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Preanesthesia evaluation

Min-Na Li, Xue-Rong Yu, Ya-Juan Wang, Man-Yun Bo, Yu-Guang Huang
Objective To assess the impacts of anesthetic brochure on anesthetic information gain, preoperative anxiety, trust to anesthesiologists, and satisfaction to the preanesthesia visit for patients undergoing general anesthesia. Methods Totally 134 patients scheduled for elective thyroid surgery under general anesthesia in Peking Union Medical College Hospital were assigned to two groups using the random number table method, among whom 68 patients received brochure before preoperative visit (brochure group) and 66 patients did not (control group)...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Michal Ivry, Goitein David, Welly Wiam, Berkenstadt Haim
BACKGROUND: Melatonin has hypnotic, sedative, analgesic, anti-inflammatory, and antioxidant properties, and is a widely used sleep agent. OBJECTIVES: Our aim was to evaluate the effect of melatonin premedication on postoperative recovery in patients undergoing bariatric surgery. SETTING: University Hospital, Israel. METHODS: Patients undergoing bariatric surgery were randomized to receive either 5 mg melatonin (M group) or placebo (P group) once on the night before surgery and again 2 hours before surgery...
November 3, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Abhijit S Nair, Ravi Kiran Mudunuri, Muthuswamy Ganapathy, Venugopal Kulkarni
No abstract text is available yet for this article.
October 2016: Saudi Journal of Anaesthesia
Douglas Salgado, Kimberly R Barber, Michael Danic
OBJECTIVES: The use of the World Health Organization Surgical Safety Checklist (SSC) has been reported to significantly reduce operative morbidity and mortality rates. Recent findings have cast doubt on the efficacy of such checklists in improving patient safety. The effectiveness of surgical safety checklists cannot be fully measured or understood without an accurate assessment of implementation fidelity, most effectively through direct observations of the checklist process. Here, we describe the use of a secure audio recording protocol in conjunction with a novel standardized scoring system to assess checklist compliance rates...
November 2, 2016: Journal of Patient Safety
Thomas R Vetter, Arthur M Boudreaux, Brent A Ponce, Joydip Barman, Sandra J Crump
The optimal timing of the preanesthesia evaluation varies with the patient's comorbidities. As anesthesiologists assume a broader role in perioperative care, there may be opportunities to provide additional patient management beyond historical routine anesthesia services. This study was thus undertaken to survey our institutional perioperative clinicians regarding their perceptions of patient medical conditions that (a) need additional time for preoperative clearance by anesthesiology before actually scheduling the date of surgery and (b) warrant additional preoperative evaluation and management services by an anesthesiologist...
December 2016: Anesthesia and Analgesia
Olivier Sobrie, Mohammed El Amine Lazouni, Saïd Mahmoudi, Vincent Mousseau, Marc Pirlot
BACKGROUND AND OBJECTIVE: The principal challenges in the field of anesthesia and intensive care consist of reducing both anesthetic risks and mortality rate. The ASA score plays an important role in patients' preanesthetic evaluation. In this paper, we propose a methodology to derive simple rules which classify patients in a category of the ASA scale on the basis of their medical characteristics. METHODS: This diagnosis system is based on MR-Sort, a multiple criteria decision analysis model...
September 2016: Computer Methods and Programs in Biomedicine
Balachundhar Subramanian, Charles Nyman, Maria Fritock, Rebecca Y Klinger, Roman Sniecinski, Philip Roman, Julie Huffmyer, Michelle Parish, Gayane Yenokyan, Charles W Hogue
BACKGROUND: The purpose of this multicenter pilot study was to: (1) determine the frequency of regional cerebral oxygen saturation (rScO2) desaturations during cardiac surgery involving cardiopulmonary bypass (CPB); (2) evaluate the accuracy of clinician-identified rScO2 desaturations compared with those recorded continuously during surgery by the near-infrared spectroscopy (NIRS) monitor; and (3) assess the effectiveness of an intervention algorithm for reversing rScO2 desaturations...
June 2016: Anesthesia and Analgesia
Bin Han, Yajie Liu, Xiaoqing Zhang, Jun Wang
BACKGROUND: Difficult airway may result in significant morbidity and mortality. Proficient airway evaluation, therefore, is one of the key elements in the safe conduct of anesthesia. A three-dimensional (3D) printing model was recently introduced for medical application. 3D printing is a fast, convenient, and relatively affordable technique. We present a case in which a 3D-printed airway model was successfully used for airway evaluation. CASE PRESENTATION: A 77-year-old man who had previously undergone total laryngectomy was scheduled for resection of a pelvic mass...
January 19, 2016: BMC Anesthesiology
Michael S Axley, Katie J Schenning
PURPOSE: The identification of older patients who may have deficits in cognitive or functional domains will become more pressing as increasing numbers of these patients present for preoperative evaluations. The number of older adults with deficiencies in these areas is projected to grow, and more of these patients will present for assessment in preoperative clinics with the expectation that surgeries will be performed. METHODS: We review current outcomes data for preoperative cognitive impairment and frailty...
December 1, 2015: Clinical Therapeutics
Julien Bordes, Pierre-Julien Cungi, Pierre-Henry Savoie, Stéphane Bonnet, Eric Kaiser
INTRODUCTION: The assessment of anesthetic risks is an essential component of preoperative evaluation. In developing world, preanesthesia evaluation may be challenging because patient's medical history and records are scare, and language barrier limits physical examination. Our objective was to evaluate the impact of routine preoperative testing in a low-resources setting. METHODS: Prospective observational study performed in a French forward surgical unit in Abidjan, Ivory Coast...
2015: Pan African Medical Journal
Omar Viswanath, Allan F Simpao, Sushmitha Santhosh
We present the case of an asymptomatic 82-year-old patient with no coronary artery disease and a negative cardiac workup who presented to the hospital for an elective total knee replacement. The patient had stable vital signs in the preanesthesia holding unit, yet the anesthesiologist recognized new-onset atrial fibrillation on the patient's monitor. The dysrhythmia was confirmed with a 12-lead electrocardiogram. The procedure was canceled, and the patient was sent for additional evaluation. An echocardiogram revealed a pulmonary embolism...
August 15, 2015: A & A Case Reports
Eric Wittkugel, Anna Varughese
BACKGROUND: Historically, anesthesiologists have conducted preanesthesia evaluation, but more recently, nurse practitioners (NPs) are increasingly assisting with the preanesthesia evaluation of children. In the current economic environment for healthcare, strategies to provide superior outcomes and exceptional patient experience at the lowest possible cost are constantly being explored. We examined whether well trained nurses, working alongside NPs, could safely and effectively assist in preanesthesia evaluation...
July 2015: Paediatric Anaesthesia
S Fischbeck, S Zimmer, R Laufenberg-Feldmann, W Laubach
BACKGROUND: The anesthesia premedication consultation is an obligatory procedure prior to any upcoming surgery. It is the anesthesiologist's responsibility to collect all necessary information regarding the patient's medical condition to decide on the appropriate narcosis and to ensure that the patient comprehends the anesthesia procedure and its effects. AIM: Information needs of patients regarding anesthesia are often not adequately fulfilled. This study was carried out to develop a structured questionnaire containing questions that patients may wish to ask the anesthesiologist (question prompt list anesthesiology QPL-A) to support information transfer from the anesthesiologist to the patient in the premedication consultation...
November 2014: Der Anaesthesist
Sammuel V Anderegg, Samaneh T Wilkinson, Rick J Couldry, Dennis W Grauer, Eric Howser
PURPOSE: The impact of an innovative medication reconciliation and discharge education program on 30-day readmissions and emergency department (ED) visits was evaluated. METHODS: An observational pre-post analysis was conducted at an academic medical center to compare rates of hospital readmissions and return to ED visits during three-month periods before and after implementation of a restructured pharmacy practice model including (1) medication reconciliation at transitions of care for every patient and discharge education for a high-risk subgroup, (2) new or expanded services in the preanesthesia testing clinic and ED, (3) a medication reconciliation technician team, and (4) pharmacist-to-patient ratios of 1:30 on acute care floors and 1:18 on critical care units...
September 1, 2014: American Journal of Health-system Pharmacy: AJHP
K Umgelter, A Anetsberger, S Schmid, E Kochs, B Jungwirth, M Blobner
BACKGROUND: The preanesthesia informed consent document is regarded mainly as a legal prerequisite but patient autonomy in the authorization of a proposed intervention requires that the relevant information is provided in a suitable and useful way. AIM: The information needs of patients was determined in relation to demographic parameters. This study carried out to evaluate if the expected extent of information regarding anesthesia during the preanesthesia visit was dependent on group-specific variables...
October 2014: Der Anaesthesist
Tomasz Gaszynski, Ewelina Gaszynska, Tomasz Szewczyk
Super-obese patients (body mass index [BMI] >50 kg/m(2)) are at a particularly high risk of anesthesia-related complications during postoperative period, eg, critical respiratory events including respiratory arrest, and over-sedation leading to problems with maintaining airway open, hypoxia and hypercapnia. In this paper authors present a case of a 39-year-old super-obese (BMI 62.3 kg/m(2)) female patient who was admitted for surgical treatment of obesity. Preanesthesia evaluation revealed hypertension and type 2 diabetes mellitus (DM) as comorbidities as well as potential for a difficult intubation- neck circumference of 46 cm, reduced neck mobility and DM type 2...
2014: Drug Design, Development and Therapy
Zhi-Hua Wang, Xin-Li Ni, Jian-Nan Li, Zhao-Yang Xiao, Chen Wang, Li-Na Zhang, Li Tong, Hai-Long Dong
BACKGROUND: Delayed emergence from general anesthesia frequently occurs in elderly patients, but the reason is not clear. Orexin has been shown to be involved in arousal from general anesthesia. In this study, we examined plasma orexin-A levels in both elderly and young patients during the anesthesia arousal cycle. METHODS: We recruited 41 patients scheduled for elective lumbar surgery and eventually evaluated 34 patients. Patients were divided into a young group (age 30-55, N = 16) and an elderly group (age 65-77, N = 18)...
April 2014: Anesthesia and Analgesia
Ingrid M M van Haelst, Wilton A van Klei, Hieronymus J Doodeman, Miriam J Warnier, Marie L De Bruin, Cor J Kalkman, Toine C G Egberts
OBJECTIVE: To investigate the association between the use of a selective serotonin reuptake inhibitor (SSRI) and the occurrence of QT interval prolongation in an elderly surgical population. METHOD: A cross-sectional study was conducted among patients (> 60 years) scheduled for outpatient preanesthesia evaluation in the period 2007 until 2012. The index group included elderly users of an SSRI. The reference group of nonusers of antidepressants was matched to the index group on sex and year of scheduled surgery (ratio, 1:1)...
January 2014: Journal of Clinical Psychiatry
Jaime Benarroch-Gampel, Taylor S Riall
Current recommendations from the 2002 ASA Task Force on Preanesthesia Evaluation are not specific to ambulatory surgery and are not based on strongly designed and adequately powered studies. Furthermore, although the ASA does not advocate routine testing or testing without indication, the guidelines for "selective" or "indicated" testing are unclear. As a result, preoperative testing in the United States is overused relative to the current ASA Task Force recommendations. Uncertainty regarding indications leads to wide variation in the use of preoperative testing across providers...
2013: Advances in Surgery
Jong-Han Lim, Seong-Il Wang, Do-Yeon Kim, Kyung-Jin Song, Tae Gyun Kim, Kwang-Bok Lee
BACKGROUND CONTEXT: The hyoid bone is used as a landmark in anterior upper cervical spine operations and is supposed to represent the level of C3 body. However, this correspondence between hyoid bone position and cervical level is not static and changes during surgery (extension after anesthesia). PURPOSE: To find the cervical level corresponding to the position of hyoid bone before and after anesthesia and to evaluate the adequacy of its usage as a surgical landmark...
September 1, 2014: Spine Journal: Official Journal of the North American Spine Society
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