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Intraoperative monitoring

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https://www.readbyqxmd.com/read/28101151/effect-of-general-anesthesia-on-serum-%C3%AE-amyloid-protein-and-regional-cerebral-oxygen-saturation-of-elderly-patients-after-subtotal-gastrectomy
#1
Peng Yu, Hua Wang, Lei Mu, Xuemei Ding, Wei Ding
The aim of the present study was to investigate the influence of general anesthesia on serum β-amyloid protein (Aβ) and regional cerebral oxygen saturation (rSO2) of elderly patients after subtotal gastrectomy. From June, 2014 to December, 2015, among 168 patients undergoing subtotal gastrectomy, the Mini-Mental State Examination and Montreal Cognitive Assessment was administered the day prior to surgery and the second and ninth days after the operation. In addition, we administered the tests to 168 healthy adult volunteers (healthy controls) who were treated in our hospital medical center in the same period...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28094425/learning-curve-in-anatomo-electrophysiological-correlations-in-subthalamic-nucleus-stimulation
#2
Dušan Hrabovsky, Marek Balaz, Martina Bockova, Věra Feitova, Zdeněk Novak, Jan Chrastina
AIM: Advances in neuroradiological planning techniques in deep brain stimulation put the need for intraoperative electrophysiological monitoring into doubt. Moreover intraoperative monitoring prolongs surgical time and there is potential association between the use of microelectrodes and increased incidence of hemorrhagic complications Material and Methods: The study analyzes the correlation between the anatomically planned trajectory and the final subthalamic electrode placement after electrophysiological monitoring in patients with Parkinson's disease and its change with the increasing experience of the surgical team...
December 14, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28089812/clinical-manifestations-and-outcomes-in-surgically-managed-gartner-duct-cysts-1
#3
Adela G Cope, Shannon Laughlin-Tommaso, Abimbola Famuyide, John B Gebhart, Matthew R Hopkins, Daniel M Breitkopf
STUDY OBJECTIVE: Gartner duct cysts (GDC) are rare embryological remnants of the mesonephric duct with the majority of cases discovered incidentally in asymptomatic patients. The largest prior published series evaluating surgical management of GDC included 4 patients. The present study aims to determine the manifestations and outcomes of surgically managed patients with GDC with important implications for surveillance, monitoring, and management of patients. DESIGN: Retrospective chart review DESIGN: Classification: Canadian Task Force Classification III SETTING: Tertiary care center PATIENTS: All women diagnosed with GDC from 1/1994-4/2014 at our institution were identified...
January 12, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28089809/sensitivity-and-specificity-of-intraoperative-neuromonitoring-for-identifying-safety-and-duration-of-temporary-aneurysm-clipping-based-on-vascular-territory-a-multimodal-strategy
#4
Brittany Staarmann, Kelly O'Neal, Mark Magner, Mario Zuccarello
BACKGROUND: Patients who undergo clipping of cerebral aneurysms face inherent risk for new postoperative neurological deficits. Intraoperative neuromonitoring (IONM) is used often for early detection of ischemic changes, while still potentially reversible. However, the value, safety, and efficacy of temporary clipping and multimodal intraoperative neuromonitoring (IONM) to minimize risks are debated. Our retrospective series examined the sensitivity and specificity of IONM using transcranial motor evoked potentials (MEPs) and somatosensory evoked potentials (SSEPs), and quantified the safety of temporary clipping by duration and vascular territory...
January 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089598/impact-of-focused-intraoperative-transthoracic-echocardiography-by-anesthesiologists-on-management-in-hemodynamically-unstable-high-risk-noncardiac-surgery-patients
#5
Thomas Kratz, Thorsten Steinfeldt, Maik Exner, Marco Campo Dell Orto, Nina Timmesfeld, Caroline Kratz, Martin Skrodzki, Hinnerk Wulf, Martin Zoremba
OBJECTIVES: Focused transthoracic echocardiography (TTE) is used perioperatively for surgical patients. Intraoperative application of TTE is feasible, but its benefits remain unclear. The intention of this study was to investigate the effect of intraoperative TTE on the management of high-risk noncardiac surgery patients. DESIGN: A prospective interventional study. SETTING: Single-center university hospital. PARTICIPANTS: Fifty consecutive hemodynamically unstable high-risk patients anesthetized for noncardiac surgery...
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28089323/neurophysiological-monitoring-of-lumbar-spinal-nerve-roots-a-case-report-of-postoperative-deficit-and-literature-review
#6
Yuguang Chen, Baoqing P Wang, Junlin Yang, Yaolong Deng
INTRODUCTION: Intraoperative neurophysiological monitoring (IONM) has proven to help reduce the probability of postoperative neurological deficit for spinal deformity correctional surgeries. However, in rare cases new deficits may still happen. We report a surgical case in which the patient had postoperative paralysis. We would like to call for more case reports with postoperative neurological deficits as they present difficult clinical cases. PRESENTATION OF CASE: A 61-year-old male patient with severe thoracolumbar kyphoscoliosis underwent posterior spinal correction and fusion with segmental T10-L5 pedicle screws and rods instrumentation with IONM...
November 19, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28078225/testicular-compartment-syndrome-an-overview-of-pathophysiology-etiology-evaluation-and-management
#7
REVIEW
Jason Gandhi, Gautam Dagur, Yefim R Sheynkin, Noel L Smith, Sardar Ali Khan
Testicular compartment syndrome (TCS) refers to the impairment of microcirculation in the testicle due to either increased venous resistance or extraluminal compression, which leads to hypoxia. TCS releases oxidants through hypoxia and ischemia/reperfusion injury (IRI). The pathophysiology, etiology, evaluation, and management of TCS are reviewed. Based on the properties of TCS, specific causes, e.g., varicocele, hydrocele, orchitis, cryptorchidism, and scrotal hernia, are suggested and categorized. The oxidant-induced stress from TCS may explain the correlations between these causes and infertility...
December 2016: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28074801/delirium-after-cardiac-surgery-a-pilot-study-from-a-single-tertiary-referral-center
#8
Ashok K Kumar, Aveek Jayant, V K Arya, Rohan Magoon, Ridhima Sharma
BACKGROUND: Advances in cardiac surgery has shifted paradigm of management to perioperative psychological illnesses. Delirium is a state of altered consciousness with easy distraction of thoughts. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. The goal of the present study was to prospectively identify the incidence, motoric subtypes, and risk factors associated with development of delirium in cardiac surgical patients admitted to postoperative cardiac intensive care, using a validated delirium monitoring instrument...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28067706/impact-of-systemic-vascular-resistance-on-the-accuracy-of-the-pulsioflex-device
#9
Matthieu Biais, Elodie Mazocky, Laurent Stecken, Bruno Pereira, Musa Sesay, Stéphanie Roullet, Alice Quinart, François Sztark
BACKGROUND: The accuracy of currently available devices using pulse contour analysis without external calibration for cardiac index (CI) estimation is negatively impacted by hyperdynamic states, low systemic vascular resistance (SVR), and abrupt changes in SVR. The aim of this study was to evaluate the accuracy of a new device, the Pulsioflex (Pulsion Medical System), in patients undergoing liver transplantation. METHODS: Thirty consecutive patients scheduled for liver transplantation were included...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28067688/perioperative-near-infrared-spectroscopy-monitoring-in-neonates-with-congenital-heart-disease-relationship-of-cerebral-tissue-oxygenation-index-variability-with-neurodevelopmental-outcome
#10
Michael C Spaeder, Darren Klugman, Kami Skurow-Todd, Penny Glass, Richard A Jonas, Mary T Donofrio
OBJECTIVES: To evaluate the value of perioperative cerebral near-infrared spectroscopy monitoring using variability analysis in the prediction of neurodevelopmental outcomes in neonates undergoing surgery for congenital heart disease. DESIGN: Retrospective cohort study. SETTING: Urban, academic, tertiary-care children's hospital. PATIENTS: Neonates undergoing surgery with cardiopulmonary bypass for congenital heart disease...
January 6, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28063271/hybrid-minimally-invasive-approach-for-transvenous-lead-extraction-a-feasible-technique-in-high-risk-patients
#11
Luca Bontempi, Francesca Vassanelli, Manuel Cerini, Gianluigi Bisleri, Alberto Repossini, Laura Giroletti, Lorenza Inama, Francesca Salghetti, Daria Liberto, Daniele Giacopelli, Abdallah Raweh, Claudio Muneretto, Antonio Curnis
INTRODUCTION: Despite the overall safety, transvenous lead extraction (TLE) remains a challenging procedure with inherent risks, where surgery can still be required in elective cases. In this study, we report our experience with a minimally invasive "hybrid" approach, defined as a procedure performed by an electrophysiologist with the support of a cardiac surgeon in the same operative session. METHODS AND RESULTS: We reported 12 cases of planned hybrid lead extraction; minithoracotomy and thoracoscopy were performed on 10 (83%) and 2 (17%) patients, respectively...
January 7, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28059837/complications-risk-factors-and-staffing-patterns-for-noncardiac-surgery-in-patients-with-left-ventricular-assist-devices
#12
Michael R Mathis, Subramanian Sathishkumar, Sachin Kheterpal, Matthew D Caldwell, Francis D Pagani, Elizabeth S Jewell, Milo C Engoren
BACKGROUND: Patients with left ventricular assist devices presenting for noncardiac surgery are increasingly commonplace; however, little is known about their outcomes. Accordingly, the authors sought to determine the frequency of complications, risk factors, and staffing patterns. METHODS: The authors performed a retrospective study at their academic tertiary care center, investigating all adult left ventricular assist device patients undergoing noncardiac surgery from 2006 to 2015...
January 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28058561/percutaneous-peritoneal-lavage-for-the-rapid-staging-of-gastric-and-pancreatic-cancer
#13
Linda M Pak, Daniel G Coit, Anne A Eaton, Peter J Allen, Michael I D'Angelica, Ronald P DeMatteo, William R Jarnagin, Vivian E Strong, T Peter Kingham
BACKGROUND: Positive peritoneal cytology is classified as M1 disease in gastric and pancreatic cancer. While peritoneal cytology is typically obtained by laparoscopic peritoneal lavage, this study sought to examine the feasibility and safety of performing this percutaneously, with monitored anesthesia care and in combination with other diagnostic procedures to condense and expedite the staging process. METHODS: Patients with gastric or pancreatic cancer scheduled for laparoscopy with peritoneal lavage were prospectively enrolled to undergo intraoperative percutaneous peritoneal lavage prior to laparoscopic peritoneal lavage...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28054177/factors-associated-with-a-low-initial-cerebral-oxygen-saturation-value-in-patients-undergoing-cardiac-surgery
#14
Kensuke Kobayashi, Tadashi Kitamura, Satoshi Kohira, Shinzo Torii, Tetsuya Horai, Mitsuhiro Hirata, Toshiaki Mishima, Koichi Sughimoto, Hirotoki Ohkubo, Yusuke Irisawa, Takuya Matsushiro, Hidenori Hayashi, Yurie Miyata, Yuta Tsuchida, Naoki Ohtomo, Kagami Miyaji
Regional cerebral oximetry using near-infrared spectroscopy device, an INVOS 5100 C (Medtronic, Minneapolis, MN, USA), during cardiac surgery aims to avoid perioperative neurological impairment, especially during cardiopulmonary bypass. However, it is not uncommon to encounter critically low initial cerebral regional oxygen saturation or a low value unresponsive to intervention. Therefore, it is important to identify factors associated with low saturation value other than true cerebral hypoxia. We investigated the relationship between preoperative regional cerebral oxygen saturation and clinical variables during cardiac surgery...
January 4, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28050479/dexmedetomidine-in-attenuation-of-haemodynamic-response-and-dose-sparing-effect-on-opioid-and-anaesthetic-agents-in-patients-undergoing-laparoscopic-cholecystectomy-a-randomized-study
#15
Nandlal Bhagat, Md Yunus, Habib Md Reazaul Karim, Ranendra Hajong, Prithwis Bhattacharyya, Manorama Singh
INTRODUCTION: Perioperative procedures are stressful and lead to haemodynamic instability with potentially devastating consequences. Dexmedetomidine is found to have many of the desired characteristics that are required in perioperative period. AIM: To evaluate the ability of pre and intraoperative dexmedetomidine to attenuate stress induced haemodynamic responses, quantifying the anaesthetic agents sparing as well as its cost-effectiveness in patients undergoing laparoscopic cholecystectomy...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28048377/su-g-iep4-14-prostate-brachytherapy-activity-measurement-and-source-localization-by-using-a-dual-photon-emission-computed-tomography-system-a-feasibility-study
#16
C Lin, Y Tsai, H Lin, K Chuang, C Chiang
PURPOSE: To monitor the activity distribution and needle position during and after implantation in operating rooms. METHODS: Simulation studies were conducted to assess the feasibility of measurement activity distribution and seed localization using the DuPECT system. The system consists of a LaBr3-based probe and planar detection heads, a collimation system, and a coincidence circuit. The two heads can be manipulated independently. Simplified Yb-169 brachytherapy seeds were used...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048080/su-f-t-80-a-mobile-application-for-intra-operative-electron-radiotherapy-treatment-planning
#17
C Williams, E Crowley, J Wolfgang
PURPOSE: Intraoperative electron radiotherapy (IORT) poses a unique set of challenges for treatment planning. Planning must be performed in a busy operating room environment over a short timeframe often with little advance knowledge of the treatment depth or applicator size. Furthermore, IORT accelerators can have a large number of possible applicators, requiring extensive databooks that must be searched for the appropriate dosimetric parameters. The goal of this work is to develop a software tool to assist in the planning process that is suited to the challenges faced in the IORT environment...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047865/we-de-bra-10-development-of-a-novel-scanning-beam-low-energy-intraoperative-radiation-therapy-sbiort-system-for-pancreatic-cancer
#18
B Wears, I Mohiuddin, R Flynn, T Waldron, Y Kim, B Allen, J Xia
PURPOSE: Developing a compact collimator system and validating a 3D surface imaging module for a scanning beam low-energy x-ray radiation therapy (SBIORT) system that enables delivery of non-uniform radiation dose to targets with irregular shapes intraoperatively. METHODS: SBIORT consists of a low energy x-ray source, a custom compact collimator module, a robotic arm, and a 3D surface imaging module. The 3D surface imaging system (structure sensor) is utilized for treatment planning and motion monitoring of the surgical cavity...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047521/su-f-t-52-study-of-energy-dependent-effect-of-dosimetry-systems-used-in-therapeutic-soft-x-ray-energy-range
#19
S Souri, X Qian, G Gill, A Jamshidi, Y Cao, Y Chen
PURPOSE: To investigate energy dependent effects of different dosimetry systems which can be used as in vivo dosimetry monitoring for intraoperative radiotherapy in therapeutic soft x-ray energy range. METHODS: Three dosimetry systems were evaluated in therapeutic soft x-ray energy range: optically stimulated luminescent dosimeter (OSLD) nanoDots, radiochromic EBT2 and EBT3 films. The x-ray photons were produced by a Zeiss Intrabeam 50 kV x-ray radiotherapy system...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045856/a-multiparametric-alarm-criterion-for-motor-evoked-potential-monitoring-during-spine-deformity-surgery
#20
Martín J Segura, María E Talarico, Mariano A Noel
PURPOSE: This is a pilot study to compare changes in the amplitude, area below the curve, number of phases, duration, and latency of the intraoperative transcranial motor evoked potentials (TcMEP) for early detection of impending spinal cord injury. An empirical ratio calculated by a combination of the above-mentioned parameters was also assessed. METHODS: Intraoperative TcMEP recordings from five patients presenting with neuromuscular kyphoscoliosis, idiopathic scoliosis, achondroplasia and lumbar kyphosis, congenital kyphosis, and achondroplasia with cervical instability were reviewed...
January 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
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