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Post anesthesia care unit

Wei-Hung Chan, Meei-Shyuan Lee, Chin Lin, Chang-Chieh Wu, Hou-Chuan Lai, Shun-Ming Chan, Chueng-He Lu, Chen-Hwan Cherng, Zhi-Fu Wu
We conducted a retrospective study to investigate the anesthesia-controlled time and factors that contribute to prolonged extubation in open colorectal surgery. Using our hospital database, demographic data, various time intervals (waiting for anesthesia time, anesthesia time, surgical time, emergence time, exit from operating room after extubation, total operating room time, and post-anesthesia care unit stay time), and incidence of prolonged extubation (≥ 15 mins), were compared between patients who received desflurane/fentanyl-based anesthesia and total intravenous anesthesia via target-controlled infusion with fentanyl/propofol...
2016: PloS One
Faramarz Mosaffa, Seyed Amir Mohajerani, Reza Aminnejad, Ali Solhpour, Shideh Dabir, Gholam Reza Mohseni
BACKGROUND: Preemptive analgesia is the blocking of pain perception afferent pathways before noxious painful stimuli. Clonidine is an alpha agonist drug that is partially selective for α-2 adrenoreceptors. Clonidine is used as anti-anxiety medication and an, analgesic, and it prolongs the duration of the block in the brachial plexus block. OBJECTIVES: To compare the effect of preemptive clonidine with midazolam on intraoperative sedation, duration of block, and postoperative pain scores...
June 2016: Anesthesiology and Pain Medicine
Ashima Sharma, Monu Yadav, B Rajesh Kumar, P Sai Lakshman, Raju Iyenger, Gopinath Ramchandran
BACKGROUND: A major change in anesthesia practice as regards to intraoperative infusion therapy is the present requirement. Switching over to balanced fluids can substantially decrease the incidence of lactic acidosis and hyperchloremic acidosis. The deleterious effects of unbalanced fluids are more recognizable during major surgeries. We prospectively studied the influence of Sterofundin (SF) and Ringer lactate (RL) on acid-base changes, hemodynamics, and readiness for extubation during scoliosis surgery...
September 2016: Anesthesia, Essays and Researches
Ge Qu, Xu-Lei Cui, Hong-Ju Liu, Zhi-Gang Ji, Yu-Guang Huang
<strong>Objective</strong> To evaluate the effects of ultrasound-guided transversus abdominis plane (TAP) block on postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries. <strong>Methods</strong> This was a randomized, controlled, double-blinded trial. Eligible patients scheduled for retroperitoneoscopic urologic surgeries were randomly assigned to two groups. Group TAP received ultrasound-guided TAP block with 0.5% ropivacaine 20 ml at 30 minutes before surgery, and Group C received TAP sham block with normal saline...
September 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
Bruce Ramshaw, Brandie Forman, Eric Heidel, Jonathan Dean, Andrew Gamenthaler, Michael Fabian
Patients who undergo laparoscopic ventral hernia repair can have significant post-operative pain and discomfort from both somatic pain due to mesh fixation and visceral pain due to CO2 insufflation pressure. In an attempt to improve outcomes, a Clinical Quality Improvement (CQI) project was implemented by a multi-disciplinary hernia team. CQI tools were applied for consecutive patients who underwent laparoscopic ventral hernia repair from June 2012 through September 2015 (39 months). Initiatives for improved patient outcomes during this period included the administration of a transversus abdominis plane (TAP) block and/or an intra-operative block with long-acting local anesthetic first, and then a low pressure pneumoperitoneum (LPP) system was implemented later in the project...
October 6, 2016: Surgical Technology International
Youssef Motiaa, Mustapha Bensghir, Abdelhamid Jaafari, Mohammed Meziane, Redouane Ahtil, Noureddine Drissi Kamili
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a technique used both for diagnosis and for the treatment of biliary and pancreatic diseases. ERCP has some anesthetic implications and specific complications. The primary outcome aim was to compare two protocols in terms of time of extubation. We also compared anesthetic protocols in terms of hemodynamic and respiratory instability, antispasmodics needs, endoscopist satisfaction, and recovery room stay. METHODS: Patients were randomized into two groups standard anesthesia group (Gr: SA) in whom induction was done by propofol, fentanyl and cisatracurium and maintenance was done by a mixture of oxygen, nitrousoxide (50%:50%) and sevoflurane; and intravenous anesthesia group to target concentration (Gr: TCI) in whom induction and maintenance of anesthesia were done with propofol with a target 0...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Roman Schumann, Andrzej P Kwater, Iwona Bonney, Diane Ladd, Julie Kim, Anupriya Gupta, Sam D Gumbert, Evan G Pivalizza
STUDY OBJECTIVE: To evaluate use of a respiratory volume monitor (RVM; ExSpiron, Respiratory Motion, Inc., Waltham, MA, USA) that provides minute ventilation (MV), tidal volume (TV) and respiratory rate (RR) measurements in obese surgical patients, hitherto undescribed. DESIGN: Prospective, IRB-approved observational study of RVM parameter accuracy in obese surgical patients, designed to test the ability of the RVM to detect predefined postoperative respiratory depression (PORD) and apneic events (POA) and to correlate STOP-Bang scores with PORD and POA...
November 2016: Journal of Clinical Anesthesia
Katherine H Dobie, Yaping Shi, Matthew S Shotwell, Warren S Sandberg
STUDY OBJECTIVE: Regional anesthesia and analgesia for shoulder surgery is most commonly performed via interscalene nerve block. We developed an ultrasound-guided technique that specifically targets the C5 nerve root proximal to the traditional interscalene block and assessed its efficacy for shoulder analgesia. DESIGN: Prospective case series. SETTING: Vanderbilt Bone and Joint Surgery Center. PATIENTS: Patients undergoing shoulder arthroscopy at an ambulatory surgery center...
November 2016: Journal of Clinical Anesthesia
Matthew Umholtz, John Cilnyk, Christopher K Wang, Jahan Porhomayon, Leili Pourafkari, Nader D Nader
STUDY OBJECTIVE: Recovery from anesthesia may be complicated with development of severe panic symptoms and anxiety. Preexisting anxiety disorder has been reported as a risk factor for development of these symptoms. We aimed to examine the frequency of emergence delirium (EDL) among veterans diagnosed with posttraumatic stress disorders (PTSDs). DESIGN: Retrospective cohort. SETTING: Postoperative recovery area. PATIENTS: Perioperative information of 1763 consecutive patients who underwent a surgical procedure requiring general anesthesia were collected...
November 2016: Journal of Clinical Anesthesia
Manuel J Richter, Ralf Ewert, Christian Warnke, Henning Gall, Simon Classen, Friedrich Grimminger, Eckhard Mayer, Werner Seeger, Hossein-Ardeschir Ghofrani
BACKGROUND: In patients with severe pulmonary arterial hypertension, subcutaneous or catheter-based intravenous application of prostanoids carries a risk of local side effects or systemic infections, which limits their use and acceptance. Recently, a fully implantable pump for continuous application of intravenous treprostinil was approved in Germany. However, surgery is a major risk for patients with severe pulmonary arterial hypertension. The purpose of this study was to investigate the safety of a fully implantable pump inserted under local or general anesthesia in patients with severe pulmonary hypertension...
September 26, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Morteza Jabbary Moghaddam, Ali Barkhori, Alireza Mirkheshti, Morteza Hashemian, Seyed Amir Mohajerani
BACKGROUND: Post-thoracotomy pain syndrome (PTPS) is pain that recurs or persists along a thoracotomy incision for at least two months following surgery. Dexmedetomidine (dex) is an α-2 agonist that also has analgesic, sedative-hypnotic, and sympatholytic properties. OBJECTIVES: To determine the effect of pre-emptive dexmedetomidine on the incidence of PTPS in patients undergoing coronary artery bypass grafting (CABG). PATIENTS AND METHODS: This randomized clinical trial enrolled 104 candidates for elective coronary artery bypass grafting (CABG) and randomly assigned them to either a dex group or a control group...
June 2016: Anesthesiology and Pain Medicine
Chawla LaToya Mason
BACKGROUND AND OBJECTIVES: This case report describes the rare occurrence of paraplegia caused by conversion disorder in a woman who received general anesthesia for breast surgery. CASE REPORT: A 46-year-old healthy woman received general anesthesia for excision of a left breast fibroepithelial lesion. In the post-anesthesia care unit, she reported bilateral loss of both sensation and motor function below the knees. Physical signs and symptoms did not correlate with any anatomical or neurological patterns; imaging revealed no abnormalities...
September 19, 2016: Revista Brasileira de Anestesiologia
G Sousa, C Pinho, A Santos, F J Abelha
INTRODUCTION: Postoperative delirium (POD) is an acute confusional state characterized by changes in consciousness and cognition, which may be fluctuating, developing in a small period of time. The aim of this study was to evaluate the relationship between alcohol abuse and the development of POD. METHODS: We prospectively evaluated consecutively all postoperative patients admitted in the Post-anesthesia Care Unit over a 1-month period for delirium, using the Portuguese versions of the the Nursing Delirium Screening Scale...
September 15, 2016: Revista Española de Anestesiología y Reanimación
Bülent Serhan Yurtlu, Bengü Köksal, Volkan Hancı, Işıl Özkoçak Turan
Non-invasive ventilation is an accepted treatment modality in both acute exacerbations of respiratory diseases and chronic obstructive lung disease. It is commonly utilized in the intensive care units, or for postoperative respiratory support in post-anesthesia care units. This report describes intraoperative support in non-invasive ventilation to neuroaxial anesthesia for an emergency upper abdominal surgery.
September 2016: Brazilian Journal of Anesthesiology
N H Bech, A H Hulst, J A Spuijbroek, L L A van Leuken, D Haverkamp
Hip arthroscopy is a fast growing orthopedic field of expertise. As in any field of surgery adequate postoperative pain management regimes are of utmost importance. The purpose of this review is to provide an overview of current knowledge on anesthetic options for perioperative pain management for hip arthroscopy. We searched the Pubmed/Medline and Embase database for literature and included 10 studies for our analysis. Because of the variety of pain scales and different ways of measured pain no meta-analysis could be performed and a descriptive review is performed...
August 2016: Journal of Hip Preservation Surgery
Zeynep Gul, Kareem Alazem, Ina Li, Manoj Monga
PURPOSE: To identify perioperative predictors of immediate pain after ureteroscopy, specifically evaluating the impact of hydrodistention from irrigation on pain. MATERIALS AND METHODS: We retrospectively identified patients who underwent ureteroscopy for the treatment of calculi. Data recorded for these patients included their maximum pain score in the post-anesthesia care unit (PACU), average flow rate of irrigant used during the procedure, patient and stone characteristics, operative procedure, and details of patients' immediate, post-operative course...
July 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Reese W Randle, Courtney J Balentine, Susan C Pitt, David F Schneider, Rebecca S Sippel
BACKGROUND: The optimal preoperative α-blockade strategy is debated for patients undergoing laparoscopic adrenalectomy for pheochromocytomas. We evaluated the impact of selective versus non-selective α-blockade on intraoperative hemodynamics and postoperative outcomes. METHODS: We identified patients having laparoscopic adrenalectomy for pheochromocytomas from 2001 to 2015. As a marker of overall intraoperative hemodynamics, we combined systolic blood pressure (SBP) > 200, SBP < 80, SBP < 80 and >200, pulse > 120, vasopressor infusion, and vasodilator infusion into a single variable...
August 25, 2016: Annals of Surgical Oncology
Clarissa Tjoakarfa, Vikram David, Atlas Ko, Raphael Hau
BACKGROUND: The use of forced air warming devices in the operating room has been shown to cause disruption of laminar airflow and a potential for increase in surgical site contamination. In contrast, conductive warming devices such as reflective blankets do not disrupt airflow and therefore have no potential for this increase in surgical site infection. However, some studies have shown them to be inferior to forced air warming devices in maintaining normothermia. We tested the hypothesis that the use of reflective blankets is as effective as forced air warming devices in maintaining intraoperative normothermia after adequate prewarming...
July 21, 2016: Journal of Arthroplasty
Letícia Hamester, Emiliane Nogueira de Souza, Cibele Cielo, Maria Antonieta Moraes, Lúcia Campos Pellanda
OBJECTIVE: to verify the effectiveness of nursing orientation provided to families of patients in the immediate post-operative following cardiac surgery before the first visit to the post-anesthesia care unit, in decreasing anxiety levels, compared to the unit's routine orientation. METHOD: open randomized clinical trial addressing family members in the waiting room before the first visit in the immediate post-operative period. The family members assigned to the intervention group received audiovisual orientation concerning the patients' conditions at the time and the control group received the unit's routine orientation...
2016: Revista Latino-americana de Enfermagem
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