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ambulatory anesthesia

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https://www.readbyqxmd.com/read/29784260/severe-obesity-and-sleep-disordered-breathing-as-risk-factors-for-emergence-agitation-in-pediatric-ambulatory-surgery
#1
Timothy Reynolds, Sumanna Sankaran, Wilson T Chimbira, Thuy Phan, Olubukola O Nafiu
PURPOSE: Sleep-disordered breathing (SDB) may be a critical risk factor for emergence agitation (EA). We hypothesized that SDB diagnosis is a predictor of EA in children after general anesthesia for ambulatory surgery. DESIGN: Prospective, observational, cohort study. METHODS: Children aged 4 to 17 years were assessed for the occurrence of EA. Differences in probability of EA were assessed using multivariable logistic regression analyses...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29782406/population-pharmacokinetics-and-pharmacodynamics-of-dexmedetomidine-in-children-undergoing-ambulatory-surgery
#2
María-Gabriela Pérez-Guillé, Alejandra Toledo-López, Liliana Rivera-Espinosa, Radames Alemon-Medina, Chiharu Murata, Ismael Lares-Asseff, Juan Luis Chávez-Pacheco, Josefina Gómez-Garduño, Ana-Lilia Zamora Gutiérrez, Claudia Orozco-Galicia, Karina Ramírez-Morales, Gustavo Lugo-Goytia
BACKGROUND: Dexmedetomidine (DEX) is an α-2 adrenergic agonist with sedative and analgesic properties. Although not approved for pediatric use by the Food and Drug Administration, DEX is increasingly used in pediatric anesthesia and critical care. However, very limited information is available regarding the pharmacokinetics of DEX in children. The aim of this study was to investigate DEX pharmacokinetics and pharmacodynamics (PK-PD) in Mexican children 2-18 years of age who were undergoing outpatient surgical procedures...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29779305/-expert-consensus-on-standardized-processes-of-ambulatory-biliary-surgery-2018-edition
#3
(no author information available yet)
The definition of ambulatory surgery is that the patient is admitted, operated and discharged within a day (24 hours) , but does not include outpatient surgery. It can shorten the average hospital stay, reduce medical expenses, accelerate the recovery of patients, and has been approved to have great social and economic benefits.The main contents of this consensus include: (1)the establishment of ambulatory biliary surgery system, which involves the facilities building, team building, the construction of management systems, operation management, operation state analysis and benefit evaluation; (2)Patient selection criteria, pre-hospital assessment, surgical scheduling, preoperative education, anesthesia and management of adverse reactions after anesthesia, intraoperative application of general surgical principles and postoperative emergency plans, perioperative nursing; (3)Discharge criteria and pre-discharge assessment, post-discharge follow-up and rehabilitation guidance; (4) quality and safety control index system of ambulatory biliary surgery...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29778971/infraclavicular-and-supraclavicular-approaches-to-brachial-plexus-for-ambulatory-elbow-surgery-a-randomized-controlled-observer-blinded-trial
#4
Shalini Dhir, Brigid Brown, Peter Mack, Yves Bureau, Janice Yu, Douglas Ross
STUDY OBJECTIVE: To compare the effectiveness of supraclavicular and infraclavicular approaches to brachial plexus block for elbow surgery. DESIGN: Prospective, parallel arm, observer-blinded, randomized controlled trial. SETTING: This study occurred in a designated block room at St. Joseph's hospital, a large academic tertiary hospital in London, Canada. PATIENTS: 150 adult ASA class I-III patients undergoing elective ambulatory elbow surgery...
May 17, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29777565/unanticipated-hospital-admission-in-pediatric-patients-with-congenital-heart-disease-undergoing-ambulatory-noncardiac-surgical-procedures
#5
Koichi Yuki, Sophia Koutsogiannaki, Sandra Lee, James A DiNardo
BACKGROUND: An increasing number of surgical and nonsurgical procedures are being performed on an ambulatory basis in children. Analysis of a large group of pediatric patients with congenital heart disease undergoing ambulatory procedures has not been undertaken. AIMS: The objective of this study was to characterize the profile of children with congenital heart disease who underwent noncardiac procedures on an ambulatory basis at our institution, to determine the incidence of adverse cardiovascular and respiratory adverse events, and to determine the risk factors for unscheduled hospital admission...
May 18, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29772594/-upper-age-limit-in-outpatient-anesthesia-opportunities-and-risks
#6
Tobias Hüppe, Nicole Kneller, Alexander Raddatz
Ambulatory surgery in elderly patients continues to increase - avoiding hospitalization and thus postoperative cognitive dysfunction in older patients being its major objectives. An upper age limit in outpatient anesthesia does not exist to date. However, functional rather than chronological age is crucial in patient selection. In consensus discussion, baseline functional status should be evaluated regularly - defined as everyday behaviors necessary to maintain daily life and encompassing areas of physical, cognitive, and social functioning...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29770180/factors-impacting-arthroscopic-rotator-cuff-repair-operational-throughput-time-at-an-ambulatory-care-center
#7
Emily J Curry, Catherine Logan, Kaytelin Suslavich, Kaitlyn Whitlock, Eric Berkson, Elizabeth Matzkin
Identifying patient factors influencing operational throughput time is becoming more imperative due to an increasing focus on value and cost savings in healthcare. The primary objective of this study was to determine patient factors influencing throughput time for primary rotator cuff repairs. Demographic information, medical history and operative reports of 318 patients from one ambulatory care center were retrospectively reviewed. Operating room set up, incision to closure and recovery room time were collected from anesthesia records...
March 29, 2018: Orthopedic Reviews
https://www.readbyqxmd.com/read/29756745/controversies-in-office-based-anesthesia-obstructive-sleep-apnea-considerations
#8
Ruchir Gupta, Srinivas Pyati
As the number of procedures being performed in the office based anesthesia (OBA) setting are increasing, so are the number of patients presenting for surgery with obstructive sleep apnea (OSA). There continues to be controversy regarding whether these patients can be safely cared for in the OBA setting. To date, no national guideline has clearly addressed this issue and while some have extrapolated lessons from what has been published for OSA in the ambulatory surgery center (ASC) setting, some argue that there is a significant difference in the availability of resources in the ASC versus the OBA setting...
May 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29741974/the-effect-of-different-intraabdominal-pressures-on-thiol-disulfide-homeostasis-in-children-who-underwent-ambulatory-laparoscopic-surgery-a-prospective-randomized-study
#9
Seyda Efsun Ozgunay, Yasemin Ustundag, Derya Karasu, Ilken Uguz, Ozcan Erel, Gulsen Korfali, Mete Kaya
BACKGROUND: Thiol/disulfide homeostasis is a significant parameter in determining the oxidative stress response after ischemia and reperfusion. We aimed to investigate the effects of applying different intraabdominal pressure (IAP) on thiol/disulfide homeostasis, ischemia-modified albumin (IMA) levels, and hemodynamics in pediatric laparoscopic surgery. MATERIALS AND METHODS: Blood samples were collected from 36 pediatric patients who were planned to undergo laparoscopic surgery for nonpalpable testis or varicocele under general anesthesia, immediately after intubation as the baseline and 5 minutes after abdominal desufflation for determining the thiol/disulfide, and IMA levels...
May 9, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29735860/risk-factors-for-postoperative-nausea-and-vomiting-in-pediatric-patients-undergoing-ambulatory-dental-treatment
#10
O Kocaturk, S Keles, I K Omurlu
Aim: This study aimed to determine the risk factors for postoperative nausea and vomiting (PONV) in children receiving dental treatment under general anesthesia and to identify the subcategories leading to risk formation. Materials and Methods: The study comprised of 100 American Society of Anesthesiologists I patients aged 2-7 years who were administered dental treatment under general anesthesia. Patients were evaluated with regard to PONV risk. Eight different independent risk factors were identified as follows: age, gender, weight, duration of anesthesia, duration of recovery, postoperative pain, rescue analgesia, and type of dental treatment...
May 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29725865/post-operative-weaning-of-opioids-after-ambulatory-surgery-the-importance-of-physician-stewardship
#11
REVIEW
Brandon Roth, Adjoa Boateng, Allison Berken, Daniel Carlyle, Nalini Vadivelu
PURPOSE OF REVIEW: We performed a systematic review to elucidate the current guidelines on weaning patients from opioids in the post-operative ambulatory surgery setting, and how pain management intraoperatively can impact this process. DESIGN: The review highlights the most up-to-date research from clinical trials, patient reports, and retrospective studies regarding both the current guidelines and weaning of opioid analgesia in ambulatory surgery setting. RECENT FINDINGS: A striking paucity of convincing evidence exists on ambulatory postoperative pain management discontinuation or weaning of pain medications...
May 3, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29719126/randomized-controlled-trial-comparing-the-supraglottic-airway-to-use-of-an-endotracheal-tube-in-sinonasal-surgery
#12
Austin S Adams, Todd J Wannemuehler, Benjamin Hull, Jeffanie Wu, Rakesh K Chandra, Kate VonWahlde, Matthew S Shotwell, Stephen Harvey, Michael Higgins, Kelly McQueen, Justin H Turner
BACKGROUND: The supraglottic airway (SGA) represents an alternative to endotracheal intubation (endotracheal tube [ETT]) in many types of ambulatory surgery. Adoption of the SGA has progressed slowly in sinonasal surgery due to concerns about airway protection. The purpose of this study was to compare quality of life measures and indices of airway protection between patients undergoing sinonasal surgery who were ventilated via an SGA or ETT. METHODS: Patients undergoing outpatient sinonasal surgery were enrolled into a randomized, single-blind study in which patients would be ventilated with either an SGA or ETT...
May 2, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29679228/recovery-time-after-oral-and-maxillofacial-ambulatory-surgery-with-dexmedetomidine-an-observational-study
#13
Belen Hernando, Antonio Martinez-Simon, Elena Cacho-Asenjo, Iñaki F Troconiz, Cristina Honorato-Cia, Alfredo Panadero, Luis L Naval, Jorge M Nuñez-Cordoba
OBJECTIVES: To evaluate the relationship between pharmacokinetic descriptors of dexmedetomidine (predicted area under the curve during the procedure, predicted plasma level at the end of the procedure, and duration of procedure) and sedation depth (proportion of time with bispectral index < 85 during the procedure) with recovery time after ambulatory procedures. MATERIALS AND METHODS: Clinical observational study of patients undergoing oral and maxillofacial ambulatory surgery with dexmedetomidine as sole sedative agent...
April 20, 2018: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29663913/trends-in-general-anesthesia-utilization-by-board-certified-pediatric-dentists
#14
Lan Pham, Thomas Tanbonliong, Marie Beverly Dizon, Annie Huang, Matthew Cooke
PURPOSE: The purpose of this study was to explore the trends and utilization of general anesthesia services among board-certified pediatric dentists practicing in the United States. METHODS: A 26 item survey was sent to 4,216 board-certified pediatric dentists by REDCap or mail. Results were tabulated, and trends were analyzed. RESULTS: A response rate of 31.8 percent was obtained. All American Academy of Pediatric Dentistry districts were represented proportionally...
March 15, 2018: Pediatric Dentistry
https://www.readbyqxmd.com/read/29658980/relative-complications-and-trends-of-outpatient-total-shoulder-arthroplasty
#15
Armin Arshi, Natalie L Leong, Christopher Wang, Zorica Buser, Jeffrey C Wang, Peter S Vezeridis, David R McAllister, Frank A Petrigliano
Outpatient arthroplasty is an appealing option among select patient populations as a mechanism for reducing health care expenditure. The purpose of this study was to determine the nationwide trends and complication profile of outpatient total shoulder arthroplasty (TSA). The authors reviewed a national administrative claims database to identify patients undergoing TSA as outpatients and inpatients from 2007 to 2016. The incidence of perioperative surgical and medical complications was determined by querying for relevant International Classification of Diseases, Ninth Revision, and Current Procedural Terminology codes...
April 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29643730/transient-femoral-nerve-palsy-following-ilioinguinal-nerve-block-for-inguinal-hernioplasty
#16
Isaac Assam Udo, Kingsley U Umeh, Catherine S Eyo
Background: Elective inguinal hernia repair in young fit patients is preferably done under ilioinguinal nerve block anesthesia in the ambulatory setting to improve throughput, save cost, and increase patient satisfaction. A rare complication of ilioinguinal nerve block is transient femoral nerve palsy (TFNP). Objectives: The aim of this study is to examine the incidence of TFNP among adults undergoing ambulatory inguinal hernia repair under ilioinguinal nerve block...
January 2018: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/29628853/crohn-s-disease-associated-silent-aspiration-in-the-outpatient-setting-anesthesiologists-beware
#17
Christopher Snell, Scott Coleman, Michele Van Hal, Farshad Rashidian, Gary Okum, Michael Stuart Green
Every anesthesia provider fears aspiration of gastric contents during an anesthetic, and it may occur even in the absence of overt signs such as coughing or choking. Whether the aspiration is frank or silent, catastrophic and deleterious consequences may ensue. Therefore, familiarity with risk factors for silent aspiration is essential. Crohn's disease reportedly delays gastric emptying making these patients more susceptible to silent aspiration during surgery. Anesthesia providers must be cognizant of this risk and vigilant in the recognition to formulate a specific treatment plan preoperatively...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29624524/blood-pressure-coefficient-of-variation-and-its-association-with-cardiac-surgical-outcomes
#18
Sayuri P Jinadasa, Ariel Mueller, Varesh Prasad, Kathirvel Subramaniam, Thomas Heldt, Victor Novack, Balachundhar Subramaniam
BACKGROUND: Multiple studies completed in the ambulatory nonsurgical setting show a significant association between short- and long-term blood pressure variability and poor outcomes. However, perioperative blood pressure variability outcomes have not been well studied, especially in the cardiac surgical setting. In this study, we sought to assess whether systolic and mean arterial blood pressure variability were associated with 30-day mortality and in-hospital renal failure in patients undergoing cardiac surgery requiring cardiopulmonary bypass...
April 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29609705/ambulatory-surgery-has-minimal-impact-on-sleep-parameters-a-prospective-observational-trial
#19
Arlene J Hudson, Robert J Walter, John Flynn, Dale F Szpisjak, Cara Olsen, Matthew Rodgers, Vincent F Capaldi, Brent McDuffie, Christopher J Lettieri
STUDY OBJECTIVES: The presence of obstructive sleep apnea (OSA) in ambulatory surgical patients causes significant perioperative concern; however, few data exist to guide clinicians' management decisions. The objective of this study was to measure changes in perioperative sleep parameters among an ambulatory surgery population. METHODS: This study is a prospective, observational study of ambulatory patients undergoing orthopedic surgery on an extremity. Study subjects completed three unattended home sleep apnea tests: baseline before surgery, the first night after surgery (N1), and third night after surgery (N3)...
March 30, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29606892/management-of-abnormal-uterine-bleeding-focus-on-ambulatory-hysteroscopy
#20
REVIEW
Shilpa Kolhe
The rapid evolution in ambulatory hysteroscopy (AH) has transformed the approach to diagnose and manage abnormal uterine bleeding (AUB). The medical management in primary care remains the mainstay for initial treatment of this common presentation; however, many women are referred to secondary care for further evaluation. To confirm the diagnosis of suspected intrauterine pathology, the traditional diagnostic tool of day case hysteroscopy and dilatation and curettage in a hospital setting under general anesthesia is now no longer required...
2018: International Journal of Women's Health
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