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Perioperative Anesthesia

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https://www.readbyqxmd.com/read/29934660/anesthetic-management-without-perioperative-platelet-transfusion-for-cervical-laminectomy-and-laminoplasty-in-a-case-of-may-hegglin-anomaly
#1
Masateru Kumemura, Takeshi Omae, Keito Kou, Sonoko Sakuraba, Naoko Niimi, Shinji Kunishima
May-Hegglin anomaly (MHA) is an inherited autosomal dominant disorder characterized by giant platelets and inclusion bodies in granulocytes, and thrombocytopenia. There is no consensus on the perioperative management of this disorder. We report a case involving a patient with MHA who was perioperatively managed without platelet transfusion for cervical laminectomy and laminoplasty. In our case, the platelet count was measured to be 0.6 × 104 /µL using an automatic blood cell counter. Peripheral blood smear and genetic test analyses were performed, leading to a definitive diagnosis of MHA...
June 22, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29933267/perioperative-management-in-hepatic-resections-comparative-effectiveness-of-neuraxial-anesthesia-and-disparity-of-care-patterns
#2
Jeron Zerillo, Parul Agarwal, Jashvant Poeran, Nicole Zubizarreta, George Poultsides, Myron Schwartz, Stavros Memtsoudis, Madhu Mazumdar, Samuel DeMaria
BACKGROUND: Complication rates after hepatic resection can be affected by management decisions of the hospital care team and/or disparities in care. This is true in many other surgical populations, but little study has been done regarding patients undergoing hepatectomy. METHODS: Data from the claims-based national Premier Perspective database were used for 2006 to 2014. The analytical sample consisted of adults undergoing partial hepatectomy and total hepatic lobectomy with anesthesia care consisting of general anesthesia (GA) only or neuraxial and GA (n = 9442)...
June 20, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29931632/effect-of-general-anesthesia-duration-on-recovery-of-secretion-and-biochemical-properties-of-tear-fluid-in-the-post-anesthetic-period
#3
E Y Zernii, V E Baksheev, E I Kabanova, V V Tiulina, M O Golovastova, O S Gancharova, M S Savchenko, L F Sotikova, A A Zamyatnin, P P Filippov, I I Senin
Changes in the biochemical composition of the tear film is a critical risk factor for the development of chronic perioperative dry eye syndrome, because increasing the duration of general anesthesia did not affect the dynamics of tear secretion recovery, but slowed down normalization of its structure and antioxidant activity in the post-anesthetic period.
June 21, 2018: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29929812/-fulminant-hepatic-failure-after-simultaneous-kidney-pancreas-transplantation-a-case-report
#4
Jimmy L Moss, Benjamin W Brown, Sher-Lu Pai, Klaus D Torp, Stephen Aniskevich
We describe an unusual case of hyperacute hepatic failure following general anesthesia in a patient receiving a simultaneous kidney-pancreas transplant. Despite an aggressive evaluation of structural, immunological, viral, and toxicological causes, a definitive cause could not be elucidated. The patient required a liver transplant and suffered a protracted hospital course. We discuss the potential causes of fulminant hepatic failure and the perioperative anesthesia management of her subsequent liver transplantation...
June 18, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29927761/one-laryngospasm-2-realities-a-case-report-highlighting-the-impact-of-data-granularity-on-post-hoc-analysis-of-perioperative-events
#5
Allan F Simpao, Annie A Ma, Jonathan M Tan, Jack O Wasey, Aaron J Masino, Jorge A Gálvez
We present the case of a laryngospasm event in a 21-month-old child in which the changes in pulse oximetry and end-tidal carbon dioxide were recorded by both our Anesthesia Information Management System and middleware medical device integration platform. When this case was analyzed retrospectively, we noted that the 2 systems recorded the event very differently with respect to pulse oximetry. This case report illustrates the impact of data sampling rates on post hoc analysis of perioperative events and highlights the importance of understanding data collection processes when using electronically recorded data...
June 18, 2018: A&A practice
https://www.readbyqxmd.com/read/29926357/preperitoneal-bupivacaine-infiltration-reduces-postoperative-opioid-consumption-acute-pain-and-chronic-postsurgical-pain-after-bariatric-surgery-a-randomized-controlled-trial
#6
Saskia L Boerboom, Ann de Haes, Lianne Vd Wetering, Edo O Aarts, Ignace M C Janssen, Jose W Geurts, Ed T Kamphuis
INTRODUCTION: A multimodal pain treatment including local anesthetics is advised for perioperative analgesia in bariatric surgery. Due to obesity, bariatric surgery patients are at risk of respiratory complications. Opioid consumption is an important risk factor for hypoventilation. Furthermore, acute postoperative pain is an important risk factor for chronic postsurgical pain. In this study, we aimed to evaluate whether preperitoneal anesthesia with bupivacaine would reduce pain and opioid consumption after bariatric surgery...
June 20, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29917085/application-of-the-six-sigma-concept-for-quality-assessment-of-different-strategies-in-dbs-surgery
#7
Witold H Polanski, K Daniel Martin, Swen Günther, Gabriele Schackert, Lisa Klingelhoefer, Mareike Fauser, Alexander Storch, Stephan B Sobottka
Background: For quality analysis, we applied the Six Sigma concept to define quality indicators and their boundaries as well as to compare treatment-dependent outcome data of deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson's disease (PD). Methods: The Unified Parkinson Disease Rating Scale (UPDRS) III with on medication and on stimulation, the reduction of daily levodopa equivalence doses (LED), and the stimulation amplitude 1 year after surgery were registered...
June 18, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29913033/comparison-of-propofol-based-versus-volatile-based-anaesthesia-and-postoperative-sedation-in-cardiac-surgical-patients-a-prospective-randomized-study
#8
Marcin Wąsowicz, Angela Jerath, Warren Luksun, Vivek Sharma, Nicholas Mitsakakis, Massimilaino Meineri, Rita Katznelson, Terrence Yau, Vivek Rao, William Scott Beattie
BACKGROUND: Clinical trials have shown conflicting results regarding the use of volatile anesthesia before or after the ischemic insult in cardiac surgical patients and effect on myocardial injury. This may be attributable to the failure of continuing volatile agents into the early postoperative period. We hypothesized that combined volatile-based anesthesia and postoperative sedation would decrease the extent of myocardial injury after coronary artery bypass grafting (CABG) when compared to intravenous, propofol-based approach...
June 18, 2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29909205/perioperative-mortality-related-to-anesthesia-within-48-h-and-up-to-30-days-following-surgery-a-retrospective-cohort-study-of-11-562-anesthetic-procedures
#9
Luciana C Stefani, Patricia W Gamermann, Amanda Backof, Fernanda Guollo, Rafael M J Borges, Adriana Martin, Wolnei Caumo, Elaine A Felix
STUDY OBJECTIVE: Studying postoperative in-hospital mortality is crucial to the understanding of the perioperative process failures and to the implementation of strategies to improve patient outcomes. We intend to classify the causes of perioperative deaths up to 30 days after procedures requiring anesthesia and to evaluate the risk factors for early (48 h) or late (30 day) mortality. DESIGN: Retrospective cohort study. SETTING: A quaternary University Hospital from South Brazil...
June 14, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29907226/paravertebral-block-associated-with-decreased-opioid-use-and-less-nausea-and-vomiting-after-reduction-mammaplasty
#10
David D Rivedal, Harry S Nayar, Jacqueline S Israel, Glen Leverson, Andrew J Schulz, Tamara Chambers, Ahmed M Afifi, Jocelyn M Blake, Samuel O Poore
BACKGROUND: In light of data finding that postoperative pain, nausea, and vomiting worsen outcomes, a renewed emphasis has been placed on optimizing the perioperative period. Use of preoperative paravertebral block (PVB) has been shown to reduce opioid administration and postoperative nausea and vomiting (PONV) in many surgical populations, though its role in reduction mammaplasty remains undefined. Therefore, we seek to evaluate PVB as an adjunct to general anesthesia (GA) for reduction mammaplasty...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29906400/developing-a-3d-gestural-interface-for-anesthesia-related-human-computer-interaction-tasks-using-both-experts-and-novices
#11
Katherina A Jurewicz, David M Neyens, Ken Catchpole, Scott T Reeves
OBJECTIVE: The purpose of this research was to compare gesture-function mappings for experts and novices using a 3D, vision-based, gestural input system when exposed to the same context of anesthesia tasks in the operating room (OR). BACKGROUND: 3D, vision-based, gestural input systems can serve as a natural way to interact with computers and are potentially useful in sterile environments (e.g., ORs) to limit the spread of bacteria. Anesthesia providers' hands have been linked to bacterial transfer in the OR, but a gestural input system for anesthetic tasks has not been investigated...
June 1, 2018: Human Factors
https://www.readbyqxmd.com/read/29905618/repeated-measures-designs-and-analysis-of-longitudinal-data-if-at-first-you-do-not-succeed-try-try-again
#12
Patrick Schober, Thomas R Vetter
Anesthesia, critical care, perioperative, and pain research often involves study designs in which the same outcome variable is repeatedly measured or observed over time on the same patients. Such repeatedly measured data are referred to as longitudinal data, and longitudinal study designs are commonly used to investigate changes in an outcome over time and to compare these changes among treatment groups. From a statistical perspective, longitudinal studies usually increase the precision of estimated treatment effects, thus increasing the power to detect such effects...
June 12, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29896017/impact-of-anesthesia-modality-and-mechanical-venous-thromboembolism-prophylaxis-on-the-incidence-of-symptomatic-deep-venous-thrombosis-after-tka
#13
Yoshinori Ishii, Hideo Noguchi, Junko Sato, Satoshi Takayama, Yui Okada, Shin-Ichi Toyabe
Background: Venous thromboembolic events (VTE) are a common complication of total knee arthroplasty (TKA). Prior studies have discussed the utility of mechanical VTE prophylaxis as a monotherapy for low-risk TKA patients. We assess the incidence of clinically significant deep venous thrombosis (DVT) or pulmonary embolism (PE) in low-risk TKA patients who receive mechanical VTE prophylaxis and undergo spinal, epidural, or general anesthesia for their surgery. Methods: A retrospective study was performed on consecutive low-risk patients who received a TKA between July 2002 and June 2015 with spinal anesthesia ( n  = 65), epidural and general anesthesia ( n  = 154), or general anesthesia alone ( n  = 152)...
April 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29894349/anesthetic-considerations-for-a-patient-with-chronic-systemic-capillary-leak-syndrome-a-case-report
#14
Resham Datta, Jason K Panchamia
Systemic capillary leak syndrome (SCLS) is an idiopathic vascular hyperpermeability that leads to profound hypotension, hypoalbuminemia, and hemoconcentration. Sixty years since its inauguration into literature, SCLS is still elusive, underdiagnosed, and profoundly dangerous. Few authors have documented anesthetic implications of classical acute SCLS, a form with complete recovery between exacerbations. However, minimal information is available about chronic SCLS, continuous generalized edema with or without exacerbations...
June 11, 2018: A&A practice
https://www.readbyqxmd.com/read/29890807/-eestablishment-of-the-model-of-goat-lumbar-spinal-fusion-by-3d-printing-technology-and-experimental-perioperative-management
#15
Feng Zhang, Jian-Tao Liu, Rui Wang, Teng Lu, Bin-Bin Niu, Jie Qie, Xuan Cai, Ting Zhang, Peng-Rong Ouyang, Xi-Jing He
OBJECTIVE: To explore the feasibility and the attention of perioperative management of goat lumbar fusion model for individualized 3D printing technology. METHODS: According to preoperative X-ray and CT three dimensional reconstruction data of 10 males Boer goat's lumbar(1-2 years old, weight 35-45 kg), the preoperative open height were determined, meanwhile, according to the theoretical entry point of nails, the length of steel plate, arc, and setting position, screw length for reference were determined, the lumbar lateral anterior plate was designed and 3D-printed...
May 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29889707/postoperative-cognitive-dysfunction-and-noncardiac-surgery
#16
Lisbeth A Evered, Brendan S Silbert
Postoperative cognitive dysfunction (POCD) is an objectively measured decline in cognition postoperatively compared with preoperative function. POCD has been considered in the anesthetic and surgical literature in isolation of cognitive decline which is common in the elderly within the community and where it is labeled as mild cognitive impairment, neurocognitive disorder, or dementia. This narrative review seeks to place POCD in the broad context of cognitive decline in the general population. Cognitive change after anesthesia and surgery was described over 100 years ago, initially as delirium and dementia...
June 8, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29881165/the-incidence-of-mild-hypothermia-after-total-knee-or-hip-arthroplasty-a-study-of-2600-patients
#17
Ruben Scholten, Borg Leijtens, Keetie Kremers, Marc Snoeck, Sander Koëter
Hypothermia is associated with a higher risk of perioperative complications and occurs frequently after total joint arthroplasty (TJA). The incidence of hypothermia following total joint arthroplasty was assessed with its risk factors and its correlation with PJI. Correlation of hypothermia with age, gender, BMI, type of arthroplasty surgery, type of anesthesia, operation time, blood loss, date of surgery and PJI was evaluated in 2600 patients. Female gender and spinal anesthesia increased the risk for hypothermia whereas an increased BMI and surgery duration correlated decreased the risk of hypothermia...
June 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29880427/dobutamine-and-nitroglycerin-versus-milrinone-for-perioperative-management-of-pulmonary-hypertension-in-mitral-valve-surgery-a-randomized-controlled-study
#18
Ashraf M Eskandr, Ahmed A Metwally, Montasser S Abu Elkassem, Sadik A Sadik, Ashraf E Elmiligy, Mohamed Mourad, Lamiaa Hussein
OBJECTIVE: To compare the effects of dobutamine and nitroglycerin to milrinone in young patients with severe pulmonary hypertension undergoing mitral valve replacement. DESIGN: A prospective randomized, double-blinded, controlled study. SETTING: Single university hospital. PARTICIPANTS: Forty patients had systolic pulmonary arterial pressure ≥60 mmHg and were scheduled for elective mitral valve replacement. The patients were divided randomly into 2 equal groups according to the drugs given during the study...
April 18, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29876654/perioperative-management-of-patients-with-cancer-pain-treated-with-opioids-a-retrospective-study
#19
Takako Fujita, Motoyo Iwade, Keiko Hamada, Makoto Ozaki
PURPOSE: We retrospectively studied perioperative management of patients receiving opioid treatment for cancer pain to facilitate establishing a standard policy for our institute. METHODS: Subjects were patients who had been administered strong opioids for cancer pain and had undergone surgery with general anesthesia. We divided the patients into groups C and D. Group C was comprised of patients who had been administered their baseline opioids continuously during the perioperative period, and group D of those who had discontinued baseline opioid use during this period...
June 6, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29873220/-crouzon-syndrome-coupled-with-osahs-and-congenital-heart-disease-a-case-report
#20
Q R Chen, Q Q Dai, J Zou, H Zheng
A case of Crouzon syndrome coupled with OSAHS and congenital heart disease in our hospital was reported. The patient who was a 2 years and 7 months old boy, was admitted in our hospital for repetitive sore throat, snoring with mouth breathing during sleep for more than 2 years and been found with some typical defect of Crouzon syndrome during physical examination. Half a year ago the boy underwent ventricular septal defect closure surgery. PSG shows severe apnea hypopnea and low ventilation existed. Under general anesthesia, the patient accepted bilateral tonsillectomy and adenoidectomy but dyspnea occurred after post-operative extubation till 2 days later the boy can breathe by himself...
May 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
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