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https://www.readbyqxmd.com/read/29221671/population-based-risk-factors-for-shoulder-dystocia
#1
Palmira Santos, Jennifer Gaudet Hefele, Grant Ritter, Jennifer Darden, Cassandra Firneno, Ann Hendrich
OBJECTIVE: To re-examine the risk factors for shoulder dystocia given the increasing rates of obesity and diabetes in pregnant women. DESIGN: Retrospective observational study. SETTING: Five hospitals located in Wisconsin, Florida, Maryland, Michigan, and Alabama. PARTICIPANTS: We evaluated 19,236 births that occurred between April 1, 2011, and July 25, 2013. METHODS: Data were collected from electronic medical records and used to evaluate the risk of shoulder dystocia...
December 5, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/29209926/a-randomized-trial-of-phenylephrine-infusion-versus-bolus-dosing-for-nausea-and-vomiting-during-cesarean-delivery-in-obese-women
#2
Ronald B George, Dolores M McKeen, Jennifer E Dominguez, Terrence K Allen, Patricia A Doyle, Ashraf S Habib
PURPOSE: Hypotension is common after spinal anesthesia for Cesarean delivery. It is associated with nausea, vomiting, and fetal acidosis. Previous research on phenylephrine excluded obese subjects. We compared the incidence of intraoperative nausea and vomiting (IONV) in obese patients who received a prophylactic phenylephrine infusion vs those who received bolus dosing for the treatment of spinal-induced hypotension. METHODS: In this multicentre, double-blinded randomized controlled trial, 160 obese women undergoing elective Cesarean delivery under spinal anesthesia were randomized to receive a prophylactic phenylephrine infusion initiated at 50 μg·min-1 (and titrated according to a predefined algorithm) or 100 μg phenylephrine boluses to treat hypotension...
December 5, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29209925/preventing-hypotension-induced-nausea-and-vomiting-during-spinal-anesthesia-for-cesarean-delivery-in-obese-parturients-a-small-solution-for-a-big-problem
#3
EDITORIAL
Warwick D Ngan Kee
No abstract text is available yet for this article.
December 5, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29200367/anesthetic-management-in-mitochondrial-encephalomyopathy-a-case-report
#4
Toru Yamamoto, Noriko Miyazawa, Shinichi Yamamoto, Hiroshi Kawahara
We report on a morbidly obese 16-year-old boy (weight, 116 kg; height, 176 cm; body mass index, 35.5 kg/m2) with mitochondrial encephalomyopathy and a history of cerebral infarction, epilepsy, and severe mental retardation. The patient was scheduled for elective surgery under general anesthesia for multiple dental caries and entropion of the left eye. Preoperative examination results, including an electrocardiogram, were normal. No obvious cardiac function abnormalities were observed on echocardiography. Midazolam (10 mg) was administered orally as premedication 30 minutes before transfer to the operating room; however, the patient was uncooperative, and his body movements were difficult to control upon entering the operating room...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/29189439/leading-causes-of-anesthesia-related-liability-claims-in-ambulatory-surgery-centers
#5
Darrell Ranum, Anair Beverly, Fred E Shapiro, Richard D Urman
OBJECTIVE: We present a contemporary analysis of patient injury, allegations, and contributing factors of anesthesia-related closed claims, which involved cases that specifically occurred in free-standing ambulatory surgery centers (ASCs). METHODS: We examined ASC-closed claims data between 2007 and 2014 from The Doctors Company, a medical malpractice insurer. Findings were coded using the Comprehensive Risk Intelligence Tool developed by CRICO Strategies. We compared coded data from ASC claims with hospital operating room (HOR) claims, in terms of injury severity category, nature of injury, nature of allegation, contributing factors identified, and contributing comorbidities and claim value...
November 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29189286/epidural-anesthesia-to-facilitate-organ-blood-flow-during-the-first-penile-transplantation-in-the-united-states-a-case-report
#6
Katarina J Ruscic, Grettel J Zamora-Berridi, Francis J McGovern, Curtis Cetrulo, Jonathan M Winograd, Kyle R Eberlin, Branko Bojovic, Dicken S Ko, T Anthony Anderson
Regional anesthesia has been used to help create local sympathectomy and improve blood flow in plastic surgery procedures involving tissue grafts and flaps. However, anesthetic techniques that reduce systemic vascular resistance must be used with caution in patients with aortic stenosis (AS). Combined neuraxial and general anesthesia with careful titration of the local anesthetic dose can be a safe approach for patients with AS undergoing microvascular procedures. We present the anesthetic management of the first North American penile transplant, on an obese patient with moderate AS...
November 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29189283/effects-of-increasing-airway-pressures-on-the-pressure-of-the-endotracheal-tube-cuff-during-pelvic-laparoscopic-surgery
#7
Eric B Rosero, Esra Ozayar, Javier Eslava-Schmalbach, Abu Minhajuddin, Girish P Joshi
BACKGROUND: Tracheal tube cuff pressures exceeding the perfusion pressures of the tracheal mucosa have been associated with complications such as sore throat, tracheal mucosa ulcers, tracheal rupture, and subglottic stenosis. Despite appropriate inflation, many factors can increase the tracheal cuff pressure during mechanical ventilation. This prospective observational cohort study was designed to test the hypothesis that during a clinical model of decreasing respiratory compliance, the pressure within the endotracheal tube cuff will rise in direct relationship to increases in the airway pressures...
November 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29179689/the-optimum-sevoflurane-concentration-for-supraglottic-airway-device-blockbuster%C3%A2-insertion-with-spontaneous-breathing-in-obese-patients-a-prospective-observational-study
#8
Haixia Wang, Xue Gao, Wei Wei, Huihui Miao, Hua Meng, Ming Tian
BACKGROUND: Airway management of the obese patient presenting for surgery is more likely to be a challenging problem. Supraglottic airway device has been adopted as a bridge to connect ventilation and tracheal intubation in obese patients who would be suffered with difficult intubation. The optimum sevoflurane concentration for supraglottic airway device insertion allowing spontaneous breathing in 50% of obese patients (ED50) is not known. The purpose of this study was to determine the ED50 of sevoflurane for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients requiring general anesthesia...
November 28, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29176373/obstructive-sleep-apnea-and-bariatric-surgical-guidelines-summary-and-update
#9
Christel A L de Raaff, Nico de Vries, Bart A van Wagensveld
PURPOSE OF REVIEW: Increasing numbers of bariatric surgical procedures and the high prevalence of obstructive sleep apnea (OSA) in this population have resulted in a growing interest in the perioperative management of OSA in bariatric surgery. This review provides a summary of the first consensus guideline on this topic as well as an update of the newest literature available. RECENT FINDINGS: All bariatric patients should be screened for OSA and obesity hypoventilation syndrome (OHS) to reduce the risk of perioperative complications...
November 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29174197/comparison-of-cardiac-measurements-by-multi-detector-computed-tomography-angiography-and-transthoracic-echocardiography-in-english-bulldogs
#10
E T Hostnik, B A Scansen, A M Habing, G A Chiappone, R R Layman, R D White
INTRODUCTION: Transthoracic echocardiography (TTE) is the primary tool for the assessment of cardiac structure and function in dogs but is challenging in English bulldogs due to dorsoventral compression of the thorax, obesity, and narrow intercostal spaces. Multi-detector computed tomography angiography (CTA) may overcome the conformational obstacles of cardiac imaging in this breed. ANIMALS: Eleven client-owned English bulldogs. MATERIALS AND METHODS: Prospective clinical trial with paired analysis of TTE and CTA studies...
November 22, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/29160727/a-review-of-perioperative-complications-of-outpatient-total-ankle-arthroplasty
#11
Todd R Borenstein, Kapil Anand, Quanlin Li, Timothy P Charlton, David B Thordarson
BACKGROUND: Total ankle arthroplasty (TAA) is commonly pursued for patients with painful arthritis. Outpatient TAA are increasingly common and have been shown to decrease costs compared to inpatient surgery. However, there are very few studies examining the safety of outpatient TAA. In this study, we retrospectively reviewed 65 consecutive patients who received outpatient TAA to identify complication rates. METHODS: The medical records of 65 consecutive outpatient TAA from October 2012 to May 2016 with a minimum 6-month follow-up were reviewed...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29160244/pulmonary-aspiration-in-adjustable-gastric-banding-carriers-undergoing-a-second-surgical-procedure-considerations-on-personal-experience-and-review-of-the-literature
#12
Contardo Vergani, Marco Venturi, Sara Badiali, Barbara Chella, Enrico Mozzi
BACKGROUND: The observation of a relatively high number of pulmonary aspirations (PA) among gastric band (GB) carriers undergoing a second surgery, prompted us to modify our strategy for GB patients candidate to further operation under general anesthesia. MATERIAL OF STUDY AND RESULTS: In January 2013, following the occurrence of PA at the induction of general anesthesia in 1 GB carrier undergoing a further operation, we reviewed our Data Base between January 2005 and 2013, to explore the rate of pulmonary aspiration in patients GB carriers undergoing a second surgery...
November 7, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29156486/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives
#13
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the society for Obstetric anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29155697/acute-intraoperative-suprachoroidal-hemorrhage-during-small-gauge-pars-plana-vitrectomy
#14
Intira Sukpen, Jay M Stewart
PURPOSE: To report the intraoperative occurrence of acute intraoperative suprachoroidal hemorrhage during small-gauge pars plana vitrectomy. METHOD: A review of a surgical patient who developed acute intraoperative suprachoroidal hemorrhage during small-gauge pars plana vitrectomy because of bucking under general anesthesia. RESULTS: A 32-year-old obese woman with proliferative diabetic retinopathy and traction retinal detachment in the left eye who developed intraoperative suprachoroidal hemorrhage during small-gauge pars plana vitrectomy because of bucking under general anesthesia while doing endolaser under air infusion...
November 16, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/29150035/thoracic-surgery-considerations-in-obese-patients
#15
REVIEW
Douglas Z Liou, Mark F Berry
The obesity epidemic in the United States has increased greatly over the past several decades, and thoracic surgeons are likely to see obese patients routinely in their practices. Obesity has direct deleterious health effects such as metabolic disorder and cardiovascular disease, and is associated with many cancers. Obese patients who need thoracic surgery pose practical challenges to many of the routine elements in perioperative management. Preoperative assessment of obesity-related comorbid conditions and risk stratification for surgery, thorough intraoperative planning for anesthesia and surgery, and postoperative strategies to optimize pulmonary hygiene and mobility minimize the risk of adverse outcomes...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29142549/comparison-of-pressure-vs-volume-controlled-ventilation-on-oxygenation-parameters-of-obese-patients-undergoing-laparoscopic-cholecystectomy
#16
Reza Movassagi, Majid Montazer, Ata Mahmoodpoor, Vahid Fattahi, Afshin Iranpour, Sarvin Sanaie
Background & Objective: There is no special guideline for the best ventilation mode during laparoscopic anesthesia in obese patients and there are too many studies with different controversial points. The aim of this study was to compare the effect of pressure controlled ventilation (PCV) vs. volume controlled ventilation (VCV) on respiratory and oxygenation parameters in patients undergoing laparoscopic cholecystectomy. Methods: Seventy patients with 30 <BMI<40 and ASA physical status I-II were studied in this randomized prospective trial...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29138510/high-fat-diet-induced-obesity-and-insulin-resistance-are-characterized-by-differential-beta-oscillatory-signaling-of-the-limbic-cortico-basal-ganglia-loop
#17
Lukas Maurer, Hui Tang, Jens K Haumesser, Jennifer Altschüler, Andrea A Kühn, Joachim Spranger, Christoph van Riesen
The concept of brain circuit disorders has been proposed for a variety of neuropsychiatric diseases, characterized by pathological disturbances of neuronal networks including changes in oscillatory signaling of re-entrant cortico-subcortical loops in the basal ganglia system. Parts of this circuitry play a pivotal role in energy homeostasis. We therefore investigated whether high-fat diet (HFD) induced obesity is associated with changes in oscillatory signaling in the limbic cortico-basal ganglia loop. We performed multi-site in-vivo electrophysiological recordings of local field potentials within this network under urethane anesthesia in adult rats after 4 weeks of HFD feeding compared to age-matched controls...
November 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29134425/quick-reference-tidal-volume-cards-reduce-the-incidence-of-large-tidal-volumes-during-surgery
#18
Chirag K Shah, Angela Moss, William Henderson, Breandan Sullivan, Ana Fernandez-Bustamante
Ventilation with large tidal volumes (V T), greater than 10 ml/kg of predicted body weight (PBW), is associated with worse outcomes in critically ill and surgical patients. We hypothesized that the availability of quick reference cards with proposed V T ranges specific to gender and different heights would reduce the intraoperative use of large V T during prolonged abdominal surgery. We compared retrospectively the incidence of median V T used during prolonged (≥4-h-long) abdominal surgery before ("before") and after ("after") the quick reference V T cards were made available in all anesthesia machines in operating rooms of a single academic US medical center...
November 13, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29108405/gabapentin-given-before-laparoscopic-sleeve-gastrectomy-reduces-postoperative-oxycodone-consumption-in-obese-patients-a-randomized-double-blind-placebo-controlled-trial
#19
Anna Rupniewska-Ladyko, Małgorzata Malec-Milewska, Ewa Kraszewska, Michal Pirozynski
BACKGROUND: Post-operative pain can be prevented. Gabapentin may be effective in this role. Our primary objective was to test the hypothesis that a prophylactic administration of gabapentin in obese patients before surgery has an opioid-sparing effect and reduces postoperative oxycodone consumption more efficiently than placebo. METHODS: The study enrolled 113 patients undergoing laparoscopic sleeve-gastrectomy under general anesthesia. The patients were randomly allocated to the control or gabapentin group and received a single oral dose of gabapentin 1200 mg or a matching placebo 1 h before surgery...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29106880/utility-of-screening-questionnaire-and-polysomnography-to-predict-postoperative-outcomes-in-children
#20
Hiromi Kako, Jennifer Tripi, Hina Walia, Dmitry Tumin, Mark Splaingard, Kris R Jatana, Joseph D Tobias, Vidya T Raman
INTRODUCTION: The prevalence of pediatric obstructive sleep apnea (OSA) has increased concurrently with the increasing prevalence of obesity. We have previously validated a short questionnaire predicting the occurrence of OSA on polysomnography (PSG). This follow-up study assessed the utility of the questionnaire in predicting postoperative outcomes. METHODS: Children undergoing surgery and completing a sleep study were prospectively screened for OSA using a short questionnaire...
November 2017: International Journal of Pediatric Otorhinolaryngology
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