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Perioperative anesthesiology

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https://www.readbyqxmd.com/read/29445309/the-role-of-pairing-an-anesthesiology-rotation-with-the-general-surgery-clerkship-positive-impact-on-surgical-and-perioperative-education
#1
Gaurav P Patel
Background: The use of an anesthesiology rotation in the realm of surgical education is not very well studied. Several studies show the importance of an anesthesiology rotation in the grand scheme of undergraduate medical education. However, its importance in perioperative medicine and surgical education is not very well understood. This study attempts to look at this relationship and determine whether or not a temporal relationship between this anesthesiology rotation and a surgical rotation is important...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29441169/perioperative-stroke-pathophysiology-and-management
#2
REVIEW
Sang-Bae Ko
Although perioperative stroke is uncommon during low-risk non-vascular surgery, if it occurs, it can negatively impact recovery from the surgery and functional outcome. Based on the Society for Neuroscience in Anesthesiology and Critical Care Consensus Statement, perioperative stroke includes intraoperative stroke, as well as postoperative stroke developing within 30 days after surgery. Factors related to perioperative stroke include age, sex, a history of stroke or transient ischemic attack, cardiac surgery (aortic surgery, mitral valve surgery, or coronary artery bypass graft surgery), and neurosurgery (external carotid-internal carotid bypass surgery, carotid endarterectomy, or aneurysm clipping)...
February 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29416871/anesthesiology-control-tower-feasibility-assessment-to-support-translation-act-fast-a-feasibility-study-protocol
#3
Teresa M Murray-Torres, Frances Wallace, Mara Bollini, Michael S Avidan, Mary C Politi
Background: Major postoperative morbidity and mortality remain common despite efforts to improve patient outcomes. Health information technologies have the potential to actualize advances in perioperative patient care, but failure to evaluate the usability of these technologies may hinder their implementation and acceptance. This protocol describes the usability testing of an innovative telemedicine-based intra-operative clinical support system, the Anesthesiology Control Tower, in which a team led by an attending anesthesiologist will use a combination of established and novel information technologies to provide evidence-based support to their colleagues in the operating room...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29401078/teaching-medical-students-clinical-anesthesia
#4
Saundra E Curry
There are many reasons for evaluating our approach and improving our teaching of America's future doctors, whether they become anesthesiologists (recruitment) or participate in patient management in the perioperative period (general patient care). Teaching medical students the seminal aspects of any medical specialty is a continual challenge. Although no definitive curricula or single clinical approach has been defined, certain key features can be ascertained from clinical experience and the literature. A survey was conducted among US anesthesiology teaching programs regarding the teaching content and approaches currently used to teach US medical students clinical anesthesia...
February 2, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29388810/knowledge-gaps-in-the-perioperative-management-of-adults-with-obstructive-sleep-apnea-and-obesity-hypoventilation-syndrome-an-official-american-thoracic-society-workshop-report
#5
Najib T Ayas, Cheryl R Laratta, John M Coleman, Anthony G Doufas, Matthias Eikermann, Peter C Gay, Daniel J Gottlieb, Indira Gurubhagavatula, David R Hillman, Roop Kaw, Atul Malhotra, Babak Mokhlesi, Timothy I Morgenthaler, Sairam Parthasarathy, Satya Krishna Ramachandran, Kingman P Strohl, Patrick J Strollo, Michael J Twery, Phyllis C Zee, Frances F Chung
The purpose of this workshop was to identify knowledge gaps in the perioperative management of obstructive sleep apnea (OSA) and obesity hypoventilation syndrome (OHS). A single-day meeting was held at the American Thoracic Society Conference in May, 2016, with representation from many specialties, including anesthesiology, perioperative medicine, sleep, and respiratory medicine. Further research is urgently needed as we look to improve health outcomes for these patients and reduce health care costs. There is currently insufficient evidence to guide screening and optimization of OSA and OHS in the perioperative setting to achieve these objectives...
February 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29369096/electroencephalography-and-brain-oxygenation-monitoring-in-the-perioperative-period
#6
Thomas W L Scheeren, Merel H Kuizenga, Holger Maurer, Michel M R F Struys, Matthias Heringlake
Maintaining brain function and integrity is a pivotal part of anesthesiological practice. The present overview aims to describe the current role of the 2 most frequently used monitoring methods for evaluation brain function in the perioperative period, ie, electroencephalography (EEG) and brain oxygenation monitoring. Available evidence suggests that EEG-derived parameters give additional information about depth of anesthesia for optimizing anesthetic titration. The effects on reduction of drug consumption or recovery time are heterogeneous, but most studies show a reduction of recovery times if anesthesia is titrated along processed EEG...
January 23, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29353441/pre-and-postoperative-management-of-risk-factors-for-postoperative-delirium-who-is-in-charge-and-what-is-its-essence
#7
Bruno Neuner, Daniel Hadzidiakos, Gabriella Bettelli
Postoperative delirium (POD) is an adverse clinical outcome characterized by cognitive, affective and behavioral symptoms with typically an acute onset and a fluctuating course. POD is attributed to certain patients' predisposing factors as well as to treatment-related precipitating factors. While there are several single-component interventions for the prevention of POD, evolving evidence suggests the importance of a system approach in the prevention of POD. This involves strategies by multidisciplinary teams with additional geriatric consultation services to identify risk factors for POD and to modify their impact on the perioperative course...
January 20, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29343282/investigation-of-perioperative-safety-and-clinical-results-of-one-stage-bilateral-total-knee-arthroplasty-in-selected-low-risk-patients
#8
Hirotaka Mutsuzaki, Arata Watanabe, Tetsuya Komatsuzaki, Tomonori Kinugasa, Kotaro Ikeda
BACKGROUND: An increased perioperative complication rate has been a concern with one-stage bilateral total knee arthroplasty (TKA). The purpose of this study was to retrospectively investigate the perioperative safety and clinical results of one-stage bilateral TKA in selected low-risk patients. METHODS: Sixty-seven patients who received one-stage bilateral TKAs for osteoarthritis who were American Society of Anesthesiology (ASA) class 1 or 2 were included in this study...
January 17, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#9
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...
January 17, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29200065/cardiac-arrest-in-the-operating-room-part-2-special-situations-in-the-perioperative-period
#10
Matthew D McEvoy, Karl-Christian Thies, Sharon Einav, Kurt Ruetzler, Vivek K Moitra, Mark E Nunnally, Arna Banerjee, Guy Weinberg, Andrea Gabrielli, Gerald A Maccioli, Gregory Dobson, Michael F O'Connor
As noted in part 1 of this series, periprocedural cardiac arrest (PPCA) can differ greatly in etiology and treatment from what is described by the American Heart Association advanced cardiac life support algorithms, which were largely developed for use in out-of-hospital cardiac arrest and in-hospital cardiac arrest outside of the perioperative space. Specifically, there are several life-threatening causes of PPCA of which the management should be within the skill set of all anesthesiologists. However, previous research has demonstrated that continued review and training in the management of these scenarios is greatly needed and is also associated with improved delivery of care and outcomes during PPCA...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29200062/is-compliance-with-surgical-care-improvement-project-cardiac-scip-card-2-measures-for-perioperative-%C3%AE-blockers-associated-with-reduced-incidence-of-mortality-and-cardiovascular-related-critical-quality-indicators-after-noncardiac-surgery
#11
Miklos D Kertai, Mary Cooter, Richard J Pollard, William Buhrman, Solomon Aronson, Joseph P Mathew, Mark Stafford-Smith
BACKGROUND: While continuation of β-blockers (BBs) perioperatively has become a national quality improvement measure, the relationship between BB withdrawal and mortality and cardiovascular-related critical quality indicators has not been studied in a contemporary cohort of patients undergoing noncardiac surgery. METHODS: For this retrospective study, the quality assurance database of a large community-based anesthesiology group practice was used to identify 410,288 surgical cases, 18 years of age or older, who underwent elective or emergent noncardiac surgical procedures between January 1, 2009, and December 31, 2014...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29190178/transanal-total-mesorectal-excision-in-lower-rectal-cancer-comparison-of-short-term-outcomes-with-conventional-laparoscopic-total-mesorectal-excision
#12
Tung-Cheng Chang, Kee-Thai Kiu
BACKGROUND: Transanal total mesorectal excision (TaTME) is a novel technique to treat rectal cancer and also to obtain good-quality specimens. This study investigated the clinical results and perioperative and pathological outcomes of TaTME in lower rectal cancer treatment in comparison with laparoscopic total mesorectal excision (LaTME). METHODS: During January 2014 to May 2017, all consecutive patients with lower rectal cancer who underwent TaTME were identified...
November 30, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29158865/-anesthesiological-aspects-and-complications-of-intracranial-meningiomas-operated-at-the-sylvanus-olympio-university-hospital-center-lom%C3%A3-about-21-cases
#13
Pilakimwé Egbohou, Tabana Mouzou, Kadanga Beketi, Essossinam Kpelao, Abdel Kader Moumouni, Hamza Doles Sama, Sarakawabalo Assénouwé, Gnimdou Akala-Yoba, Kadjika Tomta
This study aimed to point to both the anesthesiological aspects and the perioperative complications of intracranial meningiomas operated at the Sylvanus Olympio University Hospital Center, Lomé. We conducted a retrospective study by reviewing the medical records of patients with intracranial meningiomas undergoing surgery over the period December 2010-December 2015 (5 years) at the Sylvanus Olympio University Hospital Center, Lomé. Out of 46 patients operated fo brain tumors, 21 (45.6%) had meningioma. The average age was 49 ±20 years, with a male predominance (52...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29156481/-why-and-how-should-i-assess-frailty-a-guide-for-the-preoperative-anesthesia-clinic
#14
Oliver Birkelbach, Rudolf Mörgeli, Felix Balzer, Maria Olbert, Sascha Treskatsch, Rainer Kiefmann, Ursula Müller-Werdan, Anett Reisshauer, Christine Schwedtke, Bruno Neuner, Claudia Spies
Introduction: Frailty is a condition of decreased physiological reserves seen in approx. one third of elderly anesthesiological patients, and affecting many aspects of treatment as well as outcome. Although there are over 60 measurement instruments, frailty assessment is still poorly implemented. Understanding why and how to assess frailty is key to its implementation in preoperative anesthesia clinics. Method: After presenting the impact of perioperative frailty and the benefits of an early diagnosis on health related quality of life, we present an overview of the most important tools that can be used in the preoperative frailty assessment...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29129345/defining-value-based-care-in-cardiac-and-vascular-anesthesiology-the-past-present-and-future-of-perioperative-cardiovascular-care
#15
REVIEW
Lavinia M Kolarczyk, Harendra Arora, Michael W Manning, David A Zvara, Robert S Isaak
Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29098342/preoperative-evaluation-of-adult-patients-before-elective-noncardiothoracic-surgery-joint-recommendation-of-the-german-society-of-anesthesiology-and-intensive-care-medicine-the-german-society-of-surgery-and-the-german-society-of-internal-medicine
#16
REVIEW
B Zwissler
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery, and may help to optimize the patient's preoperative medical condition and guide perioperative management. Whether performance of additional technical tests (e. g., blood chemistry, electrocardiography, spirometry, chest x‑ray) can contribute to reduction of the perioperative risk is often not well known or controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists, and surgeons with respect to perioperative management of the patient's long-term medication...
November 2, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29076431/pharmacology-and-perioperative-considerations-of-pain-medications
#17
Ryan M Chadha, Stephen Aniskevich, Brian J Egan
BACKGROUND: Pain continues to be the most common medical concern, and perioperative health care providers are encountering increasing numbers of patients with chronic pain conditions. It is important to have a clear understanding of how long-term use of pain medications impacts anesthesia during the intraoperative and postoperative periods. OBJECTIVE: To review common medications used to treat chronic pain and summarize current recommendations regarding perioperative care...
October 27, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29046901/chirurgia-e-management-delle-pazienti-anziane-affette-da-carcinoma-ovarico
#18
Paolo Scollo, Giuseppe Scibilia, Basilio Pecorino
The median life expectancy of population among industrialized countries has dramatically expanded in recent years. On the other hand, the risk of developing cancer increases with age.The treatment for gynaecological malignancies is well defined with respect to the surgery, radiation treatment and chemotherapy. However, elderly patients receives substandard treatment when compared to the younger people, generally due to the presence of associated medical conditions. The assessment of the co-morbidity is an important aspect of the surgical decision-making process...
2017: Argomenti di Oncologia Geriatrica
https://www.readbyqxmd.com/read/29016368/perioperative-point-of-care-ultrasound-in-ambulatory-anesthesia-thinking-beyond-nerve-blocks
#19
Ranjit Deshpande, Davinder Ramsingh
PURPOSE OF REVIEW: Ultrasound has become readily available in the perioperative area. In this review, we aim to bring forth some uses of ultrasound beyond that in regional anesthesia. RECENT FINDINGS: Critical care and emergency physicians have embraced ultrasound in their respective fields. We as anesthesiologists and practitioners of acute care medicine are not immune to this penetration. There is been a lot of recent literature on the various uses of perioperative point of care ultrasound...
December 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28937424/a-case-report-of-incidental-hepatic-cysts-found-on-ultrasound-imaging-implications-for-the-anesthesiologist
#20
Aysha Hasan, Walid Alrayashi, David Waisel, Karen Boretsky
Point-of-care ultrasound imaging is increasingly used by anesthesiologists to facilitate rapid clinical diagnosis and treatment in the perioperative period. With its growing popularity, inevitably, unfamiliar structures will be observed. We present a case of cystic liver lesions in a healthy model during a point-of-care workshop. We address the clinical, ethical, and legal implications of incidental findings in anesthesiology. We offer recommendations and an algorithmic approach to these occurrences.
September 20, 2017: A & A Case Reports
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