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Intraoperative awareness

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https://www.readbyqxmd.com/read/28735464/radiation-dose-reduction-in-thoracic-and-lumbar-spine-instrumentation-using-navigation-based-on-an-intraoperative-cone-beam-ct-imaging-system-a-prospective-randomized-clinical-trial
#1
Nathalie Pireau, Virginie Cordemans, Xavier Banse, Nadia Irda, Sébastien Lichtherte, Ludovic Kaminski
PURPOSE: Spine surgery still remains a challenge for every spine surgeon, aware of the potential serious outcomes of misplaced instrumentation. Though many studies have highlighted that using intraoperative cone beam CT imaging and navigation systems provides higher accuracy than conventional freehand methods for placement of pedicle screws in spine surgery, few studies are concerned about how to reduce radiation exposure for patients with the use of such technology. One of the main focuses of this study is based on the ALARA principle (as low as reasonably achievable)...
July 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28734751/how-many-people-work-in-your-operating-room-an-assessment-of-factors-associated-with-instrument-recounts-within-plastic-surgery
#2
Derek D Reformat, Joshua A David, J Rodrigo Diaz-Siso, Natalie M Plana, Annie Wang, Nicholas D Brownstone, Daniel J Ceradini
BACKGROUND: Intraoperative instrument recounts are performed to avoid retained foreign surgical items. These additional counts, however, beget risks of their own, including prolonged operative times, exposure to radiation, and increased cost. Our study aimed to identify factors that increase the likelihood of instrument recounts during plastic surgery procedures, and use our findings to guide potential solutions for preventing unnecessary recounts across all surgical fields. STUDY DESIGN: This is a retrospective review of all plastic surgical cases in the main operating setting at New York University Langone Medical Center (NYULMC) between March 2014 and February 2015...
June 28, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28733690/do-obstetric-patients-opt-to-undergo-general-anaesthesia-to-avoid-being-conscious-despite-safer-alternatives
#3
Daryl Ja Tan, Melissa Mh Chan
There are various modes of anaesthesia available in the community today. This gives anaesthesiologists the freedom to select those that are safe, efficacious and most suitable for patients. However, patients may not always agree with their anaesthesiologist on the preferred mode of anaesthesia because they may have a different set of priorities, with many of them electing to have the lack of intraoperative awareness as the primary objective. Hence, disagreements between anaesthesiologists and patients may arise and could potentially disrupt doctor-patient relationship...
June 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28699067/intraoperative-clinical-testing-overestimates-the-therapeutic-window-of-the-permanent-dbs-electrode-in-the-subthalamic-nucleus
#4
Josefine Blume, J Schlaier, E Rothenfußer, J Anthofer, F Zeman, A Brawanski, U Bogdahn, M Lange
BACKGROUND: Intraoperative test stimulation is established to optimize target localization in STN DBS, but requires a time-consuming awake surgery in off-medication state. The aim of this study was to compare the thresholds of stimulation-induced effects of test stimulation and the permanent electrode. METHODS: Fifty-nine PD patients receiving bilateral STN DBS were clinically examined with stepwise increasing monopolar stimulation during surgery and DBS programming at matched stimulation depths...
July 12, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28696881/persistent-left-superior-vena-cava-incidence-and-management-in-patients-undergoing-repair-of-partial-anomalous-pulmonary-venous-connection
#5
Nicholas S Clarke, Raghav A Murthy, Kristine J Guleserian
INTRODUCTION: A association between partial anomalous pulmonary venous connection (PAPVC) and systemic venous anomalies has been described in the literature, but the true incidence is yet to be elucidated. At our institution, we sought to find the incidence of a persistent left superior vena cava (PLSVC) in patients undergoing an operation for PAPVC. METHODS: A retrospective review of all pediatric and adult patients with PAPVC who underwent surgical repair from February 2006 to February 2016...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28682951/preoperatively-screened-obstructive-sleep-apnea-is-associated-with-worse-postoperative-outcomes-than-previously-diagnosed-obstructive-sleep-apnea
#6
Ana Fernandez-Bustamante, Karsten Bartels, Claudia Clavijo, Benjamin K Scott, Rachel Kacmar, Kenneth Bullard, Angela F D Moss, William Henderson, Elizabeth Juarez-Colunga, Leslie Jameson
BACKGROUND: Obstructive sleep apnea (OSA) affects up to 26% of US adults, is often undiagnosed, and increases perioperative morbidity. We hypothesized that patients screened on the day of surgery as moderate/high risk for OSA (S-OSA) present similar perioperative respiratory complications, hospital use, and mortality than patients with previously diagnosed OSA (D-OSA). Second, we hypothesized that both OSA groups have more respiratory complications than No-OSA patients. METHODS: The electronic medical database from 1 academic and 2 community hospitals was retrospectively queried to identify adults undergoing nonemergent inpatient surgery (January 1, 2012, to December 31, 2014)...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28673212/awareness-during-general-anaesthesia-in-the-first-4-000-incidents-reported-to-webairs
#7
K Leslie, M D Culwick, H Reynolds, J A Hannam, A F Merry
The aim of this study was to analyse the incidents related to awareness during general anaesthesia in the first 4,000 cases reported to webAIRS-an anaesthetic incident reporting system established in Australia and New Zealand in 2009. Included incidents were those in which the reporter selected "neurological" as the main category and "awareness/dreaming/nightmares" as a subcategory, those where the narrative report included the word "awareness" and those identified by the authors as possibly relevant to awareness...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28663647/incidence-of-awareness-with-recall-under-general-anesthesia-in-rural-india-an-observational-study
#8
Deepak Singla, Mishu Mangla
CONTEXT: Awareness under anesthesia is a rare but extremely unpleasant phenomenon. There are very few studies in the developing world and none from rural areas where incidence of intraoperative awareness may be higher due to increased patient load, limited patient knowledge and lack of trained hospital staff, reliance on older, cheaper but less effective drugs, and lack of proper equipment both for providing anesthesia, as well as monitoring the patient. AIMS: To assess the incidence of intraoperative awareness during general anesthesia among patients in rural India and any factors associated with the same...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28661726/laparoscopic-findings-associated-with-bladder-endometriosis-are-correlated-with-disease-severity
#9
Jerome Bouaziz, Zohar Dotan, Michal Zajicek, Matityahu Zolti, Howard Carp, Mordechai Goldenberg, Daniel S Seidman, David Soriano
STUDY OBJECTIVE: Bladder involvement is rare in endometriosis. The prevalence is estimated to be ∼1% in patients with endometriosis. However, this figure seems to be an underestimation. The diagnosis of bladder endometriosis might be missed during laparoscopy. The aim of this study was to determine an intraoperative visual score of pelvic lesions that help the surgeon suspect bladder endometriosis. Design, Design Classification: A retrospective analysis was performed on the intraoperative photographs and videos of 69 patients with histological confirmation of bladder endometriosis...
June 29, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28657949/laparoscopic-surgery-for-adhesive-small-bowel-obstruction-is-associated-with-a-higher-risk-of-bowel-injury-a-population-based-analysis-of-8584-patients
#10
Ramy Behman, Avery B Nathens, James P Byrne, Stephanie Mason, Nicole Look Hong, Paul J Karanicolas
OBJECTIVE: We set out to compare the incidence of bowel repair and/or resection in a large cohort of patients with adhesive small bowel obstruction (SBO) managed operatively. BACKGROUND: Laparoscopic lysis of adhesions for adhesive SBO (aSBO) is becoming more common, yet might increase the risk of bowel injury given the distended and/or potentially compromised small bowel. METHODS: We used administrative discharge data derived from a large geographic region, identifying patients who underwent surgery for their first episode of aSBO during 2005 to 2014...
June 27, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28648840/reducing-fluid-related-complications-during-operative-hysteroscopy-the-use-of-a-new-mandatory-fluid-balance-form
#11
Heli Alkaslassy, Raz Bahar, Hillel Henry Chill, Gilad Karavani, Orna Ben-Yosseff, Asher Shushan
STUDY OBJECTIVE: To examine whether our new reporting system and mandatory fluid-balance form could improve the communication and awareness within the surgical team and therefore the safety of hysteroscopic operations. DESIGN: A case-control study DESIGN: classification: II-2 SETTING: An endoscopic gynecology unit at a tertiary-care university hospital. PATIENTS: Women aged 17-88 (median 43.9) years, who underwent operative hysteroscopy to treat uterine pathology...
June 22, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28648410/the-great-unknown-a-systematic-literature-review-about-risk-associated-with-intraoperative-imaging-during-orthopaedic-surgeries
#12
REVIEW
Amir Matityahu, Ryan K Duffy, Sabine Goldhahn, Alexander Joeris, Peter H Richter, Florian Gebhard
INTRODUCTION: Modern techniques in orthopaedic surgery using minimally invasive procedures, and increased use of fluoroscopic imaging present a potential increased risk to surgeons due to ionizing radiation exposure. This article is a systematic review of recent literature on radiation exposure of orthopaedic surgeons. MATERIALS AND METHODS: Pubmed and Cochrane searches were performed on intraoperative radiation exposure covering English and German articles published between 1...
April 21, 2017: Injury
https://www.readbyqxmd.com/read/28647750/misdiagnosed-paranasal-gossypiboma-a-10-year-experience-with-21-cases-at-a-tertiary-center
#13
P Z Wu, W Sun, Y H Wen, R Q Ma, X L Zhu, W P Wen
BACKGROUND: Different from rhinoliths, the paranasal gossypiboma is a foreign body, such as a surgical sponge, left in the nasal cavity. It is a rare, frequently misdiagnosed disease that has rarely been reported. We summarize its clinical characteristics, management, and possible risk factors. METHODOLOGY: We reviewed medical records of confirmed paranasal gossypibomas at a tertiary medical center between 2005 and 2015. Clinical symptoms, age, sex, anatomic sites, endoscopic photography, computed tomography, intraoperative findings, and past medical history were reviewed...
June 25, 2017: Rhinology
https://www.readbyqxmd.com/read/28620562/delayed-chyle-leak-following-anterior-cervical-spinal-surgery-a-case-report-and-management-algorithm
#14
Kyle Mueller, Hasan R Syed, Jay W Rhee, Mani N Nair
Injury to the thoracic duct during anterior cervical spine surgery is a rare occurrence. A delayed chyle leak following an elective anterior cervical spinal surgery has not been reported in the literature. We present a report of a 59-year-old female with multiple prior neck surgeries who underwent an anterior cervical corpectomy and fusion (ACCF). The patient developed a delayed thoracic duct injury on postoperative day (POD) one, as no injury was noted intraoperatively. She was managed with conservative care involving a low-fat diet along with octreotide which led to the resolution of her symptoms...
May 9, 2017: Curēus
https://www.readbyqxmd.com/read/28614170/implications-of-left-sided-gallbladder-in-the-emergency-setting-retrospective-review-and-top-tips-for-safe-laparoscopic-cholecystectomy
#15
Hariscine K Abongwa, Belinda De Simone, Laura Alberici, Maurizio Iaria, Gennaro Perrone, Antonio Tarasconi, Gianluca Baiocchi, Nazario Portolani, Salomone Di Saverio, Massimo Sartelli, Federico Coccolini, Jennifer E Manegold, Luca Ansaloni, Fausto Catena
BACKGROUND: Left-sided gallbladder without situs viscerum inversus (LSG-woSVI) is a rare congenital anomaly. Clinical features and routine presurgical imaging could miss the anomalous position, thereby producing complications during surgery. Laparoscopic cholecystectomy can be performed safely, but the risk of bile duct injury (BDI) is greater than in cholecystectomy of the orthotopic gallbladder. We present a retrospective review of all scientific literature for diagnosed cases of LSG-woSVI undergoing cholecystectomy from 1996 to 2014...
June 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28607941/radiographic-diagnosis-of-pincer-type-femoroacetabular-impingement-a-systematic-review
#16
REVIEW
Chanseok Rhee, Tina Le Francois, J W Thomas Byrd, Mark Glazebrook, Ivan Wong
BACKGROUND: Femoroacetabular impingement (FAI) is a well-recognized condition that causes hip pain and can lead to early osteoarthritis if not managed properly. With the increasing awareness and efficacy of operative treatments for pincer-type FAI, there is a need for consensus on the standardized radiographic diagnosis. PURPOSE: To perform a systematic review of the evidence regarding imaging modalities and radiographic signs for diagnosing pincer-type FAI. STUDY DESIGN: Systematic review; Level of evidence, 4...
May 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28600996/lower-limb-alignment-and-laxity-measures-before-during-and-after-total-knee-arthroplasty-a-prospective-cohort-study
#17
Jon V Clarke, Angela H Deakin, Frederic Picard, Philip E Riches
BACKGROUND: This study compared knee alignment and laxity in patients before, during and after total knee arthroplasty, using methodologically similar procedures, with an aim to help inform pre-operative planning. METHODS: Eighteen male and 13 female patients were recruited, mean age 66years (51-82) and mean body mass index of 33 (23-43). All were assessed pre- and postoperatively using a non-invasive infrared position capture system and all underwent total knee arthroplasty using a navigation system...
May 26, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28580893/appropriateness-of-surgical-antibiotic-prophylaxis-in-pediatric-patients-in-italy
#18
Mariavalentina Giordano, Lorena Squillace, Maria Pavia
OBJECTIVES Appropriate use of surgical antibiotic prophylaxis (SAP) reduces intraoperative wound contamination in pediatric surgery, thus minimizing the risk of surgical site infection (SSIs). Conversely, inappropriate use of SAP exposes patients to the risk of antibiotic side effects and contributes to the emergence of antimicrobial resistance. Our aims were to describe SAP administration and to analyze factors associated with nonadherence in pediatric patients. DESIGN Descriptive study. SETTING Overall, 955 pediatric patients underwent 1,038 surgical procedures...
June 5, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28580500/vascular-calcifications-on-the-preoperative-radiograph-harbinger-of-tourniquet-failure-in-patients-undergoing-total-knee-arthroplasty
#19
Julia Verena Woelfle-Roos, Laura Dautel, Benjamin Mayer, Ralf Bieger, Klaus-Dieter Woelfle, Heiko Reichel
OBJECTIVE: Vascular calcifications on the preoperative radiograph of patients scheduled for total knee arthroplasty (TKA) often give rise to concern, as their clinical relevance remains uncertain. The aim of this study was to investigate whether these vascular calcifications-especially medial artery calcifications (MACs), which increase arterial stiffness-were associated with tourniquet failure and thus with increased intraoperative blood loss. MATERIALS AND METHODS: A total of 765 patients who underwent primary TKA with a tourniquet (cuff pressure 350 mmHg) between 2009 and 2011 were screened for vascular calcifications on the preoperative radiograph...
September 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28553445/a-cross-sectional-analysis-of-glove-perforation-in-primary-and-revision-total-hip-arthroplasty
#20
D Kumar, K Shantanu, M Kumar, A Kumar, V Sharma
The number of total hip arthroplasties is ever increasing. Literature about glove perforation rates in arthroplasties in India is very scarce. The purpose of our study was to determine the incidence of glove perforation and increasing the awareness of possible glove perforations to decrease the risk of infection. We performed a prospective study in which we tested gloves worn by all scrubbed personnel. A total of 1408 gloves were collected from 42 primary total hip and 13 revision total hip arthroplasties. Incidence of glove perforation was found to be more in revision total hip arthroplasty...
November 2016: Malaysian Orthopaedic Journal
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