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Obesity, anesthesia

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https://www.readbyqxmd.com/read/28965443/effect-of-body-mass-index-on-surgical-outcomes-after-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#1
Rafael De la Garza Ramos, Jonathan Nakhla, Rani Nasser, Jacob F Schulz, Taylor E Purvis, Daniel M Sciubba, Merritt D Kinon, Reza Yassari
OBJECTIVE Obesity is an increasing public health concern in the pediatric population. The purpose of this investigation was to examine the impact of body mass index (BMI) on 30-day outcomes after posterior spinal fusion for adolescent idiopathic scoliosis (AIS). METHODS The American College of Surgeons National Surgical Quality Improvement Program Pediatric database (2013 and 2014) was reviewed. Patients 10-18 years of age who had undergone fusion of 7 or more spinal levels for AIS were included. Thirty-day outcomes (complications, readmissions, and reoperations) were compared based on patient BMI per age- and sex-adjusted growth charts as follows: normal weight (NW; BMI < 85th percentile), overweight (OW; BMI 85th-95th percentile), and obese (OB; BMI > 95th percentile)...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28965158/influence-of-non-invasive-blood-pressure-measurement-intervals-on-the-occurrence-of-intra-operative-hypotension
#2
Grant H Kruger, Amy Shanks, Sachin Kheterpal, Tyler Tremper, Chi-Jung Chiang, Robert E Freundlich, James M Blum, Albert J Shih, Kevin K Tremper
The American Society of Anesthesiologists Standards for Basic Monitoring recommends blood pressure (BP) measurement every 5 min. Research has shown distractions or technical factors can cause prolonged measurement intervals exceeding 5 min. We investigated the relationship between prolonged non-invasive BP (NIBP) measurement interval and the incidence of hypotension, detected post-interval. Our secondary outcome was to determine independent predictors of these prolonged NIBP measurement intervals. Retrospective data were analyzed from 139,509 general anesthesia cases from our institution's Anesthesia Information Management System (AIMS)...
September 30, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28964640/a-prospective-study-of-post-cesarean-delivery-hypoxia-after-spinal-anesthesia-with-intrathecal-morphine-150%C3%AE-g
#3
Karim S Ladha, Rie Kato, Lawrence C Tsen, Brian T Bateman, Toshiyuki Okutomi
INTRODUCTION: Delayed respiratory depression is a feared complication of intrathecal morphine in patients undergoing cesarean delivery. The incidence, timing and risk factors for hypoxia in this population are not known. METHODS: Patients undergoing cesarean delivery under spinal anesthesia at a tertiary care center from October 2012 to March 2016 were included in the study. The Berlin sleep apnea Questionnaire was completed before surgery. Oxygen saturation was recorded every second for 24hours after the initiation of spinal anesthesia...
June 20, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28928583/single-minute-of-positive-end-expiratory-pressure-at-the-time-of-induction-effect-on-arterial-blood-gases-and-hemodynamics-in-morbidly-obese-patients-undergoing-laparoscopic-bariatric-surgery
#4
Dipti Saxena, Priyank Singh, Atul Dixit, Bipin Arya, Mohit Bhandari, Sadhana Sanwatsarkar
BACKGROUND: The effect of positive end-expiratory pressure (PEEP) has been studied in detail after induction of general anesthesia especially in obese individuals. However, sparse information can be gathered from the literature regarding its effect when applied at the time of induction and the time of onset of its effect. Thus, this study was planned to assess the effect of PEEP when applied for a single minute in morbidly obese patients. MATERIALS AND METHODS: This was a randomized prospective study comprising seven morbidly obese patients (body mass index ≥40 kg/m(2))...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28916989/comparison-of-the-recovery-profile-between-desflurane-and-sevoflurane-in-patients-undergoing-bariatric-surgery-a-meta-analysis-of-randomized-controlled-trials
#5
REVIEW
Preet Mohinder Singh, Anuradha Borle, Jason McGavin, Anjan Trikha, Ashish Sinha
Early and clear recovery from anesthesia is the crux for preventing perioperative complications in the obese undergoing bariatric surgery. Volatile inhalation agents by virtue of high lipid solubility are expected to produce residual anesthetic effects. Prospective randomized trials comparing desflurane and sevoflurane used for anesthesia maintenance (electroencephalograph guided) during bariatric surgery published till 1st of July 2017 were searched in the medical database. Comparisons were made for surrogate markers of recovery from anesthesia that included time to eye-opening (TEo), time to tracheal-extubation (TEx), and Aldrete scores on immediately shifting to recovery (Ald-I)...
September 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28916485/moderate-intravenous-sedation-for-first-trimester-surgical-abortion-a-comparison-of-adverse-outcomes-between-obese-and-normal-weight-women
#6
Gillian Horwitz, Danielle Roncari, Kari Braaten, Rie Maurer, Jennifer Fortin, Alisa B Goldberg
OBJECTIVE: To determine if obese women experience increased rates of adverse outcomes with moderate intravenous sedation during first trimester surgical abortion compared to normal weight women. STUDY DESIGN: We performed a retrospective cohort study of all first trimester surgical abortions with moderate intravenous sedation at an outpatient facility between September 2010 and June 2015. The primary outcome was supplemental oxygen administration. Secondary outcomes included reversal agent administration, anesthesia-related adverse events, and intraoperative lowest level of consciousness (LLOC)...
September 13, 2017: Contraception
https://www.readbyqxmd.com/read/28915133/complications-and-unplanned-admissions-in-nonoperating-room-procedures
#7
Kate Leslie, Benjamin Kave
PURPOSE OF REVIEW: The purpose of this article is to review complications and unplanned hospital admissions in patients presenting for ambulatory procedures requiring anesthesia care in the gastrointestinal endoscopy, bronchoscopy, and radiology suites. RECENT FINDINGS: The range of ambulatory diagnostic and therapeutic procedures being undertaken in the gastrointestinal endoscopy, bronchoscopy, and radiology suites is expanding rapidly. Recent observational studies in gastrointestinal endoscopy confirm low incidences of complications and unplanned admissions...
September 14, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28914170/the-investigation-of-the-effects-of-topiramate-on-the-hypothalamic-levels-of-fat-mass-obesity-associated-protein-and-neuropeptide-y-in-obese-female-rats
#8
Işınsu Alkan, Berrin Zuhal Altunkaynak, Gamze Altun, Erkan Erener
OBJECTIVE: The aim of the present study is to investigate the effects of topiramate on the fat mass/obesity-associated protein (FTO) and on the neuropeptide Y (NPY) level in the hypothalamus depending on the recently increased prevalence of obesity. METHOD: In this study, twenty-four female rats were divided into four equal groups: Non-obese control, obese control, non-obese topiramate, and obese topiramate. Obese groups were fed with a 40% high-fat diet. At the end of the 9th week, the drug treatment started and the subjects were treated with topiramate once a day for 6 weeks...
September 15, 2017: Nutritional Neuroscience
https://www.readbyqxmd.com/read/28894904/factors-influencing-the-outcome-of-surgery-for-pelvic-organ-prolapse
#9
Katja Stenström Bohlin, Maud Ankardal, Emil Nüssler, Håkan Lindkvist, Ian Milsom
INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) surgery is a common gynecological procedure. Our aim was to assess the influence of obesity and other risk factors on the outcome of anterior and posterior colporrhaphy with and without mesh. METHODS: Data were retrieved from the Swedish National Register for Gynecological Surgery on 18,554 women undergoing primary and repeat POP surgery without concomitant urinary incontinence (UI) surgery between 2006 and 2015...
September 11, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28875259/the-impact-of-obesity-on-30-day-complications-in-pediatric-surgery
#10
A T Train, S B Cairo, H A Meyers, C M Harmon, D H Rothstein
PURPOSE: To examine the effects of obesity on specialty-specific surgical outcomes in children. MATERIALS AND METHODS: Retrospective cohort study using the National Surgical Quality Improvement Program, Pediatric, 2012-2014. Patients included those aged 2-17 years who underwent a surgical procedure in one of six specialties. Obesity was the primary patient variable of interest. Outcomes of interest were postoperative complications and operative times. Odds ratios for development of postoperative complications were calculated using stepwise multivariate regression analysis...
September 5, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28861414/continuous-spinal-anesthesia-for-obstetric-anesthesia-and-analgesia
#11
REVIEW
Ivan Veličković, Borislava Pujic, Charles W Baysinger, Curtis L Baysinger
The widespread use of continuous spinal anesthesia (CSA) in obstetrics has been slow because of the high risk for post-dural puncture headache (PDPH) associated with epidural needles and catheters. New advances in equipment and technique have not significantly overcome this disadvantage. However, CSA offers an alternative to epidural anesthesia in morbidly obese women, women with severe cardiac disease, and patients with prior spinal surgery. It should be strongly considered in parturients who receive an accidental dural puncture with a large bore needle, on the basis of recent work suggesting significant reduction in PDPH when intrathecal catheters are used...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28857813/risk-factors-and-mitigation-strategies-for-pancreatic-fistula-after-distal-pancreatectomy-analysis-of-2026-resections-from-the-international-multi-institutional-distal-pancreatectomy-study-group
#12
Brett L Ecker, Matthew T McMillan, Valentina Allegrini, Claudio Bassi, Joal D Beane, Ross M Beckman, Stephen W Behrman, Euan J Dickson, Mark P Callery, John D Christein, Jeffrey A Drebin, Robert H Hollis, Michael G House, Nigel B Jamieson, Ammar A Javed, Tara S Kent, Michael D Kluger, Stacy J Kowalsky, Laura Maggino, Giuseppe Malleo, Vicente Valero, Lavanniya K P Velu, Amarra A Watkins, Christopher L Wolfgang, Amer H Zureikat, Charles M Vollmer
OBJECTIVE: To identify a clinical fistula risk score following distal pancreatectomy. BACKGROUND: Clinically relevant pancreatic fistula (CR-POPF) following distal pancreatectomy (DP) is a dominant contributor to procedural morbidity, yet risk factors attributable to CR-POPF and effective practices to reduce its occurrence remain elusive. METHODS: This multinational, retrospective study of 2026 DPs involved 52 surgeons at 10 institutions (2001-2016)...
August 29, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28843955/predictors-of-use-of-monitored-anesthesia-care-for-outpatient-gastrointestinal-endoscopy-in-a-capitated-payment-system
#13
Megan A Adams, Katherine M Prenovost, Jason A Dominitz, Robert G Holleman, Eve A Kerr, Sarah L Krein, Sameer D Saini, Joel H Rubenstein
BACKGROUND & AIMS: Use of monitored anesthesia care (MAC) for gastrointestinal endoscopy has increased in the Veterans Health Administration (VHA), as in fee-for-service environments, despite the absence of financial incentives. We investigated factors associated with use of MAC in an integrated healthcare delivery system with a capitated payment model. METHODS: We performed a retrospective cohort study using multi-level logistic regression, with MAC use modeled as a function of procedure year, patient- and provider-level factors, and facility effects...
August 23, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28830869/anesthesia-and-bariatric-surgery-gut-preparation-alter-plasma-acylcarnitines-reflective-of-mitochondrial-fat-and-branched-chain-amino-acid-oxidation
#14
Sudeepa Bhattacharyya, Mohamed Ali, William H Smith, Paul E Minkler, Maria S Stoll, Charles L Hoppel, Sean H Adams
The period around bariatric surgery offers a unique opportunity to characterize metabolism responses to dynamic shifts in energy, gut function, and anesthesia. We analyzed plasma acylcarnitines in obese women (n=17) sampled in the overnight fasted/postabsorptive state ca. 1-2 weeks prior to surgery (Condition A), the morning of surgery (prior restriction to a 48 hr. clear liquid diet coupled in some cases a standard polyethylene glycol gut evacuation: Condition B), and following induction of anesthesia (Condition C)...
August 22, 2017: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28828532/pharmacokinetic-and-pharmacodynamics-of-intravenous-dexmedetomidine-in-morbidly-obese-patients-undergoing-laparoscopic-surgery
#15
Bo Xu, Dongxu Zhou, Li Ren, Steven Shulman, Xingan Zhang, Ming Xiong
BACKGROUND: This study was designed to investigate the pharmacokinetics and pharmacodynamics of dexmedetomidine in morbidly obese patients undergoing laparoscopic surgery. METHODS: Morbidly obese (body mass index ≥40 kg/m(2)) and normal weight patients scheduled for elective laparoscopic surgery were included (n = 8, each group). After baseline hemodynamic measurement, dexmedetomidine 1 μg/kg was administered over 10 min. General anesthesia was induced with propofol 1...
August 21, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28828299/immunomodulatory-effects-of-anesthetics-in-obese-patients
#16
REVIEW
Luciana Boavista Barros Heil, Pedro Leme Silva, Paolo Pelosi, Patricia Rieken Macedo Rocco
Anesthesia and surgery have an impact on inflammatory responses, which influences perioperative homeostasis. Inhalational and intravenous anesthesia can alter immune-system homeostasis through multiple processes that include activation of immune cells (such as monocytes, neutrophils, and specific tissue macrophages) with release of pro- or anti-inflammatory interleukins, upregulation of cell adhesion molecules, and overproduction of oxidative radicals. The response depends on the timing of anesthesia, anesthetic agents used, and mechanisms involved in the development of inflammation or immunosuppression...
August 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28801746/laparoscopic-nissen-fundoplication-plus-mid-gastric-plication-for-treatment-of-obese-patients-with-gastroesophageal-reflux-disease
#17
Ahmed Talha, Mohammed Ibrahim
BACKGROUND: Gastroesophageal reflux disease (GERD) is commonly associated with obesity, and its surgical management is debatable. OBJECTIVE: The objective of this study was to prove the safety and feasibility of laparoscopic Nissen's fundoplication (LNF) combined with mid-gastric plication (MGP) for treatment of obese patients with GERD. METHODS: LNF combined with MGP was done for 18 patients. All interventions were performed under general anesthesia...
August 11, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28791499/long-term-peripheral-neuropathy-symptoms-in-breast-cancer-survivors
#18
Moaath Mustafa Ali, Machelle Moeller, Lisa Rybicki, Halle C F Moore
PURPOSE: Peripheral neuropathy (PN) is a common and distressing complication from chemotherapy. Symptoms often, but not always, improve with time. The prevalence of long-term PN symptoms in breast cancer survivors is not well known. We sought to explore PN symptoms and associated risk factors among breast cancer survivors at least 2 years out from diagnosis. METHODS: We performed a cross-sectional retrospective study investigating the prevalence of patient-reported numbness, tingling, and anesthesia symptoms as a surrogate for PN in breast cancer survivors...
August 8, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28762023/efficacy-of-goal-directed-fluid-therapy-via-pleth-variability-index-during-laparoscopic-roux-en-y-gastric-bypass-surgery-in-morbidly-obese-patients
#19
İsmail Demirel, Esef Bolat, Aysun Yıldız Altun, Mustafa Özdemir, Azize Beştaş
BACKGROUND: There is no well-recognized guideline for intraoperative fluid management in bariatric surgery. Goal-directed fluid therapy (GDFT) is a new concept of perioperative fluid management which was shown to improve patients' prognoses. Dynamic indicators may better predict fluid response compared to static indicators. In this study, we aimed to assess effects of administering GDFT protocol via Pleth Variability Index (PVI) in morbidly obese patients undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) surgery...
July 31, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28733098/obesity-and-failure-of-nonsurgical-management-of-pediatric-both-bone-forearm-fractures
#20
Ugochi C Okoroafor, Lisa K Cannada, Jasmin L McGinty
PURPOSE: In pediatric extremity fractures treated nonsurgically, maintaining reduction can be difficult in obese children owing to the larger soft tissue envelope. The purpose of this study was to investigate the relationship between obesity and failure of nonsurgical management of pediatric both-bone forearm fractures. METHODS: We conducted a retrospective review of 129 skeletally immature patients older than 2 years who received nonsurgical treatment for closed radius and ulna shaft fractures at a level I pediatric trauma center between 2011 and 2014...
September 2017: Journal of Hand Surgery
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