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Anaesthesiology Interventions

R Likar, W Jaksch, T Aigmüller, M Brunner, T Cohnert, J Dieber, W Eisner, S Geyrhofer, G Grögl, F Herbst, R Hetterle, F Javorsky, H G Kress, O Kwasny, S Madersbacher, H Mächler, R Mittermair, J Osterbrink, B Stöckl, M Sulzbacher, B Taxer, B Todoroff, A Tuchmann, A Wicker, A Sandner-Kiesling
Despite many positive developments, postoperative pain and its treatment is still not always given the necessary attention. Severe pain after surgical procedures affects a significant proportion of patients. This very fact is not only detrimental to the immediate recovery process, but can also form the basis for the development of chronic pain conditions.An adequate and effective management of perioperative pain requires appropriate organizational structures. This multidisciplinary paper which was initiated by the Austrian Society for Anaesthesiology and Intensive Care and the Austrian Pain Society and developed together with numerous specialist and professional societies dealing with the subject aims at supporting the organization of perioperative pain management structures and to make best use of proven concepts...
April 13, 2017: Der Schmerz
Walid Habre, Nicola Disma, Katalin Virag, Karin Becke, Tom G Hansen, Martin Jöhr, Brigitte Leva, Neil S Morton, Petronella M Vermeulen, Marzena Zielinska, Krisztina Boda, Francis Veyckemans
BACKGROUND: Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. METHODS: The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures...
March 28, 2017: Lancet Respiratory Medicine
R Valero, E Carrero, N Fàbregas, F Iturri, N Saiz-Sapena, L Valencia
INTRODUCTION: The analysis of surgical processes should be a standard of health systems. We describe the circuit of care and postoperative treatment for neurosurgical interventions in the centres of our country. MATERIAL AND METHODS: From June to October 2014, a survey dealing with perioperative treatments and postoperative circuits after neurosurgical procedures was sent to the chiefs of Anaesthesiology of 73 Spanish hospitals with neurosurgery and members of the Neuroscience Section of SEDAR...
March 16, 2017: Revista Española de Anestesiología y Reanimación
Santi Mangiafico, Angelo Caruso, Raffaele Manta, Giuseppe Grande, Helga Bertani, Vincenzo Mirante, Flavia Pigò, Luigi Magnano, Mauro Manno, Rita Conigliaro
BACKGROUND AND AIM: The over-the-scope clip (OTSC) system is a recently developed endoscopic device. In the last few years it has been successfully used for severe bleeding or deep wall lesions, or perforations of the GI tract. We hereby report a series of patients with post pancreaticogastrostomy occuring pancreatic fistula in whom OTSCs were used as endoscopic treatment. METHODS: We prospectively collected data from January 2012 to July 2015 about cases of postoperative pancreatic fistula...
January 17, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Laurence Weinberg, Neil Collins, Kiara Van Mourik, Chong Tan, Rinaldo Bellomo
AIM: To outline the physiochemical properties and specific clinical uses of Plasma-Lyte 148 as choice of solution for fluid intervention in critical illness, surgery and perioperative medicine. METHODS: We performed an electronic literature search from Medline and PubMed (via Ovid), anesthesia and pharmacology textbooks, and online sources including studies that compared Plasma-Lyte 148 to other crystalloid solutions. The following keywords were used: "surgery", "anaesthesia", "anesthesia", "anesthesiology", "anaesthesiology", "fluids", "fluid therapy", "crystalloid", "saline", "plasma-Lyte", "plasmalyte", "hartmann's", "ringers" "acetate", "gluconate", "malate", "lactate"...
November 4, 2016: World Journal of Critical Care Medicine
D M Baron, P G H Metnitz, T Fellinger, B Metnitz, A Rhodes, S A Kozek-Langenecker
BACKGROUND: Several guidelines have been published to facilitate implementation of patient blood management (PBM). This study was performed to evaluate clinical practices in PBM. METHODS: An online survey based on the guidelines for the management of severe perioperative bleeding from the European Society of Anaesthesiology (ESA) was conducted among ESA members. We assessed characteristic data of participating physicians, preoperative assessment of bleeding risk and anaemia, intraoperative transfusion practices, specific pharmacologic treatment of significant bleeding, and clinical use of PBM algorithms...
November 2016: British Journal of Anaesthesia
Aaron Heller, John Dollerschell, Joshua Burk, Hailey Haines, Jonathan Kozinn
BACKGROUND: In the past decade, the rate and utilization of veno-venous extracorporeal membrane oxygenation (VV-ECMO) has increased dramatically. A single catheter technique has recently come into favour for providing VV-ECMO. Although it has been shown that intensivists can safely place these catheters, the safety of decannulation by intensivists has not been reported in the literature. OBJECTIVE: We describe a technique for safely decannulating the Avalon Elite VV-ECMO catheter at the bedside and assess the safety of this technique, as compared with the standard technique of decannulation in the operating room by a surgeon...
2016: Anaesthesiology Intensive Therapy
R N Werner, A F Nikkels, B Marinović, M Schäfer, M Czarnecka-Operacz, A M Agius, Z Bata-Csörgő, J Breuer, G Girolomoni, G E Gross, S Langan, R Lapid-Gortzak, T H Lesser, U Pleyer, J Sellner, G M Verjans, P Wutzler, C Dressler, R Erdmann, S Rosumeck, A Nast
Herpes zoster (HZ, shingles) is a frequent medical condition which may severely impact the quality of life of affected patients. Different therapeutic approaches to treat acute HZ are available. The aim of this European project was the elaboration of a consensus-based guideline on the management of patients who present with HZ, considering different patient populations and different localizations. This interdisciplinary guideline aims at an improvement of the outcomes of the acute HZ management concerning disease duration, acute pain and quality of life of the affected patients and at a reduction in the incidence of postherpetic neuralgia (PHN) and other complications...
January 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
M St Pierre, G Breuer, D Strembski, C Schmitt, B Lütcke
BACKGROUND: Unanticipated airway problems in infants can rapidly develop into severe hypoxemia. Team members can provide support and suggest steps of action if a shared mental model of the next steps exists. Briefing prior to induction of anaesthesia may create such a shared mental model among all team members. OBJECTIVES: The aim of the study was to assess whether a short briefing on the recommendations for an unexpected difficult airway, developed by the Working Group on Paediatric Anaesthesia of the German Society for Anaesthesiology and Intensive Care Medicine, would influence the management of an unexpected difficult mask ventilation in an infant...
September 2016: Der Anaesthesist
Na Zhao, Jin Xu, Balwinder Singh, Xuerong Yu, Taixiang Wu, Yuguang Huang
BACKGROUND: Cardiac complications are not uncommon in patients undergoing non-cardiac surgery, especially in patients with coronary artery disease (CAD) or at high risk of CAD. Perioperative cardiac complications can lead to mortality and morbidity, as well as higher costs for patient care. Nitrates, which are among the most commonly used cardiovascular drugs, perform the function of decreasing cardiac preload while improving cardiac blood perfusion. Sometimes, nitrates are administered to patients undergoing non-cardiac surgery to reduce the incidence of cardiac complications, especially for patients with CAD...
August 4, 2016: Cochrane Database of Systematic Reviews
L Quecedo Gutiérrez, R Ruiz Abascal, J M Calvo Vecino, A I Peral García, E Matute González, L E Muñoz Alameda, E Guasch Arévalo, F Gilsanz Rodríguez
In April 2013 the Ministry of Health (MSSSI) adopted the project called "Commitment to Quality by Scientific Societies in Spain", in response to social and professional demands for sustainability of the health system. The initiative is part of the activities of the Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System, and is coordinated jointly by the Quality and Cohesion Department, the Aragon Institute of Health Sciences (IACS), and the Spanish Society of Internal Medicine (SEMI)...
November 2016: Revista Española de Anestesiología y Reanimación
Vanessa Cartier, Cigdem Inan, Walter Zingg, Cecile Delhumeau, Bernard Walder, Georges L Savoldelli
BACKGROUND: Multimodal educational interventions have been shown to improve short-term competency in, and knowledge of central venous catheter (CVC) insertion. OBJECTIVE: To evaluate the effectiveness of simulation-based medical education training in improving short and long-term competency in, and knowledge of CVC insertion. DESIGN: Before and after intervention study. SETTING: University Geneva Hospital, Geneva, Switzerland, between May 2008 and January 2012...
August 2016: European Journal of Anaesthesiology
J Claesson, M Freundlich, I Gunnarsson, J H Laake, M H Møller, P O Vandvik, T Varpula, T A Aasmundstad
BACKGROUND: The objective of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) task force on fluid and drug therapy in adults with acute respiratory distress syndrome (ARDS) was to provide clinically relevant, evidence-based treatment recommendations according to standards for trustworthy guidelines. METHODS: The guideline was developed according to standards for trustworthy guidelines, including a systematic review of the literature and use of the GRADE methodology for assessment of the quality of evidence and for moving from evidence to recommendations...
July 2016: Acta Anaesthesiologica Scandinavica
Johannes Prottengeier, Marlen Petzoldt, Nikola Jess, Andreas Moritz, Christine Gall, Joachim Schmidt, Georg Breuer
BACKGROUND: Dual-tasking, the need to divide attention between concurrent tasks, causes a severe increase in workload in emergency situations and yet there is no standardised training simulation scenario for this key difficulty. OBJECTIVES: We introduced and validated a quantifiable source of divided attention and investigated its effects on performance and workload in airway management. DESIGN: A randomised, crossover, interventional simulation study...
March 2016: European Journal of Anaesthesiology
Jochen Renner, Christian Frerker, Karl-Heinz Kuck, Berthold Bein
Recent advancements in the field of cardiovascular surgery have been dominated by 3 aspects that comparably challenge a sophisticated cardiological, surgical and anaesthesiological management of this patient population. The proportion of elderly patients with relevant comorbidities increases steadily, and the number of combined cardiac surgical procedures is rising in this elderly population. A very important innovation in the last decade pertaining to the treatment of elderly patients at high risk suffering from significant aortic stenosis is the minimally invasive transcatheter aortic valve implantation (TAVI)...
November 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Ismail Gögenur
Identification of patients with high risk for post-operative complications is instrumental in all surgical specialities. Proper identification can in some cases lead to preoperative or intraoperative optimization resulting in reduced morbidity and morbidity. Several scoring systems exist for assessing overall mortality risk. Preoperative functional tests and biochemical risk markers have shown to be effective in predicting post-operative medical complications and mortality. Optimization can be done by medical interventions, improved anaesthesiological care and optimization directed towards improved communication in the surgical team...
August 17, 2015: Ugeskrift for Laeger
Laurence Rozen, David Faraoni, Cristel Sanchez Torres, Ariane Willems, Denis C F Noubouossie, Dragos Barglazan, Philippe Van der Linden, Anne Demulder
BACKGROUND: Although recent studies have assessed tranexamic acid (TXA) pharmacokinetics in different subgroups, the effective concentration of TXA required to completely inhibit fibrinolysis remains to be determined. OBJECTIVE: An in-vitro determination of the effective TXA concentration needed for 95% inhibition (EC95) of tissue-type plasminogen activator (t-PA) activated fibrinolysis, using an experimental model designed for thromboelastometry (ROTEM). DESIGN: A prospective interventional study...
December 2015: European Journal of Anaesthesiology
Denise P Veelo, Suzanne S Gisbertz, Rebekka A Hannivoort, Susan van Dieren, Bart F Geerts, Mark I van Berge Henegouwen, Markus W Hollmann
BACKGROUND: Deep muscle relaxation has been shown to facilitate operating conditions during laparoscopic surgery. Minimally invasive esophageal surgery is a high-risk procedure in which the use of deep neuromuscular block (NMB) may improve conditions in the thoracic phase as well. Neuromuscular antagonists can be given on demand or by continuous infusion (deep NMB). However, the positioning of the patient often hampers train-of-four (TOF) monitoring. A continuous infusion thus may result in a deep NMB at the end of surgery...
August 5, 2015: Trials
S M McHugh, T Aherne, T Goetz, J Byrne, E Boyle, M Allen, A Leahy, D Moneley, P Naughton
INTRODUCTION: Endovascular aneurysm repair (EVAR) is a comparatively less invasive technique than open repair (OR). Debate remains with regard to the benefit of EVAR for patients with ruptured abdominal aortic aneurysm (RAAA). We sought to evaluate and report outcomes of EVAR for RAAA in an Irish tertiary vascular referral centre. METHODS: Patients undergoing emergency surgery for ruptured or symptomatic AAA were identified from theatre logbooks and HIPE database...
October 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Matthias Grünewald
Due to the demographic and medical development, the number of patients with heart failure needing anaesthesiological care will continue to grow in the upcoming years. For the optimal care of these patients close coordination between the surgically treating, the cardiology and the anesthesiological department is important. Cardiac function and structural characters, such as cardiac valve defects should be known preoperatively. Thus, the anaesthetic management, intraoperative monitoring, as well as necessary pharmacological interventions can be tailored...
May 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
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