Neurotology
Eleni Rebelos, Heidi Immonen, Marco Bucci, Jarna C Hannukainen, Lauri Nummenmaa, Miikka-Juhani Honka, Minna Soinio, Paulina Salminen, Ele Ferrannini, Patricia Iozzo, Pirjo Nuutila
AIMS: We have previously shown that insulin enhances brain glucose uptake (BGU) in obese but not in lean subjects. The aim of this study was to investigate further this finding by combining BGU with measures of endogenous glucose production (EGP). Associations between insulin-stimulated BGU and peripheral markers such as metabolites and inflammatory markers were also explored. MATERIALS AND METHODS: Twenty morbidly obese and twelve lean controls were recruited from the larger randomized controlled SLEEVEPASS study...
August 10, 2018: Diabetes, Obesity & Metabolism
Davi da Silva Barbirato, Mariana Fampa Fogacci, Heloisa Gusman, Christina Maeda Takiya, Denise Pires de Carvalho, Carmelo Samsone
Among the systemic conditions that impact negatively on the planning and execution of surgical procedures, diabetes mellitus (DM) is the primary clinical condition responsible for complications. This study investigated bone formation in critical defects surgically filled with hydroxyapatite (HA) in diabetic rats. A descriptive, randomized sample and blinded analysis were conducted to test bone regeneration in critical bone defects surgically performed in rat calvaria. Twenty adult male Wistar rats were randomly divided into two groups: control, normoglycemic animals (CG); and test, streptozotocin-induced hyperglycemic animals (TG)...
April 19, 2018: Journal of Cranio-maxillo-facial Surgery
Raffaele Brustia, Antoine Monsel, Filomena Conti, Eric Savier, Geraldine Rousseau, Fabiano Perdigao, Denis Bernard, Daniel Eyraud, Yann Loncar, Olivier Langeron, Olivier Scatton
BACKGROUND: Enhanced Recovery After Surgery (ERAS) programmes after surgery are effective in reducing length of stay, functional recovery and complication rates in liver surgery (LS) with the indirect advantage of reducing hospitalisation costs. Preoperative comorbidities, challenging surgical procedures and complex post-operative management are the points that liver transplantation (LT) shares with LS. Nevertheless, there is little evidence regarding the feasibility and safety of ERAS programmes in LT...
August 9, 2018: World Journal of Surgery
Ayhan Kaydu, Erhan Gokcek
BACKGROUND Pulmonary aspiration of the gastric contents is a serious perioperative complication. The aim of this study was to evaluate the efficacy of portable ultrasonography in the preoperative evaluation of the gastric contents of patients. The secondary aim was to examine the relationship between gastric antrum cross-sectional area and age and body mass index (BMI). MATERIAL AND METHODS This single-center, prospective, cross-sectional study included 120 patients who underwent surgery. Measurements the gastric antral cross-sectional areas and quantitative and qualitative measurements of the stomach were taken by ultrasonography guidance in all patients...
August 9, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Berthold Moser, Christian Keller, Laurent Audigé, Mital H Dave, Heinz R Bruppacher
INTRODUCTION: Airway management in severely obese patients remains a challenging issue for anaesthetists and may lead to life-threatening situations. Supraglottic airway devices, such as the i-gel™ or the AuraGain™, were developed, with the possibility to ventilate the patient or use them as a conduit for endotracheal intubation. METHODS: In our randomized prospective trial, we hypothesized a 10 seconds faster fiberoptic trans-device intubation time through the AuraGain™ laryngeal mask compared to the i-gel™ laryngeal mask in severely obese patients...
August 8, 2018: Acta Anaesthesiologica Scandinavica
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