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Geriatric anesthesia

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https://www.readbyqxmd.com/read/27903336/-the-development-of-geriatric-anesthesia-in-china-based-on-the-concept-of-perioperative-medicine
#1
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
#2
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
#3
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
#4
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
#5
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...
August 31, 2016: 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
#6
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
#7
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
#8
https://www.readbyqxmd.com/read/27311914/protocol-for-the-electroencephalography-guidance-of-anesthesia-to-alleviate-geriatric-syndromes-engages-study-a-pragmatic-randomised-clinical-trial
#9
T S Wildes, A C Winter, H R Maybrier, A M Mickle, E J Lenze, S Stark, N Lin, S K Inouye, E M Schmitt, S L McKinnon, M R Muench, M R Murphy, R T Upadhyayula, B A Fritz, K E Escallier, G P Apakama, D A Emmert, T J Graetz, T W Stevens, B J Palanca, R L Hueneke, S Melby, B Torres, J Leung, E Jacobsohn, M S Avidan
INTRODUCTION: Postoperative delirium, arbitrarily defined as occurring within 5 days of surgery, affects up to 50% of patients older than 60 after a major operation. This geriatric syndrome is associated with longer intensive care unit and hospital stay, readmission, persistent cognitive deterioration and mortality. No effective preventive methods have been identified, but preliminary evidence suggests that EEG monitoring during general anaesthesia, by facilitating reduced anaesthetic exposure and EEG suppression, might decrease incident postoperative delirium...
2016: BMJ Open
https://www.readbyqxmd.com/read/27258175/leveraging-the-preoperative-clinic-to-engage-older-patients-in-shared-decision-making-about-complex-surgery-an-illustrative-case
#10
Sushila Murthy, David Lerner Hepner, Zara Cooper, Houman Javedan, Lauren Jan Gleason, John H Chi, Angela Maria Bader
The decision to pursue surgery is often complicated in older adults. A multidisciplinary, shared approach to decision-making may improve communication between patients and their providers and facilitate complex risk assessment. We describe a case of an older adult presenting for complex surgery in which the preoperative anesthesia clinic visit was used to facilitate involvement of the geriatrics service. This multidisciplinary approach allowed for re-evaluation and reiteration of risks and benefits, in-depth discussion of the patient's values and goals, and recommendations for care teams downstream in the patient's surgical pathway to ensure treatment consistent with patient goals and clinical recommendations...
July 15, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27110532/comparison-of-the-course-and-prognosis-of-geriatric-patients-admitted-to-the-intensive-care-unit-according-to-bmi-and-albumin-values
#11
Ozkan Onal, Gulten Ozgun
BACKGROUND: Elderly patients constitute the majority of patients undergoing treatment in the intensive care unit (ICU). Patients over the age of 65 account for 42%-52% of admission to ICU. Previous studies have shown that malnutrition is an important factor influencing the prognosis in intensive care. OBJECTIVES: In this study, the effect of body mass index (BMI) and albumin values at first admission to the ICU on the course and prognosis of geriatric patients were investigated...
February 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27090913/-anesthesiological-care-in-orthogeriatric-co-management-perioperative-treatment-of-geriatric-trauma-patients
#12
Thomas J Luger, Markus F 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...
April 2016: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/27079335/knowledge-gaps-in-cardiovascular-care-of-the-older-adult-population-a-scientific-statement-from-the-american-heart-association-american-college-of-cardiology-and-american-geriatrics-society
#13
Michael W Rich, Deborah A Chyun, Adam H Skolnick, Karen P Alexander, Daniel E Forman, Dalane W Kitzman, Mathew S Maurer, James B McClurken, Barbara M Resnick, Win K Shen, David L Tirschwell
The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on quality of life, morbidity, and mortality in older adults, patients aged ≥75 years have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older patients with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in a nursing home or assisted living facility...
May 24, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27004703/effects-of-n-acetyl-cysteine-on-renal-functions-evaluated-by-blood-neutrophil-gelatinase-associated-lipocalin-levels-in-geriatric-patients-undergoing-coronary-artery-bypass-grafting
#14
Mustafa Aldemir, Halit Buğra Koca, Elif Doğan Bakı, Görkem Çarşanba, Nilgün Öztürk Kavrut, Ali Sait Kavaklı, Fahri Adalı, Mustafa Emmiler, Osman Tansel Darçın
OBJECTIVE: Recent conflicting studies on the renal effects of N-acetyl cysteine (NAC) after cardiac surgery have been published. The aim of this study was to evaluate the renal effects of NAC using neutrophil gelatinase-associated lipocalin (NGAL) blood levels in elderly patients undergoing coronary artery bypass grafting (CABG). METHODS: This randomized, double-blinded, placebo-controlled study was conducted among geriatric patients (>65 years) scheduled to undergo CABG...
November 25, 2015: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/26873000/the-effect-of-surgical-and-psychological-stress-on-learning-and-memory-function-in-aged-c57bl-6-mice
#15
C Zhang, C Li, Z Xu, S Zhao, P Li, J Cao, W Mi
Postoperative cognitive dysfunction (POCD) is an important complication following major surgery and general anesthesia in older patients. However, the etiology of POCD remains largely to be determined. It is unknown how surgical stress and psychological stress affect the postoperative learning and memory function in geriatric patients. We therefore established a pre-clinical model in aged C57BL/6 mice and aimed to investigate the effects of surgical stress and psychological stress on learning and memory function and the possible roles of the protein kinase B/mammalian target of rapamycin (AKT/mTOR) pathway...
April 21, 2016: Neuroscience
https://www.readbyqxmd.com/read/26829953/-anesthesiological-management-of-elderly-trauma-patients
#16
M Coburn, A B Röhl, M Knobe, A Stevanovic, C Stoppe, R Rossaint
BACKGROUND: The demographic change is accompanied by an increasing number of elderly trauma patients. Geriatric patients with trauma often show several comorbidities and as a result have a high perioperative risk to develop postoperative morbidity and mortality. The 30-day mortality is high. AIM: This article presents an overview of the perioperative management of elderly trauma patients in order to improve the perioperative outcome of these high risk patients. MATERIAL AND METHODS: A literature search was carried out focusing on the latest developments in the field of elderly trauma patients in order to present guidance on preoperative, intraoperative and postoperative anesthesiological management...
February 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/26664202/thoracic-combined-spinal-epidural-anesthesia-for-laparoscopic-cholecystectomy-in-a-geriatric-patient-with-ischemic-heart-disease-and-renal-insufficiency
#17
Nandita Mehta, Sunana Gupta, Atul Sharma, Mohd Reidwan Dar
Older people undergoing any surgery have a higher incidence of morbidity and mortality, resulting from a decline in physiological reserves, associated comorbidities, polypharmacy, cognitive dysfunction, and frailty. Most of the clinical trials comparing regional versus general anesthesia in elderly have failed to establish superiority of any single technique. However, the ideal approach in elderly is to be least invasive, thus minimizing alterations in homeostasis. The goal of anesthetic management in laparoscopic procedures includes management of pneumoperitoneum, achieving an adequate level of sensory blockade without any respiratory compromise, management of shoulder tip pain, provision of adequate postoperative pain relief, and early ambulation...
2015: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/26634080/clinical-efficacy-of-the-classic-laryngeal-mask-airway-in-elderly-patients-a-comparison-with-young-adult-patients
#18
Eun Mi Kim, Min-Soo Kim, Bon-Nyeo Koo, Jeong-Rim Lee, Young Sub Lee, Jae Hoon Lee
BACKGROUND: The elderly have been reported to show anatomical and physiologic changes in the upper airway, which might affect the supraglottic airway (SGA) performance in geriatric populations. This study aimed to evaluate the clinical efficacy of the classic laryngeal mask airway (LMA-C) in the elderly compared with young adult patients. METHODS: Fifty patients aged 65-85 years (elderly group) and 50 patients aged 20-40 years (young group) who were scheduled for surgery using the LMA-C for general anesthesia were enrolled in this prospective, non-randomized, comparative study...
December 2015: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/26630466/the-clinical-and-economic-impact-of-preoperative-transthoracic-echocardiography-in-elderly-patients-with-hip-fractures
#19
Andrew Marcantonio, Brandon Steen, Michael Kain, Kasey-Jean Bramlett, John F Tilzey, Richard Iorio
PURPOSE: The purpose of this study was to evaluate preoperative transthoracic echocardiography (TTE) on cardiac intervention, length of stay (LOS), inpatient mortality, and costs. METHODS: A retrospective series of 43 preoperative TTE and 161 non-TTE (control) hip fracture patients (> 65 years) was reviewed. The data collected included ASA score, comorbidities, indication for TTE, perioperative cardiac intervention, LOS, inpatient mortality, and cost. RESULTS: One of 43 (2...
December 2015: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/26566315/outcomes-of-trochanteric-external-fixation-for-geriatric-inter-trochanteric-hip-fractures
#20
Ahmed H Yousry, Pranit N Chotai, Sherif A El Ghazaly, Tamer A Fayyad, Amr A Abdelgawad
INTRODUCTION: Trochanteric fractures are a leading cause of disability among the elderly. Internal fixation is the gold standard treatment. However, it may be challenging in the high-risk population. We present our results using external fixator in trochanteric fractures in the elderly. PATIENTS AND METHODS: During 2005-2012, twenty-three high-risk elderly patients (average age 70 years) with trochanteric fracture were managed using percutaneous external fixation (EF)...
December 2015: Journal of Orthopaedics
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