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Obesity anaesthesia

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https://www.readbyqxmd.com/read/29242649/dose-reversal-effect-relationship-of-three-different-doses-of-neostigmine-in-obese-patients-a-randomised-clinical-trial
#1
Satyen Parida, Venkatesan Kausalya, Sandeep Kumar Mishra, Sethuramachandran Adinarayanan
Background and Aims: Previous studies suggest that administration of vecuronium based on total body weight rather than ideal body weight (IBW) in obesity results in overdosing with prolonged recovery times. We hypothesised that larger doses of neostigmine could result in faster recovery in obese patients administered vecuronium based on total body weight. Methods: Forty-five obese American Society of Anesthesiologists' II patients undergoing elective surgery under general anaesthesia were randomised into 3 groups to receive neostigmine 30, 40 and 50 μg/kg...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29223575/a-comparison-between-inhalational-desflurane-and-total-intravenous-anaesthesia-propofol-and-dexmedetomidine-in-improving-postoperative-recovery-for-morbidly-obese-patients-undergoing-laparoscopic-sleeve-gastrectomy-a-double-blinded-randomised-controlled-trial
#2
Abd-Elazeem Elbakry, Wesam-Eldin Sultan, Ezzeldin Ibrahim
STUDY OBJECTIVE: Laparoscopic sleeve gastrectomy is commonly performed under total intravenous anaesthesia (TIVA) or balanced anaesthesia using an intravenous and inhalation agent. It is still unclear which anaesthesia regimen is better for this group of patients. The present study has been conducted to compare the use of the inhalation anaesthesia technique using desflurane with the TIVA technique, using propofol and dexmedetomidine. DESIGN: Prospective, randomised, double-blinded study...
December 7, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29188308/ureteroscopy-from-the-recent-past-to-the-near-future
#3
REVIEW
José Manuel Reis Santos
Stone surgery is one of oldest surgical practices undertaken by man. Hippocrates refused to let his followers "cut for the stone" and it was only in February 1980, when the first human trial of shock wave therapy on a renal stone was performed with success that a new era in minimally invasive treatment (surgery) for stones was opened up and this condemnation was finally resolved in the Hippocratic Oath. Endoscopy, using natural orifices, supported by anaesthesia, incremented by technology and with access to all points along the urinary tract, began by competing with ESWL, but is now the treatment of choice in most cases...
November 29, 2017: Urolithiasis
https://www.readbyqxmd.com/read/29159892/reliability-of-body-weight-scalars-on-the-assessment-of-propofol-induction-dose-in-obese-patients
#4
A M Araújo, H S Machado, A C Falcão, P Soares-da-Silva
BACKGROUND: Obese patients require specific perioperative care when compared with non-obese patients. The present study aimed to analyse the ability of size descriptors to estimate propofol induction dose in class II and III obese patients. METHODS: A cross-sectional study on adult patients with body mass index (BMI) equal to or greater than 35 kg/m2 and on adult patients with BMI lower than 35 kg/m2 was carried out. General anaesthesia was induced with remifentanil, propofol and rocuronium...
November 21, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29156486/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives
#5
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the society for Obstetric anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29114413/perioperative-factors-affecting-ambulatory-outcomes-following-laparoscopic-adjustable-gastric-banding
#6
Mirsad Dupanovic, Ron Krebill, Iris Dupanovic, John Nachtigal, Melissa Rockford, Walter Orr
Objective: Morbidly obese patients are traditionally hospitalised following bariatric surgery. However, laparoscopic-adjustable gastric banding (LAGB) is amenable for ambulatory care. We hypothesised that the majority of patients can receive an ambulatory LAGB and that both surgical and anaesthetic perioperative factors will significantly affect non-ambulatory LAGB outcomes. Methods: Medical records of 201 consecutive LAGB patients performed at the University of Kansas Medical Centre during a 3-y period were reviewed...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29050063/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives-part-1
#7
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the Society for Obstetric Anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29045567/individualized-positive-end-expiratory-pressure-in-obese-patients-during-general-anaesthesia-a-randomized-controlled-clinical-trial-using-electrical-impedance-tomography
#8
C Nestler, P Simon, D Petroff, S Hammermüller, D Kamrath, S Wolf, A Dietrich, L M Camilo, A Beda, A R Carvalho, A Giannella-Neto, A W Reske, H Wrigge, Jonathan Thompson
Background: General anaesthesia leads to atelectasis, reduced end-expiratory lung volume (EELV), and diminished arterial oxygenation in obese patients. We hypothesized that a combination of a recruitment manoeuvre (RM) and individualized positive end-expiratory pressure (PEEP) can avoid these effects. Methods: Patients with a BMI ≥35 kg m -2 undergoing elective laparoscopic surgery were randomly allocated to mechanical ventilation with a tidal volume of 8 ml kg -1 predicted body weight and (i) an RM followed by individualized PEEP titrated using electrical impedance tomography (PEEP IND ) or (ii) no RM and PEEP of 5 cm H 2 O (PEEP 5 )...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28840525/laparoscopic-sleeve-gastrectomy-versus-banded-roux-en-y-gastric-bypass-for-diabetes-and-obesity-a-prospective-randomised-double-blind-trial
#9
Rinki Murphy, Michael G Clarke, Nicholas J Evennett, S John Robinson, M Lee Humphreys, Hisham Hammodat, Bronwen Jones, David D Kim, Richard Cutfield, Malcolm H Johnson, Lindsay D Plank, Michael W C Booth
BACKGROUND: There are very few randomised, blinded trials comparing laparoscopic sleeve gastrectomy (LSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB) in achieving remission of type 2 diabetes (T2D), particularly silastic ring (SR)-LRYGB. We compared the effectiveness of (LSG) versus SR-LRYGB among patients with T2D and morbid obesity. METHODS: Prospective, randomised, parallel, 2-arm, blinded clinical trial conducted in a single Auckland (New Zealand) centre...
August 24, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28833337/maternal-body-mass-index-and-regional-anaesthesia-use-at-term-prevalence-and-complications
#10
Frances M Biel, Nicole E Marshall, Jonathan M Snowden
BACKGROUND: There is an evidence gap regarding the use of regional anaesthesia (epidural, spinal, or combined epidural/spinal anaesthesia) and associated complications by maternal body mass index (BMI). We examine associations between regional anaesthesia, mode of delivery, and regional anaesthesia complications by pre-pregnancy BMI categories among term deliveries. METHODS: Retrospective cohort study of births in California, 2007-2010, utilizing linked birth certificate data and patient discharge data...
August 22, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28794858/monitoring-respiration-and-oxygen-saturation-in-patients-during-the-first-night-after-elective-bariatric-surgery-a-cohort-study
#11
Liselott Wickerts, Sune Forsberg, Frederic Bouvier, Jan Jakobsson
Background: Obstructive sleep apnoea and obese hypoventilation is not uncommon in patients with obesity. Residuals effect from surgery/anaesthesia and opioid analgesics may worsen respiration during the first nights after bariatric surgery. The aim of this observational study was to monitor respiration on the first postoperative night following elective bariatric surgery. Methods: This observational study aimed to determine the incidence and severity of hypo/apnoea in low risk obsess patients undergoing elective bariatric surgery in general anesthaesia...
2017: F1000Research
https://www.readbyqxmd.com/read/28707209/anaesthetic-preparation-of-obese-patients-current-status-on-optimal-work-up
#12
REVIEW
Asta Lukosiute, Anil Karmali, Jonathan Mark Cousins
PURPOSE OF REVIEW: With the prevalence of obesity rapidly growing, bariatric anaesthesia becomes everyday anaesthesia rather than a subspecialty. In this review, we are aiming to draw attention to this complex group of patients and their comorbidities, relevant to everyday practice for contemporary anaesthetists. RECENT FINDINGS: We wanted to focus greatly on sleep-related breathing disorders, because preoperative screening, diagnosis and treatment of the aforementioned make a huge impact in the improvement of preoperative morbidity and mortality, including positive effects on the cardiovascular system...
September 2017: Current Obesity Reports
https://www.readbyqxmd.com/read/28695876/impact-of-obesity-on-surgical-outcome-after-single-incision-laparoscopic-cholecystectomy
#13
Toru Obuchi, Noriaki Kameyama, Masato Tomita, Hiroaki Mitsuhashi, Ryohei Miyata, Shigeaki Baba
INTRODUCTION: Single-incision laparoscopic cholecystectomy (SILC) is widely used as a treatment option for gallbladder disease. However, obesity has been considered a relative contraindication to this approach due to more advanced technical difficulties. The aim of this report was to review our experience with SILC to evaluate the impact of body mass index (BMI) on the surgical outcome. PATIENTS AND METHODS: Between May 2009 and February 2013, 237 patients underwent SILC at our institute...
July 7, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28667219/associations-between-maternal-size-and-health-outcomes-for-women-undergoing-caesarean-section-a-multicentre-prospective-observational-study-the-mum-size-study
#14
Alicia Therese Dennis, Karen Elaine Lamb, David Story, Michelle Tew, Kim Dalziel, Philip Clarke, Jospeh Lew, Anna Parker, Elizabeth Hessian, Gyln Teale, Scott Simmons, Dan Casalaz
OBJECTIVES: To investigate associations between maternal body mass index (BMI) at delivery (using pregnancy-specific BMI cut-off values 5 kg/m(2) higher in each of the WHO groups) and clinical, theatre utilisation and health economic outcomes for women undergoing caesarean section (CS). DESIGN: A prospective multicentre observational study. SETTING: Seven secondary or tertiary referral obstetric hospitals. PARTICIPANTS: One thousand and four hundred and fifty-seven women undergoing all categories of CS...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28629668/underestimating-the-size-of-the-problem-uk-anaesthesia-for-patients-with-obesity
#15
James Palmer, Mike Sury, Claire Nightingale, Jaideep Pandit, Tim Cook
We analysed data from 14,000 patients in the 2013 United Kingdom Anaesthesia Activity Survey of the Fifth National Audit Project of the Royal College of Anaesthetists and Association of Anaesthetists of Great Britain and Ireland to examine anaesthetic, organisational and clinical practice for patients with obesity. We compared practice then with current guidance on management of this patient group. Obesity was reported in 22%, mainly Black, Afro-Caribbean and White Caucasian patients. There was minimal variation in surgical timing, anaesthetic seniority, induction location or day-case procedure rates...
June 16, 2017: Obesity Research & Clinical Practice
https://www.readbyqxmd.com/read/28528537/intraoperative-mechanical-ventilation-state-of-the-art
#16
Lorenzo Ball, Federico Costantino, Giulia Orefice, Karthikka Chandrapatham, Paolo Pelosi
Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review was to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass...
October 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28513831/avoidance-versus-use-of-neuromuscular-blocking-agents-for-improving-conditions-during-tracheal-intubation-or-direct-laryngoscopy-in-adults-and-adolescents
#17
REVIEW
Lars H Lundstrøm, Christophe Hv Duez, Anders K Nørskov, Charlotte V Rosenstock, Jakob L Thomsen, Ann Merete Møller, Søren Strande, Jørn Wetterslev
BACKGROUND: Tracheal intubation during induction of general anaesthesia is a vital procedure performed to secure a patient's airway. Several studies have identified difficult tracheal intubation (DTI) or failed tracheal intubation as one of the major contributors to anaesthesia-related mortality and morbidity. Use of neuromuscular blocking agents (NMBA) to facilitate tracheal intubation is a widely accepted practice. However, because of adverse effects, NMBA may be undesirable. Cohort studies have indicated that avoiding NMBA is an independent risk factor for difficult and failed tracheal intubation...
May 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28456134/improvement-in-baroreflex-control-of-renal-sympathetic-nerve-activity-in-obese-sprague-dawley-rats-following-immunosuppression
#18
S A Khan, M Z A Sattar, N A Abdullah, H A Rathore, A Ahmad, M H Abdulla, E J Johns
AIM: This investigation explored the hypothesis that in obesity an inflammatory response in the kidney contributed to a renal nerve-dependent blunting of the baroreflex regulation of renal sympathetic nerve activity. METHODS: Rats received a normal (12% kcal) or high-fat (45% kcal) diet for 8 weeks plus daily injections of vehicle (0.9% NaCl i.p) or tacrolimus (0.25 mg kg(-1) day(-1) i.p) from weeks 3-8. Following anaesthesia, left renal sympathetic nerve activity was recorded, baroreflex gain curves were generated, by infusing phenylephrine and sodium nitroprusside, and cardiopulmonary baroreceptors challenged by infusing a saline load...
April 29, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28390919/symptomatic-deep-femoral-artery-pseudoaneurysm-endovascular-exclusion-case-report-and-literature-review
#19
Felice Pecoraro, Ettore Dinoto, Umberto M Bracale, Giovanni Badalamenti, Arduino Farina, Guido Bajardi
Deep femoral artery pseudoaneurysms (DFAPs) are rare and generally occur after penetrating trauma or surgical procedures. A 36-year-old obese man presented with pain in correspondence of the anterior-lateral thigh after 6 months from gunshot wound. Duplex and computed tomography (CT) showed a bilobed right DFAP (maximal diameter 12.9 cm). The patient was managed urgently, under local anesthesia, by placement in the distal DFA of a Viabahn 8 × 100-mm stent graft (W L Gore & Associates, Inc). The postoperative course was uneventful, and the 24-month CT showed regular stent-graft patency and 20-mm DFAP shrinkage...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28216710/anaesthesia-for-emergency-caesarean-section-in-a-morbidly-obese-achondroplastic-patient-with-pih-feasibility-of-neuraxial-anaesthesia
#20
Ridhima Sharma, Rohan Magoon, Ripon Choudhary, Punit Khanna
No abstract text is available yet for this article.
January 2017: Indian Journal of Anaesthesia
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