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https://www.readbyqxmd.com/read/28212912/pulmonary-embolism-in-the-postanesthesia-care-unit-a-case-study
#1
Debbie Smith, Jackie Murauski
Pulmonary embolism (PE) is a complication that can occur at any time during the perioperative period. The patient undergoing surgery to repair a hip fracture is at a high risk of developing a PE due to venous thrombosis, tissue, or fat emboli. The signs and symptoms of a PE are often nonspecific and can be obscured in the patient receiving or recovering from general anesthesia. This case study describes the presentation, diagnosis, and treatment of a patient experiencing a pulmonary embolism in the postanesthesia care unit (PACU) after surgery to repair a hip fracture...
February 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28207547/planning-for-operating-room-efficiency-and-faster-anesthesia-wake-up-time-in-open-major-upper-abdominal-surgery
#2
Hou-Chuan Lai, Shun-Ming Chan, Chueng-He Lu, Chih-Shung Wong, Chen-Hwan Cherng, Zhi-Fu Wu
Reducing anesthesia-controlled time (ACT) may improve operation room (OR) efficiency result from different anesthetic techniques. However, the information about the difference in ACT between desflurane (DES) anesthesia and propofol-based total intravenous anesthesia (TIVA) techniques for open major upper abdominal surgery under general anesthesia (GA) is not available in the literature.This retrospective study uses our hospital database to analyze the ACT of open major upper abdominal surgery without liver resection after either desflurane/fentanyl-based anesthesia or TIVA via target-controlled infusion with fentanyl/propofol from January 2010 to December 2011...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28197774/popliteal-block-for-lower-limb-surgery-in-children-with-cerebral-palsy-effect-on-sevoflurane-consumption-and-postoperative-pain-a-randomized-double-blinded-controlled-trial
#3
Derya Ozkan, Emel Gonen, Taylan Akkaya, Mesut Bakir
PURPOSE: The aim of this study was to evaluate the effects of a preoperative popliteal block on sevoflurane consumption, postoperative pain, and analgesic consumption in children with cerebral palsy (CP) following lower limb surgery. METHODS: Fifty-four patients undergoing lower limb surgery were randomized to receive either a popliteal block + general anaesthesia (group P, n = 27) or general anaesthesia without a popliteal block (group C, n = 27). After anesthesia induction with 50% N2O, O2, and 8% sevoflurane, a popliteal block was given to group P patients with ultrasound guidance as a single dose of 0...
February 14, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28192892/opioid-sparing-effect-of-nefopam-in-combination-with-paracetamol-after-major-abdominal-surgery-a-randomized-double-blind-study
#4
Philippe Cuvillon, Lana Zoric, Christophe Demattei, Sandrine Alonso, Francoise Casano, Joel L'hermite, Jacques Ripart, Jean-Yves Lefrant, Laurent Muller
BACKGROUND: Because nefopam's morphine-sparing is debated when combined with paracetamol, this study aimed to assess pain relief by IV nefopam in combination with paracetamol after major abdominal surgery. METHODS: This was a prospective, double-blinded randomized controlled study including patients (ASA I-III, > 18 y) scheduled for elective colectomy surgery by laparotomy. Patients were randomized into the nefopam group (n = 37, continuous IV 120 mg nefopam) or control group (N...
February 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28188320/effects-of-glyphosate-based-herbicide-sub-lethal-concentrations-on-fish-feeding-behavior
#5
Percilia Cardoso Giaquinto, Marina Borges de Sá, Vanessa Seiko Sugihara, Bruno Bastos Gonçalves, Helton Carlos Delício, Assaf Barki
Glyphosate-based herbicides are widely used in agricultural systems. Although the target organism are particularly plant organisms, there are numerous studies showing adverse effects in aquatic animals, such as inhibition of acetyl cholinesterase, effects on kidney, liver, and gill and stressors effects. This study analyzed the effects of commercial formulation of glyphosate on feeding behavior in Pacu (Piaractus mesopotamicus). Fish were exposed to three glyphosate concentrations (0.2, 0.6, and 1.8 ppm) for 15 days...
February 10, 2017: Bulletin of Environmental Contamination and Toxicology
https://www.readbyqxmd.com/read/28185260/a-comparison-of-sugammadex-and-neostigmine-for-reversal-of-rocuronium-induced-neuromuscular-blockade-in-children
#6
A S Ammar, K M Mahmoud, Z A Kasemy
BACKGROUND: Sugammadex is designed to be a reversal agent for steroidal muscle relaxants. The current trial was aimed to compare between sugammadex and neostigmine concerning the recovery time from neuromuscular blockade. We hypothesised that sugammadex might have shorter recovery time than neostigmine. METHODS: Sixty paediatric patients aged 2-10 years scheduled for lower abdominal surgeries were randomly assigned into two equal groups to receive 4 mg/kg sugammadex (Group S) or 0...
February 10, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28185011/continuous-intraoperative-epidural-infusions-affect-recovery-room-length-of-stay-and-analgesic-requirements-a-single-center-observational-study
#7
Aalap C Shah, Bala G Nair, Charles F Spiekerman, Laurent A Bollag
PURPOSE: Continuous intraoperative epidural analgesia may improve post-operative pain control and decrease opioid requirements. We investigate the effect of epidural infusion initiation before or after arrival in the post-anesthesia care unit on recovery room duration and post-operative opioid use. METHODS: We performed a retrospective chart review of abdominal, thoracic and orthopedic surgeries where an epidural catheter was placed prior to surgery at the University of Washington Medical Center during a 24 month period...
February 9, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28178175/the-effect-of-nicardipine-on-the-surgical-pleth-index-during-thyroidectomy-under-general-anesthesia-a-prospective-double-blind-randomized-controlled-trial
#8
Young Ju Won, Byung Gun Lim, Gwi Eun Yeo, Min Ki Lee, Dong Kyu Lee, Heezoo Kim, Il Ok Lee, Myoung Hoon Kong
BACKGROUND: The effectiveness of surgical pleth index (SPI) for managing nociception-antinociception balance during general anesthesia with vasodilators, including nicardipine has not been demonstrated. We aimed to compare the time course during surgery in SPI values in patients receiving nicardipine or remifentanil infusion during thyroidectomy. METHODS: Forty patients undergoing thyroidectomy were randomly assigned to receive nicardipine (group N; n = 19) or remifentanil (group R; n = 21) along with induction (propofol, fentanyl, and rocuronium) and maintenance (50% desflurane/nitrous oxide in oxygen) anesthesia (goal bispectral index [BIS] ∼50)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28177565/the-impact-of-capnography-monitoring-among-children-and-adolescents-in-the-postanesthesia-care-unit-a-randomized-controlled-trial
#9
Melissa L Langhan, Fang-Yong Li, J Lance Lichtor
BACKGROUND: Pulse oximetry does not reliably recognize respiratory depression, particularly in the presence of supplemental oxygen. Capnography frequently detects hypoventilation and apnea among children recovering from anesthesia. Although children are routinely monitored with capnography during anesthesia, reducing the rate of adverse events, it is not routinely used in the postanesthesia care unit (PACU), where patients remain at risk for respiratory depression. AIM: We hypothesized that children monitored with capnography would have more frequent staff interventions and fewer adverse events than children monitored with pulse oximetry alone...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28166099/pediatric-cardiopulmonary-arrest-in-the-postanesthesia-care-unit-rare-but-preventable-analysis-of-data-from-wake-up-safe-the-pediatric-anesthesia-quality-improvement-initiative
#10
Robert E Christensen, Bishr Haydar, Terri D Voepel-Lewis
BACKGROUND: Nearly 20% of anesthesia-related pediatric cardiac arrests (CAs) occur during emergence or recovery. The aims of this case series were to use the Wake Up Safe database to describe the following: (1) the nature of pediatric postanesthesia care unit (PACU) CA and subsequent outcomes and (2) factors associated with harm after pediatric PACU CA. METHODS: Pediatric CAs in the PACU were identified from the Wake Up Safe Pediatric Anesthesia Quality Improvement Initiative, a multicenter registry of adverse events in pediatric anesthesia...
February 3, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28163558/effect-of-intravenous-acetaminophen-on-post-anesthesia-care-unit-length-of-stay-opioid-consumption-pain-and-analgesic-drug-costs-after-ambulatory-surgery
#11
Moteb A Khobrani, James M Camamo, Asad E Patanwala
OBJECTIVES: The primary objective was to assess whether the use of intravenous acetaminophen (APAP) in the ambulatory surgery setting is associated with a decreased length of stay in the post-anesthesia care unit (PACU). The secondary outcomes evaluated were pain scores, opioid consumption, and total cost of analgesics used in the PACU. METHODS: This was a retrospective cohort study conducted in adult patients (18 years of age or older) who received an eye, ear, nose, or throat (EENT) procedure at an outpatient surgery center between January 2014 and January 2015...
February 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28147435/developing-models-to-predict-early-postoperative-patient-deterioration-and-adverse-events
#12
Mitchell K Petersen Tym, Guy L Ludbrook, Arthas Flabouris, Richard Seglenieks, Thomas W Painter
BACKGROUND: Accurate identification of patients at risk of early postoperative deterioration allows needs-based allocation of patients to appropriate levels of care. This study aimed to record the incidence of early postoperative deterioration and identify factors predictive of at-risk patients. Doing so may assist future evidence-based perioperative planning and allocation of patients to high-acuity facilities. METHODS: With ethical approval, data from elective non-cardiac surgical patients were collected between May and August 2013...
February 1, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28144270/a-clinical-trial-evaluating-the-laryngeal-mask-airway-supreme-in-obese-children-during-general-anesthesia
#13
Yue Tian, Xiu-Ying Wu, Lu Li, Ling Ma, Yun-Feng Li
INTRODUCTION: The laryngeal mask airway (LMA)-Supreme is a disposable double-lumen laryngeal mask airway that is widely used in clinical practice. However, its use in obese children has not been evaluated. The aim of this study was to determine whether the LMA-Supreme could perform equally as well as endotracheal intubation in obese children having a minor surgical procedure. MATERIAL AND METHODS: After ethical board approval, 100 obese male children receiving non-emergent appendectomy for chronic appendicitis or surgery to correct concealed penis were randomly divided into an endotracheal intubation group and an LMA-Supreme group...
February 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28120147/perioperative-analgesia-for-fast-track-laparoscopic-bariatric-surgery
#14
Olumuyiwa A Bamgbade, Oluwafemi Oluwole, Rong R Khaw
BACKGROUND: Postoperative pain and analgesia present challenges in bariatric surgery patients. Multimodal analgesia may provide better efficacy, less complications and expedite fast-track bariatric surgical care. There are no studies of the broader topic of perioperative analgesia and the overall impact. This study highlights the impact of multimodal intraoperative analgesia on fast-track bariatric surgery. METHODS: This observational study examined the perioperative outcome data of 412 consecutive laparoscopic bariatric surgery patients over a 6-year period...
January 24, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28116675/anesthetic-considerations-for-patients-with-esophageal-achalasia-undergoing-peroral-endoscopic-myotomy-a-retrospective-case-series-review
#15
Benjamin Löser, Yuki B Werner, Mark A Punke, Bernd Saugel, Sebastian Haas, Daniel A Reuter, Oliver Mann, Anna Duprée, Guido Schachschal, Thomas Rösch, Martin Petzoldt
PURPOSE: Peroral endoscopic myotomy (POEM) is a novel technique for treating esophageal achalasia. During POEM, carbon dioxide (CO2) is insufflated to aid surgical dissection, but it may inadvertently track into surrounding tissues, causing systemic CO2 uptake and tension capnoperitoneum. This in turn may affect cardiorespiratory function. This study quantified these cardiorespiratory effects and treatment by hyperventilation and percutaneous abdominal needle decompression (PND). METHODS: One hundred and seventy-three consecutive patients who underwent POEM were included in this four-year retrospective study...
January 23, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28098413/dermatomal-spread-following-posterior-transversus-abdominis-plane-block-in-pediatric-patients-our-initial-experience
#16
Maria A Hernandez, Tricia Vecchione, Karen Boretsky
INTRODUCTION: Several techniques for the transversus abdominis plane (TAP) block have been described. The extent of sensory changes using an ultrasound-guided posterior TAP block (pTAP) remains unclear in pediatric patients. The primary aim of this study was to report the extent of sensory changes achieved with pTAP; specifically the highest thoracic dermatome anesthetized. Secondary outcomes were pain scores (PS), opioid consumption, and complications. METHODS: We retrospectively reviewed the medical records of patients less than 21 years of age undergoing abdominal surgery with a unilateral or bilateral pTAP(s) for postoperative analgesia...
January 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28088956/-thoracic-paravertebral-block-in-the-pacu-for-immediate-postoperative-pain-relief-after-video-assisted-thoracoscopic-surgery
#17
F Liu, J Zhang, H K Zhang, Y Q Zhao, P Liang, Y X Zuo
Objective: To investigate the effectiveness and safety of the thoracic paravertebral block(TPVB) in the post postanesthesia care unit(PACU) for patients suffered moderate to severe pain after Video-Assisted Thoracoscopic Surgery(VATS). Methods: 78 atients who complained moderate to severe pain on arrival to PACU after VATS were randomly assigned into two groups: thoracic paravertebral block treatment group(P group) and sufentanil treatment group(S group). The VAS Pain score at rest and movement, heart rate, blood pressure, and pulse oximetry 1 hour after treatment and duration of patients staying in the PACU after treatment were recorded...
January 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28081331/segmental-epidural-anesthesia-for-percutaneous-kyphoplasty-comparison-with-general-anesthesia
#18
Alparslan Apan, Özgün Cuvaş Apan, Emine Arzu Köse
BACKGROUND/AIM: This is a feasibility study evaluating whether segmental epidural anesthesia is an alternative anesthetic approach to general anesthesia for percutaneous kyphoplasty. MATERIALS AND METHODS: After ethics committee approval was obtained, 52 ASA class I-III patients scheduled for elective, single-level percutaneous kyphoplasty were recruited. The patients were divided into two equal groups. In Group E (Group Epidural) segmental epidural anesthesia was performed using the loss of resistance technique with saline...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28079737/dexmedetomidine-reduces-perioperative-opioid-consumption-and-postoperative-pain-intensity-in-neurosurgery-a-meta-analysis
#19
Yi Liu, Feng Liang, Xiaochen Liu, Xinxin Shao, Nan Jiang, Xiaoliang Gan
BACKGROUND: Dexmedetomidine (DEX) has been administered to patients during neurosurgery. Some studies have found that DEX could reduce perioperative opioid consumption and postoperative pain intensity. However, no firm conclusions have been reached. The purpose of this meta-analysis was to assess the efficacy of DEX for managing pain in neurosurgical patients. MATERIALS AND METHODS: A comprehensive literature review was conducted to identify randomized controlled trials (RCTs) focusing on the effects of DEX on perioperative opioid consumption and postoperative pain intensity in patients undergoing neurosurgery...
January 10, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28079580/a-predictive-model-for-extended-postanesthesia-care-unit-length-of-stay-in-outpatient-surgeries
#20
Rodney A Gabriel, Ruth S Waterman, Jihoon Kim, Lucila Ohno-Machado
BACKGROUND: A predictive model that can identify patients who are at an increased risk for prolonged postanesthesia care unit (PACU) stay could help optimize resource utilization and case sequencing. Although previous studies identified some predictors, there is not a model that only utilizes various patients demographic and comorbidities, that are already known preoperatively, and that may affect PACU length of stay for outpatient procedures requiring the care of an anesthesiologist...
January 11, 2017: Anesthesia and Analgesia
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