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Fast track anaesthesia

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https://www.readbyqxmd.com/read/28830363/recovery-and-prediction-of-postoperative-muscle-power-is-it-still-a-problem
#1
Martin Zoremba, Dennis Kornmann, Benjamin Vojnar, Rene Burchard, Thomas Wiesmann, Hinnerk Wulf, Thomas Kratz
BACKGROUND: In the postoperative period, immediate recovery of muscular power is essential for patient safety, but this can be affected by anaesthetic drugs, opioids and neuromuscular blocking agents (NMBA). In this cohort study, we evaluated anaesthetic and patient-related factors contributing to reduced postoperative muscle power and pulse oximetric saturation. METHODS: We prospectively observed 615 patients scheduled for minor surgery. Premedication, general anaesthesia and respiratory settings were standardized according to standard operating procedures (SOP)...
August 22, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28766304/benefits-of-ultrasound-guided-transversus-abdominis-plane-block-for-open-appendectomy-in-children
#2
Ilona Batko, Barbara K Kościelniak, Ilona Al-Mutari, Krzysztof Kobylarz
BACKGROUND: One of the most frequently performed emergency surgical procedures in children is an appendectomy. The aim of this study was to determine the benefits of supplementing standard, general anaesthesia with the ultrasound-guided right TAP block. METHODS: We analyzed the medical records of 90 children of both sexes, aged 4-16 years with a body mass of 16-78 kg who underwent general anaesthesia for open appendectomy. Sixty-two individuals were anaesthetized using the standard method, while 28 patients had an additional right-sided TAP block under ultrasound guidance...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28744857/the-effect-of-pre-operative-methylprednisolone-on-early-endothelial-damage-after-total-knee-arthroplasty-a-randomised-double-blind-placebo-controlled-trial
#3
V Lindberg-Larsen, S R Ostrowski, M Lindberg-Larsen, M L Rovsing, P I Johansson, H Kehlet
We wished to evaluate whether inhibition of the systemic inflammatory response by a single pre-operative dose of methylprednisolone reduced markers of early endothelial damage after fast-track total knee arthroplasty. We randomly allocated 70 patients undergoing elective unilateral total knee arthroplasty (1:1) to receive either pre-operative intravenous methylprednisolone 125 mg (methylprednisolone group) or isotonic saline (control group). All procedures were performed under spinal anaesthesia without a tourniquet, using a standardised multimodal analgesic regime...
July 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28726359/earplugs-during-the-first-night-after-cardiothoracic-surgery-may-improve-a-fast-track-protocol
#4
Johannes Menger, Bernhard Urbanek, Keso Skhirtladze-Dworschak, Viktoria Wolf, Arabella Fischer, Harald Rinösl, Martin Dworschak
BACKGROUND: Sleep deprivation after major surgery is common and associated with worse outcome. Noise is one important reason for sleep fragmentation, which contributes to enhanced morbidity. The purpose of this work was to evaluate the impact of earplugs on patients' sleep quality during their first night after cardiothoracic surgery to eventually improve an existing fast-track concept. METHODS: Sixty-three patients undergoing cardiothoracic surgery eligible for a postoperative fast- track regimen on our cardiothoracic post anaesthesia care unit (C-PACU) were prospectively included...
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28041609/postoperative-nausea-and-vomiting-physiopathology-risk-factors-prophylaxis-and-treatment
#5
L Veiga-Gil, J Pueyo, L López-Olaondo
Recognising the importance of the prevention and early treatment of postoperative nausea and vomiting (PONV) is essential to avoid postoperative complications, improve patient satisfaction and enable the development of major outpatient surgery and fast-track surgery. The topic of PONV might seem to have become stagnant, but we are moving forward. New concepts and problems like post-discharge nausea and vomiting, new risk factors and new drugs are appearing. However, there continue to be mistaken notions about PONV, such as the association between PONV and post-anaesthesia care unit stays, or assuming that it is a risk factore characteristic of the patient, anaesthesia or surgery when it is not...
April 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27791240/feasibility-of-day-case-total-hip-arthroplasty-a-single-centre-observational-study
#6
Jens Rolighed Larsen, Birgitte Skovgaard, Thomas Prynø, Laimonas Bendikas, Lone R Mikkelsen, Malene Laursen, Mette T Høybye, Søren Mikkelsen, Lene Bastrup Jørgensen
INTRODUCTION: Recent reports indicate that total hip arthroplasty (THA) can be further accelerated and might be managed as day-case. This could provide benefits to health care expenditure, lower patient risks and change patient satisfaction. We evaluated the feasibility, efficacy, safety and patient satisfaction of same-day (<12 hours) THA operation and discharge. METHODS: Consecutive patients were screened for eligibility (primary THA, ASA 1 or 2 physical status) and the presence of a support person to follow the patient for 48 hours postoperatively in an observational study...
October 24, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27752812/interventions-to-optimize-recovery-after-laparoscopic-appendectomy-a-scoping-review
#7
James K Hamill, Jamie-Lee Rahiri, Gamage Gunaratna, Andrew G Hill
BACKGROUND: No enhanced recovery after surgery protocol has been published for laparoscopic appendectomy. This was a review of evidence-based interventions that could optimize recovery after appendectomy. METHODS: Interventions for the review Clinical pathway, fast-track or enhanced recovery protocols; needlescopic approach; single incision laparoscopic (SIL) approach; natural orifice transluminal endoscopic surgery (NOTES); regional nerve blocks; intraperitoneal local anaesthetic (IPLA); drains...
June 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/27676415/impact-of-the-post-anesthetic-care-unit-opening-hours-on-fast-track-success-in-cardiac-surgery
#8
Christian GRAß, Federica Stretti, Waseem Zakhary, Edwin Turton, Sophia Sgouoropoulou, Meinhard Mende, Jörg Ender
BACKGROUND: Fast-track (FT) treatment in cardiac anesthesia is a state-of-the-art technique. The aim of our study was to compare FT treatment in a post-anesthetic care unit (PACU) with limited opening hours with a PACU opened for unlimited hours. Primary endpoints were extubation time (ET), length of stay (LOS) in PACU and LOS in intermediate care unit (IMC). Secondary endpoints were FT success/failure, hospital LOS, re-intubation and in hospital mortality. METHODS: At our institution, FT is usually managed in a PACU with limited opening hours from 10 a...
February 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27660677/role-of-epidural-anesthesia-in-a-fast-track-liver-resection-protocol-for-cirrhotic-patients-results-after-three-years-of-practice
#9
Antonio Siniscalchi, Lorenzo Gamberini, Tommaso Bardi, Cristiana Laici, Elisa Gamberini, Letizia Francorsi, Stefano Faenza
AIM: To evaluate the potential benefits and risks of the use of epidural anaesthesia within an enhanced recovery protocol in this specific subpopulation. METHODS: A retrospective review was conducted, including all cirrhotic patients who underwent open liver resection between January 2013 and December 2015 at Bologna University Hospital. Patients with an abnormal coagulation profile contraindicating the placement of an epidural catheter were excluded from the analysis...
September 18, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27616189/fast-track-cardiac-care-for-adult-cardiac-surgical-patients
#10
REVIEW
Wai-Tat Wong, Veronica Kw Lai, Yee Eot Chee, Anna Lee
BACKGROUND: Fast-track cardiac care is a complex intervention involving several components of care during cardiac anaesthesia and in the postoperative period, with the ultimate aim of early extubation after surgery, to reduce length of stay in the intensive care unit and in the hospital. Safe and effective fast-track cardiac care may reduce hospital costs. This is an update of a Cochrane review first published in 2003, updated in 2012 and updated now in 2016. OBJECTIVES: To determine the safety and effectiveness of fast-track cardiac care compared with conventional (not fast-track) care in adult patients undergoing cardiac surgery...
September 12, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27555146/ultrashort-acting-remifentanil-is-not-superior-to-long-acting-sufentanil-in-preserving-cognitive-function-a-randomized-study
#11
RANDOMIZED CONTROLLED TRIAL
Linda A Rasmussen, Pia K Ryhammer, Jacob Greisen, Rajesh R Bhavsar, Anne-Grethe Lorentzen, Carl-Johan Jakobsen
STUDY OBJECTIVE: Postoperative cognitive dysfunction (POCD) is a well-known complication after cardiac surgery and may cause permanent disabilities with severe consequences for quality of life. The objectives of this study were, first, to estimate the frequency of POCD after on-pump cardiac surgery in patients randomized to remifentanil- or sufentanil-based anesthesia and, second, to evaluate the association between POCD and quality of recovery and perioperative hemodynamics, respectively...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/26859497/assessing-the-eligibility-of-a-non-invasive-continuous-blood-pressure-measurement-technique-for-application-during-total-intravenous-anaesthesia
#12
Robert Huhle, Joachim Siegert, Fred Wonka, Christoph Schindler, Marcelo Gama de Abreu, Thea Koch, Ute Morgenstern, Herman Theilen
OBJECTIVE: To assess the eligibility for replacement of invasive blood pressure as measured "within" the arterial vessel (IBP) with non-invasive continuous arterial blood pressure (cNIP) monitoring during total intravenous anaesthesia (TIVA), the ability of cNiP to track fast blood pressure changes needs to be quantified. A new method of statistical data analysis is developed for this purpose. METHODS: In a pilot study on patients undergoing neurosurgical anaesthesia, mean arterial pressure MAPIBP measured with IBP was compared to MAPCNP measured by the CNAP Monitor 500 in ten patients (age: 63±13 a)...
June 1, 2016: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/26685683/factors-influencing-length-of-hospital-stay-after-primary-total-knee-arthroplasty-in-a-fast-track-setting
#13
Nina M C Mathijssen, Hennie Verburg, Carsten C G van Leeuwen, Tim L Molenaar, Gerjon Hannink
PURPOSE: The goal of this study was to identify factors prior to surgery that are associated with an increased length of hospital stay after TKA using a fast-track protocol. MATERIALS AND METHODS: In total, 879 consecutive patients who underwent primary TKA were included in this retrospective cohort study. A length of stay greater than or equal to three nights was considered an increased length of hospital stay. Univariable and multivariable generalized linear mixed models were used to identify potential factors associated with increased length of hospital stay...
August 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/26658180/fast-track-in-thoracic-surgery-and-anaesthesia-update-of-concepts
#14
REVIEW
Torsten Loop
PURPOSE OF REVIEW: Update of key elements on enhanced recovery after thoracic anaesthesia and surgery. RECENT FINDINGS: Pathways to enhance recovery after thoracic surgery ('fast-track') aim to improve response to lung surgery, reduction of postoperative pulmonary complications, and restore patient's vital function. Uncomplicated recovery after lung surgery reduces morbidity, hospital stay, and costs. Video-assisted thoracoscopic surgery is a major part of enhanced recovery minimizing tissue injury and stress response...
February 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/26308519/ambulatory-anaesthesia-and-cognitive-dysfunction
#15
REVIEW
Lars S Rasmussen, Jacob Steinmetz
PURPOSE OF REVIEW: More surgical procedures are performed on an ambulatory basis and the advantages are apparent, but outpatient surgery presents challenges because of the expectation of a fast recovery soon after termination of anaesthesia. Ambulatory surgery is a well tolerated regimen with few serious adverse outcomes, hence difficult to obtain sound scientific evidence for avoiding complications. RECENT FINDINGS: Few studies have assessed recovery of cognitive function after ambulatory surgery, but it seems that both propofol and modern volatile anaesthetics are rational choices for general anaesthesia in the outpatient setting...
December 2015: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/26263799/systematic-review-of-enhanced-recovery-after-gastro-oesophageal-cancer-surgery
#16
REVIEW
E H Gemmill, D J Humes, J A Catton
INTRODUCTION: Fast track methodology or enhanced recovery schemes have gained increasing popularity in perioperative care. While evidence is strong for colorectal surgery, its importance in gastric and oesophageal surgery has yet to be established. This article reviews the evidence of enhanced recovery schemes on outcome for this type of surgery. METHODS: A systematic literature search was conducted up to March 2014. Studies were retrieved and analysed using predetermined criteria...
April 2015: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/26004961/fast-track-in-abdominal-aortic-surgery-experience-in-over-1-000-patients
#17
Piero Brustia, Alessandra Renghi, Michele Aronici, Luca Gramaglia, Carla Porta, Antonello Musiani, Massimiliano Martelli, Francesco Casella, Mrancesco Letizia De Simeis, Giovanni Coppi, Alberto Settembrini, Francesca Mottini, Renato Cassatella
BACKGROUND: Fast-track recovery programs have led to reduced patient morbidity and mortality after surgery. Minimally invasive surgery and anesthesia, with programs of early postoperative recovery are the main aspects of fast-track recovery programs. The optimization of pain control, early mobilization, and oral feeding allows for a rapid functional rehabilitation, which leads to minor morbidity and early discharge from the hospital to home. METHODS: We enrolled all nonemergent patients treated for elective abdominal aortic surgery for an aneurysm or obstructive disease from April 2000 to June 2014...
August 2015: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/25948318/neonatal-surgical-care-a-review-of-the-burden-progress-and-challenges-in-sub-saharan-africa
#18
REVIEW
Emmanuel A Ameh, Justina O Seyi-Olajide, Tunde T Sholadoye
The outcome of neonatal surgery has significantly improved over the decades in high-income countries. In sub-Saharan Africa (SSA), however, it has lagged behind. This is a review of the current state of neonatal surgery in SSA. The conditions requiring surgery in the newborn are largely congenital but the rate of emergency surgery is high, reaching 40% of all neonatal surgery in some settings. Most operations are for intestinal obstruction, commonly owing to anorectal malformations and intestinal atresia, as well as abdominal wall defects...
August 2015: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/25545286/airway-reactions-and-emergence-times-in-general-laryngeal-mask-airway-anaesthesia-a-meta-analysis
#19
REVIEW
Ana Stevanovic, Rolf Rossaint, Harald G Fritz, Gebhard Froeba, Joern Heine, Friedrich K Puehringer, Peter H Tonner, Mark Coburn
BACKGROUND: Desflurane's short emergence time supports fast track anaesthesia. Data on the rate of upper airway complications and emergence time when desflurane is used with laryngeal mask airway (LMA) are controversial and limited. OBJECTIVES: To compare recovery time variables and the rates of upper airway adverse events in patients with an LMA undergoing general surgery with desflurane, sevoflurane, isoflurane or propofol anaesthesia. DESIGN: A systematic review and meta-analysis of randomised controlled trials (RCTs)...
February 2015: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/25458452/-decree-of-anaesthesia-of-1994-day-surgery-and-medical-responsibility-necessary-reflections-on-the-inevitable-conciliation-between-regulations-and-recommendations
#20
REVIEW
G Bontemps, C Daver, C Ecoffey
Day surgery is often considered as a marker of the necessity of reorganizing the hospital to take care globally and so better meet the expectations of improvement of the management of patients. But the actual deployment of day surgery can also act as a real revelation of the stakes of conciliation between the regulations, which supervise professional practices and organization, and the functioning of hospitals. Between the regulations supervising hospitals and professional practices and the place of the recommendations, between the general legal framework of the medical activity and specific legal framework (decree of anesthesia of 1994) and the Evidence-Based Medicine, the pretext of the improvement of the patient flow in day surgery, recommended by several institutions (Sfar, ANAP, HAS), questions about the legal obligation of the passage of all the patients in the postanesthesia care unit (PACU)...
December 2014: Annales Françaises D'anesthèsie et de Rèanimation
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