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anesthesia for appendectomy in adolescent

Yang Liu, Catherine Seipel, Monica E Lopez, Jed G Nuchtern, Mary L Brandt, Sara C Fallon, Peter A Manyang, Imelda M Tjia, Rahul G Baijal, Mehernoor F Watcha
BACKGROUND: Laparoscopic appendectomy is a common emergency pediatric surgery procedure accompanied by substantial pain (pain scores >4 for >60% of the time) in 33% of these patients. We introduced a bundle of pain management interventions including local anesthetic infiltration at the incision site, intravenous (IV) opioids by patient-controlled analgesia (PCA), and scheduled doses of IV ketorolac and oral acetaminophen/hydrocodone. OBJECTIVES: To evaluate the effect of these pain management interventions on pain control after laparoscopic appendectomy...
December 2013: Paediatric Anaesthesia
Omar Hyder, Myron Yaster, Brian T Bateman, Paul G Firth
BACKGROUND: Although children with sickle cell disease often undergo surgery, there are limited current epidemiological data for this pediatric population. We performed a database analysis to estimate population characteristics, surgical procedures, and perioperative outcomes in this population. METHODS: We queried the Nationwide Inpatient Sample Database from 2000 to 2010 for discharges pertaining to patients <18 years of age having a diagnosis of sickle cell disease who underwent 1 or more surgical procedures during that admission...
November 2013: Anesthesia and Analgesia
I Balga, C Konrad, W Meissner
BACKGROUND: For the evaluation of postoperative pain therapy, nausea and vomiting (PONV), the Children's Hospital in Lucerne acts as a member of the postoperative quality improvement project QUIPSi for children. Initial results and the potential for evaluation of the postoperative pain therapy and PONV are presented here. The central questions are whether the postoperative therapy concept is sufficient and if QUIPSi serves as an ideal tool for postoperative quality improvement? METHODS: Over a period of 1...
September 2013: Der Anaesthesist
Shogo Tanaka, Kanji Ishihara, Takahiro Uenishi, Ryoya Hashiba, Yukiko Kurashima, Kohichi Ohno, Sayaka Tanaka, Masahiko Ohsawa, Takatsugu Yamamoto
BACKGROUND: Complicated appendicitis (gangrenous or perforated appendicitis) is a risk for postoperative intraabdominal abscess, but management of intraabdominal abscess may differ between laparoscopic and open appendectomy. METHODS: We reviewed 67 patients who underwent appendectomy for complicated appendicitis, including 26 who received laparoscopic appendectomy (LA group) and 41 who underwent open appendectomy (OA group). The operation was performed under general anesthesia in all 26 patients in the LA group and in 10 (24%) in the OA group...
June 2013: Osaka City Medical Journal
Tzu-Chieh Yu, James K Hamill, Andrew Liley, Andrew G Hill
OBJECTIVE: To investigate clinical benefits of warm, humidified carbon dioxide (CO(2)) insufflation for acute laparoscopic appendicectomy on postoperative pain and recovery in children (age 8-14 years). BACKGROUND: Conventional CO(2) insufflation leads to desiccation-related peritoneal inflammation and injury, which is preventable with warm, humidified CO2 gas. We hypothesized that reduced peritoneal desiccation would improve patient-centered outcomes in children after laparoscopic appendicectomy...
January 2013: Annals of Surgery
C Fortea-Sanchis, D Martínez-Ramos, J Escrig-Sos, J M Daroca-José, G A Paiva-Coronel, R Queralt-Martín, R García-Calvo, M I Rivadulla-Serrano, J L Salvador-Sanchis
BACKGROUND: There is no international consensus on the approach of choice for performing appendectomy. AIMS: To analyze and compare open and laparoscopic approaches in the surgical treatment of acute appendicitis. MATERIAL AND METHODS: A retrospective study was carried out on patients over 14-years-old operated on for suspected acute appendicitis between January 2007 and December 2009. Variables were: age, sex, body mass index, specialized surgeon or resident in training, progression duration, conversion rate, use of drains, abdominal cavity irrigation, macroscopic appearance of the appendix, onset time of anesthesia, ASA classification, postoperative hospital stay, resumption of intake of liquids, and complications...
April 2012: Revista de Gastroenterología de México
Yasuharu Ohno, Toshiya Morimura, Shin-ichi Hayashi
BACKGROUND: Even for pediatric patients, the use of laparoscopic appendectomy has been widely accepted, and three trocars usually are necessary to perform a laparoscopic appendectomy. However, single-port appendectomy for children represents an attractive alternative. To reduce the number of incisions and trocars, the authors have adopted a transumbilical laparoscopically assisted single-port appendectomy (TULAA) approach. This study aimed to evaluate the results of their single-channel, single-port appendectomy...
February 2012: Surgical Endoscopy
Amitai Bickel, Michael Gurevits, Ronny Vamos, Simon Ivry, Arieh Eitan
OBJECTIVE: To assess the influence of hyperoxygenation on surgical site infection by using the most homogeneous study population. DESIGN: A randomized, prospective, controlled trial. SETTING: Department of surgery in a government hospital. PATIENTS: A total of 210 patients who underwent open surgery for acute appendicitis. In the study group, patients received 80% oxygen during anesthesia, followed by high-flow oxygen for 2 hours in the recovery room...
April 2011: Archives of Surgery
Chih-Szu Liao, Min-Chieh Shieh
Retained intraperitoneal Penrose drain secondary to fracture and adhesions in the immediate postoperative period happens on occasion. Most are unreported because of the fear of medico-legal problems. Previous management of such iatrogenic complications requires repeated laparotomy or wound exploration. Two patients who underwent appendectomy for ruptured appendicitis, with retained intraabdominal drains in the immediate postoperative period, managed eventually by laparoscopic retrieval are presented. Both patients had right low transverse incisions and intraabdominal drains exiting through a separate right lateral abdomen skin opening...
March 2011: Journal of the Chinese Medical Association: JCMA
T J Edwards, S J Carty, A S Carr, A W Lambert
OBJECTIVE: This study sought to determine the efficacy of post-operative wound infiltration with local anaesthetic following paediatric appendicectomy. METHOD: In a randomised, controlled, prospective, clinical trial children aged between five and sixteen years were assigned to one of three treatment arms; infiltration of the surgical wound with bupivicaine, saline, or no infiltration. Anaesthetic and analgesic protocols were employed. Patients and observers were blinded to the treatment group...
2011: International Journal of Surgery
Go Miyano, Masahiko Urao, Geoffrey J Lane, Yoshifumi Kato, Tadaharu Okazaki, Atsuyuki Yamataka
AIM: The aim of this study was to compare endoloops and endostaples for closing the stump of the appendix during laparoscopic appendectomy (LA) for uncomplicated appendicitis in children. METHODS: All LA performed for appendicitis from 2005 to 2009 were analyzed prospectively. Cases of complicated appendicitis such as perforated appendicitis or intra-abdominal abscess were excluded, leaving 75 cases closed with loops and 81 cases closed with staples. Choice of technique was determined by the attending surgeon's preference...
March 2011: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Dawei Chen, Huajun Shi, Hao Dong, Kaiquan Liu, Kebao Ding
BACKGROUND: Single-incision laparoscopic surgery has received increasing attention recently. This report describes a novel technique for single-incision laparoscopic appendectomy. METHODS: From August 2008 to October 2009, 69 consecutive patients with acute appendicitis underwent gasless single-incision laparoscopic appendectomy under epidural anesthesia at our department. An approximately 1.8-cm-long incision was made at McBurney's point. Once the abdominal wall was entered, an abdominal wall lifting device was employed in the right lower quadrant to lift up the abdominal wall to establish the operating space...
May 2011: Surgical Endoscopy
Maria Cristina Smania, Jefferson Pedro Piva, Pedro Celiny R Garcia
OBJECTIVES: To evaluate the hemodynamic responses to nociceptive stimuli in children submitted to videolaparoscopic appendectomy under balanced anesthesia with isoflurane and dexmedetomidine. METHODS: Randomized, double-blind and placebo-controlled study involving 26 children submitted to videolaparoscopic appendectomy carried out at Hospital São Lucas (PUCRS) between May 2004 and February 2005. Patients were assigned to two groups: (a) Dexmedetomidine group (n=13): infusion of 1 microg/kg over 10 minutes and maintenance dose of 0...
July 2008: Revista da Associação Médica Brasileira
J Fabregat-López, B Garcia-Rojo, T M Cook
The ProSeal laryngeal mask airway (PLMA) has been used routinely for anaesthesia and for difficult airway management including airway rescue in non-fasted patients. Compared with the classic laryngeal mask airway the PLMA increases protection against gastric inflation and pulmonary aspiration, by separating the respiratory and gastro-intestinal tracts. The PLMA has potential advantages over use of the tracheal tube including smoother recovery, reduced pharyngolaryngeal morbidity and even reduced postoperative pain...
September 2008: Anaesthesia
Jason M Clark, Curt S Koontz, Lisa A Smith, Joseph E Kelley
The treatment of Meckel's diverticulum (MD) in children is resection. Some data exist for the use of laparoscopic resection. The Video-Assisted Transumbilical (VAT) single-trocar technique has been recently described for appendectomy. We also have used this technique for the resection of MD. The purpose of this study is to report our experience with laparoscopic-assisted resection of MD using both the three-trocar and the single-trocar techniques. The Institutional Review Board approved our retrospective chart review of all patients with the diagnosis of MD...
April 2008: American Surgeon
David O Osifo, Kennedy N Emeagui, Sylvester E Aghahowa
OBJECTIVE: To study the safety and benefits of parenteral ketamine and lignocaine infiltration among pediatric surgical patients with co-morbidities that would preclude the use of general anesthesia requiring endotracheal intubation/face mask in a developing country. METHODS: This prospective study was undertaken at the Leadeks Medical Centre, Benin City Edo State, Nigeria between January 2002 and December 2006. Patients requiring surgery were safely operated even in the presence of co-morbidity...
January 2008: Saudi Medical Journal
William D Driscoll, Mary Ann Columbia, Robert A Peterfreund
The cause of the awareness under general anesthesia often cannot be definitely determined from retrospective reviews of handwritten records, examinations of equipment, or interviews with clinicians. Failure to deliver the intended concentrations of anesthetic agents to the patient is one possible contributing cause for awareness. An advantage of an automated Anesthesia Information Management System (AIMS) is its ability to electronically capture and preserve case data that might otherwise be lost. We reviewed the AIMS records of 3 anesthetics in which intraoperative awareness was felt to have probably occurred...
October 2007: Journal of Neurosurgical Anesthesiology
Oğuz Ateş, Gülce Hakgüder, Mustafa Olguner, Feza M Akgür
BACKGROUND/PURPOSE: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute and perforated appendicitis. Since it was first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port without exteriorizing the appendix to perform the operation. MATERIALS AND METHODS: Single-port LA was attempted in 38 patients (23 boys, 15 girls). Under general anesthesia, an 11-mm port with two 5-mm working channels or an 11-mm port through which a 10-mm scope (0 degrees) with a parallel eyepiece and a 6-mm working channel was inserted through the umbilicus...
June 2007: Journal of Pediatric Surgery
Jeffrey Lukish, David Powell, Steve Morrow, David Cruess, Phil Guzzetta
HYPOTHESIS: Two techniques are used for laparoscopic appendectomy (LA): division of the mesoappendix with the harmonic scalpel and ligation of the appendix with an endoloop (EL), or division of the mesoappendix and appendix with an endostapler (ES). Using an ES is a cost-effective technique that provides an outcome benefit in children who require appendectomy. DESIGN: Case series. SETTING: Academic, tertiary care children's hospital. PATIENTS: Seventy-five children who underwent LA from January 1, 2002, to March 31, 2004...
January 2007: Archives of Surgery
Fernando Escolano, Carles Hervàs, Jaume Canet, Sergi Sabaté, Maged M Mabrock, Eduard Soler
BACKGROUND AND OBJECTIVE: The objective of this arm of the ANESCAT 2003 study was to analyze the characteristics of the youngest and oldest patients receiving anesthesia in Catalonia, Spain, and the procedures for which they require it. PATIENTS AND METHOD: We analyzed data from questionnaires pertaining to pediatric (under age 14 years) and geriatric patients (older than age 65 years). RESULTS: Pediatric patients underwent 6.3% of all anesthetic procedures and patients over 65 years old accounted for 32...
May 24, 2006: Medicina Clínica
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