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https://www.readbyqxmd.com/read/28545173/comparison-of-short-term-complications-of-general-and-spinal-anesthesia-for-primary-unilateral-total-knee-arthroplasty
#1
Yong Bok Park, Won Seok Chae, Sin Hyung Park, Ji Soo Yu, Sun Geun Lee, Soo Jae Yim
Purpose: To compare the occurrences of perioperative complications of two anesthetic techniques (general anesthesia [GA] and spinal anesthesia [SA] in patients undergoing primary unilateral total knee arthroplasty (TKA). Materials and Methods: Patients who underwent unilateral primary TKA due to osteoarthritis from January 2005 to January 2014 were retrospectively reviewed. They were divided into two groups: GA (n=490) and SA (n=746). The operation duration, length of perioperative stay in the operation room and occurrences of adverse events in postoperative 30 days (mean, 29...
June 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28545171/comprehensive-analysis-of-pain-management-after-total-knee-arthroplasty
#2
REVIEW
Yong Seuk Lee
Total knee arthroplasty (TKA) has been much improved recently and it is regarded as one of the most common and successful surgical procedures that provides pain relief and improves function in patients with severe knee arthritis. However, recent studies have reported that 15%-20% of patients are not satisfied after TKA without evident clinical or radiological findings and the most common causes of patient dissatisfaction include residual pain and limited function. The evaluation and treatment of painful TKA relies on a thorough understanding of the origin by careful evaluation, and a systematic approach is essential to efficiently and effectively resolve the pain...
June 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28544979/preoperative-left-hepatic-lobe-devascularisation-to-minimize-perioperative-bleeding-in-a-jehovah-s-witness-undergoing-left-hepatectomy
#3
Laurence Weinberg, Georgina Hanus, Jonathan Banting, Diana Abu-Ssaydeh, Manfred Spanger, Su Kah Goh, Vijayaragavan Muralidharan
INTRODUCTION: Major liver resection in a Jehovah's Witness presents unique clinical challenges requiring multimodal blood minimization strategies to reduce perioperative complications. We report a case where complete left hepatic lobe devascularisation was undertaken to minimize bleeding in a Jehovah's Witness undergoing left hepatectomy. PRESENTATION OF CASE: A 65-year-old male Jehovah's Witness presented for open left hepatectomy for a large left-sided hepatocellular carcinoma involving segment IV of the liver...
May 15, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28544520/safety-and-perioperative-adverse-events-in-pediatric-endoscopic-sinus-surgery-an-acs-nsqip-p-analysis
#4
Christopher R Roxbury, Lilun Li, Daniel Rhee, Kris R Jatana, Rahul K Shah, Emily F Boss
INTRODUCTION: This study describes safety outcomes of pediatric endoscopic sinus surgery (ESS) to identify risk factors for 30-day postoperative adverse events using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database. METHODS: We performed a retrospective cohort study involving patients in the 2012-2015 NSQIP-P database who underwent ESS. Predictors included demographics, comorbidities and surgical acuity. Outcomes included 30-day complications, reoperations, and readmissions...
May 23, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28544311/impact-of-body-mass-index-on-robotic-radical-cystectomy-with-intra-corporeal-urinary-diversion
#5
Nariman Ahmadi, Thomas G Clifford, Gus Miranda, Jie Cai, Monish Aron, Mihir M Desai, Inderbir S Gill
OBJECTIVES: To determine the impact of body mass index (BMI) on peri-operative and oncological outcomes following robotic radical cystectomy (RRC) with intra-corporeal urinary diversion (ICUD). SUBJECTS AND METHODS: A total of 216 patients undergoing RRC, extended lymphadenectomy and ICUD (07/2010-12/2015) were categorized into four BMI groups according to the 2004 World Health Organization (WHO) obesity classification: <25 kg/m(2) (normal), 25-29.9 kg/m(2) (pre-obese), 30-34...
May 22, 2017: BJU International
https://www.readbyqxmd.com/read/28544301/hospital-volume-and-perioperative-outcomes-for-radical-cystectomy-a-population-study
#6
Cristian Udovicich, Marlon Perera, Molla Huq, Lih-Ming Wong, Daniel Lenaghan
OBJECTIVES: To evaluate the association between hospital volume and perioperative outcomes of radical cystectomy (RC) using state population data for a contemporary Australian cohort. PATIENTS AND METHODS: Patients undergoing RC for urothelial malignancy in the state of Victoria, Australia between July 2003 and June 2014 were identified using the Victorian Admitted Episodes Dataset (VAED). Hospitals were divided into tertiles according to their caseload per year...
May 2017: BJU International
https://www.readbyqxmd.com/read/28544292/perioperative-adverse-events-in-patients-on-continued-anticoagulation-undergoing-photoselective-vaporisation-of-the-prostate-with-the-180-w-greenlight-lithium-triborate-laser
#7
Georgia L Knapp, Venu Chalasani, Henry H Woo
OBJECTIVES: To compare perioperative factors and adverse events (AEs) in men undergoing photoselective vaporisation of the prostate (PVP) with or without continued anticoagulation therapy. PATIENTS AND METHODS: Retrospective review of a PVP database of men treated with the 180-W lithium triborate (LBO) laser from 2010 to 2016. Of 373 men, 59 underwent PVP with continued anticoagulant therapy, which was defined as treatment with heparin, warfarin, clopidogrel, dipyridamol or new oral anticoagulant drugs...
May 2017: BJU International
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
#8
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...
May 23, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28543813/inhaled-pulmonary-vasodilator-therapy-for-management-of-right-ventricular-dysfunction-after-left-ventricular-assist-device-placement-and-cardiac-transplantation
#9
Leah A Sabato, David M Salerno, Jeremy D Moretz, Douglas L Jennings
Right ventricular failure (RVF) after cardiac transplant (CTX) or implantation of a continuous-flow left ventricular assist device (CF-LVAD) is associated with significant post-operative morbidity and mortality. A variety of modalities have been used to treat post-operative RVF, including management of volume status, intravenous inotropes and vasodilators, and right-sided mechanical support. Inhaled vasodilator agents are a unique treatment option aimed at minimizing systemic absorption by delivering therapy directly to the pulmonary vasculature...
May 24, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28543789/surgical-management-of-traumatic-tricuspid-insufficiency
#10
Zhiqi Zhang, Kanhua Yin, Lili Dong, Yongxin Sun, Changfa Guo, Yi Lin, Chunsheng Wang
BACKGROUND: This study reviews our experience with traumatic tricuspid insufficiency (TTI) following blunt chest trauma. METHODS: From January 2010 to June 2016, 10 patients (nine males, mean age 49.0 ± 12.4 years) underwent surgical treatment of TTI following blunt chest trauma. The mean intervals between trauma and diagnosis and between trauma and surgery were 74.1 and 81.8 months, respectively. Preoperatively, all patients exhibited severe tricuspid regurgitation...
May 24, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28543399/baroreceptor-stimulation-in-a-patient-with-preexisting-subcutaneous-implantable-cardioverter-defibrillator
#11
Kay F Weipert, Jens Andrick, Ritvan Chasan, Christopher Gemein, Astrid Most, Christian W Hamm, Damir Erkapic, Joern Schmitt
BACKGROUND: Many patients with severe heart failure (HF) have an indication for baroreflex activation therapy (BAT) and an ICD. Concerns about device-device interactions were addressed in a study with small sample size that concluded combined BAT and ICD therapy is safe. There are no published data, however, concerning device-device interactions between BAT and a subcutaneous ICD (S-ICD). Since BAT frequently interferes with surface ECG recordings there are doubts about compatibility of BAT and S-ICD devices...
May 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28543052/norepinephrine-reduces-arterial-compliance-less-than-phenylephrine-when-treating-general-anesthesia-induced-arterial-hypotension
#12
F Vallée, O Passouant, A Le Gall, J Joachim, J Mateo, A Mebazaa, E Gayat
INTRODUCTION: During general anesthesia, arterial hypotension is frequent and may be an important contributor to perioperative morbidity. We assessed the effect of a 5 μg bolus of Norepinephrine (NA) when compared with 50 μg bolus of Phenylephrine (PE) administered to treat hypotension during maintenance anesthesia, on MAP, derived cardiac output and arterial stiffness parameters. METHODS: Patients scheduled for a neurosurgical procedure under general anesthesia were prospectively included...
May 22, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28542675/analgesic-effects-of-intravenous-acetaminophen-vs-placebo-for-endoscopic-sinus-surgery-and-postoperative-pain-a-randomized-clinical-trial
#13
Matthew A Tyler, Kent Lam, Faramarz Ashoori, Chunyan Cai, Joshua J Kain, Samer Fakhri, Martin J Citardi, Davide Cattano, Amber Luong
Importance: Intravenous acetaminophen is a commonly prescribed analgesic for the prevention and treatment of postsurgical pain. Its efficacy in the context of endoscopic sinus surgery (ESS) has yielded mixed results. Objective: To compare the efficacy of perioperative intravenous acetaminophen (IVAPAP) with that of placebo in improving early postoperative pain after endoscopic sinus surgery (ESS). Design, Setting, and Participants: A prospective, randomized clinical trial including 62 patients undergoing ESS for chronic rhinosinusitis in a single tertiary referral hospital...
May 25, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28542504/level-of-surgical-experience-is-associated-with-change-in-hip-center-of-rotation-following-cementless-total-hip-arthroplasty-a-radiographic-assessment
#14
Seung-Chan Kim, Young-Wook Lim, Soon-Yong Kwon, Woo-Lam Jo, Sung-Hun Ju, Chan-Joo Park, Choong-Woo Lee, Yong-Sik Kim
OBJECTIVES: After total hip arthroplasty (THA), restoration of hip center of rotation (COR) is essential to ensure stability of the prosthetic hip and longevity of the prosthesis. Our aim was to determine whether, and how, the COR changed postoperatively compared to the native COR following implantation of a cementless acetabular component in anatomical position and to compare the accuracy of cup placement between two surgeons with different levels of surgical experience. MATERIALS AND METHODS: We evaluated 145 patients (145 hips) who underwent unilateral primary THA, who had no distorted acetabulum on the affected hip and a normal contralateral hip...
2017: PloS One
https://www.readbyqxmd.com/read/28542400/intracellular-ca2-homeostasis-and-jak1-stat3-pathway-are-involved-in-the-protective-effect-of-propofol-on-bv2-microglia-against-hypoxia-induced-inflammation-and-apoptosis
#15
Yan Lu, Yuechao Gu, Xiaowei Ding, Jiaqiang Wang, Jiawei Chen, Changhong Miao
BACKGROUND: Perioperative hypoxia may induce microglial inflammation and apoptosis, resulting in brain injury. The neuroprotective effect of propofol against hypoxia has been reported, but the underlying mechanisms are far from clear. In this study, we explored whether and how propofol could attenuate microglia BV2 cells from CoCl2-induced hypoxic injury. METHODS: Mouse microglia BV2 cells were pretreated with propofol, and then stimulated with CoCl2. TNF-α level in the culture medium was measured by ELISA kit...
2017: PloS One
https://www.readbyqxmd.com/read/28542110/pneumonia-after-liver-transplantation
#16
Stephanie A K Angarita, Tara A Russell, Fady M Kaldas
PURPOSE OF REVIEW: Pneumonia occurs in 8-23% of patients after liver transplantation and contributes considerably to their morbidity and mortality. With the increasing acuity of liver transplantation patients in the current era, pneumonias, particularly ventilator-associated pneumonias, and multidrug-resistant pathogens, are of growing concern. RECENT FINDINGS: Postliver transplantation pneumonia cause varies with the timing of infection. In the early period (<1 month postliver transplantation), nosocomial pneumonias, including ventilator-associated pneumonias and multidrug-resistant species are most common...
May 24, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28542076/comparative-analysis-of-perioperative-and-mid-term-results-of-tecab-and-midcab-for-revascularization-of-anterior-wall
#17
Markus Kofler, Thomas Schachner, Sebastian J Reinstadler, Lukas Stastny, Julia Dumfarth, Dominik Wiedemann, Gudrun Feuchtner, Guy Friedrich, Johannes Bonatti, Nikolaos Bonaros
OBJECTIVE: Totally endoscopic coronary artery bypass (TECAB) and minimally invasive direct coronary artery bypass (MIDCAB) grafting through minithoracotomy are currently the two minimally invasive surgical techniques of left ventricular anterior wall revascularization. We aimed to compare both techniques in terms of perioperative and mid-term results. METHODS: Arrested heart TECAB was carried out in 204 patients with a median (range) age of 60 (53-76) years and a median (range) EuroSCORE I of 2 (0-3)...
May 24, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28542049/hitting-the-nail-on-the-head-a-case-report-demonstrating-the-importance-of-a-multidisciplinary-approach-to-an-unusual-penetrating-intracranial-injury
#18
Allison L Thoeny, Iman A Hadaya, Benn M Lancman, Vincent Lew
A 28-year-old man presented with a penetrating injury by a nail gun to the head. Imaging revealed a nail abutting the superior sagittal sinus without active extravasation. An anesthesia-led multidisciplinary team devised a detailed perioperative plan including conception of a complex decision tree, coordination of care, and resource utilization. In the operating room, the nail was removed under general anesthesia, with blood products and equipment for craniotomy readily available, and imaging modalities reserved for immediate use...
May 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28541851/primary-malignancy-is-an-independent-determinant-of-morbidity-and-mortality-after-liver-resection
#19
Marc W Fromer, John P Gaughan, Umur M Atabek, Francis R Spitz
Although outcomes after liver resection have improved, there remains considerable perioperative morbidity and mortality with these procedures. Studies suggest a primary liver cancer diagnosis is associated with poorer outcomes, but the extent to which this is attributable to a higher degree of hepatic dysfunction is unclear. To better delineate this, we performed a matched pair analysis of primary versus metastatic malignancies using a national database. The American College of Surgeons National Surgical Quality Improvement Program (2005-2013) was analyzed to select elective liver resections...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28541569/implementation-and-evaluation-of-a-smartphone-application-for-the-perioperative-care-of-neurosurgery-patients-at-an-academic-medical-center-implications-for-patient-satisfaction-surgery-cancelations-and-readmissions
#20
Daniel R Felbaum, Jeffrey J Stewart, Amjad N Anaizi, Faheem A Sandhu, Mani N Nair, Jean-Marc Voyadzis
BACKGROUND: Smartphone applications (apps) in the health care arena are being increasingly developed with the aim of benefiting both patients and their physicians. The delivery of adequate instructions both before and after a procedure or surgery is of paramount importance in ensuring the best possible outcome for patients. OBJECTIVE: To demonstrate that app-based instructions with built-in reminders may improve patient understanding and compliance and contribute to reducing the number of surgery cancellations and postoperative complications and readmissions...
May 25, 2017: Operative Neurosurgery (Hagerstown, Md.)
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