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Anesthesia obesity

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https://www.readbyqxmd.com/read/29784260/severe-obesity-and-sleep-disordered-breathing-as-risk-factors-for-emergence-agitation-in-pediatric-ambulatory-surgery
#1
Timothy Reynolds, Sumanna Sankaran, Wilson T Chimbira, Thuy Phan, Olubukola O Nafiu
PURPOSE: Sleep-disordered breathing (SDB) may be a critical risk factor for emergence agitation (EA). We hypothesized that SDB diagnosis is a predictor of EA in children after general anesthesia for ambulatory surgery. DESIGN: Prospective, observational, cohort study. METHODS: Children aged 4 to 17 years were assessed for the occurrence of EA. Differences in probability of EA were assessed using multivariable logistic regression analyses...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29780726/operative-techniques-for-improving-surgical-exposure-in-basic-cardiac-surgery
#2
Dawn S Hui, Jason M Lizalek, Vikram S Chawa, Richard Lee
Operative exposure is key to ensuring surgical efficiency and patient safety in cardiac surgery. As the population ages and the prevalence of obesity increases, cardiac surgeons will be challenged to consider obese patient physiology and body habitus, surgical exposure and sternotomy closure techniques, and postoperative medical management to ensure optimal outcomes. In this article, we describe techniques to improve operative exposure in both obese and non-obese patients undergoing basic cardiac surgery and highlight the roles of surgical team members to ensure patient safety and provide optimal anesthetic management...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29756103/factors-affecting-successful-colonoscopy-procedures-single-center-experience
#3
Ramazan Kozan, Tonguç Utku Yılmaz, Uygar Baştuğral, Umut Kerimoğlu, Yücel Yavuz
Objective: Colonoscopy is a gold standard procedure for several colon pathologies. Successful colonoscopy means demonstration of the ileocecal valve and determination of colon polyps. Here we aimed to evaluate our colonoscopy success and results. Material and Methods: This retrospective descriptive study was performed in İstanbul Eren hospital endoscopy unit between 2012 and 2015. Colonoscopy results and patient demographics were obtained from the hospital database...
2018: Turkish Journal of Surgery
https://www.readbyqxmd.com/read/29755518/double-barrel-nasal-trumpets-to-prevent-upper-airway-obstruction-after-nasal-and-non-nasal-surgery
#4
Macario Camacho, Justin M Wei, Lauren K Reckley, Sungjin A Song
Objectives: During anesthesia emergence, patients are extubated and the upper airway can become vulnerable to obstruction. Nasal trumpets can help prevent obstruction. However, we have found no manuscript describing how to place nasal trumpets after nasal surgery (septoplasties or septorhinoplasties), likely because (1) the lack of space with nasal splints in place and (2) surgeons may fear that removing the trumpets could displace the splints. The objective of this manuscript is to describe how to place nasal trumpets even with nasal splints in place...
2018: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/29752664/patient-related-factors-predicting-workspace-conditions-during-laparoscopic-bariatric-surgery
#5
Paola Aceto, Cristina Modesti, Teresa Sacco, Roberto De Cicco, Valter Perilli, Marco Raffaelli, Carlo Lai, Liliana Sollazzi
BACKGROUND: Previous studies have focused on the role of deep neuromuscular blockade (NMB) in improving surgical conditions during laparoscopic bariatric surgery. However, a wide inter-individual variability has been noted. The aim of this study was to identify patient-related factors affecting surgeon satisfaction with the surgical space and surgery duration in laparoscopic bariatric surgery under deep NMB. METHODS: One hundred eighty-five patients scheduled for laparoscopic gastric bypass were enrolled...
May 12, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29728260/anesthesia-in-a-pediatric-patient-with-rohadd-syndrome
#6
E Esparza Isasa, M A Palomero Rodríguez, I Acebedo Bambaren, C Medrano Viñas, D Gil Mayo, F Domínguez Pérez, D Pestaña Lagunas
Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) syndrome is a rare entity that is characterised by its onset in healthy children at 2-4 years of age. It is a complex syndrome that includes, among other symptoms, rapid weight gain with hyperphagia, hypothalamic dysfunction, central hypoventilation, and autonomic dysregulation. The case is presented of a 10-year-old boy with a diagnosis of ROHHAD syndrome undergoing insertion of a port-a-cath under general anaesthesia, who developed complications during the anaesthetic procedure related to his illness...
May 1, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29708917/epidural-anesthesia-to-facilitate-organ-blood-flow-during-the-first-penile-transplantation-in-the-united-states-a-case-report
#7
Katarina J Ruscic, Grettel J Zamora-Berridi, Francis J McGovern, Curtis Cetrulo, Jonathan M Winograd, Kyle R Eberlin, Branko Bojovic, Dicken S Ko, T Anthony Anderson
Regional anesthesia has been used to help create local sympathectomy and improve blood flow in plastic surgery procedures involving tissue grafts and flaps. However, anesthetic techniques that reduce systemic vascular resistance must be used with caution in patients with aortic stenosis (AS). Combined neuraxial and general anesthesia with careful titration of the local anesthetic dose can be a safe approach for patients with AS undergoing microvascular procedures. We present the anesthetic management of the first North American penile transplant, on an obese patient with moderate AS...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29697466/perioperative-considerations-for-airway-management-and-drug-dosing-in-obese-children
#8
Jerrold Lerman, Karin Becke
PURPOSE OF REVIEW: Childhood obesity, a phenomenon that is increasing globally, holds substantial relevance for pediatric anesthesia. In particular, understanding the nuances of airway management and drug dosing in obese children can be daunting. RECENT FINDINGS: Respiratory adverse events and challenges in managing the airway may be anticipated. In addition, drug-dosing strategies for the obese child are complex and poorly understood although recent advances have clarified the optimal dosing for anesthetics in these children...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29691098/improved-patency-after-axillofemoral-bypass-for-aortoiliac-occlusive-disease
#9
Russell H Samson, David P Showalter, Michael R Lepore, Deepak G Nair, Douglas A Dorsay, Ricardo E Morales
OBJECTIVE: Axillofemoral bypasses (AxFBs) have been used since 1962 to treat aortoiliac disease. In the past, reported patency rates (37%-76%) for these extra-anatomic grafts have been inferior to those for anatomic aortic grafting. Reported low survival rates after AxFB (40%-50%) have confirmed that these procedures have been used primarily in patients at high risk for complications from aortofemoral bypass. However, modern medical and anesthesia management, preoperative scanning, donor artery preparation, postoperative graft surveillance, and graft technology may improve outcomes after AxFB, possibly supporting expansion of its use...
April 21, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29681567/recovery-of-endothelial-function-after-minor-to-moderate-surgery-is-impaired-by-diabetes-mellitus-obesity-hyperuricemia-and-sevoflurane-based-anesthesia
#10
Sachi Ohno, Atsushi Kohjitani, Masaaki Miyata, Akina Tohya, Kaoru Yamashita, Teruto Hashiguchi, Mitsuru Ohishi, Mitsutaka Sugimura
Endothelial dysfunction is observed in several cardiovascular diseases, where endothelium-dependent vasodilation is impaired by oxidative stress. However, the time course of endothelial function during the perioperative period of a minor-to-moderate surgery, and the effects of atherosclerotic risk factors and employed general anesthetics on recovery of endothelial function, are unknown. Endothelial function of 30 patients was evaluated as the reactive hyperemia index (RHI) of reactive hyperemia peripheral arterial tonometry...
April 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29663179/the-impact-of-obesity-on-pulmonary-deterioration-in-patients-undergoing-robotic-assisted-laparoscopic-prostatectomy
#11
Sebastian Blecha, Marion Harth, Florian Zeman, Timo Seyfried, Matthias Lubnow, Maximilian Burger, Stefan Denzinger, Michael T Pawlik
Obesity affects respiratory and hemodynamic function in anesthetized patients. The aim of this study was to evaluate the influence of the body mass index (BMI) on pulmonary changes in a permanent 45° steep Trendelenburg position (STP) during robotic-assisted laparoscopic prostatectomy (RALP). 51 patients undergoing RALP under standardized anesthesia were included. Perioperative pulmonary function and oxygenation were measured in awake patients (T0 ), 20 min after the induction of anesthesia (T1 ), after insufflation of the abdomen in supine position (T2 ), after 30 min in STP (T3 ), when controlling Santorini's plexus in STP (T4 ), before awakening while supine (T5 ), and after 45 min in the recovery room (T6 )...
April 16, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29629894/pulmonary-aspiration-in-adjustable-gastric-banding-carriers-undergoing-a-second-surgical-procedure-considerations-on-personal-experience-and-review-of-the-literature
#12
Contardo Vergani, Marco Venturi, Sara Badiali, Barbara Chella, Enrico Mozzi
BACKGROUND: The observation of a relatively high number of pulmonary aspirations (PA) among gastric band (GB) carriers undergoing a second surgery, prompted us to modify our strategy for GB patients candidate to further operation under general anesthesia. MATERIAL OF STUDY AND RESULTS: In January 2013, following the occurrence of PA at the induction of general anesthesia in 1 GB carrier undergoing a further operation, we reviewed our Data Base between January 2005 and 2013, to explore the rate of pulmonary aspiration in patients GB carriers undergoing a second surgery...
2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29605864/robotic-kidney-autotransplantation-in-a-porcine-model-a-procedure-specific-training-platform-for-the-simulation-of-robotic-intracorporeal-vascular-anastomosis
#13
Ho Yee Tiong, Benjamin Yen Seow Goh, Edmund Chiong, Lincoln Guan Lim Tan, Anatharaman Vathsala
Robotic-assisted kidney transplantation (RKT) with the Da Vinci (Intuitive, USA) platform has been recently developed to improve outcomes by decreasing surgical site complications and morbidity, especially in obese patients. This potential paradigm shift in the surgical technique of kidney transplantation is performed in only a few centers. For wider adoption of this high stake complex operation, we aimed to develop a procedure-specific simulation platform in a porcine model for the training of robotic intracorporeal vascular anastomosis and evaluating vascular anastomoses patency...
March 31, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29553542/novel-approach-for-simultaneous-recording-of-renal-sympathetic-nerve-activity-and-blood-pressure-with-intravenous-infusion-in-conscious-unrestrained-mice
#14
Shereen M Hamza, John E Hall
Renal sympathetic nerves contribute significantly to both physiological and pathophysiological phenomena. Evaluating renal sympathetic nerve activity (RSNA) is of great interest in many areas of research such as chronic kidney disease, hypertension, heart failure, diabetes and obesity. Unequivocal assessment of the role of the sympathetic nervous system is thus imperative for proper interpretation of experimental results and understanding of disease processes. RSNA has been traditionally measured in anesthetized rodents, including mice...
February 14, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29480892/can-patient-selection-explain-the-obesity-paradox-in-orthopaedic-hip-surgery-an-analysis-of-the-acs-nsqip-registry
#15
Joyce C Zhang, John Matelski, Rajiv Gandhi, Timothy Jackson, David Urbach, Peter Cram
BACKGROUND: The "obesity paradox" is a phenomenon described in prior research in which patients who are obese have been shown to have lower postoperative mortality and morbidity compared with normal-weight individuals. The paradox is that clinical experience suggests that obesity is a risk factor for difficult wound healing and adverse cardiovascular outcomes. We suspect that the obesity paradox may reflect selection bias in which only the healthiest patients who are obese are offered surgery, whereas nonobese surgical patients are comprised of both healthy and unhealthy individuals...
May 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29479923/effects-of-pressure-controlleda-volume-controlled-ventilation-on-hemodynamic-and-respiratory-parameters-in-patients-during-laparoscopic-cholecystectomy
#16
Mirko Mihalj, Dajana Vladić, Zoran Karlović, Željka Zadro, Višnja Majerić Kogler
Many papers have been published investigating the effects of intraoperative mechanical ventilation on the incidence of intra- and postoperative respiratory complications. The potential advantages of protective pressure over volume-controlled ventilation mode during laparoscopic surgery have yet to be proven. This study included 60 patients aged between 18 and 70 with ASA score 1-3, body mass index (BMI) ≤35 kg/m2, and without prior history of chronic respiratory diseases, who were scheduled for laparoscopic cholecystectomy under general anesthesia...
September 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29477722/feasibility-and-safety-of-ultrasonography-guidance-and-flank-position-during-percutaneous-nephrolithotomy
#17
Seyed Hassan Inanloo, Seyed Reza Yahyazadeh, Samaneh Rashidi, Erfan Amini, Mohammad Reza Nowroozi, Mohsen Ayayti, Hassan Jamshidian, Mohammad Reza Nikoobakht, Seyed Mohammad Kazem Aghamir, Omid Hemmatian, Seyed Ali Momeni
PURPOSE: Percutaneous nephrolithotomy is generally performed using fluoroscopy, which is associated with exposure to radiation. Another drawback of fluoroscopic guided percutaneous nephrolithotomy is the prone position, which is not suitable for all patients. In this study we evaluated the feasibility, safety and efficacy of ultrasound guided percutaneous nephrolithotomy with the patient in the flank position. MATERIALS AND METHODS: A total of 603 patients with a mean ± SD age of 50...
March 1, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29468091/surgical-technical-evidence-review-for-elective-total-joint-replacement-conducted-for-the-ahrq-safety-program-for-improving-surgical-care-and-recovery
#18
REVIEW
Christopher P Childers, Anaar E Siletz, Emily S Singer, Claire Faltermeier, Q Lina Hu, Clifford Y Ko, Gregory J Golladay, Stephen L Kates, Elizabeth C Wick, Melinda Maggard-Gibbons
Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29442057/inguinal-hernia-repair-in-day-surgery-the-role-of-mac-monitored-anesthesia-care-with-remifentanil
#19
P Palumbo, S Usai, C Amatucci, B Perotti, L Ruggeri, G Illuminati, G Tellan
BACKGROUND: The extension of indications for procedures in a Day Surgery (DS) setting has led to changes in the anesthetic and surgical treatment of Inguinal Hernias (IH). According to the recommendations of the European Hernia Society, the treatment of IH in DS units should be performed under Monitored Anesthesia Care (MAC). PATIENTS AND METHODS: 960 patients underwent IH repairs over a period of 24 months. The patients were randomly divided into two groups: R (remifentanil) and F (fentanyl); the group F was considered as a control group...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29434629/transcatheter-versus-surgical-aortic-valve-replacement-in-severe-symptomatic-aortic-stenosis
#20
REVIEW
Tsigkas Grigorios, Despotopoulos Stefanos, Makris Athanasios, Koniari Ioanna, Armylagos Stylianos, Davlouros Periklis, Hahalis George
Aortic stenosis (AS) is the most common type of valvular heart disease in the elderly. Surgical aortic valve replacement (SAVR) has been the standard practice for treating severe, symptomatic AS, but recently new treatment options have emerged. Transcatheter aortic valve replacement (TAVR) is now an established treatment option in patients at high surgical risk. In this review, we focus on recent developments and compare the two treatment methods in specific populations in terms of efficacy and safety (e.g...
January 2018: Journal of Geriatric Cardiology: JGC
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