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Geriatric anesthesia

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https://www.readbyqxmd.com/read/28641968/femoral-nerve-catheters-improve-home-disposition-and-pain-in-hip-fracture-patients-treated-with-total-hip-arthroplasty
#1
Diren Arsoy, James I Huddleston, Derek F Amanatullah, Nicholas J Giori, William J Maloney, Stuart B Goodman
BACKGROUND: Opioids have been the mainstay of treatment in the physiologically young geriatric hip fracture patient undergoing total hip arthroplasty (THA). However opioid-related side effects increase morbidity. Regional anesthesia may provide better analgesia, while decreasing opioid-related side effects. The goal of this study was to examine the effect of perioperative continuous femoral nerve blockade with regards to pain scores, opioid-related side effects and posthospital disposition in hip fracture patients undergoing THA...
June 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28618734/a-comparison-of-usage-of-the-laryngeal-mask-unique-tm-in-denticulate-and-edentulate-geriatric-patients
#2
Meltem Genez, Semih Küçükgüçlü, Şule Özbilgin, Bahar Kuvaki, Tangül Beydeş, Melek Aksoy Sari
BACKGROUND/AIM: Mask ventilation in geriatric and edentulous patients can be ineffective or even impossible because of the shape inside the patients' cheeks. For patients for whom a mask cannot be used for long, the use of a laryngeal mask can ease the administration of anesthesia. The aim of this study was to compare the use of the laryngeal mask Unique(TM) in denticulate and edentulate patients aged over 65 years. MATERIALS AND METHODS: This prospective study included patients according to the American Society of Anesthesiologists I-III classification, aged 65 years or more...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28604086/dexmedetomidine-infusion-for-routine-dental-management-of-an-asa-iv-patient-a-case-report
#3
Andrew S Young, Nicholas A Russell, Joseph A Giovannitti
Anesthetic management of elderly patients requires numerous physiological considerations. With aging, degenerative changes occur in the structure and functional capacity of tissues and organs. Typically, these patients experience clinical effects with lower doses of medication. Important considerations for the geriatric populations following anesthesia include increased time to recovery and avoidance of functional decline. A case is reported in which an 83-year-old Caucasian female with a complex medical history presented for routine dental treatment under intravenous sedation via dexmedetomidine infusion...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28585992/complex-lumbar-spine-fusion-for-an-elderly-patient-under-spinal-anesthesia
#4
Noah L Lessing, Charles C Edwards, Charles Lin, Charles H Brown
Spinal anesthesia for spine surgery is an emerging technique. Because of their lack of physiologic reserve, elderly patients are an appealing population for this technique. Unfortunately, the safe limits of spine surgery using spinal anesthesia for the geriatric population are not well defined. The authors describe an elderly patient with severe spine degeneration who elected for a 5-level lumbar spine fusion with spinal anesthesia. Adequate anesthesia was maintained throughout the procedure, which lasted 3 hours and 24 minutes...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28584740/impact-of-preoperative-echocardiography-on-perioperative-management-in-geriatric-hip-trauma-a-retrospective-observational-study
#5
Chhavi Sawhney, Vivek Trikha, Sai Janani, Sukhminder Jit Singh Bajwa, Vijay Sharma, Menaal Khanna
BACKGROUND AND AIM: Hip fractures are associated with a significant risk of morbidity and mortality in the elderly population. Current guidelines propose that these patients should be operated as early as possible. Preoperative cardiac investigations, especially echocardiography, have been considered to delay surgery with few changes in the patient management. The present study has been conducted to evaluate whether preoperative echocardiography improve or worsen the prognosis in such hip trauma surgery...
April 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28572583/perioperative-and-anesthesia-related-cardiac-arrests-in-geriatric-patients-a-systematic-review-using-meta-regression-analysis
#6
Karen S Braghiroli, José R C Braz, Bruna Rocha, Regina El Dib, José E Corrente, Mariana G Braz, Leandro G Braz
The worldwide population is aging, and the number of surgeries performed in geriatric patients is increasing. This systematic review evaluated anesthetic procedures to assess global data on perioperative and anesthesia-related cardiac arrest (CA) rates in geriatric surgical patients. Available data on perioperative and anesthesia-related CA rates over time and by the country's Human Development Index (HDI) were evaluated by meta-regression, and a pooled analysis of proportions was used to compare perioperative and anesthesia-related CA rates by HDI and time period...
June 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28500499/-anesthesiological-care-of-trauma-patients-in-orthogeriatric-co-management
#7
Markus F Luger, Thomas J Luger
Elderly patients increasingly need to undergo surgery under anesthesia, especially following trauma. A timely interdisciplinary approach to the perioperative management of these patients is decisive for the long-term outcome. Orthogeriatric co-management, which includes geriatricians and anesthesiologists from an early stage, is of great benefit for geriatric patients. Patient age, comorbidities and self-sufficiency in activities of daily life are decisive for an anesthesiological assessment of the state of health and preoperative risk stratification...
May 12, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28419035/clinical-practice-guidelines-decrease-unnecessary-echocardiograms-before-hip-fracture-surgery
#8
Chris Adair, Eric Swart, Rachel Seymour, Joshua Patt, Madhav A Karunakar
BACKGROUND: Preoperative assessment of geriatric patients with a hip fracture may include transthoracic echocardiography (TTE), which increases resource utilization and cost and may delay surgery. The purpose of this study was to evaluate preoperative TTE utilization at a single institution in order to determine (1) how often TTE is ordered in accordance with clinical practice guidelines (CPGs), (2) how frequently TTE reveals cardiac disease that may alter medical or anesthesia management, and (3) whether following CPGs reduces unnecessary TTE utilization without potentially missing important disease...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28403091/effects-of-preoperative-chronic-hypoxemia-on-geriatrics-outcomes-after-hip-arthroplasty-a-hospital-based-retrospective-analysis-study
#9
Furong Zhang, Ruqiang Zhang, Liang He, Jianwei Yin, Fang Wang, Junmin Li
The partial pressure of oxygen decreases as altitude increases, the preoperative chronic hypoxemia (CH) may have a plausible clinical impact. Risk factors for postoperative serious adverse events (pSAEs) in patients living in high altitudes during primary hip arthroplasty (HA) are not clear.This is an observational study embracing patients from January 1, 2011 to December 31, 2015 at Yan'an Hospital of Kunming City, a 1338-bed municipal teaching hospital of Kunming Medical University. Univariate analysis revealed that significant differences between patients with and without preoperative CH occurred in intraoperative hypotension (77 [33%] vs 34 [47%], P = ...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28323335/surgical-guidelines-for-perioperative-management-of-older-adults-what-geriatricians-need-to-know
#10
Jessica L Colburn, Sanjay Mohanty, John R Burton
A multidisciplinary panel of experts representing surgery, anesthesia, and geriatrics recently published guidelines for surgeons on the optimal perioperative management of older adults, including recommendations on postoperative recovery and posthospital transitions of care. Geriatricians have an important role in the care for older adults in the preoperative period as older adults consider surgical options and prepare for surgical procedures, during the perioperative period as inpatient consultants, and in the postoperative period as older adults transition to rehabilitation facilities or to home...
March 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28141603/prevention-and-management-of-postoperative-delirium-in-elderly-patients-following-elective-spinal-surgery
#11
Alireza K Nazemi, Anirudh K Gowd, Jonathan J Carmouche, Stephen L Kates, Todd J Albert, Caleb J Behrend
STUDY DESIGN: This study is a systematic review. OBJECTIVE: Propose an evidence-based algorithm for prevention, diagnosis, and management of postoperative delirium in geriatric patients undergoing elective spine surgery. SUMMARY OF BACKGROUND DATA: Delirium is associated with longer stays after elective surgery, increased risk of readmission, and $6.9 billion annually in medical costs. Early diagnosis and treatment of delirium can reduce length of stay (LOS), in-hospital morbidity, and health care costs...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27999879/-perioperative-patient-management-in-orthogeriatrics
#12
P Moldzio, J Peters
The management of major orthopedic surgery in the elderly prototypically reflects the perioperative risks of geriatric, often very frail patients reflecting an aging population. To improve outcome, the risks of anesthesia and surgery as well as of patient comorbidities must be thoroughly assessed and balanced using a multidisciplinary approach. Particular risks include cardiopulmonary morbidity, anemia, risk of hemorrhage and the management by anticoagulation, cerebral impairments as well as frailty and limited physiological reserves in general...
January 2017: Der Orthopäde
https://www.readbyqxmd.com/read/27903336/-the-development-of-geriatric-anesthesia-in-china-based-on-the-concept-of-perioperative-medicine
#13
T L Wang, D X Wang
No abstract text is available yet for this article.
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27871564/effect-of-remifentanil-and-fentanyl-on-postoperative-cognitive-function-and-cytokines-level-in-elderly-patients-undergoing-major-abdominal-surgery
#14
Germano De Cosmo, Flaminio Sessa, Federico Fiorini, Elisabetta Congedo
PURPOSE: Postoperative cognitive dysfunction is a frequent complication occurring in geriatric patients. Type of anesthesia and the patient's inflammatory response may contribute to postoperative cognitive dysfunction (POCD). In this prospective randomized double-blinded controlled study we hypothesized that intraoperative remifentanil may reduce immediate and early POCD compared to fentanyl and evaluated if there is a correlation between cognitive status and postoperative inflammatory cytokines level...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871540/comparison-of-the-effects-of-truview-pcd%C3%A2-video-laryngoscopy-and-macintosh-blade-direct-laryngoscopy-in-geriatric-patients
#15
Muhammed M Kurnaz, Aykut Sarıtaş
STUDY OBJECTIVE: To compare the effects of Truview PCD™ video laryngoscopy (TVL) and Macintosh blade direct laryngoscopy (MDL) on hemodynamic responses observed during laryngoscopy and orotracheal intubation conditions in geriatric patients. DESIGN: Randomized prospective study. SETTING: Operating room. PATIENTS: One hundred patients in the risk group American Society of Anesthesiologists I to III aged 65 years and older underwent elective surgery under general anesthesia...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27768775/dexmedetomidine-acts-via-the-jak2-stat3-pathway-to-attenuate-isoflurane-induced-neurocognitive-deficits-in-senile-mice
#16
Yanna Si, Yuan Zhang, Liu Han, Lihai Chen, Yajie Xu, Fan Sun, Muhuo Ji, Jianjun Yang, Hongguang Bao
BACKGROUND: Previous studies showed that isoflurane-induced cognitive deficits could be alleviated by dexmedetomidine in young animal subjects. In the current study, we examine whether dexmedetomidine could also alleviate isoflurane-induced cognitive deficits in senile animals. METHODS: Senile male C57BL/6 mice (20 months) received dexmedetomidine (50 μg/kg, i.p.) or vehicle 30 minutes prior to isoflurane exposure (1.3% for 4 h). Cognitive function was assessed 19 days later using a 5-day testing regimen with Morris water maze...
2016: PloS One
https://www.readbyqxmd.com/read/27577731/risk-factors-for-mortality-in-geriatric-hip-fractures-a-compressional-study-of-different-surgical-procedures-in-785-consecutive-patients
#17
Ersin Ercin, M Gokhan Bilgili, Cihangir Sari, S Hakan Basaran, Bulent Tanriverdi, Erdem Edipoglu, K Mumtaz Celen, Halil Cetingok, Cemal Kural
BACKGROUND: Only a little is known about whether type of surgical intervention has an effect on mortality of these patients. Our primary objective was to assess whether different type of surgical procedures has an effect on mortality among elderly patients with hip fracture. A secondary objective was to examine factors that are related to mortality in our patient population. Our hypothesis is that type of surgical procedure, especially external fixation, should have an influence on mortality outcomes...
January 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27546959/lower-limb-orthopedic-surgery-in-geriatric-patients-under-paravertebral-blocks-a-prospective-feasibility-study
#18
Rajesh Kumar Singh, J P Chaturvedi, H S Agrawal, Nitesh Agrawal
BACKGROUND: Aging causes progressive deterioration of all the organ systems. Physiological changes of aging and co-morbidities make regional anesthesia a preferred technique for this age group. Regional anesthesia with risk of hypotension and its consequences is fraught with dangers. Peripheral nerve blocks (PNBs) are much safer and give much superior post-op analgesia. The present study was undertaken to perform major lower limb orthopedic surgeries PNBs in geriatric settings. METHODS: A feasibility study was undertaken in patients above age of 60 years admitted for lower limb surgeries to undertake these surgeries under para-vertebral blocks for a period of one year from Mar 2011 to Feb 2012...
July 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27499322/less-invasive-surgery-using-external-fixator-for-the-treatment-of-subtrochanteric-femur-fracture-in-a-high-risk-geriatric-patient
#19
O Şahap Atik, Fatih I Can, M Selçuk Şenol, Toygun K Eren
A 90-year-old female patient was admitted to our clinic complaining of pain in her left hip which occurred due to fall from a chair. Her medical history included memory loss and mental changes associated with Alzheimer's disease and depression. Patient's cooperation and orientation were weak. Range of motion of the left hip was restricted and painful. Radiographs of the left hip demonstrated subtrochanteric comminuted fracture of femur. Laboratory tests revealed anemia and liver insufficiency. Departments of internal medicine and anesthesiology reported high risk for surgery...
August 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/27354078/correction-protocol-for-the-electroencephalography-guidance-of-anesthesia-to-alleviate-geriatric-syndromes-engages-study-a-pragmatic-randomised-clinical-trial
#20
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