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Perioperative assessment

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https://www.readbyqxmd.com/read/28646587/perioperative-pain-management-after-fibular-free-flap-harvesting-for-head-and-neck-reconstruction-using-mini-catheters-to-inject-local-anesthetic-a-pilot-study
#1
Andrea Ferri, Andrea Varazzani, Adriana Valente, Giuseppe Pedrazzi, Bernardo Bianchi, Silvano Ferrari, Enrico Sesenna
BACKGROUND: Fibular donor site pain management in the early postoperative period can help minimize complications, patient discomfort, and agitation. Traditional management of postoperative pain consists of systemic administration of opioids and NSAIDS. The use of local anesthetics in addition to systemic analgesics has the potential to improve pain control. Purpose of the study is to evaluate the efficacy of mini-catheters used to inject local anesthetic into the fibular donor site after flap harvesting for reconstruction of the head-and-neck area...
June 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28645673/supra-acetabular-line-is-better-than-supra-iliac-line-for-coronal-balance-referencing-a-study-of-perioperative-whole-spine-x-rays-in-degenerative-lumbar-scoliosis-and-ankylosing-spondylitis-patients
#2
Hwee Weng Dennis Hey, Cheung-Kue Kim, Won-Gyu Lee, Hyung-Suk Juh, Ki-Tack Kim
BACKGROUND CONTEXT: The aim of spinal deformity correction is to restore the spine's functional alignment by balancing it in both the sagittal and coronal planes. Regardless of posture, the ideal coronal profile is straight, and therefore readily assessable. PURPOSE: This study compares two radiological methods to determine which better predicts postoperative standing coronal balance. STUDY DESIGN/SETTING: We conducted a single-centre, radiographic comparative study between 2011 and 2015...
June 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28645181/the-clinical-benefits-of-perioperative-antioxidant-vitamin-therapy-in-patients-undergoing-cardiac-surgery-a-meta-analysis
#3
Jun Geng, Ju Qian, Weijun Si, Hao Cheng, Fuhai Ji, Zhenya Shen
The clinical benefits of perioperative antioxidant vitamin therapy in cardiac patients remain controversial. Here, we conducted a meta-analysis to determine the strength of the evidence supporting the perioperative use of antioxidant vitamins in patients undergoing cardiac surgery. We searched 4 databases (PubMed, EMBASE, Science Citation Index and Cochrane Library) for randomized controlled trials that reported the effects of antioxidant vitamin therapy on patients undergoing cardiac surgery until 6 June 2016...
June 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28644099/assessment-of-drainage-techniques-for-evacuation-of-chronic-subdural-hematoma-a-consecutive-population-based-comparative-cohort-study
#4
Kristin Sjåvik, Jiri Bartek, Lisa Millgård Sagberg, Marte Lødemel Henriksen, Sasha Gulati, Fredrik L Ståhl, Helena Kristiansson, Ole Solheim, Petter Förander, Asgeir Store Jakola
OBJECTIVE Surgery for chronic subdural hematoma (CSDH) is one of the most common neurosurgical procedures. The benefit of postoperative passive subdural drainage compared with no drains has been established, but other drainage techniques are common, and their effectiveness compared with passive subdural drains remains unknown. METHODS In Scandinavian population-based cohorts the authors conducted a consecutive, parallel cohort study to compare different drainage techniques. The techniques used were continuous irrigation and drainage (CID cohort, n = 166), passive subdural drainage (PD cohort, n = 330), and active subgaleal drainage (AD cohort, n = 764)...
June 23, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28643855/support-surfaces-in-the-prevention-of-pressure-ulcers-in-surgical-patients-an-integrative-review
#5
Karoline Faria de Oliveira, Kleiton Gonçalves Nascimento, Adriana Cristina Nicolussi, Suzel Regina Ribeiro Chavaglia, Cleudmar Amaral de Araújo, Maria Helena Barbosa
AIM: To assess the scientific evidence about the types of support surfaces used in intraoperative surgical practice in the prevention of pressure ulcers due to surgical positioning. METHOD: This is an integrative literature review. The electronic databases Cochrane, PubMed, Web of Science, Scopus, Lilacs, and CINAHL were used. The descriptors surgical patients, support surfaces, perioperative care, patient positioning, and pressure ulcer were used in the search strategy...
June 23, 2017: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/28641907/is-fusion-superior-to-non-fusion-for-the-treatment-of-thoracolumbar-burst-fracture-a-systematic-review-and-meta-analysis
#6
Tao Lan, Yang Chen, Shi-Yu Hu, Ao-Lin Li, Xin-Jian Yang
OBJECTIVE: The purpose of this meta-analysis was to compare the efficacy and safety between patients with thoracolumbar burst fracture who underwent posterior fixation alone (non-fusion) and supplemented with fusion. METHODS: A comprehensive search of related literature was performed in PubMed, Embase and the Cochrane library. Clinical outcomes (LBOS and VAS), surgical outcomes (operation time, blood loss, hospital stay and perioperative complications), and radiographic outcomes (kyphotic angle, decreased vertebral body height and segmental motion) were assessed in the meta-analysis...
June 19, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28641713/assessment-tools-for-use-during-anesthesia-centric-pediatric-advanced-life-support-training-and-evaluation
#7
Scott C Watkins, Paul J Nietert, Elisabeth Hughes, Eric T Stickles, Tracy E Wester, Matthew D McEvoy
BACKGROUND: Pediatric perioperative cardiac arrests are rare events that require rapid, skilled and coordinated efforts to optimize outcomes. We developed an assessment tool for assessing clinician performance during perioperative critical events termed Anesthesia-centric Pediatric Advanced Life Support (A-PALS). Here, we describe the development and evaluation of the A-PALS scoring instrument. METHODS: A group of raters scored videos of a perioperative team managing simulated events representing a range of scenarios and competency...
June 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28641693/-evidence-and-practice-of-enhanced-lung-recovery-after-surgery-%C3%A2-in-patients-undergoing-lung-surgery
#8
Guowei Che
The clinic application pathway is a variant of the enhanced recovery after surgery (ERAS), which based disease and team. What are the published evidence is conducive to enhanced lung recovery after surgery (ELRAS) in clinical implementation. This article mainly from the perioperative management can adopt the measures and methods were retrospectively analyzed. The measures of education and assessment of the risk factors and prevention is emphasized in preoperative. The minimally invasive surgery and process optimization is adopted by surgeon...
June 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/28641358/-pain-treatment-after-thoracic-surgery
#9
Holger Hendrix, Vladimir Kamlak, Georgi Prisadov, Katrin Welcker
The treatment of pain after thoracic surgery is a challenge and takes place in the individual clinics mostly according to clinic internal standards. It exists no currently valid S3 guideline for the treatment of acute perioperative and posttraumatic pain. For an effective pain treatment as well individual pain experience as the pain intensity of the various thoracic surgical procedures must be considered. Regular pain assessment with appropriate methods and their documentation form the basis for adequate and adapted pain therapy...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28637567/the-impact-of-early-recurrence-on-quality-of-life-after-cytoreduction-with-hipec
#10
Nathan M Hinkle, Vandana Botta, John P Sharpe, Paxton Dickson, Jeremiah Deneve, Gitonga Munene
Improved oncological outcomes after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in highly selected patients have been well documented. The extensive nature of the procedure adversely affects quality of life (QoL). The aim of this study is to longitudinally evaluate QoL following CRS/HIPEC. This is a retrospective review of a prospectively maintained database of patients with peritoneal malignancies undergoing CRS/HIPEC. Clinicopathological data, oncologic outcomes, and QoL were analyzed preoperatively and postoperatively at 2 weeks, and 1, 3, 6, and 12 months...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28637424/gabapentin-in-procedure-specific-postoperative-pain-management-preplanned-subgroup-analyses-from-a-systematic-review-with-meta-analyses-and-trial-sequential-analyses
#11
Maria Louise Fabritius, Anja Geisler, Pernille Lykke Petersen, Jørn Wetterslev, Ole Mathiesen, Jørgen Berg Dahl
BACKGROUND: It has been argued that postoperative pain treatment should be "procedure-specific", since different analgesics may have specific effects dependent on the surgical procedure. The aim of the present subgroup analysis was to compare the beneficial and harmful effects of perioperative gabapentin treatment in different surgical procedures. METHODS: Relevant databases were searched for randomized clinical trials (RCTs) comparing gabapentin versus placebo...
June 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28637309/anterior-cervical-pseudarthrosis-treated-with-bilateral-posterior-cervical-cages
#12
William Smith, Mark Gillespy, Jason Huffman, Veasna Vong, Bruce M McCormack
BACKGROUND: Pseudarthrosis after anterior cervical discectomy and fusion (ACDF) causes persistent pain and related disability. Posterior revision surgery results in higher healing rates, but is more extensive compared to anterior surgery. OBJECTIVE: To evaluate minimally disruptive, tissue sparing posterior fusion via bilateral placement of posterior cages between the facet joints as an alternative treatment option. METHODS: A retrospective, multicenter, medical chart review was performed and included 25 patients with symptomatic pseudarthrosis after ACDF treated with posterior cervical cages, and in select cases, anterior revision...
June 14, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28636504/prognostic-value-of-the-new-high-sensitive-cardiac-troponin-t-assay-hs-ctnt-after-coronary-artery-bypass-grafting
#13
Arash Mehdiani, Payam Akhyari, Hiroyuki Kamiya, Joachim Ahlers, Erhard Godehardt, Alexander Albert, Udo Boeken, Artur Lichtenberg
Background The aim of the study was to assess the value of post-operative cardiac troponin T-levels, measured with a new highly sensitive assay (hs-cTnT), as a suitable parameter to predict patients' outcome after cardiac surgery. With the introduction of the new hs-cTnT assay the correlation between measured levels and the post-operative patient's outcome remains to be evaluated. Methods Patients undergoing coronary artery bypass grafting (n = 213) were included. Perioperative measurements of hs-cTnT and CK-MB were correlated to parameters of clinical outcome and further explored...
March 21, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28631835/suprameatal-urethrolysis-with-martius-flap-for-refractory-bladder-outflow-obstruction-following-stress-incontinence-surgery-in-females
#14
Janine L Oliver, Shlomo Raz
AIMS: To present our technique of suprameatal urethrolysis with Martius flap (SMUM) and outcomes of this procedure for refractory female bladder outflow obstruction (BOO). METHODS: A retrospective chart review was performed to identify female patients who underwent SMUM between January 2010 and August 2016 after failed transvaginal urethrolysis (TVU) for BOO due to prior stress urinary incontinence (SUI) surgery. The primary outcome measure was surgical success defined as patient ability to void volitionally without need for catheterization or additional surgery for BOO...
June 20, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28629932/systemic-antimicrobial-prophylaxis-in-burn-patients-a-systematic-review
#15
REVIEW
Guillermo Enrique Ramos
OBJECTIVE: To review studies of systemic antibiotic prophylaxis in burn patients. METHODS: Human clinical trials during the period 1966-2016 where prophylactic systemic antibiotics were compared with placebo or no intervention were identified in electronic databases. RESULTS: Nineteen trials met the selection criteria. Early post-burn period prophylaxis was assessed in non severe burn patients (6 trials), and in severe burn patients (7 trials)...
June 16, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28629905/2017-american-college-of-rheumatology-american-association-of-hip-and-knee-surgeons-guideline-for-the-perioperative-management-of-antirheumatic-medication-in-patients-with-rheumatic-diseases-undergoing-elective-total-hip-or-total-knee-arthroplasty
#16
Susan M Goodman, Bryan Springer, Gordon Guyatt, Matthew P Abdel, Vinod Dasa, Michael George, Ora Gewurz-Singer, Jon T Giles, Beverly Johnson, Steve Lee, Lisa A Mandl, Michael A Mont, Peter Sculco, Scott Sporer, Louis Stryker, Marat Turgunbaev, Barry Brause, Antonia F Chen, Jeremy Gililland, Mark Goodman, Arlene Hurley-Rosenblatt, Kyriakos Kirou, Elena Losina, Ronald MacKenzie, Kaleb Michaud, Ted Mikuls, Linda Russell, Alexander Sah, Amy S Miller, Jasvinder A Singh, Adolph Yates
OBJECTIVE: This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA)...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28629904/perioperative-morbidity-of-same-day-and-staged-bilateral-total-hip-arthroplasty
#17
Lazaros A Poultsides, Georgios K Triantafyllopoulos, Stavros G Memtsoudis, Huong T Do, Michael M Alexiades, Thomas P Sculco
BACKGROUND: Management strategies for bilateral hip degenerative disease include same-day or staged bilateral total hip arthroplasty (THA), but information on outcomes remains sparse. We sought to describe in-hospital complications and blood transfusion rates after same-day and staged bilateral THAs at different time intervals and to assess risk factors for these events. METHODS: We retrospectively reviewed administrative data for 3785 patients treated with same-day bilateral (n = 1946; group A) and staged bilateral THA within (1) 0-3 months apart (n = 328; group B); (2) 3-6 months apart (n = 703; group C); and (3) 6-12 months apart (n = 808; group D), between 1999 and 2014...
May 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28629903/recording-adverse-events-following-joint-arthroplasty-financial-implications-and-validation-of-an-adverse-event-assessment-form
#18
Matthew J Lee, Khalid M S Mohamed, John C Kelly, John G Galbraith, John Street, Brian J Lenehan
BACKGROUND: In Ireland, funding of joint arthroplasty procedures has moved to a pay-by-results national tariff system. Typically, adverse clinical events are recorded via retrospective chart-abstraction methods by administrative staff. Missed or undocumented events not only affect the quality of patient care but also may unrealistically skew budgetary decisions that impact fiscal viability of the service. Accurate recording confers clinical benefits and financial transparency. The aim of this study was to compare a prospectively implemented adverse events form with the current national retrospective chart-abstraction method in terms of pay-by-results financial implications...
April 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28629445/effects-of-perioperative-statin-use-on-cardiovascular-complications-in-patients-submitted-to-non-cardiac-surgery-protocol-for-a-systematic-review-meta-analysis-and-trial-sequential-analysis
#19
Erica Aranha Suzumura, Rodrigo Antonini Ribeiro, Leticia Kawano-Dourado, Pedro Gabriel de Barros E Silva, Claudia Oliveira, Mabel Fernandes Figueiró, Alexandre Biasi Cavalcanti, Renato D Lopes, Otavio Berwanger
BACKGROUND: Preliminary evidence suggests statins may reduce major perioperative vascular events. However, evidence is limited to observational studies, underpowered trials, and non-comprehensive systematic reviews. This review aims to assess the effects of perioperative statin use on cardiovascular complications in patients submitted to non-cardiac surgery. METHODS: We will search MEDLINE/PubMed, EMBASE, LILACS, CENTRAL, Web of Science, and CINAHL for randomized controlled trials assessing the effects of perioperative statin use in adults undergoing non-cardiac surgery and reporting cardiovascular complications...
June 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28628531/costs-and-length-of-stay-for-the-acute-care-of-patients-with-motor-complete-spinal-cord-injury-following-cervical-trauma-the-impact-of-early-transfer-to-specialized-acute-sci-center
#20
Andréane Richard-Denis, Debbie Ehrmann Feldman, Cynthia Thompson, Étienne Bourassa-Moreau, Jean-Marc Mac-Thiong
OBJECTIVE: Acute spinal cord injury (SCI) centers aim to optimize outcome following SCI. However, there is no timeframe to transfer patients from regional to SCI centers in order to promote cost-efficiency of acute care. Our objective was to compare costs and length of stay (LOS) following early and late transfer to the SCI center. DESIGN: A retrospective cohort study involving 116 individuals was conducted. Group 1 (n = 87) was managed in an SCI center promptly after the trauma, whereas group 2 (n = 29) was transferred to the SCI center only after surgery...
July 2017: American Journal of Physical Medicine & Rehabilitation
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