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Obese anesthesia & Surgery

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https://www.readbyqxmd.com/read/29200367/anesthetic-management-in-mitochondrial-encephalomyopathy-a-case-report
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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/29160727/a-review-of-perioperative-complications-of-outpatient-total-ankle-arthroplasty
#7
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
#8
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/29155697/acute-intraoperative-suprachoroidal-hemorrhage-during-small-gauge-pars-plana-vitrectomy
#9
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
#10
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/29134425/quick-reference-tidal-volume-cards-reduce-the-incidence-of-large-tidal-volumes-during-surgery
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/29090036/the-autoimmunity-s-footprint-in-pediatrics-type-1-diabetes-coeliac-disease-thyroiditis
#14
Anca Orzan, Carmen Novac, Mihaela Mihu, Constantin Ionescu Tirgoviste, Mihaela Balgradean
The present case report aims to describe and discuss the approach for the management of difficult endotracheal intubation in an adult with Down syndrome undergoing cataract surgery. A 26-year-old female with Down syndrome and a validated diagnosis of cataract requiring surgery was examined in order to assess the degree of difficulty of endotracheal intubation. Patients with Down syndrome have characteristic craniofacial abnormalities which require a thorough pre-operative assessment to anticipate and prepare for a difficult endotracheal intubation...
June 2017: Mædica
https://www.readbyqxmd.com/read/29090034/endotracheal-intubation-in-a-down-syndrome-adult-undergoing-cataract-surgery-a-multidisciplinary-approach
#15
George Gabriel Moldoveanu, Emilia Severin, Andreea Paun
The present case report aims to describe and discuss the approach for the management of difficult endotracheal intubation in an adult with Down syndrome undergoing cataract surgery. A 26-year-old female with Down syndrome and a validated diagnosis of cataract requiring surgery was examined in order to assess the degree of difficulty of endotracheal intubation. Patients with Down syndrome have characteristic craniofacial abnormalities which require a thorough pre-operative assessment to anticipate and prepare for a difficult endotracheal intubation...
June 2017: Mædica
https://www.readbyqxmd.com/read/29078996/ambulatory-unicompartmental-knee-arthroplasty-short-outcome-of-50-first-cases
#16
N Ruiz, X Buisson, G Filippi, M Roulet, H Robert
INTRODUCTION: The reduction in length of stay (LOS) in orthopaedic surgery has been steady for several years. For the past 3 or 4 years in France, the trend towards outpatient surgery has been growing up, as it is a goal for hospital administration. MATERIALS AND METHODS: This is a prospective, continuous,mono-centric, single operator study on 56 UKAs. Included were all UKAs carried out between January 2014 and December 2015, meeting the following criteria: voluntary patients, supportive family environment, absence of comorbidity (oral anticoagulants, diabetes, obesity), ASA score ≤ 3...
October 24, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28964640/a-prospective-study-of-post-cesarean-delivery-hypoxia-after-spinal-anesthesia-with-intrathecal-morphine-150%C3%AE-g
#17
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...
November 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
#18
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
#19
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)...
November 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28894904/factors-influencing-the-outcome-of-surgery-for-pelvic-organ-prolapse
#20
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
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