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Geriatric anesthesia

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https://www.readbyqxmd.com/read/29137628/hypertonic-saline-for-prevention-of-delirium-in-geriatric-patients-who-underwent-hip-surgery
#1
Xi Xin, Fei Xin, Xuguang Chen, Qi Zhang, Yanan Li, Shuping Huo, Chongfu Chang, Qiujun Wang
BACKGROUND: Postoperative delirium (POD) is a common disorder in the elderly patients, and neuroinflammation is the possible underlying mechanism. This study is designed to determine whether or not hypertonic saline (HS) pre-injection can alleviate POD in aged patients. METHODS: This prospective study recruited 120 geriatric patients who underwent hip surgery. The patients were randomly divided into two groups: control group (NS group) and HS group. Patients in the NS group were pre-injected with 4 mL/kg isotonic saline, and those in the HS group were pre-injected with 4 mL/kg 7...
November 14, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29133765/geriatric-anesthesia-related-morbidity-and-mortality-in-china-current-status-and-trend
#2
REVIEW
Yang Liu, Wei Xiao, Ling-Zhong Meng, Tian-Long Wang
OBJECTIVE: The population of elderly patients and the amount of geriatric anesthesia have been growing rapidly in China. Thus, understanding the morbidity and mortality associated with geriatric anesthesia in China is critical to the improvement of anesthesia quality and outcome. The aim of the review was to discuss the geriatric anesthesia-related morbidity and mortality in China, as well as to point out the future trend. DATA SOURCES: Articles in this review were all searched from Wanfang, China National Knowledge Infrastructure (CNKI), VIP, PubMed, and Web of Science databases, based on the reports originated in China from January 2011 to December 2016...
November 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29109625/postoperative-delirium-in-elderly-citizens-and-current-practice
#3
REVIEW
Siddareddygari Velayudha Reddy, Jawaharlal Narayanasa Irkal, Ananthapuram Srinivasamurthy
Postoperative delirium (POD) represents an acute brain dysfunction in the postsurgical period. Perioperative physicians caring for the older adults are familiar with the care of dysfunction of organs such as lungs, heart, liver, or kidney in the perioperative setting, but they are less familiar with management of brain dysfunction. As early detection and prompt treatment of inciting factors are utmost important to prevent or minimize the deleterious outcomes of delirium. The purpose of this review is to prepare perioperative physicians with a set of current clinical practice recommendations to provide optimal perioperative care of older adults, with a special focus on specific perioperative interventions that have been shown to prevent POD...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29071370/determination-of-the-median-effective-dose-ed50-of-bupivacaine-and-ropivacaine-unilateral-spinal-anesthesia-prospective-double-blinded-randomized-dose-response-trial
#4
WeiBing Wang, YuanHai Li, AiJiao Sun, HongPing Yu, JingChun Dong, Huang Xu
BACKGROUND: Unilateral spinal anesthesia (USpA) has been reported to potentiate spinal anaesthesia and is used in geriatric patients. The purpose of this study was to determine the median effective dose (ED50) of 0.5% hypobaric bupivacaine and 0.5% hypobaric ropivacaine USpA for geriatric patients (age ≥ 70 years) undergoing elective hip replacement surgery. METHODS: A total of 60 geriatric patients (age ≥ 70 years) undergoing elective hip replacement surgery were enrolled in this study...
October 25, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29065869/leading-comorbidity-associated-with-30-day-post-anesthetic-mortality-in-geriatric-surgical-patients-in-taiwan-a-retrospective-study-from-the-health-insurance-data
#5
Chun-Lin Chu, Hung-Yi Chiou, Wei-Han Chou, Po-Ya Chang, Yi-You Huang, Huei-Ming Yeh
BACKGROUND: Elderly patients with aged physical status and increased underlying disease suffered from more postoperative complication and mortality. We design this retrospective cohort study to investigate the relationship between existing comorbidity of elder patients and 30 day post-anesthetic mortality by using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) from Health Insurance Database. METHODS: Patients aged above 65 years old who received anesthesia between 2000 and 2010 were included from 1 million Longitudinal Health Insurance Database in (LHID) 2005 in Taiwan...
October 24, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28960161/geriatric-comanagement-reduces-perioperative-complications-and-shortens-duration-of-hospital-stay-after-lumbar-spine-surgery-a-prospective-single-institution-experience
#6
Owoicho Adogwa, Aladine A Elsamadicy, Victoria D Vuong, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE Geriatric patients undergoing lumbar spine surgery have unique needs due to the physiological changes of aging. They are at risk for adverse outcomes such as delirium, infection, and iatrogenic complications, and these complications, in turn, contribute to the risk of functional decline, nursing home admission, and death. Whether preoperative and perioperative comanagement by a geriatrician reduces the incidence of in-hospital complications and length of in-hospital stay after elective lumbar spine surgery remains unknown...
September 29, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28953670/poor-prognosis-after-surgery-for-intertrochanteric-fracture-in-elderly-patients-with-clopidogrel-treatment-a-cohort-study
#7
Jianzheng Zhang, Xiaobin Chen, Juan Wang, Zhi Liu, Xiaowei Wang, Jixin Ren, Tiansheng Sun
Choice of surgical approach in patients under clopidogrel treatment is controversial. Intertrochanteric fractures are common in the elderly, who also suffer from a number of comorbidities.The aim of this study is to assess the prognosis of elderly patients with clopidogrel treatment after surgery for intertrochanteric fracture.This was a cohort study of 238 elderly patients who underwent proximal femur intramedullary nailing for intertrochanteric fracture between January 2012 and December 2013 at the Geriatric Trauma Center of the Beijing Army General Hospital...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28873217/geriatrics-literature-2016-year-in-review
#8
Kaitlin Willham, Kenneth Covinsky, Eric Widera
We present 10 of the most effective articles from 2016 in geriatric medicine. They address wide-ranging topics including the use of antipsychotics for delirium in palliative care, fall prevention and mobility interventions, efficacy and potential risks of testosterone, cranberry capsules and their effect on bacteriuria and pyuria, beta-blockers after acute myocardial infarction in a nursing home population, the effect of a healthy lifestyle on disability, a goals-of-care intervention in individuals with advanced dementia, the benefits of regional anesthesia in hip repair, and mindfulness in chronic pain management...
October 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28816875/controversies-in-the-management-of-geriatric-odontoid-fractures
#9
Scott C Wagner, Gregory D Schroeder, Christopher K Kepler, Alexander J Schupper, Frank Kandziora, Emiliano N Vialle, Cumhur Oner, Michael G Fehlings, Alexander R Vaccaro
Fractures of the odontoid process of C2 have become increasingly prevalent in the aging population and are typically associated with a high incidence of morbidity. Dens fractures comprise the majority of all cervical fractures in patients older than 80 years and remain the most common cervical fracture pattern in all geriatric patients. Type II odontoid fractures have been associated with limited healing potential, and both nonoperative and operative management are associated with high mortality rates. Historically, there has been some debate in the literature with regards to optimal management strategies to maximize outcomes in geriatric patients...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28798877/previously-undiagnosed-spinal-and-bulbar-muscular-atrophy-as-a-cause-of-airway-obstruction-after-robot-assisted-laparoscopic-prostatectomy
#10
Miyuki Niki, Taihei Tachikawa, Yuka Sano, Hiroki Miyawaki, Aisa Matoi, Yukari Okano, Nobutaka Kariya, Tsuneo Tatara, Munetaka Hirose
BACKGROUND: Preoperative vocal cord paralysis is a risk factor for postoperative respiratory distress following extubation after general anesthesia. We present an unusual case where a geriatric patient developed airway obstruction after robot-assisted laparoscopic prostatectomy. CASE PRESENTATION: A 67-year-old male, who had suffered from left vocal cord paralysis of unknown etiology, was scheduled for robot-assisted laparoscopic prostatectomy (RALP). General anesthesia was performed without any problems...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28698343/protocol-for-an-observational-study-of-delirium-in-the-post-anaesthesia-care-unit-pacu-as-a-potential-predictor-of-subsequent-postoperative-delirium
#11
Victoria Cui, Catherine M Tedeschi, Vanessa L Kronzer, Sherry L McKinnon, Michael S Avidan
INTRODUCTION: Postoperative delirium can be a serious consequence of major surgery, associated with longer hospital stays, readmission, cognitive and functional deterioration and mortality. Delirium is an acute, reversible disorder characterised by fluctuating course, inattention, disorganised thinking and altered level of consciousness. Delirium occurring in the hours immediately following anaesthesia and delirium occurring in the postoperative period of 1-5 days have been described as distinct clinical entities...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28641968/femoral-nerve-catheters-improve-home-disposition-and-pain-in-hip-fracture-patients-treated-with-total-hip-arthroplasty
#12
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...
November 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
#13
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
#14
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
#15
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...
September 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28584740/impact-of-preoperative-echocardiography-on-perioperative-management-in-geriatric-hip-trauma-a-retrospective-observational-study
#16
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
#17
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
#18
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 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28419035/clinical-practice-guidelines-decrease-unnecessary-echocardiograms-before-hip-fracture-surgery
#19
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
#20
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)
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