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Thoracic surgery complications anesthesia

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https://www.readbyqxmd.com/read/29783029/comparison-of-stanford-b-aortic-dissection-patients-who-received-tevar-combined-with-or-without-sleep-apnea-syndrome
#1
Xin Li, Wenwu Cai, Ping Zhang, Kun Fang, Jieting Zhu, Chang Shu
BACKGROUND: Patients with Stanford B aortic dissection usually complicated with sleep apnea syndrome. This condition always threatens the patients' respiration situation. In this study, we collected and analysis data of patients' peri-operative managements of Thoracic Endovascular Aortic Repair (TEVAR) for Stanford B Aortic Dissection (AD) complicated with Sleep Apnea Syndrome (SAS). Comparison has been made between these SAS patients and those who without SAS. METHODS: Between June 2013 and June 2014, the clinical data and outcomes of the Stanford B AD patients in the department of vascular surgery in the Second Xiangya Hospital were retrospectively reviewed and studied...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29721359/acute-cauda-equina-syndrome-following-orthopedic-procedures-as-a-result-of-epidural-anesthesia
#2
Lisa B E Shields, Vasudeva G Iyer, Yi Ping Zhang, Christopher B Shields
Background: Cauda equina syndrome (CES) is a rare complication of spinal or epidural anesthesia. It is attributed to direct mechanical injury to the spinal roots of the cauda equina that may result in saddle anesthesia and paraplegia with bowel and bladder dysfunction. Case Description: The first patient underwent a hip replacement and received 5 mL of 1% lidocaine epidural anesthesia. Postoperatively, when the patient developed an acute CES, the lumbar magnetic resonance imaging (MRI) scan demonstrated clumping/posterior displacement of nerve roots of the cauda equina consistent with adhesive arachnoiditis attributed to the patient's previous L4-L5 lumbar decompression/fusion...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29714650/real-time-view-of-anesthetic-solution-spread-during-an-ultrasound-guided-thoracic-paravertebral-block
#3
Domenico P Santonastaso, Annabella de Chiara, Marco Rispoli, Giovanni Musetti, Vanni Agnoletti
BACKGROUND: Thoracic paravertebral block is a technique for perioperative analgesia in patients undergoing thoracic, chest wall, or breast surgery, or for pain management with rib fractures, which can be performed with or without ultrasound guidance. The ultrasound guidance technique can be used to identify the thoracic paravertebral space, guide needle placement, monitor the spread of local anesthetic (LA) solution, and reduce complications such as pleural puncture and pneumothorax. The possibility of assessing anesthetic spread in real time using ultrasound guidance during paravertebral block offers numerous advantages, including the immediate and accurate identification of the extent of nervous block, with a consequent reduction of LA dose...
March 1, 2018: Tumori
https://www.readbyqxmd.com/read/29707376/is-laryngeal-mask-airway-general-anesthesia-feasible-for-minimally-invasive-esophagectomy
#4
Rui-Xiang Zhang, Yin Li, Xian-Ben Liu, Xi-Hua Lu, Hai-Bo Sun, Zong-Fei Wang, Shi-Lei Liu, Yan Zheng, Xiao-Fei Liu, Xiu-Xia Wu
Minimally invasive esophagectomy (MIE) has been identified as an oncological method with lower mortality and morbidity. This procedure is usually performed under general anesthesia using double endotracheal tube intubation and one-lung ventilation for a good visualization like other video-assisted thoracoscopic surgery (VATS). However, it is difficult to differentiate weather the postoperative hoarseness is caused by intubation or by recurrent laryngeal nerve injury during operation, and some complications related to intubation also are the focus of thoracic surgeons...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29701420/lumbar-cerebrospinal-fluid-drainage-in-endovascular-aortic-repair-reference-centre-experience
#5
Ana Margarida Martins, Marisa Silva, Maria de Lurdes Castro, Ana Ferro
INTRODUCTION: Spinal cord ischemia (SCI) and the resulting paraplegia are one of the most feared postoperative complications after thoraco-abdominal aortic surgery, with an incidence 4,3-8,0% after thoracic endovascular aortic repair (TEVAR), increasing patients morbi-mortality. Lumbar cerebrospinal fluid (CSF) drainage catheter is recommended as preventive measure in high risk patients. OBJECTIVE: To evaluate the efficiency and safety of CSF drainage catheter as preventive or therapeutic measure in endovascular aortic repair (EAR)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29696225/logis-localization-of-ground-glass-opacity-and-pulmonary-lesions-for-minimal-surgery-registry-design-and-rationale
#6
Chul Hwan Park, Dong Jin Im, Sang Min Lee, Ji Won Lee, Sung Ho Hwang, Semin Chong, Min Jae Cha, Kye Ho Lee, Woocheol Kwon, Hwan Seok Yong, Jae Wook Lee, Gong Yong Jin, Sang Hyun Paik, Kyunghwa Han, Jin Hur
Background and purpose: An optimal pulmonary localization technique for video-assisted thoracic surgery (VATS) of small lung nodules has not yet been established. The LOcalization of Ground-glass-opacity and pulmonary lesions for mInimal Surgery (LOGIS) registry aims to establish a multicenter database and investigate the usefulness and safety of localization techniques for small pulmonary lesions in individuals undergoing VATS. Methods/Design: The LOGIS registry is a large-scale, multicenter cohort study, aiming to enroll 825 patients at 10 institutions...
March 2018: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29686989/enhanced-recovery-after-surgery-protocols-in-major-urologic-surgery
#7
REVIEW
Natalija Vukovic, Ljubomir Dinic
The purpose of the review: The analysis of the components of enhanced recovery after surgery (ERAS) protocols in urologic surgery. Recent findings: ERAS protocols has been studied for over 20 years in different surgical procedures, mostly in colorectal surgery. The concept of improving patient care and reducing postoperative complications was also applied to major urologic surgery and especially procedure of radical cystectomy. This procedure is technically challenging, due to a major surgical resection and high postoperative complication rate that may reach 65%...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29629201/anesthesia-and-fast-track-in-video-assisted-thoracic-surgery-vats-from-evidence-to-practice
#8
REVIEW
Marzia Umari, Stefano Falini, Matteo Segat, Michele Zuliani, Marco Crisman, Lucia Comuzzi, Francesco Pagos, Stefano Lovadina, Umberto Lucangelo
In thoracic surgery, the introduction of video-assisted thoracoscopic techniques has allowed the development of fast-track protocols, with shorter hospital lengths of stay and improved outcomes. The perioperative management needs to be optimized accordingly, with the goal of reducing postoperative complications and speeding recovery times. Premedication performed in the operative room should be wisely administered because often linked to late discharge from the post-anesthesia care unit (PACU). Inhalatory anesthesia, when possible, should be preferred based on protective effects on postoperative lung inflammation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29629197/enhanced-recovery-after-thoracic-surgery-patient-information-and-care-plans
#9
REVIEW
Majed Refai, Marco Andolfi, Paolo Gentili, Gilda Pelusi, Francesca Manzotti, Armando Sabbatini
Many studies have confirmed that the implementation of enhanced recovery after surgery (ERAS) protocols has the advantages of reducing the potential complications after thoracic surgery and the length of hospital stay. The ERAS program involves a multidisciplinary team, aimed at integrating evidence-based knowledge into clinical practice in order to reduce the patient's stress response to the surgical procedure and improve the response to stress, guaranteeing a combination of better outcomes and cost savings...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29624542/effects-of-combined-lower-thoracic-epidural-general-anesthesia-on-pain-control-in-patients-undergoing-elective-lumbar-spine-surgery-a-randomized-controlled-trial
#10
Marvin Thepsoparn, Jariya Sereeyotin, Patt Pannangpetch
STUDY DESIGN: Randomized controlled trial. OBJECTIVE: Our objective was to compare postoperative pain relief and operating field condition of single shot low thoracic epidural anesthesia combined with general anesthesia versus general anesthesia alone. SUMMARY OF BACKGROUND DATA: Prior studies have suggested that continuous epidural analgesia provides better postoperative pain relief and less intraoperative blood loss, but with the risk of the epidural catheter contaminating the surgical field...
April 5, 2018: Spine
https://www.readbyqxmd.com/read/29616352/efast-for-the-diagnosis-of-a-perioperative-complication-during-percutaneous-nephrolithotomy
#11
Achyut Sharma, Prajjwal Bhattarai, Apurb Sharma
A 29-year-old patient with normal preanesthetic evaluation was planned for percutaneous nephrolithotomy (PCNL) for right nephrolithiasis with right pyelolithiasis. Surgery was performed under general anesthesia with endotracheal intubation with muscle relaxation. At the conclusion of surgery, when the patient was turned over to supine position, tense abdomen was noted. Immediately extended focused assessment with sonography in trauma (eFAST) was done in which both right and left quadrants of abdomen including pericardial and suprapubic region, right and left thoracic, and both lung basis were examined...
April 3, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29607171/enhanced-recovery-after-thoracic-surgery-reduces-discharge-on-highly-dependent-narcotics
#12
Min P Kim, Edward Y Chan, Leonora M Meisenbach, Razvan Dumitru, Jessica K Brown, Faisal N Masud
Background: There is large prescription drug epidemic in United States. We want to determine if ERATS (enhanced recovery after thoracic surgery) program can reduce discharge on highly dependent narcotics. Methods: We performed a retrospective analysis of prospectively collected data on patients who underwent lung resection and foregut procedures on thoracic surgery service over an 8-month time period. Patients underwent preoperative conditioning instructions, multimodal non-narcotic pharmaceutical usage, total intravenous anesthesia (TIVA) and minimizing highly addictive narcotics during the post-operative period...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29556592/late-onset-aortoesophageal-fistula-after-treatment-of-a-chronic-type-b-aortic-dissection-with-a-three-step-approach
#13
Marco Virgilio Usai, Antje Gottschalk, Thomas Schönefeld, Johannes Frederik Schaefers, Giovanni B Torsello, Andreas Rukosujew
Aortoesophageal fistula is a rare but lethal complication after thoracic endovascular repair for thoracic aortic diseases. Extensive treatment is reserved for patients fit for surgery. Various technical approaches have been described; however, mortality rates are still high. Herein, we report a case of a 76-year-old woman with aortoesophageal fistula treated by a three-step treatment approach, with close collaboration between cardiothoracic and general surgery specialists. The patient required tracheostomy after the first procedure, but this was closed at 15 days...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29519377/a-multidisciplinary-approach-on-the-perioperative-antithrombotic-management-of-patients-with-coronary-stents-undergoing-surgery-surgery-after-stenting-2
#14
REVIEW
Roberta Rossini, Giuseppe Tarantini, Giuseppe Musumeci, Giulia Masiero, Emanuele Barbato, Paolo Calabrò, Davide Capodanno, Sergio Leonardi, Maddalena Lettino, Ugo Limbruno, Alberto Menozzi, U O Alfredo Marchese, Francesco Saia, Marco Valgimigli, Walter Ageno, Anna Falanga, Antonio Corcione, Alessandro Locatelli, Marco Montorsi, Diego Piazza, Andrea Stella, Antonio Bozzani, Alessandro Parolari, Roberto Carone, Dominick J Angiolillo
Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided...
March 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29445595/anesthesia-and-analgesia-how-does-the-role-of-anesthetists-changes-in-the-eras-program-for-vats-lobectomy
#15
Federico Piccioni, Riccardo Ragazzi
Enhanced recovery after surgery (ERAS) programs are developed to prevent factors that delay postoperative recovery as well as issues that cause complications. The development of video-assist thoracoscopic surgery (VATS) techniques favors the fast recovery after thoracic procedures. ERAS strategies are based on multidisciplinary approach in which the anesthetist plays an important role from the preoperative to the postoperative phase with several goals. After preoperative evaluation and medical optimization, the anesthetist must ensure a tailored anesthetic plan aiming to a fast recovery and adequate pain relief to reduce the response to the surgical stress...
2018: Journal of visualized surgery
https://www.readbyqxmd.com/read/29434629/transcatheter-versus-surgical-aortic-valve-replacement-in-severe-symptomatic-aortic-stenosis
#16
REVIEW
Tsigkas Grigorios, Despotopoulos Stefanos, Makris Athanasios, Koniari Ioanna, Armylagos Stylianos, Davlouros Periklis, Hahalis George
Aortic stenosis (AS) is the most common type of valvular heart disease in the elderly. Surgical aortic valve replacement (SAVR) has been the standard practice for treating severe, symptomatic AS, but recently new treatment options have emerged. Transcatheter aortic valve replacement (TAVR) is now an established treatment option in patients at high surgical risk. In this review, we focus on recent developments and compare the two treatment methods in specific populations in terms of efficacy and safety (e.g...
January 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29416465/opioid-sparing-effects-of-the-thoracic-interfascial-plane-blocks-a-meta-analysis-of-randomized-controlled-trials
#17
REVIEW
Preet Mohinder Singh, Anuradha Borle, Manpreet Kaur, Anjan Trikha, Ashish Sinha
Background: Thoracic interfascial plane blocks and modification (PECS) have recently gained popularity for analgesic potential during breast surgery. We evaluate/consolidate the evidence on opioid-sparing effect of PECS blocks in comparison with conventional intravenous analgesia (IVA) and paravertebral block (PVB). Materials and Methods: Prospective, randomized controlled trials comparing PECS block to conventional IVA or PVB in patients undergoing breast surgery published till June 2017 were searched in the medical database...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29416456/evaluation-of-safety-and-efficacy-of-regional-anesthesia-compared-with-general-anesthesia-in-thoracoscopic-lung-biopsy-procedure-on-patient-with-idiopathic-pulmonary-fibrosis
#18
Waseem M Hajjar, Sami A Al-Nassar, Ghaida S Al-Sugair, Alaa Al-Oqail, Shahd Al-Mansour, Rand Al-Haweel, Adnan W Hajjar
Background: Interstitial lung diseases are diseases that need histology diagnosis or obtaining a lung biopsy to establish the diagnosis. Surgical biopsies are performed usually using the thoracoscopy technique under general anesthesia (GA) although this procedure is still associated with morbidity rate. The aim of this study is to determine the effectiveness and safety of regional anesthesia (RA) compared with GA in thoracoscopic lung biopsy procedures done on patients with idiopathic pulmonary fibrosis (IPF)...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29370900/continuous-erector-spinae-plane-block-for-analgesia-in-pediatric-thoracic-surgery-a-case-report
#19
C Gaio-Lima, C C Costa, J B Moreira, T S Lemos, H L Trindade
Erector spinae plane block has been recently described and it appears as a very promising regional analgesia technique. We report the first continuous erector spinae plane block performed in a pediatric patient for thoracic surgery. A 15-month-old boy, diagnosed with a paracardiac teratoma was scheduled for a tumor resection with a thoracotomy approach. After general anesthesia induction, a continuous erector spinae plane block at T5 level was performed with ropivacaine 0.2%. After surgery, a continuous thoracic interfascial infusion of ropivacaine 0...
January 19, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29370755/associations-between-intraoperative-ventilator-settings-during-one-lung-ventilation-and-postoperative-pulmonary-complications-a-prospective-observational-study
#20
Shuji Okahara, Kazuyoshi Shimizu, Satoshi Suzuki, Kenzo Ishii, Hiroshi Morimatsu
BACKGROUND: The interest in perioperative lung protective ventilation has been increasing. However, optimal management during one-lung ventilation (OLV) remains undetermined, which not only includes tidal volume (VT ) and positive end-expiratory pressure (PEEP) but also inspired oxygen fraction (FI O2 ). We aimed to investigate current practice of intraoperative ventilation during OLV, and analyze whether the intraoperative ventilator settings are associated with postoperative pulmonary complications (PPCs) after thoracic surgery...
January 25, 2018: BMC Anesthesiology
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