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Scoliosis AND anesthesia

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https://www.readbyqxmd.com/read/27823923/a-desflurane-and-fentanyl-dosing-regimen-for-wake-up-testing-during-scoliosis-surgery-implications-for-the-time-course-of-emergence-from-anesthesia
#1
Wei-Nung Teng, Mei-Yung Tsou, Pin-Tarng Chen, Jing-Yang Liou, Lu Yu, Dwayne R Westenskow, Chien-Kun Ting
BACKGROUND/PURPOSE: The Stagnara wake-up test assesses neurological deficits during scoliosis surgery, and response surface interaction models for opioids and inhaled agents predicts anesthetic drug effects. We hypothesized that there is an optimal desflurane-fentanyl dosing regimen that can provide a faster and more predictable wake-up time, while also ensuring adequate analgesia during wake-up testing. METHODS: Twenty-three American Society of Anesthesiologists Class I-II scoliosis patients who received desflurane-fentanyl anesthetic regimens were enrolled in this posthoc study, and their intraoperative drug administration data were collected retrospectively...
November 4, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27785761/using-physiological-monitoring-data-for-performance-feedback-an-initiative-using-thermoregulation-metrics
#2
Matthias Görges, Nicholas C West, Simon D Whyte
BACKGROUND: Feedback of performance data can improve professional practice and outcomes. Vital signs are not routinely used for quality improvement because of their limited access. Intraoperative hypothermia has been associated with deleterious effects, including surgical site infections and bleeding. We speculated that providing feedback could help keep temperature monitoring and management a priority in the anesthesiologist's mind, thereby improving perioperative temperature management...
October 26, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27752170/-impact-of-dexmedetomidine-sevoflurane-anesthesia-on-intraoperative-wake-up-test-in-children-patients-undergoing-scoliosis-surgery
#3
L X Quan, H X An, D X Wang
OBJECTIVE: To observe the effects of 0.4 μg/(kg×h) dose of dexmedetomidine on intra-operative wake-up test in children patients undergoing scoliosis surgery. METHODS: Sixty patients for posterior scoliosis correction (ASA I-II, aged 5-16 years) from March 2013 to April 2015 were enrolled in this prospective, double-blinded, randomized, placebo-controlled study, The patients were randomly classified into two groups to receive dexmedetomidine (group RD, n=30) or saline solution (group R, n=30)...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/27749348/perioperative-surgical-home-in-pediatric-settings-preliminary-results
#4
Karen Thomson, Sophie R Pestieau, Janish J Patel, Heather Gordish-Dressman, Ariana Mirzada, Zeev N Kain, Matthew E Oetgen
BACKGROUND: The Perioperative Surgical Home (PSH) is a patient-centered, team-based approach that aims to improve the value of perioperative care. We implemented a PSH for patients with adolescent idiopathic scoliosis who were undergoing posterior spinal fusion at Children's National Health System. We hypothesized that this PSH would improve patient surgical outcomes and reduce hospital length of stay (LOS). METHODS: A multidisciplinary group created evidence-based protocols for the preoperative, operative, postoperative, and postdischarge care of this patient population...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27746547/a-comparative-study-of-sterofundin-and-ringer-lactate-based-infusion-protocol-in-scoliosis-correction-surgery
#5
Ashima Sharma, Monu Yadav, B Rajesh Kumar, P Sai Lakshman, Raju Iyenger, Gopinath Ramchandran
BACKGROUND: A major change in anesthesia practice as regards to intraoperative infusion therapy is the present requirement. Switching over to balanced fluids can substantially decrease the incidence of lactic acidosis and hyperchloremic acidosis. The deleterious effects of unbalanced fluids are more recognizable during major surgeries. We prospectively studied the influence of Sterofundin (SF) and Ringer lactate (RL) on acid-base changes, hemodynamics, and readiness for extubation during scoliosis surgery...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27703636/bronchoscopic-concerns-in-proteus-syndrome-a-case-report
#6
Jung-Min Hong, Hyeon Jeong Lee, Eun Soo Kim, Hae-Kyu Kim, Soeun Jeon, Hyae-Jin Kim
Proteus syndrome (PS) is a rare congenital hamartomatous disorder with multisystem involvement. PS shows highly clinical variability due to overgrowth of the affected areas, and several features can make anesthetic management challenging. Little is known about the airway problem associated with anesthesia in PS patients. An 11-year-old girl with PS was scheduled for ear surgery under general anesthesia. She had features complicating intubation including facial asymmetry and disproportion, abnormal teeth, limitation of neck movement due to torticollis, and thoracolumbar scoliosis...
October 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27695352/cost-analysis-of-magnetically-controlled-growing-rods-compared-with-traditional-growing-rods-for-early-onset-scoliosis-in-the-us-an-integrated-health-care-delivery-system-perspective
#7
David W Polly, Stacey J Ackerman, Karen Schneider, Jeff B Pawelek, Behrooz A Akbarnia
PURPOSE: Traditional growing rod (TGR) for early-onset scoliosis (EOS) is effective but requires repeated invasive surgical lengthenings under general anesthesia. Magnetically controlled growing rod (MCGR) is lengthened noninvasively using a hand-held magnetic external remote controller in a physician office; however, the MCGR implant is expensive, and the cumulative cost savings have not been well studied. We compared direct medical costs of MCGR and TGR for EOS from the US integrated health care delivery system perspective...
2016: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/27669044/trajectory-of-post-operative-wound-pain-within-the-first-two-weeks-following-posterior-spinal-fusion-surgery-in-adolescent-idiopathic-scoliosis-patients
#8
Mun Keong Kwan, Chee Kidd Chiu, Teik Seng Chan, Kok Ian Chong, Siti Mariam Mohamad, Mohd Shahnaz Hasan, Chris Yin Wei Chan
STUDY DESIGN: Prospective Cohort Study. OBJECTIVE: To determine and evaluate the trajectory of surgical wound pain from day 1 to day 14 after PSF surgery in AIS patients. SUMMARY OF BACKGROUND DATA: Information regarding how the post-operative pain improves with time offers invaluable information not only to the patients and parents but also to assist the clinician in managing post-operative pain. METHODS: AIS patients who were planned for elective PSF surgery from September 2015 to December 2015 were prospectively recruited into this study...
September 23, 2016: Spine
https://www.readbyqxmd.com/read/27603190/intraoperative-hypothermia-is-common-but-not-associated-with-blood-loss-or-transfusion-in-pediatric-posterior-spinal-fusion
#9
Mathew D Schur, Gideon W Blumstein, Derek A Seehausen, Patrick A Ross, Lindsay M Andras, David L Skaggs
BACKGROUND: Intraoperative hypothermia may be associated with increased blood loss due to the effects of temperature on clotting but this has not been evaluated in the setting of pediatric posterior spinal fusion (PSF). The purpose of this study was to determine if a correlation exists between intraoperative hypothermia and estimated blood loss (EBL) or transfusion requirements in pediatric patients undergoing PSF. METHODS: A retrospective review of consecutive patients undergoing PSF for scoliosis at a single institution between 6/2004 and 3/2012 was performed...
September 3, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27583851/quadratus-lumborum-block-for-femoral-femoral-bypass-graft-placement-a-case-report
#10
Kunitaro Watanabe, Shingo Mitsuda, Joho Tokumine, Alan Kawarai Lefor, Kumi Moriyama, Tomoko Yorozu
INTRODUCTION: Atherosclerosis has a complex etiology that leads to arterial obstruction and often results in inadequate perfusion of the distal limbs. Patients with atherosclerosis can have severe complications of this condition, with widespread systemic manifestations, and the operations undertaken are often challenging for anesthesiologists. CASE REPORT: A 79-year-old woman with chronic heart failure and respiratory dysfunction presented with bilateral gangrene of the distal lower extremities with obstruction of the left common iliac artery due to atherosclerosis...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27506101/tranexamic-acid-in-surgical-treatment-of-scoliosis-in-children-a-case-report
#11
Goran Rakić, Danica Stanić, Anna Uram Benka, Marina Pandurov, Jovana M Simin, Biljana Drasković
INTRODUCTION: Children who are subjected to surgical treatment for scoliosis usually end up receiving a lot of blood transfusions since they tend to lose one or more blood volumes during the surgery. Tranexamic acid is an antifibrinolytic agent, increasingly used in children to reduce perioperative blood loss in various settings, including corrective surgery of scoliosis. CASE REPORT: A 12-year-old girl, weighing 44 kg, was admitted to our hospital for scoliosis correction...
March 2016: Medicinski Pregled
https://www.readbyqxmd.com/read/27398889/prolonged-perioperative-low-dose-ketamine-does-not-improve-short-and-long-term-outcomes-after-pediatric-idiopathic-scoliosis-surgery
#12
Marina Perelló, David Artés, Cristina Pascuets, Elisabeth Esteban, Ana Maria Ey
STUDY DESIGN: Randomized, double-blind, placebo-controlled study, with a six-month follow-up period. OBJECTIVES: To test the hypothesis that a 72-hour dose of subanesthetic ketamine in this surgical procedure reduces postoperative morphine use; To assess if there are fewer adverse effects, if postoperative recovery is faster, if there is less peri-incisional hyperalgesia or if there is lower incidence of persistent postsurgical pain. SUMMARY OF BACKGROUND DATA: Tissue injury and high opioid requirements following posterior spinal fusion surgery produce central sensitization, which can in turn be associated with hyperalgesia and chronic pain...
July 7, 2016: Spine
https://www.readbyqxmd.com/read/27386117/torsion-of-left-main-bronchus-during-general-anesthesia-for-posterior-instrumented-spinal-fusion
#13
Renuka Arumainathan, Stephen A C Morris, Marina George
Pulmonary function tests such as flow-volume loops and reconstructive radiological imaging may aid the detection of large airway obstruction prior to corrective surgery for severe scoliosis. Intraoperative use of halo-gravity traction may help to reduce the severity of the scoliosis, and thus the extrinsic compression or torsion of the airways.
July 2016: Clinical Case Reports
https://www.readbyqxmd.com/read/27343792/marfan-syndrome-new-diagnostic-criteria-same-anesthesia-care-case-report-and-review
#14
Maria Rita Araújo, Céline Marques, Sara Freitas, Rita Santa-Bárbara, Joana Alves, Célia Xavier
BACKGROUND: Marfan's Syndrome (MFS) is a disorder of connective tissue, mainly involving the cardiovascular, musculoskeletal, and ocular systems. The most severe problems include aortic root dilatation and dissection. Anesthetic management is vital for the improvement on perioperative morbidity. CASE REPORT: 61-year-old male with MFS, presenting mainly with pectus carinatum, scoliosis, ectopia lens, previous spontaneous pneumothorax and aortal aneurysm and dissection submitted to thoracoabdominal aortic prosthesis placement...
July 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27188109/-a-patient-with-klippel-feil-syndrome-having-difficulties-in-inserting-and-placing-an-endotracheal-tube-under-general-anesthesia
#15
Yusuke Hashidume, Shunsuke Tachibana, Yukimasa Takada, Mitsutaka Edanaga, Michiaki Yamakage
A patient with Klippel-Feil syndrome had difficulties in inserting and placing an endotracheal tube under general anesthesia. Klippel-Feil syndrome, characterized by cervical vertebral fusion, scoliosis and endocardiosis, is a rare disease. Anesthesiologists should pay attention to management of anesthesia in airway troubles. A 53-year-old woman diagnosed with Klippel-Feil syndrome was scheduled for general anesthesia with intubation. We tried to insert an endotracheal tube using McGRATH MAC, but it was difficult to insert and place the tube...
April 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/27182837/preliminary-results-of-magnetically-controlled-growing-rods-for-early-onset-scoliosis
#16
Karsten Ridderbusch, Martin Rupprecht, Philip Kunkel, Christian Hagemann, Ralf Stücker
BACKGROUND: Growth-sparing techniques for the treatment of early onset scoliosis (EOS) have developed significantly over the last years. Traditional growing rods (GRs) require repeated surgical lengthening under anesthesia. Since June 2011 we have been using the magnetically controlled growing rods (MCGR) to treat patients with progressive EOS. METHODS: Thirty-five patients with EOS of different etiologies underwent treatment with MCGR. We record about our preliminary results of 24 patients who fulfilled the inclusion criteria of a minimum follow-up (FU) of 12 month and >3 lengthenings...
May 13, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27157204/-marfan-syndrome-new-diagnostic-criteria-same-anesthesia-care-case-report-and-review
#17
Maria Rita Araújo, Céline Marques, Sara Freitas, Rita Santa-Bárbara, Joana Alves, Célia Xavier
BACKGROUND: Marfan's Syndrome (MFS) is a disorder of connective tissue, mainly involving the cardiovascular, musculoskeletal, and ocular systems. The most severe problems include aortic root dilatation and dissection. Anesthetic management is vital for the improvement on perioperative morbidity. CASE REPORT: 61-year-old male with MFS, presenting mainly with pectus carinatum, scoliosis, ectopia lens, previous spontaneous pneumothorax and aortal aneurysm and dissection submitted to thoracoabdominal aortic prosthesis placement...
July 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27072552/early-onset-scoliosis-with-intraspinal-anomalies-management-with-growing-rod
#18
Arvind Jayaswal, Pankaj Kandwal, Ankur Goswami, G Vijayaraghavan, Ashok Jariyal, B N Upendra, Ankit Gupta
OBJECTIVE: To evaluate clinical and radiological outcomes of growing rod (GR) in the management of Early Onset Scoliosis (EOS) with intraspinal anomalies. BACKGROUND DATA: The effect of repeated distractions following GR, in the presence of intraspinal anomalies has not been studied. METHODS: During 2007-2012, 46 patients underwent fusionless surgery. Out of these 46 patients, 13 patients had one or more intraspinal anomalies. 11 patients had undergone prior neurosurgical procedure while 2 (filum terminale lipoma and syringomyelia) did not...
April 12, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27017770/-anesthetic-management-using-transesophageal-echocardiography-and-ev1000-in-a-patient-with-ebstein-s-anomary-undergoing-scoliosis-surgery
#19
Kazuki Tanimura, Yukiko Miura, Hisanari Ishii
An 18-year-old female patinet with Ebstein anomaly underwent surgical repair of scoliosis under total intravenous anesthesia. In addtition to normal monitors, we used transesophageal echocardiography (TEE) and EV1000 (Edwards Lifesciences, Irvine, USA), which show stroke volume variation and stroke volume index simultaneously in a rectangular coordinates. TEE detected reversal of intracardiac shunt which caused SpO2 decrease during fixing screws at thoracic vertebrae, then manual ventilation with oxygen unproved SpO2...
February 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26977161/orthopedic-manifestations-of-mobius-syndrome-case-series-and-survey-study
#20
Philip McClure, David Booy, Julia Katarincic, Craig Eberson
Background. Mobius Syndrome is a rare disease defined by bilateral congenital 7th nerve palsy. We focus on reporting the prevalence of orthopedic disease in this population. Methods. Twenty-three individuals with Mobius Syndrome underwent orthopedic physical examination, and additional 96 patients filled out a survey for self-reported orthopedic diagnoses. Results. Clubfoot was present in 60% of individuals in the physical exam series and 42% of those in the survey. Scoliosis was present in 26% and 28%, respectively...
2016: International Journal of Pediatrics
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