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Perioperative managment

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https://www.readbyqxmd.com/read/29916984/le-fort-ii-osteotomy-and-modified-technique-presentation
#1
Héctor-Omar Malagón-Hidalgo, Roberto Vilchis-López, Diego-Raúl González-Chapa, Richael-Antonio Silva-Suárez, Eugenio García-Cano, José-Luis Lastiri-Barrios, Fernando González-Magaña
INTRODUCTION: The LeFort II osteotomy has a specific number of indications, thus this is true, there is less experience with the technique. The authors present a modification to the technique and extensive step-by-step procedure explanation in order to share their experience for making a safe surgery. MATERIAL AND METHODS: A clinical report is presented of a nonsyndromatic patient with nasomaxillary hypoplasia, in which the authors make an LeFort II osteotomy with circumvestibular, transcaruncular, and "W"-shaped approaches, with minimal scar showing, in order to offer better aesthetic outcomes as well as functional and skeletal...
June 18, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29915947/a-pilot-study-of-a-breast-surgery-enhanced-recovery-after-surgery-eras-protocol-to-eliminate-narcotic-prescription-at-discharge
#2
Kristin E Rojas, Donna-Marie Manasseh, Peter L Flom, Solomon Agbroko, Nicole Bilbro, Charusheela Andaz, Patrick I Borgen
BACKGROUND: The evolving conceptualization of the management of surgical pain was a major contributor to the supply of narcotics that led to the opioid crisis. We designed and implemented a breast surgery-specific Enhanced Recovery After Surgery (ERAS) protocol using opioid-sparing techniques to eliminate narcotic prescription at discharge without sacrificing perioperative pain control. METHODS: A pilot observational study included patients with and without cancer undergoing lumpectomy...
June 18, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29915804/using-advanced-wound-care-and-hyperbaric-oxygen-to-manage-wound-complications-following-treatment-of-vulvovaginal-carcinoma
#3
C Griffiths, R S Howell, H Boinpally, E Jimenez, E Chalas, F Musa, S Gorenstein
Postoperative management of patients with vulvar cancer is associated with a high incidence of poor wound healing and radiation -induced late tissue necrosis. This case series demonstrates the impact on wound healing with the use of hyperbaric oxygen therapy and advanced wound care following radical vulvectomy and/or radiation therapy. A retrospective case series was performed of all patients from 2016 to 2017 with lower genital cancer who underwent radical surgery with or without chemoradiation treatment, experienced wound dehiscence or late tissue radionecrosis, and were treated with advanced wound care, including hyperbaric oxygen therapy (HBO)...
May 2018: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/29913395/the-effect-of-nonsteroidal-anti-inflammatory-drugs-on-bone-healing-in-humans-a-qualitative-systematic-review
#4
REVIEW
Alain Borgeat, Christian Ofner, Andrea Saporito, Mazda Farshad, José Aguirre
STUDY OBJECTIVE: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in postoperative pain management. While an increasing number of in vitro and animal studies point toward an inhibitory effect of NSAIDs on bone healing process, the few existing retro- and prospective clinical studies present conflicting data. DESIGN: The aim of this qualitative, systematic review was to investigate the impact of perioperative use of NSAIDs in humans on postoperative fracture/spinal fusion healing compared to other used analgesics measured as fracture nonunion with radiological control...
June 15, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29912740/homograft-versus-conventional-prosthesis-for-surgical-management-of-aortic-valve-infective-endocarditis-a-systematic-review-and-meta-analysis
#5
Bobby Yanagawa, Amine Mazine, Derrick Y Tam, Peter Jüni, Deepak L Bhatt, Stephen Spindel, John D Puskas, Subodh Verma, Jan O Friedrich
OBJECTIVE: Surgical management of aortic valve infective endocarditis (IE) with cryopreserved homograft has been associated with lower risk of recurrent IE, but there is equipoise with regard to the optimal prosthesis. This systematic review and meta-analysis were performed to compare outcomes between homograft and conventional prosthesis for aortic valve IE. METHODS: We searched MEDLINE database to September 2017 for studies comparing homograft versus conventional prosthesis...
June 15, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29912732/a-novel-biportal-full-endoscopy-technique-for-lumbar-lateral-recess-stenosis-technical-report
#6
Xinchun Liu
Full endoscopy spine surgery is one of the minimally invasive procedures for lumbar spine disease and is especially popular in East Asia. As for the interlaminar approach, lumbar recess stenosis can be manipulated through a uniportal bigger diameter working channel spinal endoscope or a smaller one, or a biportal arthroscope. Each kind of procedure has its advantages and shortcomings. Here, a novel experience in biportal interlaminar approach for lumbar recess stenosis is presented. A smaller uniportal spinal endoscope is adopted for biportal procedures rather than the arthroscope...
June 15, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29911573/managing-post-thoracotomy-pain-epidural-or-systemic-analgesia-and-extended-care-a-randomized-study-with-an-as-usual-control-group
#7
Elina Tiippana, Kaisa Nelskylä, Eija Nilsson, Eero Sihvo, Matti Kataja, Eija Kalso
Background and aims Thoracotomies can cause severe pain, which persists in 21-67% of patients. We investigated whether NSAID + intravenous patient-controlled analgesia (IV-PCA) with morphine is an efficacious alternative to thoracic epidural analgesia (TEA). We also wanted to find out whether an extended controlled pain management protocol within a clinical study can decrease the incidence of persistent post-thoracotomy pain. Methods Thirty thoracotomy patients were randomized into 3 intervention groups with 10 patients in each...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29910489/does-the-phase-of-the-menstrual-cycle-really-matter-to-anaesthesia
#8
Madhuri S Kurdi, Ashwini H Ramaswamy
The menstrual cycle is a physiological phenomenon that is accompanied by several hormonal fluctuations involving oestrogen and progesterone. Oestrogen and progesterone exert several physiological effects. There are many questions pertaining to the influence of the physiology of menstruation on anaesthesia. We attempted to find out whether the phase of the menstrual cycle can alter the physiological functions during anaesthesia, the perioperative management and outcomes. We performed a literature search in Google Scholar, PubMed and Cochrane databases for original and reviewed articles on the phases of the menstrual cycle and their relation to anaesthesia-related physiological parameters to find an answer to these questions...
May 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29910098/a-meta-analysis-evaluates-the-efficacy-of-intravenous-acetaminophen-for-pain-management-in-knee-or-hip-arthroplasty
#9
Hongzhang Guo, Changde Wang, Yufang He
BACKGROUND: The objective of this study was to assess whether intravenous acetaminophen for patients undergoing knee or hip arthroplasty could reduce the opioid consumption and improve pain management. METHOD: Eligible studies were searched from electronic databases including PubMed, Web of Science, Embase (Ovid interface) and Cochrane Library (Ovid interface). The quality assessments were performed according to the Cochrane systematic review method. The assessed outcomes were including opioid consumption, pain scores, length of hospital stays and total occurrence of adverse events...
June 14, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29907898/inpatient-glycemic-management-of-non-cardiac-cvd-focus-on-stroke-and-pvd
#10
REVIEW
Estelle Everett, Nestoras Mathioudakis
PURPOSE OF REVIEW: Hyperglycemia occurs frequently in hospitalized patients with stroke and peripheral vascular disease (PVD). Guidelines for inpatient glycemic management are not well established for this patient population. We will review the clinical impact of hyperglycemia in this acute setting and review the evidence for glycemic control. RECENT FINDINGS: Hyperglycemia in acute stroke is associated with poor short and long-term outcomes, and perioperative hyperglycemia in those undergoing revascularization for PVD is linked to increased post-surgical complications...
June 16, 2018: Current Diabetes Reports
https://www.readbyqxmd.com/read/29904819/perioperative-management-of-patients-with-addiction-to-opioid-and-non-opioid-medications
#11
REVIEW
Donna-Ann Thomas, Praba Boominathan, Jyotsna Goswami, Sudipta Mukherjee, Nalini Vadivelu
PURPOSE OF REVIEW: With the rise of the opioid epidemic, anesthesiologists will find themselves faced with opioid-addicted patients more frequently. Addiction to opioids may also occur concurrently with abuse of other non-opioid medications. Our review article seeks to outline an armamentarium of pain management strategies in the perioperative period for these patients with addiction to opioid and non-opioid medications. RECENT FINDINGS: Statistics from the CDC demonstrate a shocking increase in opioid prescription rates and opioid-related deaths...
June 14, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29900874/dabigatran-in-patients-with-myocardial-injury-after-non-cardiac-surgery-manage-an-international-randomised-placebo-controlled-trial
#12
P J Devereaux, Emmanuelle Duceppe, Gordon Guyatt, Vikas Tandon, Reitze Rodseth, Bruce M Biccard, Denis Xavier, Wojciech Szczeklik, Christian S Meyhoff, Jessica Vincent, Maria Grazia Franzosi, Sadeesh K Srinathan, Jason Erb, Patrick Magloire, John Neary, Mangala Rao, Prashant V Rahate, Navneet K Chaudhry, Bongani Mayosi, Miriam de Nadal, Pilar Paniagua Iglesias, Otavio Berwanger, Juan Carlos Villar, Fernando Botto, John W Eikelboom, Daniel I Sessler, Clive Kearon, Shirley Pettit, Mukul Sharma, Stuart J Connolly, Shrikant I Bangdiwala, Purnima Rao-Melacini, Andreas Hoeft, Salim Yusuf
BACKGROUND: Myocardial injury after non-cardiac surgery (MINS) increases the risk of cardiovascular events and deaths, which anticoagulation therapy could prevent. Dabigatran prevents perioperative venous thromboembolism, but whether this drug can prevent a broader range of vascular complications in patients with MINS is unknown. The MANAGE trial assessed the potential of dabigatran to prevent major vascular complications among such patients. METHODS: In this international, randomised, placebo-controlled trial, we recruited patients from 84 hospitals in 19 countries...
June 9, 2018: Lancet
https://www.readbyqxmd.com/read/29899438/complications-of-antireflux-surgery
#13
REVIEW
Rena Yadlapati, Eric S Hungness, John E Pandolfino
Antireflux surgery anatomically restores the antireflux barrier and is a therapeutic option for proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease or PPI intolerance. Laparoscopic fundoplication is the standard antireflux surgery, though its popularity has declined due to concerns regarding wrap durability and adverse events. As the esophagogastric junction is an anatomically complex and dynamic area subject to mechanical stress, wraps are susceptible to disruption, herniation or slippage...
June 14, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29898653/does-implementation-of-an-enhanced-recovery-after-surgery-program-for-hip-replacement-improve-quality-of-recovery-in-an-australian-private-hospital-a-quality-improvement-study
#14
Nicole Lay Tin Tan, Justin Lindley Hunt, Stella May Gwini
BACKGROUND: Enhanced recovery after surgery programs may improve recovery and reduce duration of hospital stay after joint replacement surgery. However, uptake is incomplete, and the relative importance of program components is unknown. This before-and-after quality improvement study was designed to determine whether adding 'non-surgical' components, to pre-existing 'surgical' components, in an Australian private healthcare setting, would improve patient recovery after total hip replacement...
June 13, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29898280/upper-gastrointestinal-bleeding-in-neck-of-femur-fracture-patients-a-single-tertiary-centre-experience
#15
Jessamine Liu, Rohit Gupta, Karen Hay, Chrys Pulle, Tony Rahman, Shaun Pandy
This study aimed to identify the incidence of perioperative acute upper gastrointestinal bleeding (UGIB) in our hip fracture patients; to evaluate the characteristics, management and clinical outcomes of these patients; and to explore risk factors and protective factors. Of the 1691 consecutive patients admitted for surgical management of hip fractures, 11 (0.65%) had UGIB and a further four patients for each case were selected as controls for evaluation of risk factors and protective factors. Pre-existing peptic ulcer disease was identified as a risk factor for acute UGIB (odds ratio 7...
June 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29898202/association-of-perioperative-red-blood-cell-transfusions-with-venous-thromboembolism-in-a-north-american-registry
#16
Ruchika Goel, Eshan U Patel, Melissa M Cushing, Steven M Frank, Paul M Ness, Clifford M Takemoto, Ljiljana V Vasovic, Sujit Sheth, Marianne E Nellis, Beth Shaz, Aaron A R Tobian
Importance: Increasing evidence supports the role of red blood cells (RBCs) in physiological hemostasis and pathologic thrombosis. Red blood cells are commonly transfused in the perioperative period; however, their association with postoperative thrombotic events remains unclear. Objective: To examine the association between perioperative RBC transfusions and postoperative venous thromboembolism (VTE) within 30 days of surgery. Design, Setting, and Participants: This analysis used prospectively collected registry data from the American College of Surgery National Surgical Quality Improvement Program (ACS-NSQIP) database, a validated registry of 525 teaching and nonteaching hospitals in North America...
June 13, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29898181/changes-in-bacterial-number-at-different-sites-of-oral-cavity-during-perioperative-oral-care-management-in-gastrointestinal-cancer-patients-preliminary-study
#17
Tomoko Kawano, Hideo Shigeishi, Eri Fukada, Takamichi Yanagisawa, Nobukazu Kuroda, Toshinobu Takemoto, Masaru Sugiyama
OBJECTIVE: The objective of this study was to clarify differences in bacterial accumulation between gastrointestinal cancer patients who underwent severely invasive surgery and those who underwent minimally invasive surgery. MATERIAL AND METHODS: We performed a preliminary investigation of gastrointestinal cancer patients who were treated at the Department of Surgery, Takarazuka Municipal Hospital, from 2015 to 2017 (n=71; 42 laparoscopic surgery, 29 open surgery) to determine changes in bacterial numbers at different sites of the oral cavity (tongue dorsum, gingiva of upper anterior teeth, palatoglossal arch), as well as mouth dryness and tongue coating indices...
June 11, 2018: Journal of Applied Oral Science: Revista FOB
https://www.readbyqxmd.com/read/29898152/aortic-valve-replacement-combined-with-ascending-aortic-aneurysmectomy-in-a-patient-with-sickle-cell-disease-a-case-report
#18
Lucas Molinari Veloso da Silveira, Ana Paula Tagliari, Ronaldo David da Costa, Cristiano Blaya Martins, Orlando Wender
Sickle cell anemia is a haematological disorder characterized by multiple vaso-occlusive complications, resulting in a reduced life expectancy. These patients are exposed to several triggering factors for sickle cell crises when they are submitted to cardiovascular surgeries with extracorporeal circulation. Therefore, meticulous care and perioperative management are required. This paper reports a successful case of combined cardiovascular surgery - aortic valve replacement and ascending aortic aneurysmectomy - with no serious post-operative complications...
March 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29894349/anesthetic-considerations-for-a-patient-with-chronic-systemic-capillary-leak-syndrome-a-case-report
#19
Resham Datta, Jason K Panchamia
Systemic capillary leak syndrome (SCLS) is an idiopathic vascular hyperpermeability that leads to profound hypotension, hypoalbuminemia, and hemoconcentration. Sixty years since its inauguration into literature, SCLS is still elusive, underdiagnosed, and profoundly dangerous. Few authors have documented anesthetic implications of classical acute SCLS, a form with complete recovery between exacerbations. However, minimal information is available about chronic SCLS, continuous generalized edema with or without exacerbations...
June 11, 2018: A&A practice
https://www.readbyqxmd.com/read/29894342/severe-disruption-of-water-and-electrolyte-balance-after-appendectomy-a-case-report
#20
Olga Bossong, Christoph Rudin, Gabor Szinnai, Thomas O Erb, Jens Moll
Perioperative derangements of fluid and electrolyte homeostasis are rare complications in healthy children. Nonetheless, early diagnosis and treatment are mandatory to avoid a potentially life-threatening situation. However, the variety of underlying pathologies may prove to make accurate diagnosis challenging. This case report presents the management of an unexpected occurrence of a perioperative partial diabetes insipidus with massive fluid loss. Diagnostic and therapeutic procedures are discussed in the context of laboratory findings, and an overview of the existing literature is given...
June 11, 2018: A&A practice
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