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Hypotension caused by general anesthesia

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https://www.readbyqxmd.com/read/29915988/effects-of-preoperative-oral-carbohydrates-on-quality-of-recovery-in-laparoscopic-cholecystectomy-a-randomized-double-blind-placebo-controlled-trial
#1
Jeong Soo Lee, Young Song, Ji Young Kim, Joon Seong Park, Dong Sup Yoon
BACKGROUND: While carbohydrate loading is an important component of enhanced patient recovery after surgery, no study has evaluated the effects of preoperative carbohydrate loading after laparoscopic cholecystectomy (LC) on patient satisfaction and overall recovery. Thus, we aimed to investigate the impact of preoperative oral carbohydrates on scores from the quality of recovery 40-item (QoR-40) questionnaire after LC. METHODS: A total of 153 adults who underwent LC were randomized into three groups...
June 18, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29902969/bispectral-index-to-guide-induction-of-anesthesia-a-randomized-controlled-study
#2
Dirk Rüsch, Christian Arndt, Leopold Eberhart, Scarlett Tappert, Dennis Nageldick, Hinnerk Wulf
BACKGROUND: It is unknown to what extent hypotension frequently observed following administration of propofol for induction of general anesthesia is caused by overdosing propofol. Unlike clinical signs, electroencephalon-based cerebral monitoring allows to detect and quantify an overdose of hypnotics. Therefore, we tested whether the use of an electroencephalon-based cerebral monitoring will cause less hypotension following induction with propofol. METHODS: Subjects were randomly assigned to a bispectral index (BIS)-guided (target range 40-60) or to a weight-related (2 mg...
June 15, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29776668/-fatal-cardiac-tamponade-that-developed-in-the-post-anesthesia-care-unit-a-rare-complication-after-lung-lobectomy
#3
Hyung Mook Lee, Young Jae Jeon, Hye Won Chung, Hyo Min Yun, Mi Hyun Kim
BACKGROUND AND OBJECTIVES: Cardiac tamponade is potentially fatal medical condition, which rarely occurs as a complication of lung lobectomy. We present the first case of cardiac tamponade to develop in a Post-Anesthesia Care Unit following a lung lobectomy. CASE REPORT: A 54-year-old man with pulmonary squamous cell carcinoma underwent an apparently uncomplicated lung lobectomy. His hemodynamics was unremarkable throughout the surgery and initially in the Post-Anesthesia Care Unit...
May 15, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29509526/recurrent-coronary-artery-spasm-induced-by-vasopressors-during-two-operations-in-the-same-patient-under-general-anesthesia
#4
Naotaka Kishimoto, Munenori Kato, Yasunori Nakanishi, Akari Hasegawa, Yoshihiro Momota
Variant angina is caused by coronary artery spasm (CAS) with ST-segment elevation. We herein report a case of recurrent CAS during 2 operations in the same patient. An 80-year-old woman was scheduled to undergo tracheostomy, submandibular dissection, left partial maxillectomy, and coronoidectomy. We administered ephedrine and phenylephrine to manage hypotension during general anesthesia. Immediately after the administration of these drugs, the ST segment elevated. We decided to cease the operation and transport the patient to the department of cardiology...
December 0: Anesthesia Progress
https://www.readbyqxmd.com/read/29457116/a-spinal-cord-infarction-that-occurred-after-laparoscopic-gastrectomy-performed-under-general-anesthesia-and-epidural-analgesia
#5
Kei Houri, Shinichi Hamasaki, Takatoshi Tsujimoto, Tomohisa Uchida, Tatsushige Iwamoto, Toru Shirai, Shinichi Nakao
Background: Spinal cord infarction (SCI) after epidural anesthesia is quite rare. Although most cases of perioperative SCI are associated with aortic, cardiac, or spinal surgery, and/or abnormal preoperative conditions, such as spinal stenosis or hypercoagulopathy, intraoperative events, such as severe hypotension or epidural puncture and catheterization, can be contributory factors. Case presentation: A 52-year-old male was underwent laparoscopic gastrectomy. Before induction of general anesthesia, an epidural catheter was placed without any problems...
2018: JA clinical reports
https://www.readbyqxmd.com/read/29372413/persistent-isoflurane-induced-hypotension-causes-hippocampal-neuronal-damage-in-a-rat-model-of-chronic-cerebral-hypoperfusion
#6
Tomohisa Yamamoto, Tatsushige Iwamoto, Seishi Kimura, Shinichi Nakao
BACKGROUND: Postoperative cognitive dysfunction (POCD) is likely to occur in elderly people, who often suffer from cerebral hypoperfusion and white matter lesions even in the absence of cerebral infarctions. METHODS: Thirty-two adult male rats were randomly assigned to one of four groups: the cerebral normoperfusion + normotension group (n = 8), cerebral normoperfusion + hypotension group (n = 8), chronic cerebral hypoperfusion (CCH) + normotension group (n = 8), and CCH + hypotension group (n = 8)...
April 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29295799/profound-prolonged-bradycardia-and-hypotension-after-interscalene-brachial-plexus-block-with-bupivacaine
#7
Mathew Nelson, Alexandra Reens, Lara Reda, David Lee
BACKGROUND: Interscalene brachial plexus blocks have been a routinely performed method of anesthesia for shoulder surgery that decreases the need for general anesthesia, length of stay, and recovery time. We describe a case of bupivacaine toxicity after an interscalene block. CASE REPORT: The patient was a 66-year-old man who presented to our Emergency Department by emergency medical services from an ambulatory surgery center where he had undergone rotator cuff surgery, with bradycardia and hypotension...
March 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29145824/observations-on-significant-hemodynamic-changes-caused-by-a-high-concentration-of-epidurally-administered-ropivacaine-correlation-and-prediction-study-of-stroke-volume-variation-and-central-venous-pressure-in-thoracic-epidural-anesthesia
#8
RANDOMIZED CONTROLLED TRIAL
Jeong-Min Hong, Hyeon Jeong Lee, Young-Jae Oh, Ah Rhem Cho, Hyae Jin Kim, Do-Won Lee, Wang-Seok Do, Jae-Young Kwon, Haekyu Kim
BACKGROUND: Thoracic epidural anesthesia (TEA) exacerbates hypotension due to peripheral vasodilator effects following the use of general anesthetics. This study aimed to compare the hemodynamic changes caused by three different concentrations of epidural ropivacaine and to evaluate the performance of the stroke-volume variation (SVV) and central venous pressure (CVP) during TEA with general anesthesia. METHODS: A total of 120 patients were administered 8 mL of ropivacaine solution via epidural injection, following randomization into one of three groups based on the concentration of ropivacaine in the study solution: 0...
November 16, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29031174/dynamic-right-ventricular-outflow-obstruction-a-rare-cause-of-hypotension-during-anestesia-induction
#9
Maria Enrica Antoniucci, Christian Colizzi, Gabriella Arlotta, Maria Calabrese, Michele Corrado, Sergio Guarneri, Lorenzo Martinelli, Andrea Scapigliati, Roberto Zamparelli, Franco Cavaliere
INTRODUCTION: Dynamic obstruction of right ventricle outflow tract (RVOTO) is a rare condition that may acutely cause severe heart failure. It has been reported in some hypertrophic cardiomyopathies, after lung transplantation, and in some cases of hemodynamic instability after cardiopulmonary bypass. PRESENTATION OF CASE: We report the case of a 71-year-old man who developed severe hypotension during the induction of general anesthesia for surgical coronary revascularization...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28757837/hypoxic-hepatitis-during-the-perioperative-period-in-patients-with-severe-pulmonary-disease-and-cor-pulmonale
#10
Hyuckgoo Kim, Sang-Jin Park, Deokhee Lee
Hypoxic hepatitis (HH) is characterized by marked and transient elevations in liver enzyme levels in the absence of other potential causes of liver injury. Although rare, it can occur in the presence of hemodynamic instability and hypoxemia in patients with cor pulmonale. We report two cases of perioperative HH in patients with severe pulmonary disease and cor pulmonale. The first case is of a patient with cor pulmonale who underwent hemiarthroplasty for a femur fracture. Transient hypotension developed during spinal anesthesia and severe hypoxemia were observed in the postoperative period...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28118795/the-perforation-of-the-superior-vena-cava-secondary-to-the-left-subclavian-dialysis-catheter
#11
Atila Turkyilmaz, Sami Karapolat, Mehmet Kilic, Celal Tekinbas
INTRODUCTION: The perforation of the superior vena cava during the placement of dialysis catheter and consequent hemothorax is a rare serious complication. CASE REPORT: Dialysis catheter was placed in the left subclavian vein in a 69-year-old male patient with chronic renal insufficiency who was hospitalized for intracerebral hematoma. During hemodialysis a day after the procedure, the patient was noted having right-sided hemothorax, causing lethargy, dyspnea, hypotension, and bradycardia...
February 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27787391/cardiac-arrest-in-a-patient-with-anterior-fascicular-block-after-administration-of-dexmedetomidine-with-spinal-anesthesia-a-case-report
#12
Baek Jin Kim, Bong Il Kim, Sung Hye Byun, Eugene Kim, Shin Yeung Sung, Jin Yong Jung
BACKGROUND: Dexmedetomidine is a sedative and analgesic agent that is administered intravenously as an adjunct to spinal anesthesia. It does not suppress the respiratory system significantly, but has adverse effects on the cardiovascular system, for example, bradycardia and hypotension. We here report a patient who underwent cardiac arrest during spinal anesthesia after intravenous infusion of dexmedetomidine. METHODS: A 57-year-old woman with no significant medical history underwent spinal anesthesia for arthroscopic meniscus resection after rupturing the right knee meniscus...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27610263/severe-hypotension-hypoxia-and-subcutaneous-erythema-induced-by-indigo-carmine-administration-during-open-prostatectomy
#13
Koichiro Nandate, Bryan B Voelzke
Indigo carmine (also known as 5,5'-indigodisulfonic acid sodium salt or indigotine) is a blue dye that is administered intravenously to examine the urinary tract and usually is biologically safe and inert. Indigo carmine rarely may cause adverse reactions. We treated a 66-year-old man who had general anesthesia and radical retropubic prostatectomy for prostate cancer. He had a previous history of allergy to bee sting with nausea, vomiting, and dizziness. Within 1 minute after injection of indigo carmine for evaluation of the ureters, the patient developed hypotension to 40 mmHg, severe hypoxia (the value of SpO2 (peripheral capillary oxygen saturation) was 75% on 40% inspired oxygen concentration), poor air movement and bilateral diffuse wheezing on auscultation, and marked subcutaneous erythema at the upper extremities...
2016: Case Reports in Urology
https://www.readbyqxmd.com/read/27598398/bispectral-index-monitoring-reduces-the-dosage-of-propofol-and-adverse-events-in-sedation-for-endobronchial-ultrasound
#14
RANDOMIZED CONTROLLED TRIAL
Natividad Quesada, Diego Júdez, Javier Martínez Ubieto, Ana Pascual, Enrique Chacón, Francisco De Pablo, Elisa Mincholé, Salvador Bello
BACKGROUND: Current guidelines recommend monitoring the anesthetic depth of sedation during respiratory endoscopy by using clinical scales despite their subjective nature and the potential change in the level of sedation caused by frequent stimulation. Monitoring by means of the bispectral index (BIS) has shown its utility in reducing the use of drugs and their adverse events in general anesthesia, but evidence in prolonged sedation is insufficient. OBJECTIVE: Our objective was to evaluate BIS in patients undergoing endobronchial ultrasound (EBUS)...
2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27327853/effects-of-carbon-dioxide-insufflation-during-direct-cholangioscopy-on-biliary-pressures-and-vital-parameters-a%C3%A2-pilot-study-in-porcine-models
#15
Saurabh Mukewar, Emmanuel C Gorospe, Mary A Knipschield, Juliane Bingener, Christopher Gostout
BACKGROUND AND AIMS: Direct per-oral cholangioscopy allows endoscopic visualization of the biliary tract. Insufflation with carbon dioxide (CO2) is an alternative to saline solution irrigation during direct cholangioscopy. There are no data on maximal CO2 insufflation in direct cholangioscopy without causing biliary barotrauma or fatal gas embolism. We aimed to evaluate the safety of increasing CO2 insufflation in direct cholangioscopy without causing biliary barotrauma or fatal gas embolism...
January 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27025125/-efficacy-and-safety-of-lung-recruitment-maneuver-in-patients-with-different-peripheral-chemoreflex-sensitivity
#16
N V Trembach, I B Zabolotskikh
BACKGROUND: The concept of open lungs, which includes a maintaining of positive end-expiratory pressure (PEEP) and lung recruitment maneuver (LRM), proven in the prevention of atelectasis occurring during anesthesia with mechanical ventilation (MV). However, it adversely affects the central hemodynamics, and can increase the incidence of perioperative complications, especially in elderly patients. The sensitivity of the peripheral chemoreflex (SPCR) is a marker of disturbed neuroreflex regulation of the cardiorespiratory system...
November 2015: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/26991585/neurocognitive-deficits-and-cerebral-desaturation-during-shoulder-arthroscopy-with-patient-in-beach-chair-position-a-review-of-the-current-literature
#17
REVIEW
Dane Salazar, Antony Hazel, Alexander J Tauchen, Benjamin W Sears, Guido Marra
Arthroscopic shoulder surgery with the patient in the beach-chair position (BCP) has been associated with neurocognitive complications caused by cerebral ischemia. We reviewed the current literature for the incidence of postoperative neurocognitive deficits, number of reported neurocognitive complications, and incidence of intraoperative cerebral desaturation events in patients who underwent arthroscopic shoulder surgery in the BCP. Among 10 studies with a composite enrollment of 24,701 patients, there was only 1 case of a postoperative neurocognitive deficit (overall incidence, 0...
March 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/26816003/perioperative-angiotensin-converting-enzyme-inhibitors-or-angiotensin-ii-type-1-receptor-blockers-for-preventing-mortality-and-morbidity-in-adults
#18
REVIEW
Zui Zou, Hong B Yuan, Bo Yang, Fengying Xu, Xiao Y Chen, Guan J Liu, Xue Y Shi
BACKGROUND: Perioperative hypertension requires careful management. Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II type 1 receptor blockers (ARBs) have shown efficacy in treating hypertension associated with surgery. However, there is lack of consensus about whether they can prevent mortality and morbidity. OBJECTIVES: To systematically assess the benefits and harms of administration of ACEIs or ARBs perioperatively for the prevention of mortality and morbidity in adults (aged 18 years and above) undergoing any type of surgery under general anaesthesia...
January 27, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26770048/effects-of-dexmedetomidine-infusion-on-the-recovery-profiles-of-patients-undergoing-transurethral-resection
#19
RANDOMIZED CONTROLLED TRIAL
So-Young Kwon, Jin-Deok Joo, Ga-Young Cheon, Hyun-Seok Oh, Jang-Hyeok In
Transurethral resection has been the gold standard in the operative management of benign prostatic hyperplasia and bladder tumor; however, it is associated with several complications that may cause patient discomfort. We evaluated the usefulness of continuous infusion of dexmedetomidine on emergence agitation, hemodynamic status, and recovery profiles in patients undergoing elective surgery by a randomized clinical trial. Sixty patients aged 30 to 80 yr who were scheduled for elective transurethral resection under general anesthesia were included in this study...
January 2016: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/26556900/neonatal-pneumothorax-pressures-surpass-higher-threshold-in-lung-recruitment-maneuvers-an-in-vivo-interventional-study
#20
Patricio González-Pizarro, Javier García-Fernández, Susana Canfrán, Fernando Gilsanz
BACKGROUND: Causing pneumothorax is one of the main concerns of lung recruitment maneuvers in pediatric patients, especially newborns. Therefore, these maneuvers are not performed routinely during anesthesia. Our objective was to determine the pressures that cause pneumothorax in healthy newborns by a prospective experimental study of 10 newborn piglets (<48 h old) with healthy lungs under general anesthesia. METHODS: The primary outcome was peak inspiratory pressure (PIP) causing pneumothorax...
February 2016: Respiratory Care
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