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Obesity, anesthesia

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https://www.readbyqxmd.com/read/28099786/labor-intervention-and-outcomes-in-women-who-are-nulliparous-and-obese-comparison-of-nurse-midwife-to-obstetrician-intrapartum-care
#1
Nicole S Carlson, Elizabeth J Corwin, Nancy K Lowe
BACKGROUND: Women who are obese have slower labors than women of normal weight, and show reduced response to interventions designed to speed labor progress like oxytocin augmentation and artificial rupture of membranes. The optimal labor management for these women has not been described. METHODS: This retrospective cohort study compared 2 propensity score-matched groups of women (N = 360) who were healthy, nulliparous, spontaneously laboring, and obese (body mass index ≥ 30 kg/m(2) )...
January 18, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28079580/a-predictive-model-for-extended-postanesthesia-care-unit-length-of-stay-in-outpatient-surgeries
#2
Rodney A Gabriel, Ruth S Waterman, Jihoon Kim, Lucila Ohno-Machado
BACKGROUND: A predictive model that can identify patients who are at an increased risk for prolonged postanesthesia care unit (PACU) stay could help optimize resource utilization and case sequencing. Although previous studies identified some predictors, there is not a model that only utilizes various patients demographic and comorbidities, that are already known preoperatively, and that may affect PACU length of stay for outpatient procedures requiring the care of an anesthesiologist...
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28034584/percutaneous-endovascular-aneurysm-repair-in-morbidly-obese-patients
#3
Jason A Chin, Laura Skrip, Bauer E Sumpio, Jonathan A Cardella, Jeffrey E Indes, Timur P Sarac, Alan Dardik, Cassius I Ochoa Chaar
OBJECTIVE: Endovascular aneurysm repair (EVAR) with percutaneous femoral access (PEVAR) has several potential advantages. Morbidly obese (MO) patients present unique anatomical challenges and have not been specifically studied. This study examines the trends in the use of PEVAR and its surgical outcomes compared with open femoral cutdown (CEVAR) in MO patients. METHODS: The American College of Surgeons National Surgical Quality Improvement Program files for the years 2005 to 2013 were reviewed...
December 26, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28030871/obesity-and-neonatal-cord-blood-gas-results-at-cesarean-effect-of-intraoperative-blood-pressure
#4
Mark F Powell, Charity J Morgan, Jessica A Cantu, Yasser Sakawi, Joseph R Biggio, Alan T N Tita, Jeff M Szychowski, Rodney K Edwards
Objective Our aims were to evaluate whether there is an inverse association between body mass index (BMI) and umbilical artery pH and to investigate the contribution of intraoperative hypotension on the umbilical artery pH. Study Design We conducted a retrospective cohort study of all women with a nonanomalous singleton at 37 to 41 weeks who underwent a scheduled cesarean delivery under spinal anesthesia at our facility from January 2006 to March 2012. The primary outcome was the proportion of patients in each BMI category with arterial cord pH < 7...
December 28, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/28012862/impact-of-obesity-on-post-dural-puncture-headache
#5
J Song, T Zhang, A Choy, A Penaco, V Joseph
INTRODUCTION: Previous studies have suggested an inverse relationship between obesity and development of dural puncture headache following spinal anesthesia. However, few have investigated the relationship between obesity and headaches after accidental dural puncture with an epidural needle. This study explored whether obesity has any association with headaches following an accidental dural puncture. METHODS: Records of patients who received epidural analgesia for labor and vaginal delivery between January 2011 and June 2015 were reviewed...
October 29, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28011172/wake-sleep-and-cardiovascular-regulatory-changes-in-rats-made-obese-by-a-high-fat-diet
#6
Marco Luppi, Abed A Al-Jahmany, Flavia Del Vecchio, Matteo Cerri, Alessia Di Cristoforo, Timna Hitrec, Davide Martelli, Emanuele Perez, Giovanni Zamboni, Roberto Amici
Obesity is known to be associated with alterations in wake-sleep (WS) architecture and cardiovascular parameters. This study was aimed at assessing the possible influence of diet-induced obesity (DIO) on sleep homeostasis and on the WS state-dependent levels of arterial pressure (AP) and heart rate in the rat. Two groups of age-matched Sprague-Dawley rats were fed either a high-fat hypercaloric diet, leading to DIO, or a normocaloric standard diet (lean controls) for 8 weeks. While under general anesthesia, animals were implanted with instrumentation for the recording of electroencephalogram, electromyogram, arterial pressure, and deep brain temperature...
December 21, 2016: Behavioural Brain Research
https://www.readbyqxmd.com/read/27984247/dynamic-ultrasound-guided-short-axis-needle-tip-navigation-technique-for-facilitating-cannulation-of-peripheral-veins-in-obese-patients
#7
Kenichi Ueda, Patrick Hussey
This preliminary observational study evaluated a specific ultrasound technique for venous access. Ultrasound was utilized for navigating a needle and catheter within the vessel lumen after venopuncture. One hundred adult obese surgical patients without visible vessels on their upper extremities were enrolled. Forty-five different operators ranging from medical students to attending anesthesia faculty performed venous cannulation with the specific ultrasound technique. Veins in 95 patients were cannulated successfully on the first attempt...
December 14, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27920541/the-effect-of-body-mass-index-on-perioperative-thermoregulation
#8
Ayşe Belin Özer, Aysun Yildiz Altun, Ömer Lütfi Erhan, Tuba Çatak, Ümit Karatepe, İsmail Demirel, Gonca Çağlar Toprak
PURPOSE: We evaluated the effects of body mass index (BMI) on thermoregulation in obese patients scheduled to undergo laparoscopic abdominal surgery. METHODS: Sixty patients scheduled to undergo laparoscopic abdominal surgery with no pre-medication were included in the study. The patients were classified into 4 groups according to BMI <24.9, 25-39.9, 40-49.9, and >50. Anesthesia was provided with routine techniques. Tympanic and peripheral temperatures were recorded every 5 minutes starting with the induction of anesthesia...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27916062/-perioperational-management-of-gynecological-cancer-patients-with-severe-internal-medical-complications-a-serial-of-37-clinical-cases
#9
J Hu, W Q Lyu, Y L Guo, H W Wen, H Qiao, Y Qu
Objective: To evaluate the effectiveness and safety of perioperational management of gynecological cancer patients with severe internal medical complications. Methods: We collected 37 cases of gynecological cancer patients with severe internal medical complications who were hospitalized in Peking University First Hospital from Jan. 2010 to Nov. 2014. All of the cases were planned to move to ICU right after operation based on the preoperational assessment of anesthetist and physician. The median age was 69.4 years, and 25 cases (68%,25/37) of them were over 70 years old...
November 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#10
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27900560/serum-leptin-obestatin-and-ghrelin-levels-and-gastric-emptying-rates-of-liquid-and-solid-meals-in-non-obese-rats-with-roux-en-y-bypass-surgery-or-prosthesis-placement-implications-for-the-role-of-vagal-afferents
#11
Yunus Yavuz, Zarife Nigar Özdemir Kumral, Gülsün Memi, Özge Dağdeviren Çevik, Cumhur Yeğen, Berrak Ç Yeğen
BACKGROUND: The present study aimed to investigate the effects of Roux-en-Y gastric bypass (RYGB) and prosthesis placement on gastric emptying rate in conjunction with serum ghrelin-obestatin-leptin responses in non-obese rats with intact or denervated afferent innervation. METHODS: Under anesthesia, male Sprague-Dawley rats underwent either sham operation, RYGB, prosthesis, and/or Gregory cannula placement. Three weeks later, liquid or solid gastric emptying tests were performed and serum ghrelin, leptin and obestatin levels were measured...
November 29, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27885537/safety-analysis-of-bariatric-patients-undergoing-outpatient-upper-endoscopy-with-non-anesthesia-administered-propofol-sedation
#12
Tyler McVay, John C Fang, Linda Taylor, Alexander Au, Wesley Williams, Angela P Presson, Ragheed Al-Dulaimi, Eric Volckmann, Anna Ibele
BACKGROUND: Non-anesthesia administered propofol (NAAP) has been shown to be a safe and effective method of sedation for patients undergoing gastrointestinal endoscopy. Bariatric surgery patients are potentially at a higher risk for sedation-related complications due to co-morbidities including obstructive sleep apnea. The outcomes of NAAP in bariatric patients have not been previously reported. METHODS: In this retrospective cohort study, severely obese patients undergoing pre-surgical outpatient esophagogastroduodenoscopy (EGD) were compared to non-obese control patients (BMI ≤ 25 kg/m(2)) undergoing diagnostic EGD at our institution from March 2011-September 2015 using our endoscopy database...
November 24, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27875102/obesity-increases-operative-time-in-children-undergoing-laparoscopic-cholecystectomy
#13
T K Pandian, Daniel S Ubl, Elizabeth B Habermann, Christopher R Moir, Michael B Ishitani
INTRODUCTION: Few studies have assessed the impact of obesity on laparoscopic cholecystectomy (LC) in pediatric patients. MATERIALS AND METHODS: Children who underwent LC were identified from the 2012 to 2013 American College of Surgeons' National Surgical Quality Improvement Program Pediatrics data. Patient characteristics, operative details, and outcomes were compared. Multivariable logistic regression was utilized to identify predictors of increased operative time (OT) and duration of anesthesia (DOAn)...
November 22, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27871572/the-effects-of-sevoflurane-and-desflurane-on-the-hemodynamics-and-respiratory-functions-in-laparoscopic-sleeve-gastrectomy
#14
Hatice Kaya Ozdogan, Suleyman Cetinkunar, Faruk Karateke, Sibel Cetinalp, Muge Celik, Sefa Ozyazici
STUDY OBJECTIVES: Sleeve gastrectomy has been one of the most commonly performed bariatric surgery methods. The study aimed to compare the effects of 2 most commonly used inhalation anesthetics, sevoflurane and desflurane, on the peroperative hemodynamic alterations and postoperative respiratory functions in morbidly obese patients undergoing sleeve gastrectomy. DESIGN: Nonrandomized cohort. SETTINGS: Operating room, postoperative period. PATIENTS: Eighty-four morbidly obese patients with a body mass index greater than 40 kg/m(2) who had scheduled to undergo sleeve gastrectomy operation were prospectively included in the study...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871524/predictors-of-desaturation-during-patient-transport-to-the-postoperative-anesthesia-care-unit-an-observational-study
#15
François Labaste, Stein Silva, Léa Serin-Moulin, Etienne Lefèvre, Bernard Georges, Jean-Marie Conil, Vincent Minville
BACKGROUND: The transport of postoperative patients to the postoperative anesthesia care unit (PACU) is a high-risk period for hypoxemia. The aim of this study was to determine risk factors for hypoxemia during transfers to the PACU. METHODS: An observational, prospective, monocentric, and noninterventional study was conducted in the University Hospital of Toulouse in 2015 during a 5-week period. All patients who were transferred to PACU were included. Twenty-eight variables related to patient, surgery, and anesthesia were recorded...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871519/intrapleural-placement-of-a-thoracic-epidural-catheter-in-a-patient-with-spinal-stenosis
#16
Kiran Belani, Mario Montealegre-Gallegos, Brian Ferla, Robina Matyal
Due to the close proximity of the thoracic epidural space and parietal pleura, pleural puncture with intrapleural catheter placement is a potential complication of thoracic epidural anesthesia. The authors present a case of an obese patient with a history of spinal stenosis that underwent thoracotomy. Repeated failed attempts at epidural anesthesia were complicated by intrapleural placement of the catheter. The patient subsequently developed clinical signs of pneumothorax and required urgent thoracostomy.
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870737/the-influence-of-body-mass-index-on-sensorimotor-block-and-vasopressor-requirement-during-spinal-anesthesia-for-elective-cesarean-delivery
#17
T C Ngaka, J F Coetzee, R A Dyer
BACKGROUND: It has been suggested that the dose requirement for spinal anesthesia (SA) is lower in obese patients for cesarean delivery (CD). In this prospective, observational, noninferiority study, we tested the hypothesis that obesity would not have a clinically important effect on vasopressor requirements or block height. METHODS: Two groups of 25 parturients, group O (body mass index [BMI] >40 kg/m) and group N (BMI <32 kg/m) requiring elective CD were recruited...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27867460/percutaneous-dual-valve-intervention-in-a-high-risk-patient-with-severe-aortic-and-mitral-stenosis
#18
Blaz Mrevlje, Mohamad Aboukura, Christoph A Nienaber
Aortic stenosis is the most frequent and mitral stenosis is the least frequent native single-sided valve disease in Europe. Patients with the combination of severe symptomatic degenerative aortic and mitral stenosis are very rare. Guidelines for the treatment of heart valve diseases are clear for single-valve situations. However, there is no common agreement or recommendation for the best treatment strategy in patients with multiple valve disease and severe concomitant comorbidities. A 76-year-old female patient with the combination of severe degenerative symptomatic aortic and mitral stenosis and several comorbidities including severe obesity, who was found unsuitable surgical candidate by the heart team and unsuitable for two-time general anesthesia in the case of two-step single-valve percutaneous approach by anesthesiologists, underwent successful percutaneous dual-valve single-intervention (transcatheter aortic valve implantation and percutaneous mitral balloon commissurotomy)...
July 2016: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/27861607/transient-elastography-based-liver-stiffness-age-dependently-increases-in-children
#19
Daisuke Tokuhara, Yuki Cho, Haruo Shintaku
BACKGROUND AND AIMS: Pediatric use of liver transient elastography (TE) is attractive for its non-invasiveness, but reference values have not been established. We aimed to determine reference values for TE in children. METHODS: In pediatric patients (1 to 18 years), TE (FibroScan®) with an M probe was used for both liver stiffness measurement (LSM) and measurement of hepatic fat deposition by using a controlled attenuation parameter (CAP). The patients were divided into three relevant age groups: preschoolers (1 to 5 years), elementary school children (6 to 11 years), and adolescents (12 to 18 years)...
2016: PloS One
https://www.readbyqxmd.com/read/27811485/mask-ventilation-during-induction-of-general-anesthesia-influences-of-obstructive-sleep-apnea
#20
Shin Sato, Makoto Hasegawa, Megumi Okuyama, Junko Okazaki, Yuji Kitamura, Yumi Sato, Teruhiko Ishikawa, Yasunori Sato, Shiroh Isono
BACKGROUND: Depending on upper airway patency during anesthesia induction, tidal volume achieved by mask ventilation may vary. In 80 adult patients undergoing general anesthesia, the authors tested a hypothesis that tidal volume during mask ventilation is smaller in patients with sleep-disordered breathing priorly defined as apnea hypopnea index greater than 5 per hour. METHODS: One-hand mask ventilation with a constant ventilator setting (pressure-controlled ventilation) was started 20 s after injection of rocuronium and maintained for 1 min during anesthesia induction...
January 2017: Anesthesiology
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