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Intraoperative monitoring

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https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#1
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28719527/pupillometry-guided-intraoperative-remifentanil-administration-versus-standard-practice-influences-opioid-use-a-randomized-study
#2
Nada Sabourdin, Jérôme Barrois, Nicolas Louvet, Agnès Rigouzzo, Marie-Laurence Guye, Christophe Dadure, Isabelle Constant
BACKGROUND: Pupillometry has shown promising results for assessing nociception in anesthetized patients. However, its benefits in clinical practice are not demonstrated. The aim of this prospective randomized study was to evaluate the impact of intraoperative pupillometry monitoring on perioperative opioid consumption in major gynecologic surgery. METHODS: After receiving ethics committee approval and written consent of patients, American Society of Anesthesiologists status I to II women undergoing gynecologic surgery were included in this single-blinded, prospective, parallel-arm randomized study...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28719456/warning-criteria-for-intraoperative-neurophysiologic-monitoring
#3
Quanmeng Liu, Qinzhou Wang, Hongen Liu, William K K Wu, Matthew T V Chan
PURPOSE OF REVIEW: Intraoperative changes in somatosensory (SEP) and motor evoked potentials (MEPs) may indicate potential injury to the spinal cord and will require timely intervention to prevent permanent damage. This review focuses on the validity of currently recommended warning criteria for intraoperative evoked potential monitoring. RECENT FINDINGS: Current guideline recommends a decrease in SEP amplitude by 50% and MEP amplitude by 50-100% as warning signals for injury to the ascending sensory and descending motor pathway, respectively...
July 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28717226/safe-brain-tumor-resection-does-not-depend-on-surgery-alone-role-of-hemodynamics
#4
Stefanie Bette, Benedikt Wiestler, Felicitas Wiedenmann, Johannes Kaesmacher, Martin Bretschneider, Melanie Barz, Thomas Huber, Yu-Mi Ryang, Eberhard Kochs, Claus Zimmer, Bernhard Meyer, Tobias Boeckh-Behrens, Jan S Kirschke, Jens Gempt
Aim of this study was to determine if perioperative hemodynamics have an impact on perioperative infarct volume and patients' prognosis. 201 cases with surgery for a newly diagnosed or recurrent glioblastoma were retrospectively analyzed. Clinical data and perioperative hemodynamic parameters, blood tests and time of surgery were recorded. Postoperative infarct volume was quantitatively assessed by semiautomatic segmentation. Mean diastolic blood pressure (dBP) during surgery (rho -0.239, 95% CI -0.11 - -0...
July 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28713053/perils-of-intraoperative-neurophysiologic-monitoring-analysis-of-false-negative-results-in-spine-surgeries
#5
Arvydas Tamkus, Kent S Rice, Michael McCaffrey
BACKGROUND CONTEXT: Although some authors published case reports describing false negatives in intraoperative neurophysiologic monitoring (IONM), systematic review of causes of false negative IONM results is lacking. PURPOSE: The objective was to analyze false negative IONM findings in spine surgery. STUDY DESIGN: Retrospective cohort analysis PATIENT SAMPLE: A cohort of 109 patients with new postoperative neurological deficits was analyzed for possible false negative IONM reporting...
July 13, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28710663/a-multi-train-electrical-stimulation-protocol-facilitates-transcranial-electrical-motor-evoked-potentials-and-increases-induction-rate-and-reproducibility-even-in-patients-with-preoperative-neurological-deficits
#6
Shuta Ushio, Shigenori Kawabata, Satoshi Sumiya, Tsuyoshi Kato, Toshitaka Yoshii, Tsuyoshi Yamada, Mitsuhiro Enomoto, Atsushi Okawa
This study sought to evaluate the facilitation effect of repetitive multi-train transcranial electrical stimulation (mt-TES) at 2 repetition rates on transcranial electrical motor evoked potential (Tc-MEP) monitoring during spinal surgery, and to assess the induction rate in patients with impaired motor function from a compromised spinal cord or spinal nerve. We studied 32 consecutive patients with impaired motor function undergoing cervical or thoracic spinal surgery (470 muscles). A series of 10 TESs with 5 pulse trains were preoperatively delivered at 2 repetition rates (1 and 5 Hz)...
July 14, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28708603/monte-carlo-skin-dose-simulation-in-intraoperative-radiotherapy-of-breast-cancer-using-spherical-applicators
#7
Farhad Moradi, Ngie Min Ung, M U Khandaker, Ghafour Amouzad Mahdiraji, Marniza Saad, Rozita Abdul Malik, Anita Zarina Bustam, Zainor Zaili, David A Bradley
The relatively new treatment modality electronic intraoperative radiotherapy (IORT) is gaining popularity, irradiation being obtained within a surgically produced cavity being delivered via a low-energy X-ray source and spherical applicators, primarily for early stage breast cancer. Due to the spatially dramatic dose-rate fall off with radial distance from the source and effects related to changes in the beam quality of the low keV photon spectra, dosimetric account of the Intrabeam system is rather complex...
July 14, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28707698/cost-effectiveness-of-intraoperative-nerve-monitoring-in-avoidance-of-bilateral-recurrent-laryngeal-nerve-injury-in-patients-undergoing-total-thyroidectomy
#8
Z Al-Qurayshi, E Kandil, G W Randolph
BACKGROUND: Intraoperative nerve monitoring (IONM) provides dynamic neural information and is recommended for high-risk thyroid surgery. In this analysis, the cost-effectiveness of IONM in preventing bilateral recurrent laryngeal nerve (RLN) injury was investigated. METHODS: A Markov chain model was constructed based on IONM use. The base-case patient was defined as a 40-year-old woman presenting with a 4·1-cm left-sided papillary thyroid cancer who developed RLN injury with loss of monitoring signal during planned bilateral thyroidectomy...
July 14, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28707173/intraoperative-ventilation-of-morbidly-obese-patients-guided-by-transpulmonary-pressure
#9
Lars Eichler, Katarzyna Truskowska, A Dupree, P Busch, Alwin E Goetz, Christian Zöllner
BACKGROUND: Bariatric surgery has proven a successful approach in the treatment of morbid obesity and its concomitant diseases such as diabetes mellitus and arterial hypertension. Aiming for optimal management of this challenging patient cohort, tailored concepts directly guided by individual patient physiology may outperform standardized care. Implying esophageal pressure measurement and electrical impedance tomography-increasingly applied monitoring approaches to individually adjust mechanical ventilation in challenging circumstances like acute respiratory distress syndrome (ARDS) and intraabdominal hypertension-we compared our institutions standard ventilator regimen with an individually adjusted positive end expiratory pressure (PEEP) level aiming for a positive transpulmonary pressure (P L) throughout the respiratory cycle...
July 14, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28707021/the-response-to-trendelenburg-position-is-minimally-affected-by-underlying-hemodynamic-conditions-in-patients-with-aortic-stenosis
#10
Abraham Sonny, Daniel I Sessler, Jing You, Babak Kateby Kashy, Sheryar Sarwar, Akhil K Singh, Shiva Sale, Andrej Alfirevic, Andra E Duncan
PURPOSE: Trendelenburg positioning is commonly used to temporarily treat intraoperative hypotension. The Trendelenburg position improves cardiac output in normovolemic or anesthetized patients, but not hypovolemic or non-anesthetized patients. Therefore, the response to Trendelenburg positioning may vary depending on patient population or hemodynamic conditions. We thus tested the hypothesis that the effectiveness of the Trendelenburg position, as indicated by an increase in cardiac output, improves after replacement of a stenotic aortic valve...
July 13, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28701605/role-of-transesophageal-echocardiography-in-surgical-retrieval-of-embolized-amplatzer-device-and-closure-of-coronary-cameral-fistula
#11
Bhupesh Kumar, Alok Kumar, Ganesh Kumar, Harkant Singh
Congenital coronary artery fistula is an uncommon anomaly. Transcatheter coil embolization or Amplatzer vascular plug device closure of fistula is often done in symptomatic patients with safe accessibility to the feeding coronary artery. Embolization of Amplatzer vascular plug device is rare. We report an 11-year-old male child who presented to us with increasing shortness of breath for 7 years. He had a history of Amplatzer vascular plug device closure of right coronary-cameral fistula 8 years back. Echocardiography demonstrated a dilated aneurysmal right coronary artery with turbulent jet entering into the right ventricle (RV) and device embolized into the left pulmonary artery (LPA)...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28698088/microsurgical-repair-of-ruptured-aneurysms-associated-with-moyamoya-pattern-collateral-vessels-of-the-middle-cerebral-artery-a-report-of-two-cases
#12
Min Lang, Nina Z Moore, Alex M Witek, Varun R Kshettry, Mark Bain
BACKGROUND: Patients with Moyamoya or other intracranial steno-occlusive disease are at risk for developing aneurysms associated with flow through collateral vessels. Because these lesions are rare, the optimal management remains unclear. Here, we describe two cases of microsurgical repair of ruptured collateral vessel aneurysms associated with middle cerebral artery (MCA) occlusion. CASE DESCRIPTION: The first patient was a 61-year-old male who presented with right frontal and intraventricular hemorrhage...
July 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28695815/effectiveness-of-underbody-forced-air-warming-system-in-preventing-hypothermia-in-patients-undergoing-major-surgeries
#13
Hao Liang, Jie Yi
Objective To compare the effectiveness of the forced-air warming system and the conventional warming care practice in preventing hypothermia in patients undergoing major surgeries.Methods A total of 62 patients were enrolled in this study. Patients of both sexes,aged≥18 years,and with an ASA physical status Ⅰ-Ⅲ were included and allocated randomly into intervention group(n=30)or control group(n=32). Patients in the intervention group were provided forced-air warming,either prior to induction or during the surgery procedure depending on core temperature monitoring results...
June 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28694041/real-time-three-dimensional-3d-visualization-of-fusion-image-for-accurate-subdural-electrodes-placement-of-epilepsy-surgery
#14
Ayataka Fujimoto, Tohru Okanishi, Sotaro Kanai, Keishiro Sato, Mitsuyo Nishimura, Hideo Enoki
INTRODUCTION: The perfect match between pre-surgical estimated seizure onset zone and subdural electrodes (SEs) position is requested for epilepsy surgery. However, post-surgical neuro images sometimes disappoint physicians due to SEs malposition. To place SEs, we used to use intraoperative photograph and fluoroscopy. With this procedure, we just recognized approximate location of SEs during surgery. The purpose of the study is to perform precise SEs location intraoperatively using intra operative computer tomography (CT) and image-guidance...
July 7, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28693345/anesthesia-quality-and-patient-safety-in-china-a-survey
#15
Bin Zhu, Huan Gao, Xiangyong Zhou, Jeffrey Huang
There has been no nationwide investigation into anesthesia quality and patient safety in China. The authors surveyed Chinese anesthesiologists about anesthesia quality by sending a survey to all anesthesiologist members of the New Youth Anesthesia Forum via WeChat. The respondents could choose to use a mobile device or desktop to complete the survey. The overall response rate was 43%. Intraoperative monitoring: 77.9% of respondents reported that electrocardiogram monitoring was routinely applied for all patients; only 55% of the respondents reported that they routinely used end-tidal carbon dioxide monitoring for their patients under general anesthesia...
March 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28691985/hemodynamically-directed-two-person-chest-compressions-a-case-report
#16
Michael Dorbad, Ashley Kass, Michael Marvin
Cardiopulmonary resuscitation has a low success rate both in and out of the hospital setting. Return of spontaneous circulation, however, is considerably higher for intraoperative cardiac arrests. Chest compressions remain of utmost importance. Optimal chest compression depth is believed to be greater than 5 cm. However, this depth is often not achieved. We describe a case in which the adequacy of chest compressions, based on hemodynamic monitoring, was achieved with 2 persons simultaneously providing a compressive force...
July 6, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28690584/decompression-in-chiari-malformation-clinical-ocular-motor-cerebellar-and-vestibular-outcome
#17
Nicolina Goldschagg, Katharina Feil, Franziska Ihl, Siegbert Krafczyk, Mathias Kunz, Jörg Christian Tonn, Michael Strupp, Aurelia Peraud
BACKGROUND: Treatment of Chiari malformation can include suboccipital decompression with resection of one cerebellar tonsil. Its effects on ocular motor and cerebellar function have not yet been systematically examined. OBJECTIVE: To investigate whether decompression, including resection of one cerebellar tonsil, leads to ocular motor, vestibular, or cerebellar deficits. PATIENTS AND METHODS: Ten patients with Chiari malformation type 1 were systematically examined before and after (1 week and 3 months) suboccipital decompression with unilateral tonsillectomy...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28690286/a-case-of-recurrent-pneumothorax-associated-with-birt-hogg-dub%C3%A3-syndrome-treated-with-bilateral-simultaneous-surgery-and-total-pleural-covering
#18
Kyoshiro Takegahara, Naoyuki Yoshino, Jitsuo Usuda
Birt-Hogg-Dubé syndrome is an autosomal dominant genetic disorder characterized by a triad of skin tumors, renal tumors, and multiple pulmonary cysts. Our patient was a 40-year-old man with a history of recurrent bilateral pneumothorax and a family history of pneumothorax. The patient visited our department with chest pain and was diagnosed with left pneumothorax based on a chest X-ray. Thoracic computed tomography (CT) showed multiple cysts in both lungs. We performed thoracoscopic bilateral bullectomy with curative intent...
July 10, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28689398/an-electrode-configuration-for-recording-muscle-motor-evoked-potentials-in-the-upper-extremities-during-intraoperative-neurophysiological-monitoring
#19
Young-Doo Choi, Seung-Hyun Jin, Chi-Heon Kim, Gil Ho Kwak, Bo Eun Kim, Chun Kee Chung
OBJECTIVE: The main aim of the present study is to examine the electrode configurations used to record the muscle motor evoked potential (mMEP) in the upper extremities during surgery with the goal of producing a high and stable mMEP signal, in particular among the abductor pollicis brevis (APB), abductor digiti minimi (ADM), and across the APB-ADM muscles, which have been widely used for the mMEP in the upper extremities. METHODS: Thirty right-handed patients were recruited in this prospective study...
July 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28688529/predictors-of-cross-clamp-induced-intraoperative-monitoring-changes-during-carotid-endarterectomy-using-both-electroencephalography-and-somatosensory-evoked-potentials
#20
Natalie Domenick Sridharan, Partha Thirumala, Rabih Chaer, Jeffrey Balzer, Becky Long, Donald Crammond, Michel Makaroun, Efthymios Avgerinos
OBJECTIVE: The efficacy of selective shunting during carotid endarterectomy (CEA) using intraoperative monitoring (IOM) for detection of cerebral ischemia is well established. There is mounting evidence that monitoring of both electroencephalography (EEG) and somatosensory evoked potentials (SSEPs) increases the sensitivity of cerebral ischemia detection. Predictors of cerebral ischemia requiring selective shunt placement using IOM of both EEG and SSEPs have not been previously identified...
July 5, 2017: Journal of Vascular Surgery
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