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https://www.readbyqxmd.com/read/28643079/similar-clinical-outcomes-with-preoperative-and-postoperative-start-of-thromboprophylaxis-in-tha-a-register-based-study
#1
Pål O Borgen, Are H Pripp, Eva Dybvik, Lilian Leistad, Ola E Dahl, Olav Reikerås
BACKGROUND: Elective THA is associated with a high risk of thromboembolic events. Although these events may be less common now than they were in the past, they can be serious, and most patients undergoing the procedure therefore still receive thromboprophylaxis. However, controversy remains regarding whether to begin thromboprophylaxis before THA or after to best balance the risks of clotting and bleeding. QUESTIONS/PURPOSES: We asked the following questions: (1) Is there a difference in bleeding events with pre- versus postoperative thromboprophylaxis? (2) Is there a difference in thromboembolic episodes after THA between the two regimens? (3) How do the two approaches of thromboprophylaxis influence mortality, readmissions, and other complications? METHODS: We used a population-based followup design with predefined data based on international health codification to assess clinical effects of LMWH prophylaxis initiated before or after THA...
June 22, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28640104/the-easytube-during-general-anesthesia-for-minor-surgery-a-randomized-controlled-trial
#2
Oliver Robak, Sonia Vaida, Luis Gaitini, Andreas Thierbach, Ricardo Urtubia, Peter Krafft, Michael Frass
BACKGROUND: The EasyTube (EzT) is a supraglottic airway device that is used for emergency airway situations. Ventilation during general anesthesia should also be feasible, but literature on the EzT is scarce. We evaluated the EzT in comparison with the endotracheal tube (ETT) in its use during general anesthesia in a comparative study. METHODS: A total of 400 patients with American Society of Anesthesiologists (ASA) physical status I to II scheduled for minor surgery in 4 centers were randomized for ventilation via the ETT or EzT...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28632532/postpartum-tubal-sterilization-making-the-case-for-urgency
#3
Michael G Richardson, Sarah J Hall, Lisa C Zuckerwise
The parturient who requests postpartum sterilization has given consideration to and has made decisions regarding this aspect of her medical care long before her delivery. She arrives at parturition expecting the postpartum procedure to be performed as intended. The American Congress of Obstetricians and Gynecologists has reaffirmed its opinion that postpartum sterilization is an urgent procedure, owing to the safety and superior effectiveness of tubal sterilization via minilaparotomy in the immediate postpartum period, and the adverse consequences for mothers, babies, and society when the procedure is not actualized as desired and intended...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28630690/incidence-and-risk-factors-for-surgical-site-infections-in-obstetric-and-gynecological-surgeries-from-a-teaching-hospital-in-rural-india
#4
Ashish Pathak, Kalpana Mahadik, Manmat B Swami, Pulak K Roy, Megha Sharma, Vijay K Mahadik, Cecilia Stålsby Lundborg
BACKGROUND: Surgical site infections (SSI) are one of the most common healthcare associated infections in the low-middle income countries. Data on incidence and risk factors for SSI following surgeries in general and Obstetric and Gynecological surgeries in particular are scare. This study set out to identify risk factors for SSI in patients undergoing Obstetric and Gynecological surgeries in an Indian rural hospital. METHODS: Patients who underwent a surgical procedure between September 2010 to February 2013 in the 60-bedded ward of Obstetric and Gynecology department were included...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28628578/neuraxial-anesthesia-in-obstetric-patients-receiving-thromboprophylaxis-with-unfractionated-or-low-molecular-weight-heparin-a-systematic-review-of-spinal-epidural-hematoma
#5
Lisa R Leffert, Heloise M Dubois, Alexander J Butwick, Brendan Carvalho, Timothy T Houle, Ruth Landau
Venous thromboembolism remains a major source of morbidity and mortality in obstetrics with an incidence of 29.8/100,000 vaginal delivery hospitalizations; cesarean delivery confers a 4-fold increased risk of thromboembolism when compared with vaginal delivery. Revised national guidelines now stipulate that the majority of women delivering via cesarean and women at risk for ante- or postpartum venous thromboembolism receive mechanical or pharmacological thromboprophylaxis. This practice change has important implications for obstetric anesthesiologists concerned about the risk of spinal epidural hematoma (SEH) among anticoagulated women receiving neuraxial anesthesia...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28627976/administration-of-rocuronium-based-on-real-body-weight-versus-fat-free-mass-in-patients-with-lymphedema
#6
Zhang Jing, Aikeremujiang Muheremu, Pengfei Liu, Xiaoyun Hu, Zhao Binjiang
Objective To compare the clinical pharmacokinetics of rocuronium when applied according to fat-free mass versus real body weight during anesthetic induction of patients with lymphedema. Methods Sixty patients with lymphedema (age, 18-60 years; American Society of Anesthesiologists physical status, I-II) undergoing elective surgery with general anesthesia were randomly divided into two groups. Rocuronium was administered based on the fat-free mass in 30 patients and real body weight in 30 patients. General anesthesia was induced with propofol and remifentanil by target-controlled infusion...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28625429/automated-anesthesia-carts-reduce-drug-recording-errors-in-medication-administrations-a-single-center-study-in-the-largest-tertiary-referral-hospital-in-china
#7
Ying Wang, Yingying Du, Yingying Zhao, Yang Ren, Wei Zhang
AIM: To clinically evaluate a type of patented automated anesthesia cart in medication administrations in anesthesia. MATERIALS AND METHODS: This was a prospectively randomized open label clinical trial. In 10 designated operating suits in the First Affiliated Hospital of Zhengzhou University, in China. 1066 cases originated from 10,812 medication administrations in anesthesia were randomized. 78 registered anesthesiologists managed the medication. The patients received medication administrations in anesthesia with either an automated or a conventional manual cart...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28618734/a-comparison-of-usage-of-the-laryngeal-mask-unique-tm-in-denticulate-and-edentulate-geriatric-patients
#8
Meltem Genez, Semih Küçükgüçlü, Şule Özbilgin, Bahar Kuvaki, Tangül Beydeş, Melek Aksoy Sari
BACKGROUND/AIM: Mask ventilation in geriatric and edentulous patients can be ineffective or even impossible because of the shape inside the patients' cheeks. For patients for whom a mask cannot be used for long, the use of a laryngeal mask can ease the administration of anesthesia. The aim of this study was to compare the use of the laryngeal mask Unique(TM) in denticulate and edentulate patients aged over 65 years. MATERIALS AND METHODS: This prospective study included patients according to the American Society of Anesthesiologists I-III classification, aged 65 years or more...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28617519/pain-and-opioid-use-after-total-shoulder-arthroplasty-with-injectable-liposomal-bupivacaine-versus-interscalene-block
#9
Marc R Angerame, John A Ruder, Susan M Odum, Nady Hamid
Postoperative pain control is a significant concern after total shoulder arthroplasty. Injectable periarticular liposomal bupivacaine, which has been found to decrease opioid use after orthopedic procedures, has been proposed as a viable alternative to regional anesthesia. This study compared the efficacy of liposomal bupivacaine vs interscalene block among patients undergoing total shoulder arthroplasty. A retrospective review was conducted of 79 patients who underwent anatomic total shoulder arthroplasty performed by a single surgeon between January 2013 and April 2015...
June 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28611538/breast-conserving-surgery-under-local-anesthesia-in-elderly-patients-with-severe-cardiorespiratory-comorbidities-a-hospital-based-case-control-study
#10
Hasan Karanlik, Berkay Kılıç, Ilknur Yıldırım, Süleyman Bademler, Ilker Ozgur, Burak Ilhan, Semen Onder
INTRODUCTION: We report the feasibility and safety of local anesthesia (LA) in patients having breast-conserving surgery (BCS). METHODS: 37 patients with American Society of Anesthesiologists (ASA) score of 4 having BCS under LA and 54 age-matched subjects with ASA score of 3-4 having BCS under general anesthesia (GA) were included. Patients were retrospectively evaluated for the follow-up duration, duration of surgery, postoperative satisfaction scores (1-10), complication and survival time for locoregional recurrence and overall survival rates...
March 2017: Breast Care
https://www.readbyqxmd.com/read/28606281/-effect-of-different-anesthetic-techniques-on-the-prognosis-of-hepatocellular-carcinoma-after-hepatectomy
#11
T Yan, J J Zhao, X Y Bi, J Q Cai, H Zheng
Objective: To investigate the influence of different anesthetic techniques on the prognosis of hepatocellular carcinoma (HCC)after hepatectomy. Methods: A total of 185 consecutive patients with HCC confirmed underwent surgery in Cancer Hospital, Chinese Academy of Medical Sciences were recruited from January 2006 to January 2008. The patients were assessed as American Society of Anesthesiologists (ASA)Ⅰ-Ⅲ, with body mass index (BMI) (22.8±4.6)kg/m(2). There were 169 males, with an average age of 56 years old and 16 females, with an average age of 53 years old...
June 13, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28603701/a-comparison-of-intravenous-ephedrine-or-phenylephrine-for-prevention-of-postspinal-hypotension-during-elective-lower-abdominal-surgery-a-randomized-double-blind-case-control-study
#12
Khosrou Naghibi, Mojtaba Rahimi, Zahra Mashayekhi
BACKGROUND: In this randomized, double-blinded case-control study, we investigated the intravenous effects of ephedrine or phenylephrine on prevention of post-spinal hypotension in elective lower abdominal surgery under spinal anesthesia. MATERIALS AND METHODS: One hundred and thirty-five patients, American Society of Anesthesiologists physical status I or II candidate for elective lower abdominal surgery under spinal anesthesia were randomized to three groups (45 each)...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28599629/dose-dependent-effects-of-intravenous-methoxamine-infusion-during-hip-joint-replacement-surgery-on-postoperative-cognitive-dysfunction-and-blood-tnf-%C3%AE-level-in-elderly-patients-a-randomized-controlled-trial
#13
Shenghui Sun, Defeng Sun, Lin Yang, Jun Han, Ruochuan Liu, Lijie Wang
BACKGROUND: Postoperative cognitive dysfunction (POCD), common in elderly patients, is thought to be closely associated with intraoperative instability of hemodynamics and excessive excretion of tumor necrosis factor-α (TNF-α). Methoxamine is a blood-pressure increasing drug commonly used for maintaining intraoperative hemodynamics. Methoxamine potentially promotes TNF-α expression, leading to an increased risk of POCD. This study aimed to investigate the dose-dependent effect of methoxamine on the incidence of early POCD and blood TNF-α level...
June 9, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28598918/falls-from-the-o-r-or-procedure-table
#14
Richard C Prielipp, Julia L Weinkauf, Thomas M Esser, Brian J Thomas, Mark A Warner
Patient safety secured by constant vigilance remains a primary responsibility of every anesthesia professional. Although significant attention has been focused on patient falls occurring before and after surgery, a potentially catastrophic complication is when patients fall off an operating room or procedure table during anesthesia care. Because such events are (fortunately) uncommon, and because very little information is published in our literature, we queried 2 independent closed claims databases (the American Society of Anesthesiologists Closed Claims Project and the secure records of a private, anesthesia specialty-specific liability insurer) for information...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28587389/comparison-of-the-hemodynamics-and-dynamics-of-fluid-shift-of-ringer-s-solution-before-surgery-in-children-and-adults
#15
Guizhou Zhu, Yuhong Li, Guomei Ru, Qiannan Ding
The present study investigated the hemodynamics, vascular and extravascular volume expansion induced by infusion of lactated Ringer's solution in children and adults before surgery. This was a prospective randomized double-blind study. A total of 28 patients (14 children and 14 adult patients; American Society of Anesthesiology status I) scheduled for similar minor pelvic, anal rectal or lower limb surgery were recruited for the present study. All patients were administered with 10 ml/kg of lactated Ringer's solution at a constant rate over 20 min...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28580078/does-preoperative-anxiety-felt-by-patients-requested-to-participate-in-clinical-trials-related-to-general-anesthesia-before-elective-surgery-depend-on-temperament
#16
Jae Hoon Oh, Woo Jong Shin, Suin Park, Kyoung Hun Kim
BACKGROUND: Preoperative anxiety may differ according to patient temperament. It will be increased when patients are requested to participate in a study involving anesthesia. The purpose of this study was to show that the anxiety felt when patients are requested to participate may differ according to temperament in both patients who agree and disagree to participate. METHODS: Three hundred and twenty-one patients over age 18 with American Society of Anesthesiologists 1 and 2 completed a survey questionnaire...
June 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28562733/randomized-clinical-study-on-the-analgesic-effect-of-local-infiltration-versus-spinal-block-for-hemorrhoidectomy
#17
Luis Antônio Borges, Plínio da Cunha Leal, Ed Carlos Rey Moura, Rioko Kimiko Sakata
BACKGROUND AND OBJECTIVES: Postoperative analgesia and early recovery are important for hospital discharge. The primary objective of this study was to compare the analgesic effectiveness of perianal infiltration and subarachnoid anesthesia for hemorrhoidectomy. The secondary objective was to compare time to discharge, adverse effects and complications. DESIGN AND SETTING: Randomized, prospective and comparative study at Dr. Mário Gatti Hospital. METHODS: Forty patients aged 18-60, in American Society of Anesthesiologists physical status category 1 or 2, were included...
May 29, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28553161/presentation-of-a-method-at-the-exploration-stage-according-to-ideal-percutaneous-nephrolithotomy-pcnl-under-local-infiltrative-anesthesia-is-a-feasible-and-effective-method-retrospective-analysis-of-439-patients
#18
Thorsten H Ecke, Dimitri Barski, Guido Weingart, Carsten Lange, Steffen Hallmann, Jürgen Ruttloff, Friedhelm Wawroschek, Holger Gerullis
INTRODUCTION: This study addresses minimally invasive anesthesiologic and analgetic approaches for stone surgery in the upper urinary tract. Aim of this retrospective analysis is to compare feasibility, safety and complication rates of percutaneous nephrolithotomy (PCNL) under local infiltration anesthesia alone (Group I) and additive intravenous analgetics and/or sedative medications (Group II). MATERIAL AND METHODS: This is a single center study. A total of 439 patients have been included from November 2003 until March 2012...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28546120/local-anesthesia-for-endovascular-treatment-of-unruptured-intracranial-aneurysms-feasibility-safety-and-periprocedural-complications
#19
Jihye Song
OBJECTIVE: The aim of the study is to report the feasibility, safety and outcomes associated with endovascular treatment (EVT) of unruptured intracranial aneurysms (UIA) under local anesthesia (LA). METHODS: Between March 2011 and December 2016, 184 consecutive patients with 198 UIA were treated with coil embolization under LA at the author's center. The data about medical comorbidities according to American Society of Anesthesiologists (ASA) grade, procedural details, and clinical and radiographic outcomes were reviewed...
May 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28541856/early-and-late-complications-in-laparoscopic-gastric-bypass-comparative-study-between-manual-and-stapled-anastomosis
#20
Débora Acín-Gándara, Fernando Pereira-Pérez, Manuel Medina-García, Gil Rodriguez-Caravaca, Beatriz Martínez-Torres, Alfonso Antequera-Pérez, Alejandro Nájar García-Muñoz
The aim of this study is to evaluate the early and late complications of laparoscopic gastric bypass (GBP) with manual versus stapled gastrojejunal anastomosis. Eighty-two patients with morbid obesity and body mass index (35-56 kg/m2) who underwent GBP were divided into two groups: manual gastrojejunal anastomosis (Group 1) and stapled anastomosis (Group 2). Early and late complications were evaluated. No differences were found between both groups in age, sex, body mass index, American Society of Anesthesia classification, and comorbidity...
May 1, 2017: American Surgeon
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