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Perioperative Anesthesia

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https://www.readbyqxmd.com/read/28817531/bias-confounding-and-interaction-lions-and-tigers-and-bears-oh-my
#1
Thomas R Vetter, Edward J Mascha
Epidemiologists seek to make a valid inference about the causal effect between an exposure and a disease in a specific population, using representative sample data from a specific population. Clinical researchers likewise seek to make a valid inference about the association between an intervention and outcome(s) in a specific population, based upon their randomly collected, representative sample data. Both do so by using the available data about the sample variable to make a valid estimate about its corresponding or underlying, but unknown population parameter...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28816281/-application-of-flurbiprofen-axetil-in-pain-management-associated-during-transrectal-ultrasound-guided-prostate-biopsy
#2
K Lan, W B Yang, X W Zhang, W J Bai, Q Li, T Xu
OBJECTIVE: To examine the effects of perioperative intravenous administration of flurbiprofen axetil (FA) on pain associated with transrectal ultrasound-guided prostate biopsy. METHODS: This was a randomized,controlled study. Eighty-one patients who underwent 12 core prostate biopsy were included in the study. The patients were randomly assigned to one of three groups (n=27 in each) by type of procedure during prostate biopsy. Group intrarectal local anesthesia (IRLA) received intrarectal 5% (0...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28814371/dental-management-considerations-in-a-pediatric-patient-with-moyamoya-disease
#3
Htet Bo, David Avenetti, Evelina Kratunova
Moyamoya disease is a rare progressive cerebral arteriopathy associated with risk of ischemic and hemorrhagic brain complications. The dental care of affected individuals should be performed in a pain- and stress-free manner to decrease the chance of occurrence of episodes of hypocapnia, hypercapnia, hypotension, hypovolemia, and hypothermia. Dental treatment may be provided in an outpatient dental setting or in a hospital setting, but both venues require interdisciplinary collaboration to ensure safe delivery of patient care...
May 15, 2017: Journal of Dentistry for Children
https://www.readbyqxmd.com/read/28814096/ankle-block-vs-single-shot-popliteal-fossa-block-as-primary-anesthesia-for-forefoot-operative-procedures-prospective-randomized-comparison
#4
Oliver N Schipper, Kenneth J Hunt, Robert B Anderson, W Hodges Davis, Carroll P Jones, Bruce E Cohen
BACKGROUND: Postoperative pain is often difficult to control with oral medications, requiring large doses of opioid analgesia. Regional anesthesia may be used for primary anesthesia, reducing the need for general anesthetic and postoperative pain medication requirements in the immediate postoperative period. The purpose of this study was to compare the analgesic effects of an ankle block (AB) to a single-shot popliteal fossa block (PFB) for patients undergoing orthopedic forefoot procedures...
August 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28808868/effect-of-multimodal-analgesia-on-opioid-use-after-open-ventral-hernia-repair
#5
Jeremy A Warren, Caroline Stoddard, Ahan L Hunter, Anthony J Horton, Carlyn Atwood, Joseph A Ewing, Steven Pusker, Vito A Cancellaro, Kevin B Walker, William S Cobb, Alfredo M Carbonell, Robert R Morgan
BACKGROUND: There is limited data on enhanced recovery after surgery (ERAS) protocols after ventral hernia repair (VHR). This study reports the impact of multimodal analgesia on opioid use after open VHR. METHODS: Retrospective review of open VHR treated during the initial 6 months after ERAS implementation. Protocol focused on opioid sparing using intraoperative ketamine and/or lidocaine infusion, selective epidural anesthesia, and postoperative ketamine infusion, ketorolac, and acetaminophen...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28804498/feasibility-of-cervical-epidural-anesthesia-for-breast-cancer-surgery
#6
Manuel Wenk, Christina Massoth, Daniel M Pöpping, Michael Möllmann
BACKGROUND: Effects of perioperative cervical level neuraxial blocks on the dissemination of cancer metastases have become a matter of substantial interest. However, experience with these catheters has been limited and data on feasibility and efficacy is sparse. METHODS: Data from 39 patients scheduled to undergo breast cancer surgery while awake with a cervical epidural alone was retrospectively analyzed. RESULTS: In 26 patients (66,7%, 95% CI 51,7-81,7) the cervical epidural catheter was sufficient for surgery...
2017: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/28803771/perioperative-management-of-patients-with-end-stage-renal-disease
#7
REVIEW
Hirotsugu Kanda, Yuji Hirasaki, Takafumi Iida, Megumi Kanao-Kanda, Yuki Toyama, Takashi Chiba, Takayuki Kunisawa
End-stage renal disease (ESRD) is associated with significant alterations in cardiovascular function; homeostasis of body fluid, electrolytes, and acid-base equilibrium; bone metabolism, erythropoiesis; and blood coagulation. The prevalence of ESRD is increasing rapidly worldwide, as is the number of patients requiring surgery under general anesthesia. Patients with ESRD have significantly higher risks of perioperative morbidity and mortality due to multiple comorbidities. The perioperative management of patients with ESRD under general anesthesia therefore requires special considerations and a careful multidisciplinary approach...
April 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28802488/characterization-of-surgical-procedures-in-the-spanish-mohs-surgery-registry-regesmohs-for-2013-2015
#8
E de Eusebio Murillo, A Martín Fuentes, V Ruiz-Salas, J R Garcés, R Miñano Medrano, J L López-Estebaranz, T Alonso-Alonso, M Á Rodríguez-Prieto, Y Delgado Jiménez, V Morales, P Redondo Bellón, E Manubens-Mercadé, O Sanmartín-Jiménez, C Guillén Barona, R Cabeza, N Cano, A Toll-Abelló, R Navarro Tejedor, J L Artola Igarza, I Allende Markixana, A Alfaro Rubio, C Ciudad Blanco, H Vázquez-Veiga, L Barchino Ortiz, M A Descalzo, I García-Doval
INTRODUCTION: The Spanish Mohs Surgery Registry is used to collect data on the use and outcomes of Mohs micrographic surgery (MMS) in Spain. The aim of this study was to describe perioperative and intraoperative data recorded for MMS procedures performed between July 2013 (when the registry started) and January 2016. MATERIAL AND METHODS: Prospective cohort study of data from 18 hospitals. The data collected included type of anesthesia, surgical technique, hospital admission, number of Mohs stages, management of preoperative risk factors, additional treatments, previous treatments, type of tumor, operating time, and complications...
August 9, 2017: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/28801082/-how-to-videos-improve-residents-performance-of-essential-perioperative-electronic-medical-records-and-clinical-tasks
#9
Veronica Zoghbi, Robert C Caskey, Kristoffel R Dumon, Jacqueline M Soegaard Ballester, Ari D Brooks, Jon B Morris, Daniel T Dempsey
OBJECTIVE: The ability to use electronic medical records (EMR) is an essential skill for surgical residents. However, frustration and anxiety surrounding EMR tasks may detract from clinical performance. We created a series of brief, 1-3 minutes "how to" videos demonstrating 7 key perioperative EMR tasks: booking OR cases, placing preprocedure orders, ordering negative-pressure wound dressing supplies, updating day-of-surgery history and physical notes, writing brief operative notes, discharging patients from the postanesthesia care unit, and checking vital signs...
August 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28800981/near-infrared-spectroscopy-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#10
Matthew J Chan, Tricia Chung, Neil J Glassford, Rinaldo Bellomo
OBJECTIVES: To identify the normal baseline preoperative range of cerebral tissue oxygen saturation (SctO2) derived using near-infrared spectroscopy (NIRS) and the efficacy of perioperative interventions designed to modulate SctO2 in cardiac surgical patients. DESIGN: Systematic review and meta-analysis of relevant randomized controlled trials (RCTs) extracted from the Medline, Embase, and Cochrane Central Register of Controlled Trials databases. SETTING: Hospitals performing cardiac surgery...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28800725/a-novel-thermal-compression-device-for-perioperative-warming-a-randomized-trial-for-feasibility-and-efficacy
#11
Peter Luke Santa Maria, Chloe Santa Maria, Andreas Eisenried, Nathalia Velasquez, Brian Thomas Kannard, Abhinav Ramani, David Mark Kahn, Amanda Jane Wheeler, John Gerhard Brock-Utne
BACKGROUND: Inadvertent perioperative hypothermia (IPH) leads to surgical complications and increases length of stay. IPH rates are high with the current standard of care, forced air warming (FAW). Our hypothesis is that a prototype thermal compression device that heats the popliteal fossa and soles of the feet, with lower leg compression, increases perioperative temperatures and reduces IPH compared to the current standard of care. METHODS: Thirty six female breast surgery patients, at a tertiary academic hospital, were randomized to the device or intraoperative FAW (stage I) with a further 18 patients randomized to the device with a single heating area only (stage II, popliteal fossa or sole of the feet)...
August 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28800722/randomized-comparison-of-sevoflurane-versus-propofol-remifentanil-on-the-cardioprotective-effects-in-elderly-patients-with-coronary-heart-disease
#12
Yunlong Zhang, Wendong Lin, Sheliang Shen, Hongfa Wang, Xiaona Feng, Jiehao Sun
BACKGROUND: It is skeptical about cardioprotective property of sevoflurane in patients undergoing noncardiac surgery, especially in the elderly patients with coronary heart disease. We hypothesized that long duration of sevoflurane inhalation in noncardiac surgery could ameliorate myocardial damage in such patients. METHODS: This was a randomized, prospective study. One hundred twenty-one elderly patients with coronary heart disease were randomly allocated into two groups...
August 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28799968/core-temperature-monitoring-in-obstetric-spinal-anesthesia-using-an-ingestible-telemetric-sensor
#13
Leon du Toit, Dominique van Dyk, Ross Hofmeyr, Carl J Lombard, Robert A Dyer
BACKGROUND: Perioperative hypothermia may affect maternal and neonatal outcomes after obstetric spinal anesthesia. Core temperature is often poorly monitored during spinal anesthesia, due to the lack of an accurate noninvasive core temperature monitor. The aim of this study was to describe core temperature changes and temperature recovery during spinal anesthesia for elective cesarean delivery. We expected that obstetric spinal anesthesia would be associated with a clinically relevant thermoregulatory insult (core temperature decrease >1...
August 9, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28797982/identification-of-preoperative-and-intraoperative-risk-factors-for-complications-in-the-elderly-undergoing-elective-craniotomy
#14
Stephen J Johans, Jonathan R Garst, Daniel J Burkett, Kurt Grahnke, Brendan Martin, Tarik F Ibrahim, Douglas E Anderson, Vikram C Prabhu
BACKGROUND: Neurosurgical patients are aging as the general population is getting older. METHODS: A retrospective review of patients ≥ 65 years of age who underwent an elective craniotomy from 2007-2015 to identify risk factors for 30-day morbidity/mortality was conducted. Key preoperative variables included age, co-morbidities, and functional status based on the Karnofsky Performance Status (KPS) score and modified Rankin Scale (mRS) score. Outcome variables included long-term care (LTC) complications, neurologic complications, systemic/infectious complications, length of stay (LOS), functional outcomes, and mortality...
August 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28797751/outcomes-of-cancer-surgery-after-inhalational-and-intravenous-anesthesia-a-systematic-review
#15
REVIEW
Sinor Soltanizadeh, Thea H Degett, Ismail Gögenur
Perioperative factors are probably essential for different oncological outcomes. This systematic review investigates the literature concerning overall mortality and postoperative complications after cancer surgery with inhalational (INHA) and intravenous anesthesia (TIVA). A search was conducted according to the PRISMA guidelines, including studies with patients undergoing surgery for cancer and where TIVA was compared with INHA. Two investigators identified relevant papers in the databases: PubMed, Scopus, EMBASE and the Cochrane Library...
August 7, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28793822/dose-response-head-to-head-comparison-of-inodilators-dobutamine-milrinone-and-levosimendan-in-chronic-experimental-pulmonary-hypertension
#16
Marta Tavares-Silva, Mohamed Alaa, Sara Leite, José Oliveira-Pinto, Lucas Lopes, Adelino F Leite-Moreira, André P Lourenço
The choice of inodilator drug in the acute management of patients with pulmonary hypertension (PH) having right ventricular (RV) failure remains unsettled and challenging. Comprehensive experimental evaluations may provide further insight and fundamental translational research clues to support inodilator selection and clinical trial design. Our aim was to compare acute dose-response hemodynamic effects of inodilators dobutamine (DOB), milrinone (MIL), and levosimendan (LEV) in chronic experimental PH. Seven-week-old male Wistar rats were randomly injected with 60 mg·kg(-1) monocrotaline (MCT) or vehicle (Ctrl, n = 7) and underwent systemic and pulmonary artery (PA) pressure and RV pressure-volume (PV) hemodynamic evaluation under halogenate anesthesia 24 to 30 days after injection...
September 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28777814/prevalence-of-preoperative-anemia-abnormal-mean-corpuscular-volume-and-red-cell-distribution-width-among-surgical-patients-in-singapore-and-their-influence-on-one-year-mortality
#17
Yilin Eileen Sim, Hide Elfrida Wee, Ai Leen Ang, Niresh Ranjakunalan, Biauw Chi Ong, Hairil Rizal Abdullah
INTRODUCTION: Preoperative anemia and high red cell distribution width (RDW) are associated with higher perioperative mortality. Conditions with high RDW levels can be categorized by mean corpuscular volume (MCV). The relationship between RDW, anemia and MCV may explain causality between high RDW levels and outcomes. We aim to establish the prevalence of preoperative anemia and distribution of RDW and MCV among pre-surgical patients in Singapore. In addition, we aim to investigate the association between preoperative anemia, RDW and MCV levels with one-year mortality after surgery...
2017: PloS One
https://www.readbyqxmd.com/read/28774488/crystalloid-versus-colloid-fluids-for-reduction-of-postoperative-ileus-after-abdominal-operation-under-combined-general-and-epidural-anesthesia
#18
Mohammad Reza Ghodraty, Faranak Rokhtabnak, Hossein Reza Dehghan, Alireza Pournajafian, Masoud Baghaee Vaji, Zahra Sadat Koleini, Jahan Porhomayon, Nader D Nader
BACKGROUND: The main objective of this study was to compare the effect of perioperative administration of crystalloid versus colloid solutions and its impact on reversal of ileus after resection with primary anastomosis of intestine. We hypothesized that inclusion of colloids will improve the return of intestinal motility. METHODS: In a double-blinded clinical trial, 91 the American Society of Anesthesiologists I to III patients undergoing abdominal operation for resection with anastomosis of small or large intestine were randomized to receive either lactated Ringer solution crystalloid group or 6% hydroxyethyl starch colloid group to replace intraoperative fluid loss (blood loss + third space)...
July 31, 2017: Surgery
https://www.readbyqxmd.com/read/28770108/the-combination-of-ketorolac-with-local-anesthesia-for-pain-control-in-day-care-retinal-detachment-surgery-a-randomized-controlled-trial
#19
Xiaohong Chen, Bingqian Liu, Xiaoling Liang, Jiaqing Li, Tao Li, Yonghao Li, Xiling Yu, Cancan Lyu, Xiujuan Zhao, Silvia Tanumiharjo, Chenjin Jin, Lin Lu
This study aims to evaluate the efficacy of ketorolac with local anesthesia compared to local anesthesia alone for perioperative pain control in day care retinal detachment surgery. The randomized controlled trial included 59 eyes of 59 participants for retinal detachment surgery who were randomly assigned (1 : 1) into the ketorolac (K) group and control (C) group. All participants underwent conventional local anesthesia while patients in the K group received an extra administration of preoperative ketorolac...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28767640/efficacy-and-safety-of-3-different-anesthesia-techniques-used-in-total-hip-arthroplasty
#20
Chengwei Liang, Jionglin Wei, Xiaoxi Cai, Weilong Lin, Yongqian Fan, Fengjian Yang
BACKGROUND This study compared the efficacy and safety of 3 different anesthesia techniques used in total hip arthroplasty (THA). MATERIAL AND METHODS We allocated 198 patients preparing to undertake THA into 3 groups: general anesthesia group (GA group, n=66), caudal epidural anesthesia group (CEA group, n=66), and spinal-epidural anesthesia group (SEA group, n=66). We compared postoperative adverse effects occurring in patients of the 3 anesthesia groups. The Visual Analog Scale (VAS) score, Minimum Mental State Examination (MMSE) score, and β-amyloid (Aβ) expression were calculated to determine the effects of different anesthesia on the postoperative pain and cognitive dysfunction of patients...
August 2, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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