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Preoperative NOT Anesthesia

Xizhong Zhu, Liu Yang, Xiaojun Duan
Symptomatic cystic lesions of the talus are rare. The traditional operations usually do not provide visualization to reveal the deep structure of the lesion and could cause cartilage damage or other severe traumatic injury. We report an operative technique to reach the cystic lesion without talar cartilage damage, remove the lesion, and fill defect with a bone graft assisted by anterior arthroscopy and evaluate its safety and reliability for future study. Seven cases of talar bone cyst were included. The patients were placed in the supine position after anesthesia induction and noninvasive ankle traction was applied...
October 9, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Miles Berger, Katie J Schenning, Charles H Brown, Stacie G Deiner, Robert A Whittington, Roderic G Eckenhoff, Martin S Angst, Sinziana Avramescu, Alex Bekker, Marek Brzezinski, Greg Crosby, Deborah J Culley, Maryellen Eckenhoff, Lars I Eriksson, Lis Evered, Jim Ibinson, Richard P Kline, Andy Kofke, Daqing Ma, Joseph P Mathew, Mervyn Maze, Beverley A Orser, Catherine C Price, David A Scott, Brendan Silbert, Diansan Su, Niccolo Terrando, Dian-Shi Wang, Huafeng Wei, Zhoncong Xie, Zhiyi Zuo
As part of the American Society of Anesthesiology Brain Health Initiative goal of improving perioperative brain health for older patients, over 30 experts met at the fifth International Perioperative Neurotoxicity Workshop in San Francisco, CA, in May 2016, to discuss best practices for optimizing perioperative brain health in older adults (ie, >65 years of age). The objective of this workshop was to discuss and develop consensus solutions to improve patient management and outcomes and to discuss what older adults should be told (and by whom) about postoperative brain health risks...
October 9, 2018: Anesthesia and Analgesia
Gregory D Schroeder, Alan S Hilibrand, Christopher K Kepler, James C McKenzie, Kristen J Nicholson, Christie Stawicki, Jonathan Paul, Priyanka Kumar, Douglas A Hollern, Hamadi Murphy, Paul W Milhouse, Mark F Kurd, Barret I Woods, Kris E Radcliff, David G Anderson, Alexander R Vaccaro, Jeffery A Rihn
STUDY DESIGN: This is a prospective case series. OBJECTIVE: To determine the actual cost of performing 1- or 2-level anterior cervical discectomy and fusion (ACDF) using actual patient data and the time-driven activity-based cost methodology. SUMMARY OF BACKGROUND DATA: As health care shifts to use value-based reimbursement, it is imperative to determine the true cost of surgical procedures. Time-driven activity-based costing determines the cost of care by determining the actual resources used in each step of the care cycle...
October 9, 2018: Clinical Spine Surgery
H Vogel, W Schaaf, M Jacob
BACKGROUND: Video-assisted patient education (VaPE) has in the past been a subject of many studies. Compared to conventional methods, most authors reported a better transfer of information, some found increased patient satisfaction and a time-sparing effect. There was no increase in anxiety caused by VaPE. Some authors even found a reduction of anxiety levels before anesthesia. All publications to date have focused on the patient's point of view. There have been no reports on how anesthetists as users assess VaPE...
October 9, 2018: Der Anaesthesist
Zhi Cheng, Qian-Qian Yang, Pin Zhu, Ji-Ying Feng, Xiao-Bao Zhang, Zhi-Bin Zhao
OBJECTIVES: Preoperative fasting, water deprivation, and intraoperative fluid loss and redistribution result in hypovolemia in patients undergoing surgery. Some findings have indicated that the superior vena cava (SVC) diameter and variation, as determined by transesophageal echocardiography during surgery, do not reflect central venous pressure effectively. This study aimed to compare and correlate the SVC diameter and variation with the stroke volume variation for predicting fluid responsiveness in patients undergoing invasive positive pressure ventilation...
October 8, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Pradhnya Sen, Chintan Shah, Alok Sen, Elesh Jain, Amit Mohan
PURPOSE: To compare the visual and refractive outcomes and complications of primary and secondary intraocular lens (IOL) implantation after open-globe injury in pediatric patients. SETTING: Sadguru Netra Chikitsalaya, Madhya Pradesh, India. DESIGN: Retrospective case series. METHODS: Patients had primary cataract extraction with IOL implantation with globe repair (Group A) or repair followed by secondary IOL implantation (Group B)...
October 5, 2018: Journal of Cataract and Refractive Surgery
Reto Stump, Ivo Dobrev, Niklaus Krayenbühl, Rudolf Probst, Christof Röösli
BACKGROUND: Bone conduction (BC) is an alternative to air conduction (AC) for stimulation of the inner ear. Stimulation for BC can occur directly on the skull bone, on the skin covering the skull bone, or on soft tissue (i.e., eye, dura). All of these stimuli can elicit otoacoustic emissions (OAE). This study aims to compare OAEs generated by different combinations of stimuli in live humans, including direct stimulation of the intracranial contents via the dura, measured intraoperatively...
September 28, 2018: Hearing Research
Ryota Watanabe, Beatriz P Monteiro, Marina C Evangelista, Amélie Castonguay, Daniel Edge, Paulo V Steagall
BACKGROUND: Buprenorphine is a potent lipophilic opioid analgesic that is largely used in the multimodal treatment of acute pain. Simbadol (buprenorphine hydrochloride) is the first and only FDA-approved high-concentration formulation of buprenorphine for use in cats. The aim of this study was to evaluate the analgesic efficacy of carprofen in combination with one of two commercial formulations of buprenorphine (Simbadol and Vetergesic, 1.8 mg/mL and 0.3 mg/mL, respectively) in dogs undergoing ovariohysterectomy...
October 5, 2018: BMC Veterinary Research
Debbie Chi, Edward R Mariano, Stavros G Memtsoudis, Laurence C Baker, Eric C Sun
BACKGROUND: Total knee arthroplasty is a commonly performed procedure and an important contributor to national health care spending. Reducing the incidence of readmission could have important consequences for patient well-being and relevant financial implications. Whether regional anesthesia techniques are associated with decreased readmission rates and costs among privately insured patients remains unknown. METHODS: Using administrative claims data, we identified 138,362 privately insured patients 18-64 years of age who underwent total knee arthroplasty between 2002 and 2013...
October 3, 2018: Anesthesia and Analgesia
Soeren Wagner, Joerg Quente, Sven Staedtler, Katharina Koch, Tanja Richter-Schmidinger, Johannes Kornhuber, Harald Ihmsen, Juergen Schuettler
BACKGROUND: The obstructive sleep apnea syndrome (OSAS) is characterized by temporary cerebral hypoxia which can cause cognitive dysfunction. On the other hand, hypoxia induced neurocognitive deficits are detectable after general anesthesia. The objective of this study was to evaluate the impact of a high risk of OSAS on the postoperative cognitive dysfunction after intravenous anesthesia. METHODS: In this single center trial between June 2012 and June 2013 43 patients aged 55 to 80 years with an estimated hospital stay of at least 3 days undergoing surgery were enrolled...
October 2, 2018: BMC Anesthesiology
Yuichi Morita, Tomokazu Okimoto, Yasutsugu Nagamoto, Shingo Mochizuki, Kazunori Yamada
Transcatheter aortic valve implantation (TAVI) has evolved into a standard therapy for aged patients with severe aortic valve stenosis who are not candidates for surgery. However, the reports about the safety of TAVI for patients with dextrocardia situs inversus are few. An 84-year-old man with dextrocardia situs inversus underwent a TAVI for severe aortic stenosis (AS) with an aortic valve area of 0.5 cm2 , and a mean pressure gradient of 46 mmHg. Preoperative computed tomography (CT) revealed an inverted (rightward) orientation of the ventricle apex as well as the great vessels...
June 2018: Journal of Cardiology Cases
Yujiro Kawai, Yasuyuki Toyoda, Hikaru Kimura, Miki Horigome, Yasutoshi Tsuda, Takahiro Takemura
Aplastic anemia is a syndrome involving pancytopenia caused by bone marrow insufficiency. Pancytopenia increases the surgical risk of bleeding and infection. Here, we report a successful transcatheter aortic valve implantation (TAVI) in a patient with aplastic anemia. The patient was a 76-year-old woman who was admitted to our hospital with syncope. Laboratory testing showed pancytopenia, and echocardiography revealed severe aortic valve stenosis. Although the log.EuroSCORE and STS Score were not overly high, because of the presence of pancytopenia, surgical aortic valve replacement was considered too high risk, making her a candidate for TAVI...
December 2017: Journal of Cardiology Cases
Zyad J Carr, Brian Vells, Brendan R Wood, Joshua D Lowery, Ann M Rogers, Allen A Kunselman, Kunal Karamchandani, Sonia J Vaida
BACKGROUND: We theorized that modafinil, an atypical psychomotor stimulant, utilized to improve daytime somnolence in patients with obstructive sleep apnea, would improve functional recovery after general anesthesia by improving time to extubation, post-anesthesia care unit (PACU) length of stay and subjective recovery after general anesthesia. METHODS: A double blind, randomized, placebo-controlled pilot study was performed. 102 patients with the diagnosis of obstructive sleep apnea (OSA) were randomized to receive either 200 mg of modafinil or placebo before general anesthesia...
September 2018: Medicine (Baltimore)
Kai-Uwe Lewandrowski
Background: The objective of this study was to analyze readmission rates after outpatient transforaminal endoscopic decompression surgery for lumbar foraminal and lateral recess stenosis done in an ambulatory surgery center. Endoscopic lumbar spinal surgery is gaining popularity for the treatment of lumbar disc herniations. Recent advances in surgical techniques allow for percutaneous endoscopically assisted bony decompression for neurogenic claudication symptoms due to spinal stenosis...
June 2018: International Journal of Spine Surgery
Weiwei Jiang, Xiang Liu, Fengli Liu, Shungen Huang, Jie Yuan, Yingzuo Shi, Huan Chen, Jie Zhang, Changgui Lu, Wei Li, Qiming Geng, Xiaoqun Xu, Weibing Tang
BACKGROUND AND OBJECTIVES: Pre-operative oral carbohydrate administration (POCA) is an important aspect of enhanced recovery after surgery and has many advantages. The objective of this study was to explore the safety and effect of pre-operative oral carbohydrate administration in infants. METHODS AND STUDY DESIGN: This was a prospective, multi-center, randomized study that randomly assigned 1200 infants into four groups. In the control group (group A), the infants were strictly restricted to 6-h preoperative fasting before anesthesia...
2018: Asia Pacific Journal of Clinical Nutrition
Ali Konan, Mehmet Ruhi Onur, Mustafa Nasuh Özmen
PURPOSE: Anal fistula is an abnormal tract or cavity between the anal canal and perianal skin. Surgical treatment of anal fistulas requires the identification of the course of the primary and secondary tracts and their relation with the sphincter musculature in order to appropriately manage them and drain any abscess. Physical examination alone is not as accurate as imaging modalities in detecting these features of the fistula, and recurrences are usually due to missed or inadequately managed infective components...
September 28, 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Constance N Burke, Rebecca D'Agostino, Alan R Tait, Shobha Malviya, Terri Voepel-Lewis
PURPOSE: Determine whether preoperative oral acetaminophen increases gastric residual volume and lowers gastric pH. DESIGN: Prospective, randomized. METHODS: Healthy children, 1 to 14 years, having elective magnetic resonance imaging (MRI) were randomized to oral acetaminophen within 1 hour of induction versus fasting. Gastric volume and pH were measured immediately after intubation. Adverse events were documented from induction through 72 hours post MRI...
September 27, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Kai-Chieh Chan, Han-Tse Kuo, Valerie Wai-Yee Ho, Wen-Yu Chuang, Zung-Chung Chen
OBJECTIVE: Several surgical techniques and modifications have been described to reduce the high recurrence rate after excision of preauricular sinus (PAS). This study was designed to evaluate the surgical outcomes of PAS excision using a new modified supra-auricular approach (SAA) and to assess the predisposing factors for recurrence. METHODS: A total of 175 (158 patients) PAS excision procedures were performed from 2007 to 2016 in a single institute using this modified SAA with helix cartilage suture to obliterate the dead space...
November 2018: International Journal of Pediatric Otorhinolaryngology
Honorine Delivet, Delphine Beauvais, Adelaide Mialot, Thomas Vacher, Lucile Marsac, Christopher Brasher, Daphné Michelet, Souhayl Dahmani
BACKGROUND: Preventive strategies are available to reduce preoperative anxiety in children, the ideal time for implementing such strategies remains poorly determined. AIMS: The aim of this study was to determine psychological factors and events involved in the development of preoperative anxiety in children. METHODS: This study consisted of prospective evaluations of anxiety trait and state during the preoperative period. Attendance at a preanesthetic consultation is obligatory for all patients undergoing surgery in France...
September 24, 2018: Paediatric Anaesthesia
Kazuma Hashimoto, Ayano Tsuji, Shiho Takenaka, Akimune Ohmura, Ryusuke Ueki, Hideki Noma, Michiko Imamura, Yasuo Miyoshi, Nobutaka Kariya, Tsuneo Tatara, Munetaka Hirose
Background: C-reactive protein (CRP) is an acute phase reactant released in response to inflammation or tissue injury. Inflammation is one of the pathogenic factors related to transition from acute postsurgical pain (APSP) to chronic postsurgical pain (CPSP). Although several risk factors are reportedly associated with CPSP, the effects of CRP levels on CPSP have not been examined. Objectives: The present study investigated the relationship between perioperative risk factors, including CRP levels on postoperative day one and CPSP, in patients undergoing mastectomy...
August 2018: Anesthesiology and Pain Medicine
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