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Hypoxemia during anesthesia

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https://www.readbyqxmd.com/read/29027770/bispectral-index-bis-and-non-bis-anesthetic-protocols-on-postoperative-recovery-outcomes-a-systematic-review-and-meta-analysis
#1
Min-Hsien Chiang, Shao-Chun Wu, Shih-Wei Hsu, Jo-Chi Chin
BACKGROUND: The study aimed to compare bispectral index (BIS) and non-BIS anesthetic protocols on postoperative recovery outcomes. METHODS: Medline, PubMed, Cochrane, EMBASE, and Google Scholar databases were searched until January 21, 2016. RESULTS: Twenty-six studies were included with a total of 9537 patients. BIS monitoring was significantly associated with shorter time to eye opening (P=0.001), time to extubation (P<0.001), and time to orientation (P=0...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28956237/usefulness-of-oxygen-reserve-index-ori%C3%A2-a-new-parameter-of-oxygenation-reserve-potential-for-rapid-sequence-induction-of-general-anesthesia
#2
Keisuke Yoshida, Tsuyoshi Isosu, Yoshie Noji, Makiko Hasegawa, Yuzo Iseki, Rieko Oishi, Tsuyoshi Imaizumi, Norie Sanbe, Shinju Obara, Masahiro Murakawa
The oxygen reserve index (ORi™) is a new parameter for monitoring oxygen reserve noninvasively. The aim of this study was to examine the usefulness of ORi for rapid sequence induction (RSI). Twenty adult patients who were scheduled for surgical procedures under general anesthesia were enrolled. After attaching a sensor capable of measuring ORi, oxygen (6 L/min) and fentanyl (2 μg/kg) were administered. After 3 min, propofol 2 mg/kg and rocuronium 1 mg/kg were administered without ventilation. Regardless of changes in ORi, tracheal intubation was performed either 2 min after administration of propofol or when percutaneous oxygen saturation (SpO2) reached 98%...
September 27, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28920806/accuracy-of-noninvasive-anesthetic-monitoring-in-the-anesthetized-giraffe-giraffa-camelopardalis
#3
Mads F Bertelsen, Carsten Grøndahl, George F Stegmann, Cathrine Sauer, Niels H Secher, J Michael Hasenkam, Mads Damkjær, Christian Aalkjær, Tobias Wang
This study evaluated the accuracy of pulse oximetry, capnography, and oscillometric blood pressure during general anesthesia in giraffes (Giraffa camelopardalis). Thirty-two giraffes anesthetized for physiologic experiments were instrumented with a pulse oximeter transmittance probe positioned on the tongue and a capnograph sampling line placed at the oral end of the endotracheal tube. A human size 10 blood pressure cuff was placed around the base of the tail, and an indwelling arterial catheter in the auricular artery continuously measured blood pressure...
September 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28913499/perioperative-hyperoxia-perhaps-a-malady-in-disguise
#4
REVIEW
Yalim Dikmen, Aybike Onur
Oxygen is an element, which is used liberally during several medical procedures. The use of oxygen during perioperative care is a controversial issue. Anesthesiologists use oxygen to prevent hypoxemia during surgical procedures, but the effects of its liberal use can be harmful. Another argument for using high oxygen concentrations is to prevent surgical site infections by increasing oxygen levels at the incision site. Although inconclusive, literature concerning the use of high oxygen concentrations during anesthesia show that this approach may cause hemodynamic changes, altered microcirculation and increased oxidative stress...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28852473/evaluation-of-operating-room-reverse-trendelenburg-positioning-and-its-effect-on-postoperative-hypoxemia-aspiration-and-length-of-stay-a-retrospective-study-of-consecutive-patients
#5
C Michael Dunham, Barbara M Hileman, Amy E Hutchinson, Tamara Antonaccio, Elisha A Chance, Gregory S Huang, Gregory Szmaj, Kristen Calabro, Cynthia Bishop, Tyson T Schrickel
BACKGROUND: In 2014, this group published an investigation of surgical patients from 2012 who had substantial rates of postoperative hypoxemia (POH) and perioperative pulmonary aspiration (POPA). Therefore, we investigated whether intraoperative reverse Trendelenburg positioning (RTP) decreases POH and POPA rates. METHODS: Consecutive ASA I-IV surgical patients who had preoperative pulmonary stability requiring general anesthesia with endotracheal intubation were evaluated...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28802605/laparoscopic-cholecystectomy-under-neuraxial-anesthesia-compared-with-general-anesthesia-systematic-review-and-meta-analyses
#6
REVIEW
Marcelo A Longo, Bárbara T Cavalheiro, Getúlio R de Oliveira Filho
BACKGROUND: Pneumoperitoneum during laparoscopic cholecystectomy (LC) can cause hypercapnia, hypoxemia, hemodynamic changes and shoulder pain. General anesthesia (GA) enables the control of intraoperative pain and ventilation. The need for GA has been questioned by studies suggesting that neuraxial anesthesia (NA) is adequate for LC. STUDY OBJECTIVE: To quantify the prevalence of intraoperative pain and to verify whether evidence on the maintenance of ventilation, circulation and surgical anesthesia during NA compared with GA is consistent...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28759496/addition-of-nasal-cannula-can-either-impair-or-enhance-preoxygenation-with-a-bag-valve-mask-a-randomized-crossover-design-study-comparing-oxygen-flow-rates
#7
David McQuade, Matthew R Miller, Clare Hayes-Bradley
BACKGROUND: A critical safety component of emergency anesthesia is the avoidance of hypoxemia during the apneic phase of a rapid sequence intubation. Preoxygenation with a bag valve mask (BVM) or anesthetic circuit may be improved with supplemental oxygen by nasal cannula (NC) if there is a mask leak. In addition, NC is recommended for apneic oxygenation after induction and may be placed before preoxygenation. However, the optimum NC flow rate for preoxygenation or whether the presence of NC alone creates a mask leak remains unclear...
July 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28759491/the-evaluation-of-a-noninvasive-respiratory-volume-monitor-in-pediatric-patients-undergoing-general-anesthesia
#8
Andrea D Gomez-Morad, Joseph P Cravero, Brian C Harvey, Rachel Bernier, Erin Halpin, Brian Walsh, Viviane G Nasr
BACKGROUND: Pediatric patients following surgery are at risk for respiratory compromise such as hypoventilation and hypoxemia depending on their age, comorbidities, and type of surgery. Quantitative measurement of ventilation in nonintubated infants/children is a difficult and inexact undertaking. Current respiratory assessment in nonintubated patients relies on oximetry data, respiratory rate (RR) monitors, and subjective clinical assessment, but there is no objective measure of respiratory parameters that could be utilized to predict early respiratory compromise...
July 27, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28757837/hypoxic-hepatitis-during-the-perioperative-period-in-patients-with-severe-pulmonary-disease-and-cor-pulmonale
#9
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/28658164/the-analgesic-efficacy-of-oxycodone-hydrochloride-versus-fentanyl-during-outpatient-artificial-abortion-operation-a-randomized-trial
#10
RANDOMIZED CONTROLLED TRIAL
Kangjie Xie, Wen Zhang, Wumei Fang, Yanhong Lian, Sufeng Lin, Jun Fang
BACKGROUND: Problems like body movement, respiratory depression, and complained of pain are still common phenomenon in outpatient artificial abortion general anesthesia. Oxycodone hydrochloride is a semisynthetic opioid and has a good therapeutic effect on visceral pain. We hypothesize that oxycodone hydrochloride would be superior to fentanyl in outpatient artificial abortion surgery. METHODS: In this clinical trial 149 American Society of Anesthesiologists (ASA) I or II female outpatients scheduled for elective artificial abortion surgeries under general anesthesia were randomly divided into 3 groups: oxycodone hydrochloride 0...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28658112/propofol-decreases-etomidate-related-myoclonus-in-gastroscopy
#11
RANDOMIZED CONTROLLED TRIAL
Jinfeng Liu, Rongfang Liu, Chao Meng, Zhenhua Cai, Xiaoqi Dai, Chao Deng, Jiahang Zhang, Huacheng Zhou
OBJECTIVE: Myoclonus, a common complication during intravenous induction with etomidate, is bothersome to both anesthesiologists and patients. This study explored the preventive effect of pretreatment with propofol on etomidate-related myoclonus. METHODS: This was a prospective, double-blind, clinical, randomized controlled study. Totally, 363 patients who were scheduled for a short-duration, painless gastrointestinal endoscopy were divided into 5 groups. Four groups received 0 mg/kg (E group), 0...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28621297/endoscopic-ultrasound-with-or-without-fine-needle-aspiration-has-a-meaningful-impact-on-clinical-care-in-the-pediatric-population
#12
Amit Raina, Maire A Conrad, Benjamin Sahn, Alireza Sedarat, Gregory G Ginsberg, Nuzhat A Ahmad, Vinay Chandrasekhara, Petar Mamula, Michael L Kochman
BACKGROUND AND OBJECTIVES: The safety and utility of endoscopic ultrasound (EUS) for the evaluation and management of gastrointestinal (GI) tract disorders among adults has been established. The literature on safety and efficacy in a pediatric referral population (under 21 years of age) is limited. We hypothesized that EUS is safe and useful in the pediatric population. We reviewed the pediatric EUS experience at a single tertiary-care system. We describe the indications, findings, safety, technical success rate, and impact on clinical outcomes...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28544250/prevalence-of-and-risk-factors-for-intraoperative-gastroesophageal-reflux-and-postanesthetic-vomiting-and-diarrhea-in-dogs-undergoing-general-anesthesia
#13
Carlos Torrente, Isabel Vigueras, Edgar G Manzanilla, Cecilia Villaverde, Laura Fresno, Bibiana Carvajal, Marina Fiñana, Cristina Costa-Farré
OBJECTIVE: To determine the prevalence of intraoperative gastroesophageal reflux (GER) and postanesthetic vomiting and diarrhea, and to evaluate risk factors associated with these gastrointestinal disorders (GID) in dogs undergoing general anesthesia. DESIGN: Prospective observational study. SETTING: University teaching hospital. ANIMALS: Two hundred thirty-seven client-owned dogs undergoing general inhalant anesthesia for diagnostic or surgical purposes...
July 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28539301/-anesthesia-management-in-robotic-assisted-esophagectomy-with-triple-incisions-analysis-of-53-cases
#14
Xiao-Qing Liu, Tian-Hua Zhang, Jing Cheng, Hui-Ting Li, Long-Hui Cao, Zi-Hui Tan, Wen-Qian Lin
Between March, 2016 and January, 2017, 53 patients underwent robotic-assisted esophagectomy with triple incisions. All the patients were intubated with Double lumen endotracheal tub with one-lung ventilation and CO2 pneumoperitoneum, and CO2 pneumothorax was used in 7 cases. Most of the patients could tolerate OLV and CO2 pneumoperitoneum, and 4 patients with CO2 pneumothorax had hypoxemia and required double-lung ventilation or high frequency ventilation; 15 patients developed postoperative pulmonary complications and were transferred to ICU...
May 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28538020/incidence-and-risk-factors-of-hypoxemia-during-interventional-rigid-bronchoscopy-under-spontaneous-assisted-ventilation
#15
Saowapark Chumpathong, Jamsak Tscheikuna, Thanatporn Boonsombat, Saipin Muangman, Choopong Luansritisakul
BACKGROUND: Interventional rigid bronchoscopy for tracheobronchial stenosis can be performed under total intravenous anesthesia and spontaneous-assisted ventilation. Intraoperative hypoxemia can occur during this procedure, but the incidence and risk factors have not yet been determined. METHODS: Medical records of patients who underwent rigid bronchoscopy for the treatment of tracheobronchial stenosis under total intravenous anesthesia and spontaneous-assisted ventilation during the study period from January 2011 to December 2012 were retrospectively reviewed...
October 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28416836/-comparison-between-flexible-laryngeal-mask-airway-and-reinforced-tracheal-tube-used-for-lumbar-vertebral-surgery-in-prone-position
#16
Y L Zheng, W F Song, D X Wang
OBJECTIVE: To estimate the safety and feasibility of flexible laryngeal mask airway (FLMA) for lumbar vertebral surgery in prone position. METHODS: In the study, 120 adult patients scheduled for lumbar vertebral surgery under intravenous general anesthesia were divided into group FLMA and reinforced tracheal tube (RTT) group at random. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded at the beginning of anesthesia induction (T0) and on the time of artificial airway intubation (T1), 1 min after intubation (T2), extubation (T3), 1 min after extubation (T4) as well...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28403091/effects-of-preoperative-chronic-hypoxemia-on-geriatrics-outcomes-after-hip-arthroplasty-a-hospital-based-retrospective-analysis-study
#17
Furong Zhang, Ruqiang Zhang, Liang He, Jianwei Yin, Fang Wang, Junmin Li
The partial pressure of oxygen decreases as altitude increases, the preoperative chronic hypoxemia (CH) may have a plausible clinical impact. Risk factors for postoperative serious adverse events (pSAEs) in patients living in high altitudes during primary hip arthroplasty (HA) are not clear.This is an observational study embracing patients from January 1, 2011 to December 31, 2015 at Yan'an Hospital of Kunming City, a 1338-bed municipal teaching hospital of Kunming Medical University. Univariate analysis revealed that significant differences between patients with and without preoperative CH occurred in intraoperative hypotension (77 [33%] vs 34 [47%], P = ...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28372678/randomized-trial-of-a-novel-double-lumen-nasopharyngeal-catheter-versus-traditional-nasal-cannula-during-total-intravenous-anesthesia-for-gastrointestinal-procedures
#18
RANDOMIZED CONTROLLED TRIAL
Adam B King, Bret D Alvis, Douglas Hester, Susan Taylor, Michael Higgins
STUDY OBJECTIVE: Patients undergoing general anesthesia routinely experience episodes of hypoxemia. There are multiple causes of procedural oxygen desaturation including upper airway obstruction and central hypoventilation. We hypothesize that oxygen supplementation via nasopharyngeal catheter (NPC) will decrease the number of episodes of hypoxemia as compared to traditional NC oxygen supplementation in patients undergoing general anesthesia provided by an anesthesia provider for gastrointestinal endoscopy procedures...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28348895/in-flight-hypoxemia-in-a-tracheostomy-dependent-infant
#19
Jason Quevreaux, Christopher Cropsey
Millions of passengers board commercial flights every year. Healthcare providers are often called upon to treat other passengers during in-flight emergencies. The case presented involves an anesthesia resident treating a tracheostomy-dependent infant who developed hypoxemia on a domestic flight. The patient had an underlying congenital muscular disorder and was mechanically ventilated while at altitude. Although pressurized, cabin barometric pressure while at altitude is less than at sea level. Due to this environment patients with underlying pulmonary or cardiac pathology might not be able to tolerate commercial flight...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28334593/pediatric-postoperative-pulse-oximetry-monitoring-during-transport-to-the-postanesthesia-care-unit-reduces-frequency-of-hypoxemia
#20
Thomas J Caruso, Tara E Mokhtari, Monica J Coughlan, Diane S Wu, Juan L Marquez, Melissa Duan, Heather Freeman, Andrew Giustini, Mary Tweedy, Paul J Sharek
BACKGROUND: The standard use of pulse oximetry during the transport of postoperative patients from the operating room (OR) to the postanesthesia care unit (PACU) is not routinely practiced. A study was conducted to determine if the frequency of hypoxemia on admission to the PACU decreased after implementation of routine use of transport pulse oximeters for postoperative patients being transferred to the PACU. METHODS: In this prospective cohort study, which was conducted at an academic pediatric hospital, the primary outcome measure was the frequency of hypoxemic events on arrival to the PACU...
March 2017: Joint Commission Journal on Quality and Patient Safety
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