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Anesthesia for liver surgery

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https://www.readbyqxmd.com/read/28671280/impact-of-obstructive-sleep-apnea-in-transsphenoidal-pituitary-surgery-an-analysis-of-inpatient-data
#1
Sei Y Chung, Michael J Sylvester, Varesh R Patel, Michael Zaki, Soly Baredes, James K Liu, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities...
July 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28654556/patient-controlled-intravenous-analgesia-with-combination-of-dexmedetomidine-and-sufentanil-on-patients-after-abdominal-operation-a-prospective-randomized-controlled-blinded-multicenter-clinical-study
#2
Yongtao Gao, Xiaoming Deng, Hongbing Yuan, Yufang Leng, Tiezheng Zhang, Xuzhong Xu, Suming Tian, Jun Fang, Wen Ouyang, Xinming Wu
OBJECTIVE: To investigate the effect of combination of dexmedetomidine and sufentanil on patient-controlled intravenous analgesia (PCIA) in patients after abdominal operation and to assess the safety and validity of this treatment. METHODS: This is a prospective, randomized controlled, blinded, multicenter clinical study. A total of 210 patients from 9 clinical research centers underwent selective abdominal operation with general anesthesia were enrolled in the study, including laparoscopic-assisted abdominal operation on stomach, intestines or open surgery on stomach, intestines, kidneys and liver, ASA status I-II...
June 16, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28621689/age-adjusted-charlson-comorbidity-index-score-as-predictor-of-survival-of-patients-with-digestive-system-cancer-who-have-undergone-surgical-resection
#3
Yaohua Tian, Zhong Jian, Beibei Xu, Hui Liu
Comorbidities have considerable effects on survival outcomes. The primary objective of this retrospective study was to examine the association between age-adjusted Charlson comorbidity index (ACCI) score and postoperative in-hospital mortality in patients with digestive system cancer who have undergone surgical resection of their cancers. Using electronic hospitalization summary reports, we identified 315,464 patients who had undergone surgery for digestive system cancer in top-rank (Grade 3A) hospitals in China between 2013 and 2015...
June 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28378083/minor-laparoscopic-liver-resection-toward-1-day-surgery
#4
Nicola de'Angelis, Benjamin Menahem, Philippe Compagnon, Jean Claude Merle, Francesco Brunetti, Alain Luciani, Daniel Cherqui, Alexis Laurent
BACKGROUND: Technical advances in laparoscopy and enhanced recovery after surgery programs have progressively decreased the need for hospitalization. The present study aimed to explore the feasibility and safety of an early discharge protocol after minor laparoscopic liver resection (LLR). METHODS: The study sample consisted of patients with both benign and malignant hepatic lesions involving no more than two hepatic segments who underwent minor LLR and were discharged within 24 h...
April 4, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28293808/low-pre-operative-heart-rate-variability-and-complexity-are-associated-with-hypotension-after-anesthesia-induction-in-major-abdominal-surgery
#5
James R Padley, Erez Ben-Menachem
Significant hypotension after induction of general anesthesia is common and has the potential for serious complications. This study aimed to determine if pre-operative heart rate variability (HRV) was associated with post-induction hypotension in patients undergoing major abdominal surgery. Patients undergoing semi-elective major abdominal surgery were consecutively recruited during pre-admission clinic assessment. Exclusion criteria included cardiac conduction disease, arrhythmias or severe liver or renal disease...
March 14, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28251651/effect-of-the-%C3%AE-2-receptor-agonists-medetomidine-detomidine-xylazine-and-romifidine-on-the-ketamine-metabolism-in-equines-assessed-with-enantioselective-capillary-electrophoresis
#6
Friederike A Sandbaumhüter, Regula Theurillat, Regula Bettschart-Wolfensberger, Wolfgang Thormann
The combination of ketamine and an α2 -receptor agonist is often used in veterinary medicine. Four different α2 -receptor agonists, medetomidine, detomidine, xylazine and romifidine, which differ in their chemical structure and thus in selectivity for the α2 -receptor and in the sedative and analgesic potency, are typically employed during surgery of equines. Recovery following anesthesia with ketamine and an α2 -receptor agonist is dependent on the α2 -receptor agonist. This prompted us to investigate i) the inhibition characteristics for the N-demethylation of ketamine to norketamine and ii) the formation of the ketamine metabolites norketamine, 6-hydroxynorketamine (6HNK) and 5,6-dehydronorketamine (DHNK) in presence of the four α2 -receptor agonists and equine liver microsomes...
March 2, 2017: Electrophoresis
https://www.readbyqxmd.com/read/28224207/-differentiated-application-of-recommended-guideline-techniques-for-treatment-of-inguinal-hernia
#7
H Niebuhr, M Pawlak, F Köckerling
The new worldwide guidelines of all international hernia societies only recommend the mesh-based methods TEP, TAPP and Lichtenstein. The best mesh-free technique, the Shouldice operation, should only be used if the patient has declined the use of a mesh or no mesh is available. The systematic use of the Shouldice technique for smaller inguinal hernias and younger men should be confined to study settings. A tailored approach should be taken for mesh-based procedures to minimize the risk to patients. Due to lower pain rates the laparoendoscopic techniques TEP and TAPP are the methods of choice for primary male unilateral inguinal hernia...
April 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28207547/planning-for-operating-room-efficiency-and-faster-anesthesia-wake-up-time-in-open-major-upper-abdominal-surgery
#8
Hou-Chuan Lai, Shun-Ming Chan, Chueng-He Lu, Chih-Shung Wong, Chen-Hwan Cherng, Zhi-Fu Wu
Reducing anesthesia-controlled time (ACT) may improve operation room (OR) efficiency result from different anesthetic techniques. However, the information about the difference in ACT between desflurane (DES) anesthesia and propofol-based total intravenous anesthesia (TIVA) techniques for open major upper abdominal surgery under general anesthesia (GA) is not available in the literature.This retrospective study uses our hospital database to analyze the ACT of open major upper abdominal surgery without liver resection after either desflurane/fentanyl-based anesthesia or TIVA via target-controlled infusion with fentanyl/propofol from January 2010 to December 2011...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28192894/remote-ischemic-preconditioning-in-cardiac-anesthesia-a-review-focusing-on-translation
#9
Christian Stoppe, Patrick Meybohm, Carina Benstoem, Andreas Goetzenich
Remote ischemic conditioning (RIC) is a powerful cardioprotective strategy. Its clinical application is simple, cheap and so far free from secondary side effects. Given the heterogeneous results of recent large-scale clinical trials, its clinical relevant benefit is still doubted. Following a MEDLINE-based search on all publications concerning RIC in experimental or clinical settings, this review focuses on the translation from bench to bedside. A short resume of mechanistic insights is followed by the presentation of current clinical evidence of beneficial effects of RIC and the critical assessment of the recently published large-scale trials...
June 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28183558/frequency-of-inadequate-neuromuscular-blockade-during-general-anesthesia
#10
Timur Dubovoy, Amy M Shanks, Scott Devine, Sachin Kheterpal
STUDY OBJECTIVE: We used electronic health record data to define frequency of inadequate intraoperative neuromuscular blockade (NMB). DESIGN: Retrospective observational study using electronic health record data. SETTING: Operating room in a tertiary care academic hospital. PATIENTS: A total of 129,209 adult patients with American Society of Anesthesiologists physical status 1 to 5 undergoing general anesthesia in an outpatient or inpatient setting who received nondepolarizing NMB...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28133947/serious-gaming-for-orthotopic-liver-transplant-anesthesiology-a-randomized-control-trial
#11
Daniel Katz, Jeron Zerillo, Sang Kim, Bryan Hill, Ryan Wang, Andrew Goldberg, Samuel DeMaria
Anesthetic management of orthotopic liver transplantation (OLT) is complex. Given the unequal distributions of liver transplant surgeries performed at different centers, anesthesiology providers receive relatively uneven OLT training and exposure. One well-suited modality for OLT training is the "serious game," an interactive application created for the purpose of imparting knowledge or skills, while leveraging the self-motivating elements of video games. We therefore developed a serious game designed to teach best practices for the anesthetic management of a standard OLT and determined if the game would improve resident performance in a simulated OLT...
April 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28105066/electroacupuncture-for-the-prevention-of-postoperative-gastrointestinal-dysfunction-in-participants-undergoing-vascular-laparotomy-under-general-anesthesia-a-randomized-controlled-trial
#12
Meng-Yue Liu, Cheng-Wei Wang, Zhou-Peng Wu, Ning Li
BACKGROUND: Postoperative gastrointestinal dysfunction (PGD) is a common complication following laparotomy under general anesthesia (GA). Abdominal distension occurs in 8-28% of surgeries within 24 h postoperatively. The present study aimed to analyze the efficacy of electroacupuncture (EA) for the prevention of PGD by applying preoperative EA stimulation of PC6 (Neiguan), ST36 (Zusanli), and ST37 (Shangjuxv) bilaterally twice within 24 h prior to surgery, compared with no acupuncture treatment...
2017: Chinese Medicine
https://www.readbyqxmd.com/read/28091794/the-impact-of-liver-disorders-on-perioperative-management-of-reoperative-cardiac-surgery-a-retrospective-study-in-adult-congenital-heart-disease-patients
#13
Koko Adachi, Hiroaki Toyama, Yu Kaiho, Osamu Adachi, Hiroto Hudeta, Masanori Yamauchi
PURPOSE: We evaluated the preoperative prevalence of risk factors for liver disorders and the relationship between the liver disorders and perioperative outcomes in adult congenital heart disease (ACHD) patients. METHODS: This retrospective study included 32 ACHD patients who underwent reoperative cardiac surgery. RESULTS: Preoperatively, 38% of the study patients had risk factors, including congestive liver (CL) due to right heart failure (31%), chronic hepatitis C (HC) (22%), and both CL and HC (16%)...
April 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28078860/effects-of-two-different-anesthetic-methods-on-cellular-immunity-of-patients-after-liver-cancer-resection
#14
RANDOMIZED CONTROLLED TRIAL
Y Xu, Y Sun, H Chen, Y Wang, G N Wang
This study aims to investigate the effects of epidural block in combination with general anesthesia and general anesthesia alone on the immune function of patients undergoing primary liver cancer resection. Twenty-four patients with liver cancer who received treatment in the Third Hospital of Harbin Medical University, Heilongjiang, China, were enrolled and randomly allocated into group A and group B, with 12 in each group. The data on the T lymphocyte subpopulation, pro-inflammatory cytokines and antiinflammatory cytokines were recorded before, immediately after and 24 h after liver cancer resection to compare differences and changes...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28067701/economic-evaluation-of-pharmacologic-pre-and-postconditioning-with-sevoflurane-compared-with-total-intravenous-anesthesia-in-liver-surgery-a-cost-analysis
#15
RANDOMIZED CONTROLLED TRIAL
Klaus Eichler, Martin Urner, Claudia Twerenbold, Sabine Kern, Urs Brügger, Donat R Spahn, Beatrice Beck-Schimmer, Michael T Ganter
BACKGROUND: Pharmacologic pre- and postconditioning with sevoflurane compared with total IV anesthesia in patients undergoing liver surgery reduced complication rates as shown in 2 recent randomized controlled trials. However, the potential health economic consequences of these different anesthesia regimens have not yet been assessed. METHODS: An expostcost analysis of these 2 trials in 129 patients treated between 2006 and 2010 was performed. We analyzed direct medical costs for in-hospital stay and compared pharmacologic pre- and postconditioning with sevoflurane (intervention) with total IV anesthesia (control) from the perspective of a Swiss university hospital...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28032548/simplified-technique-for-75-and-90-hepatic-resection-with-hemodynamic-monitoring-in-a-large-white-swine-model
#16
Petru Bucur, Mohamed Bekheit, Chloe Audebert, Irene Vignon-Clementel, Eric Vibert
BACKGROUND: Accurate measuring of the hepatic hemodynamic parameters in humans is inconvenient. Swine has been a favorite surgical model for the study of liver conditions due to many similarities with human livers. However, pigs cannot tolerate pedicle clamping and to reduce bleeding during resection a simplified technique is required. The aim of this study is to present a simplified technique for different percentages of hepatic resection in a porcine model. METHODS: Twenty-two consecutive large white pigs were operated with 75% and 90% liver resection...
March 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28030435/feasibility-and-technique-for-transvaginal-natural-orifice-transluminal-endoscopic-surgery-liver-resection-a-porcine-model
#17
Toshio Katagiri, Yuichiro Otsuka, Santiago Horgan, Bryan J Sandler, Garth R Jacobsen, Alisa M Coker, Masaru Tsuchiya, Tetsuya Maeda, Hironori Kaneko
INTRODUCTION: Natural orifice transluminal endoscopic surgery (NOTES) is a challenging minimally invasive procedure. Although laparoscopic techniques for liver resection are gaining acceptance worldwide, few studies have investigated NOTES liver resection. We used a porcine model to assess the feasibility and safety of transvaginal NOTES liver resection (TV NOTES LR). MATERIALS AND METHODS: Nine female pigs underwent TV NOTES LR. A nonsurvival acute porcine model with general anesthesia was used in all cases...
February 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27932181/use-of-terlipressin-in-an-elderly-patient-with-moderate-aortic-valve-stenosis-accompanied-by-episodic-atrial-fibrillation-during-liver-transplantation-a-case-report
#18
Y J Won, B G Lim, D Chung, E Park, H Kim, I O Lee, M H Kong
Anesthesia for patients with moderate aortic stenosis accompanied by atrial fibrillation during high-risk surgery such as liver transplantation remains a challenge in maintaining control of heart rate and maintenance of cardiac output. The action of terlipressin on vasopressin receptors (mainly V1 receptors) leads to splanchnic vasoconstriction and is the key mechanism responsible for increasing systemic vascular resistance and reducing heart rate. We report successful anesthetic management using low-dose terlipressin infusion in an elderly patient who had moderate aortic stenosis with atrial fibrillation during urgent deceased-donor liver transplantation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27920414/morbidity-and-mortality-and-predictors-of-outcome-following-hepatectomy-at-a-saudi-tertiary-care-center
#19
Faisal Al-Alem, Rafif Essam Mattar, Ola Abdelmonem Fadl, Abdulsalam Alsharabi, Faisal Al-Saif, Mazen Hassanain
BACKGROUND: Hepatic resection is a major surgical procedure. Data on outcomes of hepatectomy in Saudi Arabia are scarce. OBJECTIVE: To measure morbidity and mortality and assess predictors of outcome after hepatectomy. DESIGN: Descriptive study. SETTING: Tertiary care center in Saudi Arabia with well established hepatobiliary surgery unit. PATIENTS AND METHODS: All patients undergoing liver resection in our institute during 2006-2014...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27837084/intraoperative-diagnosis-of-intracardiac-thrombus-during-orthotopic-liver-transplantation-with-transesophageal-echocardiography-a-case-series-and-literature-review
#20
Adam A Dalia, Hisham Khan, Antolin S Flores
Anesthesia for orthotopic liver transplantation (OLT) is challenging for any anesthesiologist as the patients undergoing this procedure are among the most critically ill. Adding to the underlying complexity of OLT management is the rare complication of an intracardiac thrombus (ICT). Intracardiac thrombi can present following liver allograft reperfusion resulting in high morbidity and mortality. Currently there is no consensus treatment for ICT, and the gold standard for diagnosis is intraoperative transesophageal echocardiography (TEE); these 2 factors lead to a dangerous amalgam of the difficulty in diagnosing and treating the disease...
November 10, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
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