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Postoperative care

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https://www.readbyqxmd.com/read/28918556/effects-of-pregabalin-on-postoperative-pain-after-hysterectomy-under-spinal-anesthesia-with-intrathecal-morphine-a-randomized-controlled-trial
#1
Taniga Kiatchai, Vimolluck Sanansilp, Namtip Triyasunant, Sasithorn Saengprateep, Paksiree Changkittirat, Vuthinun Achariyapota
PURPOSE: To determine if preoperative pregabalin could decrease 24-h postoperative morphine consumption after spinal anesthesia with intrathecal morphine compared with placebo. METHODS: A randomized, double-blind, controlled trial was performed in the tertiary care center. Patients aged between 18 and 65 years who were American Society of Anesthesiologists class I-II and scheduled for abdominal hysterectomy with or without salpingo-oophorectomy were randomly allocated to a placebo or a pregabalin group...
September 16, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28917602/comparing-inpatient-versus-outpatient-bowel-preparation-in-children-and-adolescents-undergoing-appendicovesicostomy
#2
David L Weatherly, Konrad M Szymanski, Benjamin M Whittam, William E Bennett, Shelly King, Rosalia Misseri, Martin Kaefer, Richard C Rink, Mark P Cain
PURPOSE: The need for mechanical inpatient bowel preparation (IBP) in reconstructive pediatric urology has come under scrutiny, secondary to literature demonstrating little benefit regarding outcomes. Starting in 2013, a majority of patients undergoing reconstructive procedures at our institution no longer underwent IBP. We hypothesized that outpatient bowel preparation (OBP) would reduce length of stay (LOS) without increasing postoperative complications after appendicovesicostomy surgery...
August 26, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28917256/postoperative-stereotactic-body-radiotherapy-for-spinal-metastases
#3
Majed Alghamdi, Chia-Lin Tseng, Sten Myrehaug, Pejman Maralani, Chris Heyn, Hany Soliman, Young Lee, Mark Ruschin, Leodante Da Costa, Victor Yang, Mikki Campbell, Arjun Sahgal
Spine is a common site of metastases in cancer patients. Spine surgery is indicated for select patients, typically those with mechanical instability and/or malignant epidural spinal cord (or cauda equina) compression. Although post-operative conventional palliative external beam radiation therapy has been the standard of care, technical improvements in radiation planning and image-guided radiotherapy have allowed for the application of stereotactic body radiotherapy (SBRT) to the spine. Spine SBRT is intended to ablate residual tumor and optimize local control by delivering several fold greater biologically effective doses...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28917016/predictors-of-outpatient-resource-utilization-following-ventral-and-incisional-hernia-repair
#4
Alex Wade, Margaret A Plymale, Daniel L Davenport, Sara E Johnson, Vashisht V Madabhushi, Erica Mastoroudis, Charlie Tancula, John Scott Roth
INTRODUCTION: Little is known about the predictors of increased ambulatory costs following open ventral and incisional hernia repair (VIHR); however, postoperative complications would be expected to be associated with an increased burden on outpatient resources. The purpose of this study is to evaluate the impact of perioperative factors on outpatient resource utilization following VIHR. METHODS: With IRB approval, the surgery scheduling system was queried to identify all cases of VIHR done at our institution over 3 years...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916417/in-hospital-clinical-outcomes-after-upper-gastrointestinal-surgery-data-from-an-international-observational-study
#5
T Szakmany, J Ditai, M Kirov, D Protsenko, B Osinaike, A Venara, N Demartines, M Hubner, R M Pearse, J R Prowle
AIMS: Previous research suggests that patients undergoing upper gastrointestinal surgery are at high risk of poor postoperative outcomes. The aim of our study was to describe patient outcomes after elective upper gastrointestinal surgery at a global level. METHODS: Prospective analysis of data collected during an international seven-day cohort study of 474 hospitals in 27 countries. Patients undergoing elective upper gastrointestinal surgery were recruited. Outcome measures were in-hospital complications and mortality at 30-days...
August 18, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28915807/descemet-membrane-detachment-in-femtosecond-laser-assisted-cataract-surgery-a-case-report
#6
Peiqing Chen, Yanan Zhu, Ke Yao
BACKGROUND: Femtosecond laser-assisted cataract surgery (FLACS) has grown in popularity among ophthalmologists as a novel technique. However, descemet membrane detachment (DMD) began to be found as the complication after FLACS. We report a case of serious DMD following FLACS due to the inappropriate incision design. CASE PRESENTATION: An 85-year-old man with apparent cornea arcus senilis underwent femtosecond laser-assisted cataract surgery in his right eye. A biplanar model was chosen for the main incision...
September 16, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28914700/use-of-ketorolac-after-outpatient-urogynecologic-surgery-a-randomized-control-trial
#7
Elisa R Trowbridge, Dahea Kim, Lauren Caldwell, Denise Franko, Jessica Nicole Jackson, Ashley Shilling, Kathie L Hullfish
OBJECTIVE: Patient surveys highlight a prevalence of moderate to severe pain in the postanesthesia care unit. Multimodal analgesia has been promoted to improve this with fewer opioid-induced adverse effects. The aim of this study was to evaluate the opioid sparing and analgesic effect of postoperative intravenous (IV) ketorolac after outpatient transvaginal surgery. METHODS: Forty patients were enrolled in this institutional review board-approved, randomized, double-blind, placebo-controlled study, to receive either 30 mg of IV ketorolac or IV saline placebo postoperatively...
September 13, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28913958/preoperative-nutritional-management-of-bariatric-patients-in-australia-the-current-practice-of-dietitians
#8
Ruth Bourne, Judith Tweedie, Fiona Pelly
AIM: The aim of this observational study was to investigate the reported practices of Australian dietitians managing bariatric surgery patients in the preoperative stage. METHODS: An online survey of dietitians providing nutritional care to bariatric patients was developed for the purpose of this investigation. The survey questions were guided by the Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic and Nonsurgical Support of the Bariatric Surgery Patient guidelines and current literature...
September 15, 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/28913495/improvement-of-recovery-parameters-using-patient-controlled-epidural-analgesia-after-oncological-surgery-a-prospective-randomized-single-center-study
#9
Armeana Olimpia Zgâia, Cosmin Ioan Lisencu, Alexandru Rogobete, Cătălin Vlad, Patriciu Achimaş-Cadariu, Gabriel Lazăr, Maximilian Muntean, Florin Ignat, Vlad Ormindean, Alexandru Irimie
PURPOSE: The aim of this study was to compare patient-controlled epidural analgesia (PCEA) versus conventional opioid intravenous (IV) infusion after gastrointestinal cancer surgery regarding several post-surgery parameters of recovery. METHODS: One hundred and one patients were prospectively randomized to receive either thoracic/lumbar PCEA (PCEA group) or the standard analgesia technique used in our hospital, conventional IV infusion of morphine (IVMO group) after gastrointestinal cancer surgery...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28913494/the-public-perception-of-the-anaesthesiologist-in-romania-a-survey
#10
Adela Hilda Onutu, Cristina Rus, Iurie Acalovschi
BACKGROUND: Previous studies have shown that the public perception of anaesthesiologists' duties regarding perioperative management lacks a good understanding. The aim of this study was to assess the public perception of the anaesthesiologist's role before, during and after surgery, in Romania. METHOD: The prospective cross-sectional study was undertaken between January 2015 and August 2016. A questionnaire that comprised 23 questions was uploaded on Google at https://docs...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28913487/perioperative-surgical-home-meeting-tomorrow-s-challenges
#11
REVIEW
Teodora O Nicolescu
New healthcare models pose a variety of changes for anesthesiologists, ranging from the need to improve quality and to cost containment: as such, the concept of Perioperative Surgical Home (PSH) has been developed. Modelled after the UK's Enhanced Recovery After Surgery (ERAS), PSH takes a step further by coordinating care starting from the time a surgical decision is made for the patient to as many as 30 days postoperatively, taking a logical evidenced-based approach to judicious preoperative testing. Perioperative surgical home also relies heavily on engineering imported strategies such as the use of Lean Six Sigma methodologies, and involves active participation of all stakeholders...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28913483/the-prevalence-of-perioperative-complications-in-patients-with-and-without-obstructive-sleep-apnoea-a-prospective-cohort-study
#12
Tatiana Ambrosii, Serghei Şandru, Adrian Belîi
BACKGROUND AND AIMS: Patients with obstructive sleep apnoea (OSA) have a high risk of postoperative complications. The purpose of the study was to record the spectrum and frequency of postoperative complications in patients with OSA versus (vs.) without OSA depending on the type of surgery and type of anaesthesia in a large cohort of patients. METHODS: We conducted a prospective, descriptive study (n = 400). Ethics Committee approval was obtained and written informed consent was signed...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28913315/the-algorithm-oriented-management-of-nasal-bone-fracture-according-to-stranc-s-classification-system
#13
Ki-Sung Park, Seung-Soo Kim, Wu-Seop Lee, Wan-Suk Yang
BACKGROUND: Nasal bone fracture is one of the most common facial bone fracture types, and the surgical results exert a strong influence on the facial contour and patient satisfaction. Preventing secondary deformity and restoring the original bone state are the major goals of surgeons managing nasal bone fracture patients. In this study, a treatment algorithm was established by applying the modified open reduction technique and postoperative care for several years. METHODS: This article is a retrospective chart review of 417 patients who had been received surgical treatment from 2014 to 2015...
June 2017: Arch Craniofac Surg
https://www.readbyqxmd.com/read/28912876/effect-of-intercostal-nerve-block-combined-with-general-anesthesia-on-the-stress-response-in-patients-undergoing-minimally-invasive-mitral-valve-surgery
#14
Yanping Zhan, Guo Chen, Jian Huang, Benchao Hou, Weicheng Liu, Shibiao Chen
The aim of the present study was to investigate the effect of intercostal nerve block combined with general anesthesia on the stress response and postoperative recovery in patients undergoing minimally invasive mitral valve surgery (MIMVS). A total of 30 patients scheduled for MIMVS were randomly divided into two groups (n=15 each): Group A, which received intercostal nerve block combined with general anesthesia and group B, which received general anesthesia alone. Intercostal nerve block in group A was performed with 0...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28912041/postoperative-b-type-natriuretic-peptide-monitoring-for-the-assessment-of-the-magnitude-of-shunting-through-blalock-taussig-anastomoses
#15
Cristian Mirabile, Alessandra Mazzola, Liana Valeanu, Vanessa Lopez-Lopez, Claudio Barbanti, Camilla Biselli, Carole Hennequin, Sophie Malekzadeh-Milani, Mirela Bojan
BACKGROUND: The Modified Blalock-Taussig shunt (MBTS) is the most common palliative operation performed in patients with complex cardiac defects. Postoperative morbidity and mortality rates are high, mainly due to shunt thrombosis and over-shunting. Over-shunting may be difficult to identify postoperatively based on conventional criteria. Since plasma B-type natriuretic peptide (BNP) concentrations correlate with the magnitude of shunting in various left-to-right shunt cardiac defects, we investigated its ability to identify postoperative MBTS over-shunting...
September 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28912030/liver-function-assessment-using-technetium-99m-galactosyl-single-photon-emission-ct-ct-fusion-imaging-a-prospective-trial
#16
Takehiro Okabayashi, Yasuo Shima, Sojiro Morita, Yasuhiro Shimada, Tatsuaki Sumiyoshi, Kenta Sui, Jun Iwata, Tatsuo Iiyama
BACKGROUND: The prediction of postoperative liver function remains a largely subjective practice based on computed tomography (CT) volumetric analysis. However, the future liver volume after a hepatectomy is not the only factor that contributes to postoperative liver function and outcomes. STUDY DESIGN: In this prospective trial, 185 consecutive patients who underwent liver surgery between 2014 and 2015 were studied. Volumetric and functional rates of remnant liver were measured using technetium-99m-galactosyl human serum albumin single photon emission computed tomography/computed tomography ((99m)Tc-GSA SPECT/CT) fusion imaging to evaluate post-hepatectomy remnant liver function...
September 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28911828/laparoscopic-sentinel-lymph-node-mapping-with-indocyanine-green-icg-using-ispies-platform-the-initial-experience-in-argentina
#17
Julian Di Guilmi, Maria Cecilia Darin, Maria Toscano, Gustavo Maya
OBJECTIVE: To demonstrate the initial experience in Argentina using the iSpies ICG platform in performing sentinel lymph node mapping in early-stage cervical cancer. Design Step-by-step video and pictures BACKGROUND: Laparoscopic and robotic sentinel lymph node mapping using ICG has been shown to be safe and feasible. However, the use of fluorescent imaging through a minimally invasive approach in developing countries is very limited given the cost restrictions of acquiring the near infrared technology and the fluorescent dyes...
September 11, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28911286/the-effect-of-a-surgery-specific-cardiac-output-guided-haemodynamic-algorithm-on-outcomes-in-patients-undergoing-pancreaticoduodenectomy-in-a-high-volume-centre-a-retrospective-comparative-study
#18
L Weinberg, J Banting, L Churilov, R L McLeod, K Fernandes, I Chao, T Ho, D Ianno, V Liang, V Muralidharan, C Christophi, M Nikfarjam
In this retrospective observational study performed in a high-volume hepatobiliary-pancreatic unit, we evaluated the effect of a surgery-specific goal-directed therapy (GDT) physiologic algorithm on complications and length of hospital stay. We compared patients who underwent pancreaticoduodenectomy with either a standardised Enhanced Recovery After Surgery program (usual care group), or a standardised Enhanced Recovery After Surgery program in combination with a surgery-specific cardiac output-guided algorithm (GDT group)...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28910436/integrating-data-collection-into-office-work-flow-and-electronic-health-records-for-clinical-outcomes-research
#19
C Alessandra Colaianni, Patricia A Levesque, Robin W Lindsay
Meticulous collection of clinical outcomes metrics in patients undergoing elective surgery is important to ensure quality care; it is also increasing in importance as the Centers for Medicare & Medicaid Services moves to tie reimbursement to outcomes and insurance approval. This study assesses a systematic method for gathering preoperative and postoperative data on patients with nasal obstruction who undergo functional septorhinoplasty that was developed at the Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts...
September 14, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28906298/a-simple-flap-design-for-the-salvage-of-immediate-implant-based-breast-reconstruction
#20
Sukru Yazar, Altug Altinkaya, Emine Cigdem Karadag, Halil Kara, Cihan Uras
BACKGROUND: Breast reconstruction with implants is a real challenge in patients with large breast volume. Skin-reducing inverted-T mastectomy is the best solution for these patients. Delayed wound healing or necrosis at the T-junction area can be seen in this procedure, although it may also lead to severe conditions such as the exposure and loss of implant. In this article, the use of local pedicled flap for the management of these situations was discussed. METHODS: Between April 2010 and July 2015, 54 patients underwent breast reconstruction by inverted-T skin-reducing mastectomy and immediate implant-based breast reconstruction at our clinic...
September 12, 2017: Annals of Plastic Surgery
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