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Preoperative NOT Anesthesia

S Grau, C Denizci, N von Spreckelsen, R Goldbrunner, B W Böttiger, J Hinkelbein
Background and Aims: In contrast to propofol, volatile agents are often considered harmful to maintain anesthesia due to increasing brain volume and potential deleterious effects. Patients for cranioplasty, including patients with large bone defects, could be susceptible for intraoperative complications but have not properly been investigated so far. The aim of the present study was to evaluate brain swelling, intraoperative conditions, surgical course, and postoperative complication rates of propofol-based vs...
April 2018: Journal of Anaesthesiology, Clinical Pharmacology
Devon Flaherty, Sang Kim, Jeron Zerillo, Chang Park, Thomas Joseph, Bryan Hill, Hung-Mo Lin, Jiawen Li, Carlyle Hamsher, Menachem M Weiner, Samuel DeMaria
OBJECTIVES: The primary objective of this study was to determine whether liver transplantation recipients with preoperative prolonged corrected (QTc) intervals have a higher incidence of intraoperative cardiac events and/or postoperative mortality compared with their peers with normal QTc intervals. DESIGN: This was a retrospective cohort study. SETTING: Single academic hospital in New York, NY. PARTICIPANTS: Patients undergoing liver transplantation between 2007 and 2016...
July 21, 2018: Journal of Cardiothoracic and Vascular Anesthesia
David J Mathew, Rana A Greene, Yousaf Jamal Mahsood, Numan Hallaji, Ana Maria B Vargas, Ya-Ping Jin, Antonio Finelli, Matteo Parotto, Avner Belkin, Graham E Trope, Yvonne M Buys
PURPOSE: This study evaluated the effect of preoperative brimonidine tartrate 0.2% on intraocular pressure (IOP) during robotic-assisted laparoscopic radical prostatectomy (RALP) in steep Trendelenburg position (sTBURG). METHODS: In this prospective randomized controlled masked interventional trial, eligible patients scheduled for RALP in sTBURG at the Toronto General Hospital had one eye randomized to placebo (artificial tears) or drug (brimonidine tartrate 0.2%) preoperatively...
August 7, 2018: Journal of Glaucoma
Andreea Seicean, Prateek Kumar, Sinziana Seicean, Duncan Neuhauser, Robert J Weil
OBJECTIVE The goal of this study was to compare outcomes of carotid endarterectomy performed by neurological, general, and vascular surgeons. METHODS The authors identified 80,475 patients who underwent carotid endarterectomy between 2006 and 2015 in the National Surgical Quality Improvement Program, a prospectively collected, national clinical database with established reproducibility and validity. Nine hundred forty-three patients were operated on by a neurosurgeon; 75,649 by a vascular surgeon; and 3734 by a general surgeon...
August 10, 2018: Journal of Neurosurgery
Jost von Hardenberg, Niklas Westhoff, Daniel Baumunk, Daniel Hausmann, Thomas Martini, Alexander Marx, Stefan Porubsky, Martin Schostak, Maurice Stephan Michel, Manuel Ritter
OBJECTIVES: Magnetic resonance imaging/transrectal ultrasound (MRI/TRUS) fusion-guided focal high intensity focused ultrasound (HIFU) therapy of the prostate has recently been developed as a selective HIFU-therapy technique to enable targeted ablation of prostate cancer. Here we report a series of patients treated with focal HIFU therapy, discuss its potential pitfalls, and address controversies concerning the indications. MATERIALS AND METHODS: This single-center prospective study reports outcomes of patients treated from September 2014 to March 2016...
August 6, 2018: Urologic Oncology
Frederick E Sieber, Karin J Neufeld, Allan Gottschalk, George E Bigelow, Esther S Oh, Paul B Rosenberg, Simon C Mears, Kerry J Stewart, Jean-Pierre P Ouanes, Mahmood Jaberi, Erik A Hasenboehler, Tianjing Li, Nae-Yuh Wang
Importance: Postoperative delirium is the most common complication following major surgery in older patients. Intraoperative sedation levels are a possible modifiable risk factor for postoperative delirium. Objective: To determine whether limiting sedation levels during spinal anesthesia reduces incident delirium overall. Design, Setting, and Participants: This double-blind randomized clinical trial (A Strategy to Reduce the Incidence of Postoperative Delirum in Elderly Patients [STRIDE]) was conducted from November 18, 2011, to May 19, 2016, at a single academic medical center and included a consecutive sample of older patients (≥65 years) who were undergoing nonelective hip fracture repair with spinal anesthesia and propofol sedation...
August 8, 2018: JAMA Surgery
Gopalakrishnan C Nair, Misha J C Babu, Riju Menon, Pradeep Jacob
Introduction: Thyroidectomy is effective and safe procedure for permanent cure of hyperthyroidism (HT). Iodine preparations are widely used before operation to prevent excess blood loss. Ideal regimen for refractory HT is debated. This retrospective case-control study is designed to study the efficacy of various regimens of preoperative preparations. Materials and Methods: Case records, anesthesia charts, and follow-up details of hyperthyroid patients undergoing thyroidectomy were reviewed and compared with an age- and sex-matched euthyroid patients operated during the same period...
May 2018: Indian Journal of Endocrinology and Metabolism
Ying-Cheng Huang, Chien-Jen Hsu, Jenn-Huei Renn, Kai-Cheng Lin, Shan-Wei Yang, Yih-Wen Tarng, Wei-Ning Chang, Chun-Yu Chen
BACKGROUND: The wide-awake local anesthesia no tourniquet (WALANT) technique is applied during various hand surgeries. We investigated the perioperative variables and clinical outcomes of open reduction and internal fixation (ORIF) for distal radius fractures under WALANT. METHODS: From January 2015 to January 2017, 60 patients with distal radius fractures were treated, and 24 patients (40% of all) were treated with either a volar or a dorsal plate via WALANT procedure...
August 6, 2018: Journal of Orthopaedic Surgery and Research
Robert J Fleck, Sally R Shott, Mohamed Mahmoud, Stacey L Ishman, Raouf S Amin, Lane F Donnelly
Sleep-disordered breathing has a spectrum of severity that spans from snoring and partial airway collapse with increased upper airway resistance, to complete upper airway obstruction with obstructive sleep apnea during sleeping. While snoring occurs in up to 20% of children, obstructive sleep apnea affects approximately 1-5% of children. The obstruction that occurs in obstructive sleep apnea is the result of the airway collapsing during sleep, which causes arousal and impairs restful sleep. Adenotonsillectomy is the first-line treatment of obstructive sleep apnea and is usually effective in otherwise healthy nonsyndromic children...
August 2018: Pediatric Radiology
Brendan F Judy, Jordan W Swanson, Wuyang Yang, Phillip B Storm, Scott P Bartlett, Jesse A Taylor, Gregory G Heuer, Shih-Shan Lang
OBJECTIVE Evaluation of increased intracranial pressure (ICP) in the pediatric craniosynostosis population based solely on ophthalmological, clinical, and radiographic data is subjective, insensitive, and inconsistent. The aim of this study was to examine the intraoperative ICP before and after craniectomy in this patient population. METHODS The authors measured the ICP before and after craniectomy using a subdural ICP monitor in 45 children. They regulated end-tidal carbon dioxide and the monitoring site under general anesthesia to record consistent ICP readings...
August 3, 2018: Journal of Neurosurgery. Pediatrics
H Kafrouni, Joelle Saroufim, Myriam Abdel Massih
Background: Patients suffering from undiagnosed obstruction of the central airways: the trachea and main stem bronchi are at increased risk for perioperative and postoperative complications, especially if general anesthesia is performed. Case Description: This report discusses a 30-year-old asymptomatic Caucasian female who faced recurrent distal airway collapse during mediastinoscopy for biopsy of an anterior mediastinal mass, which led to the inability to extubate her...
2018: Case Reports in Medicine
M Shahnaz Hasan, Jin-Keat Tan, Chris Yin Wei Chan, Mun Keong Kwan, Fathil Syafiq Abdul Karim, Khean-Jin Goh
BACKGROUND: Drugs used in anesthesia can affect somatosensory evoked potential (SSEP) monitoring, which is used routinely for intraoperative monitoring of spinal cord integrity during spinal surgery. OBJECTIVE: The objective of this study was to determine whether combined total intravenous anesthesia (TIVA) technique with propofol/remifentanil is associated with less SSEP suppression when compared to combined volatile agent desflurane/remifentanil anesthesia during corrective scoliosis surgery at a comparable depth of anesthesia...
May 2018: Journal of Orthopaedic Surgery
Xitao Wang, Gengwen Huang, Dingcheng Shen, Jiayan Lin, Caihong Ning, Xintong Cao, Liandong Ji, Yebin Lu, Wei Wei
OBJECTIVE: To explore the appropriate operative strategy in recurrent groin hernia repair. METHODS: Clinical and follow-up data of 82 patients with recurrent groin hernia undergoing operation at Department of Pancreatobiliary Surgery, Xiangya Hospital of Central South University from April 2010 to April 2017 were analyzed retrospectively. The operative approaches included laparoscopic transabdominal preperitoneal (TAPP) hernia repair, Lichtenstein repair and hybrid repair...
July 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Maria J Susano, Liliana Vasconcelos, Tiago Lemos, Pedro Amorim, Fernando J Abelha
BACKGROUND AND OBJECTIVES: Postoperative delirium and postoperative cognitive dysfunction are some of the most common complications in older surgical patients and are associated with adverse outcomes. The aim of this study was to evaluate portuguese anesthesiologists' perspectives and knowledge about adverse postoperative cognitive disorders, and routine clinical practice when caring for older surgical patients. METHODS: We used a prospective online survey with questions using a Likert scale from 1 to 5 (completely disagree to completely agree), or yes/no/don't know answer types...
July 24, 2018: Revista Brasileira de Anestesiologia
Ozgur Senturk
Introduction Tranexamic acid (TA) has been used successfully in primary total knee arthroplasty (TKA) to minimize blood loss and transfusions. The aim of this study was to evaluate the effect of perioperative single low-dose TA administration on postoperative blood loss and necessity for blood transfusion in patients undergoing total knee arthroplasty under spinal anesthesia. Material and Methods Data of patients undergoing TKA between January 2013 through December 2015 were retrospectively reviewed. Patients that underwent unilateral knee arthroplasty under spinal anesthesia were separated into two groups: those where TA was used (10 mg/kg) and a control group where TA was not used...
May 17, 2018: Curēus
Raymond Sroka, Emmanuel M Gabriel, Danna Al-Hadidi, Steven J Nurkin, Richard D Urman, Timothy D Quinn
The objective of this retrospective analysis was to describe the development and implementation of an anesthesiologist-led multidisciplinary committee to evaluate high-risk surgical patients in order to improve surgical appropriateness. The study was conducted in an anesthesia preoperative evaluation clinic at an academic comprehensive cancer center. One hundred sixty-seven high-risk surgical patients with cancer-related diagnoses were evaluated and discussed at a High-Risk Committee (HRC) meeting to determine surgical appropriateness and optimize perioperative care...
July 23, 2018: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
Rachel Joffe, Mohammed Al Aklabi, Sudeshna Bhattacharya, Dominic Cave, Thomas Calleja, Daniel Garros, Nicholas Majesic, Lindsay Ryerson, Catherine Morgan
OBJECTIVES: Cardiac surgery-associated acute kidney injury is common in children and associates with negative outcomes. Novel interventions to reduce cardiac surgery-associated acute kidney injury require knowledge of its pathophysiology. States of altered perfusion, oxygen delivery, and energy consumption occur during cardiopulmonary bypass and could protect against or contribute to renal cellular injury and recovery. Near-infrared spectroscopy is noninvasive technology for monitoring regional blood flow and tissue oxygenation...
July 19, 2018: Pediatric Critical Care Medicine
Arianna F Yanes, Alexandra Weil, Karina C Furlan, Emily Poon, Murad Alam
Importance: Patients undergoing skin surgery under local anesthesia can experience anxiety. Adjuvant intraoperative anxiety reduction methods may help. Objectives: To assess whether hand-holding or holding a stress ball reduces patient anxiety during excisional surgery of head or neck skin cancer with the patient under local anesthesia and to measure pain and patient satisfaction. Design, Setting, and Participants: In this nonblinded, single-center randomized clinical trial, performed from January 24 through April 26, 2017, at a dermatology outpatient service in an urban, academic medical center, a consecutive sample of 135 adults who required excisional removal of nonmelanoma skin cancer of the head or neck was randomized and studied...
July 18, 2018: JAMA Dermatology
Cheryl H T Chow, Stephanie Wan, Eliza Pope, Zhen Meng, Louis A Schmidt, Norman Buckley, Ryan J Van Lieshout
OBJECTIVE: To systematically review and meta-analyze studies assessing the effectiveness of audiovisual (AV) interventions aimed at reducing anxiety in parents whose children are undergoing elective surgery. METHODS: A comprehensive search of multiple electronic databases was performed. A narrative synthesis of findings and random-effects meta-analyses were used to summarize the results. Our primary outcome was parental anxiety. Secondary outcomes included children's preoperative anxiety and postoperative outcomes; parental satisfaction, knowledge, and need for anesthesia information...
August 2018: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
Daniel C O'Brien, Yuti Desai, Robert T Swanson, Uma Parekh, Jane Schubart, Michele M Carr
OBJECTIVES: To investigate the relationships between preoperative sleep study findings of children undergoing adenotonsillectomy anesthesia emergence time, recovery room time, and length of stay. STUDY DESIGN: Retrospective case series with chart review. SETTING: Tertiary care children's hospital. SUBJECTS AND METHODS: All children aged 1-17 years who had undergone adenotonsillectomy between 2013 and 2016 were included...
July 6, 2018: American Journal of Otolaryngology
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