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Post anesthesia care unit

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https://www.readbyqxmd.com/read/28625445/prospective-double-blind-randomized-placebo-controlled-clinical-trial-of-the-pectoral-nerves-pecs-block-type-ii
#1
Barbara Versyck, Geert-Jan van Geffen, Patrick Van Houwe
STUDY OBJECTIVE: The aim of this clinical trial was to test the hypothesis whether adding the pectoral nerves (Pecs) block type II to the anesthetic procedure reduces opioid consumption during and after breast surgery. DESIGN: A prospective randomized double blind placebo-controlled study. SETTING: A secondary hospital. PATIENTS: 140 breast cancer stage 1-3 patients undergoing mastectomy or tumorectomy with sentinel node or axillary node dissection...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28624028/impact-of-long-acting-local-anesthesia-on-clinical-and-financial-outcomes-in-laparoscopic-colorectal-surgery
#2
Deborah S Keller, Rodrigo Pedraza, Reena N Tahilramani, Juan R Flores-Gonzalez, Sergio Ibarra, Eric M Haas
BACKGROUND: Our objective was to assess clinical and financial outcomes with long-acting liposomal bupicavaine (LB) in laparoscopic colorectal surgery. METHODS: Patients that received local infiltration with LB were strictly matched to a control group, and compared for postoperative pain, opioid use, length of stay (LOS), hospital costs, and complication, readmission, and reoperation rates. RESULTS: A total of 70 patients were evaluated in each cohort...
July 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28623540/identification-of-surgical-patients-at-high-risk-of-osas-using-the-berlin-questionnaire-to-detect-potential-high-risk-of-adverse-respiratory-events-in-post-anesthesia-care-unit
#3
Fei Liu, Li Liu, Fang Zheng, Xiangdong Tang, Yongxin Bao, Yunxia Zuo
Obstructive sleep apnea syndrome (OSAS) increases the risk of post-surgery complications. This study uses Berlin Questionnaire (BQ) to identify Chinese adult surgical patients who are at a high risk of OSAS and to determine if the BQ could be used to detect potential high risk of adverse respiratory events in the post anesthesia care unit (PACU). Results indicated that only 11.4% of the patients were considered at a high risk of OSAS. Age and body mass index are the key factors for the risk of OSAS prevalence in China and also gender specific...
June 7, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28607335/the-surgical-stress-response-and-the-potential-role-of-preoperative-glucocorticoids-on-post-anesthesia-care-unit-recovery
#4
Kristin J Steinthorsdottir, Henrik Kehlet, Eske K Aasvang
The immediate postoperative course in the post-anaesthesia care unit (PACU) remains a challenge across surgical procedures. Postoperative pain, sedation/cognitive dysfunction, nausea and vomiting (PONV), circulatory and respiratory problems and orthostatic intolerance constitute the bulk of the difficulties that may delay the postoperative recovery. A common feature in the observed organ dysfunctions is the inflammatory response to surgery during the acute postoperative recovery phase, suggesting that control of inflammation may improve outcomes and reduce complications...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28583057/auricular-acupressure-in-the-prevention-of-postoperative-nausea-and-emesis-a-randomized-controlled-trial
#5
Cynthia Feng, Jovan Popovic, Richard Kline, Jung Kim, Rafael Matos, Sarah Lee, Joseph Bosco
INTRODUCTION: Successful antiemesis contributes significantly to quality, safety, and patient satisfaction. Patients undergoing general anesthesia often experience postoperative nausea and vomiting (PONV). Acupressure offers a side effect-free alternative to common first-line antiemetics. Because the patient may perceive needle acupuncture as uncomfortable, acupressure is a desirable alternative for the prevention of PONV. METHODS: This study was a randomized, prospective, double-blinded clinical trial investigating the effect of acupressure in patients with a history of PONV and motion sickness...
April 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28578646/clonidine-but-not-dexamethasone-prolongs-ropivacaine-induced-supraclavicular-brachial-plexus-nerve-block-duration
#6
Dawood Nasir, Irina Gasanova, Shaina Drummond, John Alexander, Jo Howard, Emily Melikman, Gary Hill, Abu Minhajuddin, Babatunde Ogunnaike, Charles Whitten
BACKGROUND: Ultrasound-guided supraclavicular brachial plexus block (USSB) provides excellent postoperative analgesia after upper extremity surgery. Dexamethasone and clonidine have been added to local anesthetics to enhance and prolong the duration of analgesia. OBJECTIVE: The objective of this randomized prospective study is to evaluate the efficacy of dexamethasone, clonidine, or combination of both as adjuvants to ropivacaine on the duration of USSB for postoperative analgesia...
June 4, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28551058/-anesthesia-recovery-comparison-between-remifentanil-propofol-and-remifentanil-desflurane-guided-by-bispectral-index-%C3%A2-monitoring
#7
Raphael Grossi Rocha, Eduardo Giarola Almeida, Lara Moreira Mendes Carneiro, Natália Farias de Almeida, Walkíria Wingester Vilas Boas, Renato Santiago Gomez
BACKGROUND AND OBJECTIVES: There is a strong demand for fast and predictable anesthesia recovery with few side effects. Choice of the hypnotic agent could impact on that. This study investigated the differences between recoveries after remifentanil-propofol and remifentanil-desflurane anesthesias guided by bispectral index (BIS(®)). METHODS: Forty patients were randomly assigned into 2 groups according to the anesthesia technique applied: remifentanil-propofol (REM-PRO) and remifentanil-desflurane (REM-DES)...
May 25, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28538591/intrathecal-morphine-and-oral-analgesics-provide-safe-and-effective-pain-control-after-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#8
Ying Li, Rebecca A Hong, Christopher B Robbins, Kathleen M Gibbons, Ashlee E Holman, Michelle S Caird, Frances A Farley, Matthew D Abbott, Michelle C Burke
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To demonstrate that intrathecal morphine (ITM) and oral analgesics provide effective pain control after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS), and this protocol has a low complication rate so patients can be admitted to a general care floor. SUMMARY OF BACKGROUND DATA: Previous studies have shown that ITM combined with intravenous patient-controlled analgesia or epidural infusion (EPI) provides effective pain control after PSF for AIS...
May 23, 2017: Spine
https://www.readbyqxmd.com/read/28532707/sedated-suture-adjustment-in-children-undergoing-adjustable-suture-strabismus-surgery
#9
Warachaya Phanphruk, Maan Alkharashi, Aykut Bilge, David G Hunter
PURPOSE: To study methods and adverse events of postoperative, sedated suture adjustment after strabismus surgery in the post-anesthesia care unit (PACU). METHODS: We reviewed the postoperative experience of all children ≤18 years of age undergoing adjustable suture strabismus surgery at Boston Children's Hospital over a 3-year period. Time in the hospital, adverse events, and surgical outcomes were reviewed to evaluate safety and healthcare resource utilization...
May 19, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28527544/a-prospective-study-of-nausea-and-vomiting-after-breast-cancer-surgery
#10
Susan W Wesmiller, Catherine M Bender, Yvette P Conley, Dana H Bovbjerg, Gretchen Ahrendt, Marguerite Bonaventura, Susan M Sereika
PURPOSE: Postoperative nausea and vomiting (PONV) and post-discharge nausea and vomiting (PDNV) continue to be common and disturbing complications experienced after surgery, particularly in women and especially in women undergoing breast cancer surgery. The purpose of this study was to assess the incidence and risk factors associated with PONV and PDNV from preoperative to 48 hours postoperatively in 97 women scheduled for breast cancer surgery. DESIGN: Prospective, comparative design...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28520718/retrospective-observational-evaluation-of-postoperative-oxygen-saturation-levels-and-associated-postoperative-respiratory-complications-and-hospital-resource-utilization
#11
Satya Krishna Ramachandran, Aleda Thompson, Jaideep J Pandit, Scott Devine, Amy M Shanks
INTRODUCTION: The clinical importance of postoperative episodic hypoxemia is still unclear, and therefore largely under-studied. As a result, there is limited understanding of its relationship with early postoperative respiratory complications (PRC, defined as intubation within three days of surgery) and hospital resource utilization. MATERIALS AND METHODS: This single center study was performed using a retrospective observational design. We described population based definitions of desaturation from continuous SpO2 monitoring data captured in the post anesthesia care unit (PACU), namely median SpO2 in PACU, duration of desaturation below median, nadir desaturation, and length of oxygen therapy relative to PACU duration...
2017: PloS One
https://www.readbyqxmd.com/read/28499420/continuous-femoral-nerve-blockade-and-single-shot-sciatic-nerve-block-promotes-better-analgesia-and-lower-bleeding-for-total-knee-arthroplasty-compared-to-intrathecal-morphine-a-randomized-trial
#12
Nora Elizabeth Rojas Álvarez, Rosemberg Jairo Gomez Ledesma, Adilson Hamaji, Marcelo Waldir Mian Hamaji, Joaquim Edson Vieira
BACKGROUND: Knee arthroplasty leads to postoperative pain. This study compares analgesia and postoperative bleeding achieved by intrathecal morphine with a continuous femoral plus single-shot sciatic nerve block. METHODS: A randomized non-blinded clinical trial enrolled patients aged over 18 years old, ASA I to III who underwent total knee arthroplasty. All patients underwent spinal anesthesia with isobaric bupivacaine, 20 mg. One group received 100 mcg of intrathecal morphine (M group), and the other received a femoral nerve block by continuous infusion plus a "single shot" block of the sciatic nerve at the end of the surgery (FI group)...
May 12, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28496141/a-randomized-comparison-of-the-prone-ventilation-endotracheal-tube-versus-the-traditional-endotracheal-tube-in-adult-patients-undergoing-prone-position-surgery
#13
Wangyuan Zou, Jiali Shao, Xia Liang, Lin Li, Zhenghua He, Qulian Guo
Endotracheal tube displacement or dislocation is a severe complication that can occur in patients who require prone position ventilation. We hypothesized the prone position tube (PPT) would reduce the incidence of displacement of an endotracheal tube in an adult prone operation compared to a traditional tube (TT). A total of 80 adult patients undergoing neurosurgery or spine surgery were recruited. Sixty patients with prone position ventilation were randomly divided into the traditional routine endotracheal tube group (Group TT, n = 30) and the prone position ventilation endotracheal tube group (Group PPT, n = 30)...
May 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28494898/the-effect-of-desflurane-versus-propofol-anesthesia-on-postoperative-delirium-in-elderly-obese-patients-undergoing-total-knee-replacement-a-randomized-controlled-double-blinded-clinical-trial
#14
Pedro Tanaka, Stuart Goodman, Barbara R Sommer, William Maloney, James Huddleston, Hendrikus J Lemmens
STUDY OBJECTIVE: The goal of this study was to investigate the incidence of delirium, wake-up times and early post-operative cognitive decline in one hundred obese elderly patients undergoing total knee arthroplasty. DESIGN: Prospective randomized trial. SETTINGS: Operating room, postoperative recovery area, hospital wards. PATIENTS: 100 obese patients (ASA II and III) undergoing primary total knee replacement under general anesthesia with a femoral nerve block catheter...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28494892/postoperative-analgesic-efficacy-of-single-shot-and-continuous-transversus-abdominis-plane-block-after-laparoscopic-cholecystectomy-a-randomized-controlled-clinical-trial
#15
Yun-Mi Choi, Gyeong-Jo Byeon, Soon-Ji Park, Young-Min Ok, Sang-Wook Shin, Kwangho Yang
STUDY OBJECTIVE: To compare the analgesic efficacy of ultrasound-guided single-shot and continuous transversus abdominis plane (TAP) block to that of IV-PCA in patients undergoing laparoscopic cholecystectomy. DESIGN: Prospective randomized controlled trial. SETTING: Post-anesthesia care unit and General ward. PATIENTS: 108 American Society of Anesthesiologist (ASA) physical status I-II patients undergoing laparoscopic cholecystectomy...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28489477/combined-sciatic-and-lumbar-plexus-nerve-blocks-for-the-analgesic-management-of-hip-arthroscopy-procedures-a-retrospective-review
#16
J Douglas Jaffe, Theodore Ross Morgan, Gregory B Russell
Hip arthroscopy is a minimally invasive alternative to open hip surgery. Despite its minimally invasive nature, there can still be significant reported pain following these procedures. The impact of combined sciatic and lumbar plexus nerve blocks on postoperative pain scores and opioid consumption in patients undergoing hip arthroscopy was investigated. A retrospective analysis of 176 patients revealed that compared with patients with no preoperative peripheral nerve block, significant reductions in pain scores to 24 hours were reported and decreased opioid consumption during the post anesthesia care unit (PACU) stay was recorded; no significant differences in opioid consumption out to 24 hours were discovered...
May 10, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28477230/a-matched-case-control-comparison-of-hospital-costs-and-outcomes-for-knee-replacement-patients-admitted-postoperatively-to-acute-care-versus-rehabilitation
#17
Brian K Tse, Tessa L Walters, Steven K Howard, T Edward Kim, Stavros G Memtsoudis, Eric C Sun, Alex Kou, Lorrie Graham, Robert King, Edward R Mariano
For select total knee arthroplasty (TKA) patients, we have established an alternative pathway to bypass the acute care surgical ward and directly admit patients from the post-anesthesia care unit to on-campus rehabilitation. We retrospectively examined whether this 'fast track' pathway decreased costs and improved patient outcomes. After reviewing records of consecutive primary unilateral TKA patients over a 15-month period, each patient admitted to rehabilitation was matched with a control admitted to the acute care ward...
May 5, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28476033/dexmedetomidine-plus-sufentanil-for-pediatric-flexible-bronchoscopy-a-retrospective-clinical-trial
#18
Xiujing Dang, Weidong Hu, Zhendong Yang, Shiyu Su
Several studies have reported the use of dexmedetomidine (DEX) plus opioids for flexible bronchoscopy in both adults and children. To determine whether DEX plus sufentanil (SF) is safe for children, 142 children undergoing flexible bronchoscopy were assigned to one of three groups, each of which received the same SF loading dose and similar DEX and SF maintenance doses, but different loading doses of DEX: DS1 (DEX 0.5 μg·kg-1), DS2 (DEX 1.0 μg·kg-1), and DS3 (DEX 1.5 μg·kg-1). The Ramsay sedation scale was maintained at 3 in all groups...
April 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/28470102/oct1-genetic-variants-are-associated-with-postoperative-morphine-related-adverse-effects-in-children
#19
Rajiv Balyan, Xue Zhang, Vidya Chidambaran, Lisa J Martin, Tomoyuki Mizuno, Tsuyoshi Fukuda, Alexander A Vinks, Senthilkumar Sadhasivam
AIM: Large interindividual variability in morphine pharmacokinetics (PK) could contribute to variability in morphine analgesia and adverse events. Respiratory depression (RD) and postoperative nausea and vomiting (PONV) are significant adverse drug response of intravenous morphine in the perioperative setting limiting its efficacy in achieving adequate surgical pain relief. OCT1 is a transporter in the liver that transports morphine from the bloodstream into hepatocytes. Earlier we reported association of genetic polymorphisms in OCT1 with morphine PK, and lower morphine clearance in Caucasian children as compared with African-American (AA) children...
May 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28461390/propofol-sedation-exacerbates-kidney-pathology-and-dissemination-of-bacteria-during-staphylococcus-aureus-bloodstream-infections
#20
Lavanya Visvabharathy, Nancy E Freitag
Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for large numbers of postsurgical nosocomial infections across the United States and worldwide. Propofol anesthesia is widely used in surgery and in intensive care units, and recent evidence indicates that even brief exposure to propofol can substantially increase host susceptibility to microbial infection. Here, we delineate the impact of propofol sedation on MRSA bloodstream infections in mice in the presence and absence of prophylactic antibiotic treatment...
July 2017: Infection and Immunity
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