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Geriatric anesthesia

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https://www.readbyqxmd.com/read/29784256/perioperative-delirium-protocol-for-the-older-patient
#1
Thomas J Pallaria, Casey Panebianco, Mary C Kamienski
PURPOSE: Delirium is an acute change in cognition and attention. It may affect any age group. It is most common in older patients and is associated with a significant increase in mortality. The purpose of this project was to implement an assessment protocol to identify patients at risk for postoperative delirium. DESIGN: A case study approach was used. METHODS: The Confusion Assessment Method (CAM) tool for screening and diagnostic purposes was used to train surgeons, anesthesia providers, and nurses...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29661338/anesthesia-in-the-elderly-patient-undergoing-otolaryngology-head-and-neck-surgery
#2
REVIEW
Takumi Codère-Maruyama, Albert Moore
Geriatric patients undergoing surgery have a whole set of specific physiologic changes, perioperative needs, and postoperative complications. This review presents an overview of the basic concepts and the evolving challenges pertaining to the care of geriatric patients undergoing otolaryngologic procedures from the perspective of the anesthesiologist.
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29643876/clinical-effects-of-single-femoral-nerve-block-in-combination-with-general-anesthesia-on-geriatric-patients-receiving-total-knee-arthroplasty
#3
Jing Zhang, Yan Yuan, Yongjun Zhang, Ying Wang
Objective: To evaluate the clinical effects of single femoral nerve block (sFNB) combined with general anesthesia on geriatric patients receiving unilateral total knee arthroplasty (UTKA). Methods: Sixty geriatric UTKA patients who were treated in The First People's Hospital of Changzhou from January 2015 to August 2015 were randomly divided into an sFNB + laryngeal mask airway (FLA) group, an sFNB + tracheal intubation (FGA) group and a tracheal intubation (GA) group...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29643802/the-beneficial-effects-of-cognitive-training-with-simple-calculation-and-reading-aloud-scra-in-the-elderly-postoperative-population-a-pilot-randomized-controlled-trial
#4
Kay Kulason, Rui Nouchi, Yasushi Hoshikawa, Masafumi Noda, Yoshinori Okada, Ryuta Kawashima
Background: There has been little research conducted regarding cognitive treatments for the elderly postsurgical population. Patients aged ≥60 years have an increased risk of postoperative cognitive decline, a condition in which cognitive functions are negatively affected. This cognitive decline can lead to a decline in quality of life. In order to maintain a high quality of life, the elderly postsurgical population may benefit from treatment to maintain and/or improve their cognitive functions. This pilot study investigates the effect of simple calculation and reading aloud (SCRA) cognitive training in elderly Japanese postsurgical patients...
2018: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/29601386/corr-insights%C3%A2-is-anesthesia-technique-associated-with-a-higher-risk-of-mortality-or-complications-within-90-days-of-surgery-for-geriatric-patients-with-hip-fractures
#5
Jaimo Ahn
No abstract text is available yet for this article.
March 28, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29601378/is-anesthesia-technique-associated-with-a-higher-risk-of-mortality-or-complications-within-90-days-of-surgery-for-geriatric-patients-with-hip-fractures
#6
Vimal Desai, Priscilla H Chan, Heather A Prentice, Gary L Zohman, Glenn R Diekmann, Gregory B Maletis, Brian H Fasig, Diana Diaz, Elena Chung, Chunyuan Qiu
BACKGROUND: Postoperative mortality and complications after geriatric hip fracture surgery remain high despite efforts to improve perioperative care for these patients. One factor of particular interest is anesthetic technique, but prior studies on this are limited by sample selection, competing risks, and incomplete followup. QUESTIONS/PURPOSES: (1) Among older patients undergoing surgery for hip fracture, does 90-day mortality differ depending on the type of anesthesia received? (2) Do 90-day emergency department returns and hospital readmissions differ based on anesthetic technique after geriatric hip fracture repairs? (3) Do 90-day Agency for Healthcare Research and Quality (AHRQ) outcomes differ according to anesthetic techniques used during hip fracture surgery? METHODS: We conducted a retrospective study on geriatric patients (65 years or older) with hip fractures between 2009 and 2014 using the Kaiser Permanente Hip Fracture Registry...
March 28, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29550773/ability-of-postoperative-delirium-to-predict-intermediate-term-postoperative-cognitive-function-in-patients-undergoing-elective-surgery-at-an-academic-medical-centre-protocol-for-a-prospective-cohort-study
#7
Amrita Aranake-Chrisinger, Jenny Zhao Cheng, Maxwell R Muench, Rose Tang, Angela Mickle, Hannah Maybrier, Nan Lin, Troy Wildes, Eric Lenze, Michael Simon Avidan
INTRODUCTION: Postoperative delirium (POD) is a common complication in elderly patients, characterised by a fluctuating course of altered consciousness, disordered thinking and inattention. Preliminary research has linked POD with persistent cognitive impairment and decreased quality of life. However, these findings maybe confounded by patient comorbidities, postoperative complications and frailty. Our objective is to determine whether POD is an independent risk factor for persistent impairments in attention and executive function after elective surgery...
March 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29520917/the-use-of-hyaluronic-acid-subdermal-filler-for-entropion-in-canines-and-felines-40-cases
#8
Jessica E McDonald, Amy M Knollinger
PURPOSE: To evaluate the use of hyaluronic acid (HA) subdermal filler in canines and felines for entropion. METHODS: Complete ophthalmologic examination was performed by a board-certified veterinary ophthalmologist or ABVO-approved resident. Each case was characterized as primary, secondary, spastic or cicatricial entropion. HA subdermal filler, specifically Restylane® and Restylane Silk® , were utilized in dogs and cats, respectively. Subdermal injection was performed 1-2 mm from the eyelid margin in the affected area until normal eyelid conformation was achieved...
March 9, 2018: Veterinary Ophthalmology
https://www.readbyqxmd.com/read/29461445/impact-of-anesthesia-on-hospital-mortality-and-morbidities-in-geriatric-patients-following-emergency-hip-fracture-surgery
#9
Chunyuan Qiu, Priscilla H Chan, Gary L Zohman, Heather A Prentice, Jessica J Hunt, Diana C LaPlace, Vu T Nguyen, Glenn R Diekmann, Gregory B Maletis, Vimal Desai
OBJECTIVES: To determine the impact of anesthesia type on in-hospital mortality and morbidity for geriatric fragility hip fracture surgery. DESIGN: Retrospective cohort study. SETTING: Integrates health care delivery system across 38 facilities in the United States. PATIENTS/PARTICIPANTS: We identified 16,695 patients 65 years of age and older who underwent emergent hip fracture repairs between 2009 and 2014 through the Kaiser Permanente hip fracture registry and excluded pathologic or bilateral fractures...
March 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29446038/preoperative-evaluation-of-the-elderly-surgical-patient-and-anesthesia-challenges-in-the-xxi-century
#10
Gabriella Bettelli
Universally recognized goals of preoperative anesthesia assessment are the evaluation of patient's health status to define the entity of the surgical risk, and the anticipation of possible complications while optimizing and planning preventive strategies. Data obtained by Comprehensive Geriatric Assessment (CGA) and frailty evaluation are of extreme usefulness in surgical risk evaluation in older patients and in the decision about surgery. It is from the team-based discussion of such results that the most appropriate treatment can be individuated, surgery invasiveness and duration critically analyzed and if needed modified, and the best perioperative strategy carefully tailored...
March 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29398999/the-fascia-iliaca-block-as-the-primary-intraoperative-anesthesia-for-hip-fracture-surgery-a-preliminary-study
#11
Joseph J Ruzbarsky, Elizabeth B Gausden, Elan M Goldwyn, Isaac P Lowenwirt, Vitaly Kotlyar
Background: Early surgical intervention for hip fractures in the elderly has proven efficacious. However, surgical delays commonly occur in this patient population due to comorbid conditions that put these patients at a high risk for hypotension-related complications of general or neuraxial anesthesia or anticoagulants that delay the safe use of neuraxial anesthesia. Questions/Purposes: The questions/purposes of this study are (1) to investigate if a fascia iliaca block in conjunction with light to moderate sedation could provide adequate analgesia throughout open surgery for intertrochanteric hip fractures (AO/OTA 31-1) without requiring conversion to general anesthesia with airway support and (2) to assess its perioperative complication profile...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/29366390/postoperative-daily-living-activities-of-geriatric-patients-administered-general-or-spinal-anesthesia-for-hip-fracture-surgery-a-retrospective-cohort-study
#12
Taeko Fukuda, Shinobu Imai, Masaya Nakadera, Yukiko Wagatsuma, Hiromasa Horiguchi
PURPOSE: Maintaining independence after hip fracture repair is important for geriatric patients and general welfare. We investigated the effects of anesthetic methods on postoperative activities of daily living (ADLs) following hip fracture surgery in elderly patients. METHODS: The medical records of 12,342 patients aged ≥65 years who underwent typical surgeries for hip fracture using either general anesthesia or spinal anesthesia were reviewed. To adjust for baseline differences and minimize selection bias for the chosen method of anesthesia, patients were matched by propensity scores...
January 2018: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29332302/preoperative-cognitive-impairment-as-a-predictor-of-postoperative-outcomes-in-a-collaborative-care-model
#13
Kahli Zietlow, Shelley R McDonald, Richard Sloane, Jeffrey Browndyke, Sandhya Lagoo-Deenadayalan, Mitchell T Heflin
OBJECTIVES: To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (POSH) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics. DESIGN: Retrospective analysis of individuals enrolled in a quality improvement program. SETTING: Tertiary academic center. PARTICIPANTS: Older adults undergoing surgery and referred to POSH (N = 157)...
March 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29299599/association-of-integrated-care-coordination-with-postsurgical-outcomes-in-high-risk-older-adults-the-perioperative-optimization-of-senior-health-posh-initiative
#14
Shelley R McDonald, Mitchell T Heflin, Heather E Whitson, Thomas O Dalton, Michael E Lidsky, Phillip Liu, Cornelia M Poer, Richard Sloane, Julie K Thacker, Heidi K White, Mamata Yanamadala, Sandhya A Lagoo-Deenadayalan
Importance: Older adults undergoing elective surgery experience higher rates of preventable postoperative complications than younger patients. Objective: To assess clinical outcomes for older adults undergoing elective abdominal surgery via a collaborative intervention by surgery, geriatrics, and anesthesia focused on perioperative health optimization. Design, Setting, and Participants: Perioperative Optimization of Senior Health (POSH) is a quality improvement initiative with prospective data collection...
January 3, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29297793/colonic-diverticulosis-and-diverticular-hemorrhage-in-a-geriatric-female-orangutan-pongo-abelii
#15
Simone Vitali, Paul Eden, Karen Payne, Geoffrey Forbes
A 57-yr-old female Sumatran orangutan ( Pongo abelii) presented with signs of intermittent lethargy and inappetence, then subsequently developed profuse hemorrhagic diarrhea. Colonoscopy under anesthesia revealed diverticulosis of the descending colon, with multiple large diverticula containing fecoliths. There was no evidence of diverticulitis, but a regenerative anemia had developed following an acute diverticular bleed. The orangutan recovered with conservative therapy. Colonic diverticulosis has been reported in nonhuman primates and appears to have a similar clinical presentation to the condition as it occurs in humans...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29259553/indication-of-cognitive-change-and-associated-risk-factor-after-thoracic-surgery-in-the-elderly-a-pilot-study
#16
Kay Kulason, Rui Nouchi, Yasushi Hoshikawa, Masafumi Noda, Yoshinori Okada, Ryuta Kawashima
Background: This pilot study investigated the effects of partial pulmonary lobectomy lung surgery on cognitive functions of elderly Japanese patients. It is recognized that elderly patients undergoing surgery have increased risk of Postoperative Cognitive Decline (POCD), a condition in which learning, memory, and processing speed is greatly reduced after surgery. Since elderly patients are more likely to exhibit symptoms of POCD, the incidence is increasing as the population receiving surgery is aging. Methods: Cognitive function was measured for all subjects ( n = 12) before and after surgery using three different cognitive tests: Mini-Mental Status Exam-Japanese (MMSE-J), Frontal Assessment Battery (FAB), and a computerized Cogstate Brief Battery (CBB)...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/29239943/achieving-milestones-as-a-prerequisite-for-proceeding-with-a-clinical-trial
#17
Angela M Mickle, Hannah R Maybrier, Anke C Winter, Sherry L McKinnon, Brian A Torres, Nan Lin, Eric J Lenze, Susan Stark, Maxwell R Muench, Eric Jacobsohn, Sharon K Inouye, Michael S Avidan, Troy S Wildes
BACKGROUND: Although the National Institutes of Health (NIH) invests $30 billion in research annually, many funded studies fail to generate results that can inform practice. The National Institutes of Health introduced a phased funding mechanism as one potential solution. Study-specific milestones are established for an initial pilot phase. We assess the utility of this phased approach through the ongoing Electroencephalography (EEG) Guidance of Anesthesia to Alleviate Geriatric Syndromes (ENGAGES) pragmatic clinical trial...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29216345/effect-of-influenza-vaccination-against-postoperative-pneumonia-and-mortality-for-geriatric-patients-receiving-major-surgery-a-nationwide-matched-study
#18
Wan-Chi Liu, Chao-Shun Lin, Chun-Chieh Yeh, Hsin-Yun Wu, Yuarn-Jang Lee, Chi-Li Chung, Yih-Giun Cherng, Ta-Liang Chen, Chien-Chang Liao
Background: Limited information is available on the association between influenza vaccination and postoperative outcomes. Methods: Using Taiwan's National Health Insurance Research Database reimbursement claims data from 2008-2013, we conducted a matched cohort study of 16903 patients aged >66 years who received influenza vaccinations and later underwent major surgery. Using a propensity score matching procedure adjusted for sociodemographic characteristics, medical condition, surgery type, and anesthesia type, 16903 controls who underwent surgery but were not vaccinated were selected...
February 14, 2018: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#19
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
February 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29189287/pharmacological-considerations-in-the-elderly
#20
Shamsuddin Akhtar
PURPOSE OF REVIEW: This review discusses the pharmacology of contemporary anesthetic medications in geriatric patients, neurophysiological changes with aging, current recommendations for dosing anesthetic drugs. It also addresses current practice patterns and ongoing studies, which are likely to affect future anesthetic drug management in the elderly. RECENT FINDINGS: Potency of anesthetic drugs is increased in the elderly. In addition to changes at the receptor level, neurophysiological changes in functional connectivity with aging contributes to increased sensitivity of anesthetic drugs...
February 2018: Current Opinion in Anaesthesiology
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