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Preoperative NOT Anesthesia

Marilaeta Cindryani, I Made Gede Widnyana, I Gusti Ngurah Mahaalit Aribawa, Tjokorda Ga Senapathi
Background: Anesthesia crisis management (ACM) simulation would expose anesthesiology residents and trainees to dynamic emergencies that need quick yet effective responses to gain their core strength and capabilities as anesthesiologists. Our department had already employed ACM simulation into modules and practiced in examinations. The aim is to enhance professional working ethics and human responsibility in residents, which would be accomplished in semi-realistic simulation. This would be a useful tool for lecturers to evaluate current teaching methods and measure protégés in daily emergencies, which should be done better in continuous pattern...
2018: Advances in Medical Education and Practice
Soudabeh Haddadi, Reyhaneh Shahrokhirad, Malek Moien Ansar, Shideh Marzban, Mitra Akbari, Arman Parvizi
Background: Retrobulbar block is one of the chosen methods for local anesthesia in cataract surgery. Since it is a painful procedure, using analgesic and sedative drugs is recommended. Current medications have side effects and evaluating of new drugs or new uses of existing safer drugs is necessary. Objectives: The aim of this study was to compare the administration of melatonin and acetaminophen on pain and hemodynamic changes during retrobulbar block. Methods: In a double-blinded randomized trial, 180 patients undergoing cataract surgery were randomly divided into three groups: Melatonin group (received melatonin 6 mg), acetaminophen group (received acetaminophen 500 mg), and control group (received placebo)...
October 2018: Anesthesiology and Pain Medicine
Ellen M Soffin, Melinda M Gibbons, Elizabeth C Wick, Stephen L Kates, Maxime Cannesson, Michael J Scott, Michael C Grant, Samantha S Ko, Christopher L Wu
Enhanced recovery after surgery (ERAS) protocols represent patient-centered, evidence-based, multidisciplinary care of the surgical patient. Although these patterns have been validated in numerous surgical specialities, ERAS has not been widely described for patients undergoing hip fracture (HFx) repair. As part of the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery, we have conducted a full evidence review of interventions that form the basis of the anesthesia components of the ERAS HFx pathway...
December 7, 2018: Anesthesia and Analgesia
Christopher W Liu, Anuj Bhatia, Arlene Buzon-Tan, Susan Walker, Dharini Ilangomaran, Jamal Kara, Lakshmikumar Venkatraghavan, Atul J Prabhu
BACKGROUND: The recreational and medical use of cannabinoids has been increasing. While most studies and reviews have focused on the role of cannabinoids in the management of acute pain, no study has examined the postoperative outcomes of surgical candidates who are on cannabinoids preoperatively. This retrospective cohort study examined the impact of preoperative cannabinoid use on postoperative pain scores and pain-related outcomes in patients undergoing major orthopedic surgery. METHODS: Outcomes of patients who had major orthopedic surgery at our hospital between April 1, 2015 and June 30, 2017 were reviewed...
December 7, 2018: Anesthesia and Analgesia
Petros Tzimas, Evangelia Samara, Anastasios Petrou, Anastasios Korompilias, Athanasios Chalkias, Georgios Papadopoulos
BACKGROUND: Hip fracture is common and morbid in elderly patients. Postoperative cognitive dysfunction (POCD) is also very common in these subjects undergoing surgery with an incidence which exceeds 40% in some reports. To date, the evidence is ambiguous as to whether anesthetic technique may affect the patients' outcome as far as postoperative cognitive function is concerned. OBJECTIVE: The aim of this study was to compare the effect of general and subarachnoid (spinal) anesthesia on the development of POCD up to 30 days after surgery in elderly patients undergoing hip fracture surgery...
December 2018: Injury
Mariano E Menendez, Sarah M Lawler, Jonathan Shaker, Nicole W Bassoff, Jon J P Warner, Andrew Jawa
BACKGROUND: As payment models shift toward a focus on value, an accurate understanding of surgical costs and preoperative correlates of high-cost patients is important for effective implementation of cost-saving strategies. This study used time-driven activity-based costing (TDABC) to explore inpatient cost of total shoulder arthroplasty (TSA) and to identify preoperative characteristics of high-cost patients. METHODS: Using TDABC, we calculated the cost of inpatient care for 415 patients undergoing elective primary TSA between 2016 and 2017...
December 5, 2018: Journal of Bone and Joint Surgery. American Volume
Ji-Hong Jiang, Chun-Zhi Li, Chang-Ming Zhao, Rong-Ming Xu
OBJECTIVE: To explore the clinical effect of percutaneous transforaminal endoscopic discectomy via lateral position assisted with local anesthesia for lumbar disc herniation in elder with systemic diseases. METHODS: The clinical data of 44 elder patients with lumbar disc herniation and systemic diseases treated from June 2013 to June 2017 were retrospectively analyzed. Including 26 males and 18 females, aged 70 to 86 years old with an average of(77.5±3.5) years, course of disease was 3 weeks to 6 months...
November 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Mara Buijs, Patricia J Zondervan, Daniel M de Bruin, Krijn P van Lienden, Axel Bex, Otto M van Delden
BACKGROUND: Irreversible electroporation (IRE) has the potential to overcome limitations of thermal ablation, enabling small renal mass (SRM) ablation near vital structures. PURPOSE: To assess feasibility and safety of percutaneous IRE for the treatment of SRMs. MATERIALS AND METHODS: This prospective study is a phase 2 trial (NCT02828709) of IRE for patients with SRMs. Primary endpoints are feasibility and safety. Device- and procedural-adverse events were assessed by Clavien-Dindo and Common Terminology Criteria for Adverse Events version 4...
November 30, 2018: Urologic Oncology
Guillaume Dewe, Arnaud Steyaert, Marc De Kock, Fernande Lois, Raymond Reding, Patrice Forget
OBJECTIVE: Living donor hepatectomy (LDH) has important consequences in terms of acute and chronic pain. We proposed an anesthetic protocol based on the best currently available evidence. We report the results of this protocol's application. RESULTS: We performed a retrospective descriptive study of 100 consecutive donors undergoing LDH. The protocol included standardized information provided by the anesthetist, pharmacological anxiolysis and preventive analgesia...
November 26, 2018: BMC Research Notes
Jasper Kees Wim Gerritsen, Lidia Arends, Markus Klimek, Clemens Maria Franciscus Dirven, Arnaud Jean-Pierre Edouard Vincent
BACKGROUND: Intraoperative stimulation mapping (ISM) using electrocortical mapping (awake craniotomy, AC) or evoked potentials has become a solid option for the resection of supratentorial low-grade gliomas in eloquent areas, but not as much for high-grade gliomas. This meta-analysis aims to determine whether the surgeon, when using ISM and AC, is able to achieve improved overall survival and decreased neurological morbidity in patients with high-grade glioma as compared to resection under general anesthesia (GA)...
November 21, 2018: Acta Neurochirurgica
Zhiwu Ji, Hao Tian, Jincai Shang, Wensi Liu, Min Zhong, Zhendong Chen
The effect of different doses of ulinastatin on cellular immunity and hepatorenal functions in patients undergoing laparoscopic colorectal-carcinoma surgery was observed and analyzed. The 200 patients with laparoscopic colorectal-carcinoma surgery in our hospital were selected as research subjects and divided into 4 groups containing equal patients, namely, saline group, 0.5 x 104U/kg ulinastatin group, 1 x 104U/kg ulinastatin group, and 1.5 x 104U/kg ulinastatin group, which were denoted as group A, group B, group C and group D, respectively...
September 2018: Pakistan Journal of Pharmaceutical Sciences
Alessandra Moretto, Maria Grazia Bosatra, Laura Marchesini, Simonetta Tesoro
BACKGROUND: Patients suffering from mucopolysaccharidosis are among the most complex from the anesthesiological point of view, especially regarding the management of the airway. The evidence base for anesthesia management is often limited to case reports and small case series. AIMS: To identify useful information about experience with each subtype of mucopolysaccharidosis reported in the literature and propose a guide on the best options for airway management to the anesthesiologists who take care of these patients...
November 16, 2018: Italian Journal of Pediatrics
Wei-Cheng Liu, Yan-Ping Zhan, Xiu-Hong Wang, Ben-Chao Hou, Jian Huang, Shi-Biao Chen
BACKGROUND: Both selective digestive decontamination (SDD) and probiotics have been reported to reduce endotoxemia. However, the available results are conflicting and few studies have investigated the combined effect of SDD and probiotics. This study aimed to examine the effectiveness of a comprehensive preoperative regimen of SDD in combination with probiotics and smectite on perioperative endotoxemia and cytokine activation in patients who underwent elective cardiac surgery with cardiopulmonary bypass (CPB) in a pilot, prospective, randomized, controlled trial...
November 2018: Medicine (Baltimore)
Taku Ukai, Goro Ebihara, Masahiko Watanabe
BACKGROUND: Postoperative nausea and vomiting (PONV) may lead to extended hospital stay due to severe discomfort and restriction of patient activity. We retrospectively studied PONV incidence following total hip arthroplasty (THA) to evaluate the effect of opioid administration via epidural catheter. METHODS: Our study included 155 affected joints in 136 patients who underwent a first THA from 2011 to 2016. For postoperative analgesia, an epidural catheter was preoperatively placed and used for continuous analgesic delivery into the epidural space up to 2 days after surgery...
November 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Nikolaos Patelis, Maria Diakomi, Anastasios Maskanakis, Konstantinos Maltezos, Dimitrios Schizas, Marianna Papaioannou
Anesthesia for carotid endarterectomy (CEA), general or locoregional, has been an issue of debate in literature ever since the first Cochrane review in 1991. The largest available study on the subject, the GALA trial, has not shown any difference in patient's outcome - incidence of stroke and 30-day-mortality postsurgery. However, increasing evidence favors regional anesthesia as an independent factor of reduced morbidity after CEA. The advantages and disadvantages of general versus regional anesthesia for CEA have been well established...
October 2018: Saudi Journal of Anaesthesia
Philipp Gude, Thomas Weber
The known guidelines before a planned operation on aspiration, fasting and preoperative risk evaluation also apply in obstetrics. Extended measures are only justified under concrete anamnestic or specific symptoms. Neuraxial anesthesia techniques should be offered to the mother as early as possible, as waiting for a certain opening of the cervix is not justified. Catheter procedures offer numerous advantages and are useful for possible emergency situations. Low-dose local anesthetic concentrations in combination with an opioid are still recommended...
October 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Marilia F Lemos, Sylvio V Lemos-Neto, Louis Barrucand, Nubia Verçosa, Eduardo Tibirica
BACKGROUND AND OBJECTIVES: Preoperative instruction is known to significantly reduce patient anxiety before surgery. The present study aimed to investigate the effects of preoperative education on the level of anxiety of cancer patients undergoing surgery using the self-reported Beck anxiety inventory. METHODS: This study is a short-term observational study, including 72 female patients with a diagnosis of endometrial cancer who were scheduled to undergo surgical treatment under general anesthesia...
November 3, 2018: Revista Brasileira de Anestesiologia
Wei Liu, Huangdong Hui, Yunhai Zhang, Weilong Lin, Yongqian Fan
Introduction: The objective was to evaluate the safety and efficacy of intra-articular injection of tranexamic acid (TXA) in patients between 80 and 100 years of age with femoral neck fracture undergoing hip hemi-arthroplasty (HA). Material and Methods: We conducted a retrospective review to assess perioperative blood loss and transfusion rate after intra-articular injection of TXA during HA. This was a single-center, retrospective, single-surgeon, and standard care cohort study covering the period between January and December 2016...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Suresh Bishokarma, Shikher Shrestha, Munu Napit, Dinesh Nath Gongal
INTRODUCTION: Preoperative diagnosis of intracranial space occupying lesion based solely on clinical and neuroimaging evaluation may not be sufficient to institute treatment plan without histopathological certainty. Frame based stereotactic biopsy is a technique of retrieving biopsy specimen to determine the histopathology. The aim of this study is to assess the efficacy and accuracy of frame based technique. METHODS: This is a cross-sectional study conducted among 80 patients who underwent computed tomography guided frame based stereotactic biopsy during a period of 6 years...
July 2018: JNMA; Journal of the Nepal Medical Association
Konrad Johannes Stuermer, Stella Sanader, Heinz Dieter Kluenter, Karl-Bernd Hüttenbrink
OBJECTIVE: To examine if vestibular irritation after stapes surgery may be provoked by pressure changes across the tympanic membrane, which consecutively results in displacements of the ossicular chain and the piston prosthesis suspended to it. METHODS: In this prospective study 15 patients (13 female, 2 male) received unilateral stapes surgery (4 left, 11 right ear) with stapedotomy (n=14) or stapedectomy (n=1) at an academic tertiary referral center. Surgery was performed under local anesthesia via a transmeatal approach with a piston prosthesis 0...
October 29, 2018: Auris, Nasus, Larynx
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