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Preoperative fasting

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https://www.readbyqxmd.com/read/29452803/preoperative-fasting-in-children-review-of-existing-guidelines-and-recent-developments
#1
REVIEW
P Frykholm, E Schindler, R Sümpelmann, R Walker, M Weiss
The current guidelines for preoperative fasting recommend intervals of 6, 4, and 2 h (6-4-2) of fasting for solids, breast milk, and clear fluids, respectively. The objective is to minimize the risk of pulmonary aspiration of gastric contents, but also to prevent unnecessarily long fasting intervals. Pulmonary aspiration is rare and associated with nearly no mortality in paediatric anaesthesia. The incidence may have decreased during the last decades, judging from several audits published recently. However, several reports of very long fasting intervals have also been published, in spite of the implementation of the 6-4-2 fasting regimens...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29445595/anesthesia-and-analgesia-how-does-the-role-of-anesthetists-changes-in-the-eras-program-for-vats-lobectomy
#2
Federico Piccioni, Riccardo Ragazzi
Enhanced recovery after surgery (ERAS) programs are developed to prevent factors that delay postoperative recovery as well as issues that cause complications. The development of video-assist thoracoscopic surgery (VATS) techniques favors the fast recovery after thoracic procedures. ERAS strategies are based on multidisciplinary approach in which the anesthetist plays an important role from the preoperative to the postoperative phase with several goals. After preoperative evaluation and medical optimization, the anesthetist must ensure a tailored anesthetic plan aiming to a fast recovery and adequate pain relief to reduce the response to the surgical stress...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29445590/enhanced-recovery-after-surgery-eras-and-fast-track-in-video-assisted-thoracic-surgery-vats-lobectomy-preoperative-optimisation-and-care-plans
#3
REVIEW
Antonio D'Andrilli, Erino A Rendina
Main specific interventions for preoperative clinical optimisation of patients undergoing lung cancer surgery include assessment and treatment of comorbidities, minimizing preoperative hospitalization, minimizing preoperative fasting, and optimisation of antibiotic and thrombo-embolic prophylaxis. Preoperative patient optimisation is considered a crucial part of enhanced recovery after thoracic surgery pathways. Potentially, advantages of this fast-track management could be even higher when considering video-assisted thoracic surgery (VATS) major lung resection, because reduced trauma related to minimally invasive techniques is one of the main factors improving postoperative outcome...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29443724/preoperative-fasting-guidelines-in-pediatric-anesthesia-are-we-ready-for-a-change
#4
Hanna Andersson, Achim Schmitz, Peter Frykholm
PURPOSE OF REVIEW: Study after study shows that prolonged fasting before anesthesia is common in children. Pediatric anesthesiologists around the world are concerned that the current guidelines may be part of the problem. This review focuses on what can be done about it. RECENT FINDINGS: We discuss new insights into the physiology of gastric emptying of different categories of food and drink. The evidence for negative effects of prolonged fasting occurring in spite of implementation of the current guidelines is examined...
February 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29430885/abdominal-aortic-aneurysm-calcification-trying-to-identify-a-reliable-semiquantitative-method
#5
Marina Dias-Neto, Emmanuel Neves, Fábio Sousa-Nunes, Tiago Henriques-Coelho, Sérgio Sampaio
BACKGROUND: The main objective of this study was to assess the correlation between three semiquantitative and one computerized method based on Agatston Score (AS), when measuring abdominal aortic calcification (AAC) in abdominal aortic aneurysm (AAA) patients. Secondary aim was to access differences in AAC upon clinical variables, when different methods of calcium scoring are used. METHODS: This was an observational, retrospective, cross-sectional study. A database of AAA patients consecutively submitted to elective repair between 2008 and 2015 was used...
February 8, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29430225/superior-mesenteric-artery-syndrome-improved-by-enteral-nutritional-therapy-according-to-the-controlling-nutritional-status-score
#6
Kazuhiro Takehara, Kazuhiro Sakamoto, Rina Takahashi, Masaya Kawai, Shingo Kawano, Shinya Munakata, Kiichi Sugimoto, Makoto Takahashi, Yutaka Kojima, Tetsu Fukunaga, Yoshiaki Kajiyama, Seiji Kawasaki
Superior mesenteric artery syndrome (SMAS) is a relatively rare disease that involves bowel obstruction symptoms, such as vomiting and gastric distension, owing to the compression of the third portion of the duodenum from the front by the superior mesenteric artery (SMA) and from the rear by the abdominal aorta and the spine. SMAS is diagnosed on the basis of an upper gastrointestinal examination series indicating the obstruction of the third portion of the duodenum or a computed tomography scan indicating the narrowing of the branch angle between the aorta and the SMA (i...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29417772/-case-control-study-on-two-different-surgical-approaches-combined-fixation-with-lumbar-interbody-fusion-for-the-treatment-of-single-segmental-lumbar-vertebra-diseases
#7
Zhong-You Zeng, Wei-Feng Yan, Yong-Xing Song, Ke-Ya Mao, Jian-Fei Ji, Jian-Qiao Zhang, Peng Wu, Fei Pei, Guo-Hao Song, Jian-Fu Han, Wei Yu
OBJECTIVE: To discuss the advantages and disadvantages of two different surgical approaches combined fixation with lumbar interbody fusion in treating single segmental lumbar vertebra diseases. METHODS: The clinical data of 86 patients with single segmental lumbar vertebra diseases treated from June 2011 to June 2013 was retrospectively analyzed. There were 33 males and 53 females, aged from 28 to 76 years old with an average of 53.0 years. Among them, there were 39 cases of lumbar disc degeneration, 22 cases of lumbar disc herniation complicated with spinal canal stenosis, 9 cases of huge lumbar disc herniation and 16 cases of lumbar degenerative spondylolisthesis (Meyerding degree I )...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29417569/evolution-of-self-care-and-functional-mobility-after-single-event-multilevel-surgery-in-children-and-adolescents-with-spastic-diplegic-cerebral-palsy
#8
Griet Dequeker, Anja Van Campenhout, Hilde Feys, Guy Molenaers
AIM: To explore the evolution of self-care and functional mobility after multilevel surgery in children and adolescents with spastic diplegic cerebral palsy and to identify factors affecting these outcomes. METHOD: Thirty-four participants (22 males, 12 females) were evaluated before surgery, and at 2 months, 6 months, 1 year, 18 months, and 2 years after surgery. Self-care was assessed with the Pediatric Evaluation of Disability Inventory Dutch edition. The Mobility Questionnaire47 (MobQues47) and Functional Mobility Scale (FMS) were used to measure functional mobility...
February 8, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29405303/iron-deficiency-and-preoperative-anaemia-in-patients-scheduled-for-elective-hip-and-knee-arthroplasty-an-observational-study
#9
Ø Jans, C S Nielsen, N Khan, K Gromov, A Troelsen, H Husted
BACKGROUND AND OBJECTIVES: Preoperative anaemia is prevalent in elderly patients scheduled for major orthopaedic surgery and is associated with increased transfusion risk and postoperative morbidity. New guidelines recommend preoperative correction of anaemia and iron deficiency in all patients with a Hb < 13 g/dl. However, iron deficiency and other causes of preoperative anaemia in hip- (THA) and knee (TKA) arthroplasty are only sparsely studied. MATERIALS AND METHODS: Preoperative Hb and iron status were prospectively collected from 882 unselected elective fast-track THA/TKA patients and analysed according to both WHO anaemia criteria (Hb < 12 g/dl females, <13 g/dl males) and Hb < 13 g/dl for both genders...
February 6, 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29390555/predicting-new-onset-diabetes-after-minimally-invasive-subtotal-distal-pancreatectomy-in-benign-and-borderline-malignant-lesions-of-the-pancreas
#10
Ho Kyoung Hwang, Jiae Park, Sung Hoon Choi, Chang Moo Kang, Woo Jung Lee
The purpose of this study was to evaluate the time-dependent probability and risk factors of pancreatogenic diabetes mellitus (PDM) in patients who underwent minimally invasive subtotal distal pancreatectomy.Changes in glucose metabolic consequence of 34 patients (laparoscopic: 31, robotic: 3) who underwent surgery from December 2005 to December 2014 were estimated by assessing impaired fasting glucose, PDM, and PDM-free time analysis.A total of 22 patients showed glucose intolerance, including 13 (38.2%) with impaired fasting glucose and 9 (26...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29388798/preoperative-evaluation-of-neurovascular-relationship-in-trigeminal-neuralgia-by-three-dimensional-fast-low-angle-shot-3d-flash-and-three-dimensional-constructive-interference-in-steady-state-3d-ciss-mri-sequence
#11
Dengfa Yang, Jianmin Shen, Xianwu Xia, Yeqing Lin, Tiejun Yang, Hanshun Lin, Yong Jin, Kaiyu Zhou, Youcheng Li
OBJECTIVE: The purpose of the study was to evaluate the value of high-resolution three-dimensional fast low angle shot (3D-FLASH) and three-dimensional constructive interference in steady-state (3D-CISS) MRI sequence solely or the combination of both in the visualization of neurovascular relationship in patients with trigeminal neuralgia (TN). METHODS: 65 patients with unilateral TN underwent 3D-FLASH and 3D-CISS imaging were retrospectively studied. Neurovascular relationship at the intracisternal segment of trigeminal nerve was reviewed by two experienced neuroradiologist, who was blinded to the clinical details...
February 13, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29373452/generic-preoperative-planning-for-proximal-femoral-osteotomy-in-the-treatment-of-nonunion-of-the-femoral-neck
#12
Keith Mayo, Djoldas Kuldjanov
Despite improvements in surgical technique and overall patient care, failed treatment of fractures of the femoral neck persists. For the physiologically young patient, joint preservation is the preferred method of treatment. Unfortunately, the best treatment option, proximal femoral osteotomy, is fast becoming a lost art. Preoperative planning is critical in this regard. The described preoperative planning work flow is a reliable method for obtaining the desired deformity correction for a variety of proximal femoral malunions and nonunion...
February 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29354901/-effects-of-laparoscopic-sleeve-gastrectomy-on-insulin-secretion-patterns-in-morbidly-obese-patients
#13
Chunhua Qian, Cuiling Zhu, Jingyang Gao, Le Bu, Donglei Zhou, Ning Li, Shen Qu
OBJECTIVE: To assess the effects of laparoscopic sleeve gastrectomy (LSG) on insulin secretion mode and metabolism of glucose and lipid in morbidly obese patients. METHODS: Clinical data of 65 morbidly obese patients [body mass index (BMI) ≥30 kg/m2] undergoing LSG at Shanghai 10th People's Hospital from August 2012 to December 2016 were retrospectively analyzed. According to the result of OGTT, these obese patients were divided into three groups: normal glucose tolerance (NGT, 23 cases), impaired glucose tolerance (IGT, 22 cases) and type 2 diabetes mellitus (DM, 20 cases) groups...
January 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29339302/bilateral-ureteral-stent-remove-after-15-years-a-case-report
#14
Stefano Restaino, Francesco Fanfani, Matteo Vittori, Alessandro D'Addessi, Giovanni Scambia, Barbara Costantini
We present the first case of patients with more than 15 years forgotten ureteral stents. A 68-year-old woman affected by cervical cancer, who underwent a radical hysterectomy in 1997 and reported a placement of bilateral ureteral stents. She was admitted in our Hospital for stranguria, dysuria, and lower back pain for 10 days. Preoperative radiological evaluation showed the persistence of ureteral stents. She never removed the stent which had been positioned for a long period of time(since 1997). We proceed to remove in general anaesthesia bilateral stents by urethral cystoscopic...
January 12, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29334639/vestibular-schwannoma-and-hearing-preservation-usefulness-of-level-specific-ce-chirp-abr-monitoring-a-retrospective-study-on-25-cases-with-preoperative-socially-useful-hearing
#15
Luciano Mastronardi, Ettore Di Scipio, Guglielmo Cacciotti, Raffaelino Roperto
BACKGROUND AND OBJECTIVES: Decision-making regarding the therapy of vestibular schwannoma (VS) changed over the last decades, during which curative microsurgery has been promoted. Goals of VS microsurgery are: extensive resection, facial nerve (FN) preservation and, in selected cases, hearing preservation (HP). The aim of this study is to evaluate postoperative HP with reference to tumor size in patients operated on with Level Specific (LS)-CE-Chirp® ABR monitoring. PATIENTS AND METHODS: Twentyfive consecutive patients with socially useful hearing (SUH) underwent VS microneurosurgery by retrosigmoid (RS) approach...
February 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29313317/laparoscopic-excision-of-an-unusual-presentation-of-a-nabothian-cyst-case-report-and-review-of-the-literature
#16
Joseph Nassif, Hasan Nahoul, Ali Mourad, Ryan Yammine, Sally Khoury, Ali Khalil
Nabothian cysts are mucinous retention cysts formed through the accumulation of cervical mucus inside blocked cervical crypts leading to non-neoplastic mucinous cystic lesion in relation to the uterine cervix. The formation of Nabothian cysts is a common gynecological benign condition in women of reproductive age. While the presence of small-sized Nabothian cysts is usually clinically asymptomatic and requires no treatment or intervention, the diagnosis of larger Nabothian cysts can be mistaken with malignant tumors, including mucin producing carcinomas such as Adenoma malignum...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29309686/congress-of-neurological-surgeons-systematic-review-and-evidence-based-guidelines-on-the-role-of-imaging-in-the-diagnosis-and-management-of-patients-with-vestibular-schwannomas
#17
Ian F Dunn, Wenya Linda Bi, Srinivasan Mukundan, Bradley N Delman, John Parish, Tyler Atkins, Anthony L Asher, Jeffrey J Olson
QUESTION 1: What sequences should be obtained on magnetic resonance imaging (MRI) to evaluate vestibular schwannomas before and after surgery? TARGET POPULATION: Adults with vestibular schwannomas. RECOMMENDATIONS: Initial Preoperative Evaluation Level 3: Imaging used to detect vestibular schwannomas should use high-resolution T2-weighted and contrast-enhanced T1-weighted MRI. Level 3: Standard T1, T2, fluid attenuated inversion recovery, and diffusion weighted imaging MR sequences obtained in axial, coronal, and sagittal plane may be used for detection of vestibular schwannomas...
December 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29306619/comparative-study-between-conventional-fasting-versus-overnight-infusion-of-lipid-or-carbohydrate-on-insulin-and-free-fatty-acids-in-obese-patients-undergoing-elective-on-pump-coronary-artery-bypass-grafting-a-prospective-randomized-trial
#18
Hisham Hosny, Mohamed Ibrahim, Wael El-Siory, Amr Abdel-Monem
OBJECTIVES: Postoperative insulin resistance represents a major component of postoperative metabolic disorder. The authors compared the effects of preoperative infusion of lipid emulsion or carbohydrate to conventional preoperative fasting on postoperative insulin and free fatty acid (FFA) levels. DESIGN: A prospective randomized double-blinded study. SETTINGS: Tertiary university hospital. PARTICIPANTS: Sixty-three patients undergoing coronary artery bypass grafting...
November 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29306574/incidence-and-risk-factors-of-postoperative-urinary-retention-and-bladder-catheterization-in-patients-undergoing-fast-track-total-joint-arthroplasty-a-prospective-observational-study-on-371-patients
#19
Ruben Scholten, Keetie Kremers, Sebastiaan A W van de Groes, Diederik M Somford, Sander Koëter
BACKGROUND: Postoperative urinary retention (POUR) appears to be a common complication in lower limb joint arthroplasty; however, reports on its incidence vary. There is no general consensus on its definition and there is no scientific evidence on treatment principles. We performed a prospective observational study to establish the incidence of POUR and its risk factors, including the preoperative postvoid residual urine volume and the perioperative fluid balance, in fast-track total joint arthroplasty (TJA)...
December 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29306223/do-preoperative-oral-carbohydrates-improve-postoperative-outcomesin-patients-undergoing-coronary-artery-bypass-grafts
#20
Ömer Faruk Şavluk, Mehmet Ali Kuşçu, Füsun Güzelmeriç, Mustafa Emre Gürcü, Atakan Erkılınç, Deniz Çevirme, Halide Oğuş, Tuncer Koçak
Background/aim: The aim of this prospective study was to determine whether the preoperative oral intake of carbohydrate-rich drinks by patients undergoing a coronary artery bypass graft attenuates postoperative insulin requirements, improves postoperative patient discomfort, provides inotropic support, shortens the length of the ICU stay, and shortens the duration of postoperative mechanical ventilation. Materials and methods: This randomized prospective clinical study included 152 patients with coronary artery disease who were divided into 4 groups...
December 19, 2017: Turkish Journal of Medical Sciences
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