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Post Anesthesia Care

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https://www.readbyqxmd.com/read/29792218/sudden-cardiac-arrest-under-spinal-anesthesia-in-a-mission-hospital-a-case-report-and-review-of-the-literature
#1
Bamidele Johnson Alegbeleye
BACKGROUND: Sudden cardiac arrest following spinal anesthesia is relatively uncommon and a matter of grave concern for any anesthesiologist as well as clinicians in general. There have been, however, several reports of such cases in the literature. Careful patient selection, appropriate dosing of the local anesthetic, volume loading, close monitoring, and prompt intervention at the first sign of cardiovascular instability should improve outcomes. The rarity of occurrence and clinical curiosity of this entity suggest reporting of this unusual and possibly avoidable clinical event...
May 24, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29788801/perioperative-noninvasive-cardiac-output-monitoring-in-parturients-with-singleton-and-twin-pregnancies-undergoing-caesarean-section-under-spinal-anesthesia-with-prophylactic-phenylephrine-drip-a-prospective-observational-cohort-study
#2
S Orbach-Zinger, E Razinsky, I Bizman, S Firman, R Gat, A Davis, E Ashwal, A Shmueli, M Vaturi, R Gabbay-Benziv, L A Eidelman
INTRODUCTION: Spinal anesthesia is considered the gold standard anesthetic technique for cesarean deliveries (CD) but is associated with a high rate of hypotension. The recent international consensus recommends continuous prophylactic phenylephrine infusion (PPI) administered throughout CD to prevent hypotension. However little information is available on the hemodynamic profiles of women with twin pregnancies as compared to singleton pregnancies perioperatively. Therefore, in this study we aim we compare maternal hemodynamic changes both intraoperatively and postoperatively with the use of the NICAS bio impendence monitor in healthy singleton versus twin parturients undergoing CD deliveries with spinal anesthesia with PPI...
May 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29783683/estimating-respiratory-rate-in-post-anesthesia-care-unit-patients-using-infrared-thermography-an-observational-study
#3
Nadine Hochhausen, Carina Barbosa Pereira, Steffen Leonhardt, Rolf Rossaint, Michael Czaplik
The post-anesthesia care unit (PACU) is the central hub for recovery after surgery, especially when the surgery is performed under general anesthesia. Aside from clinical aspects, respiratory impairment is one of the major causes of morbidity and affected recovery in the PACU and should therefore be monitored. In previous studies, infrared thermography was applied to assess the breathing rate (BR) of healthy volunteers. Here, the transferability of published methods for postoperative patients in the PACU was examined...
May 18, 2018: Sensors
https://www.readbyqxmd.com/read/29777144/benefits-in-radical-mastectomy-protocol-a-randomized-trial-evaluating-the-use-of-regional-anesthesia
#4
Marcio Matsumoto, Eva M Flores, Pedro P Kimachi, Flavia V Gouveia, Mayra A Kuroki, Alfredo C S D Barros, Marcelo M C Sampaio, Felipe E M Andrade, João Valverde, Eduardo F Abrantes, Claudia M Simões, Rosana L Pagano, Raquel C R Martinez
Surgery is the first-line treatment for early, localized, or operable breast cancer. Regional anesthesia during mastectomy may offer the prevention of postoperative pain. One potential protocol is the combination of serratus anterior plane block (SAM block) with pectoral nerve block I (PECS I), but the results and potential benefits are limited. Our study compared general anesthesia with or without SAM block + PECS I during radical mastectomy with axillary node dissection and breast reconstruction using evaluations of pain, opioid consumption, side effects and serum levels of interleukin (IL)-1beta, IL-6 and IL-10...
May 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29776668/-fatal-cardiac-tamponade-that-developed-in-the-post-anesthesia-care-unit-a-rare-complication-after-lung-lobectomy
#5
Hyung Mook Lee, Young Jae Jeon, Hye Won Chung, Hyo Min Yun, Mi Hyun Kim
BACKGROUND AND OBJECTIVES: Cardiac tamponade is potentially fatal medical condition, which rarely occurs as a complication of lung lobectomy. We present the first case of cardiac tamponade to develop in a Post-Anesthesia Care Unit following a lung lobectomy. CASE REPORT: A 54-year-old man with pulmonary squamous cell carcinoma underwent an apparently uncomplicated lung lobectomy. His hemodynamics was unremarkable throughout the surgery and initially in the Post-Anesthesia Care Unit...
May 15, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29771731/effect-of-intravenous-dexmedetomidine-during-general-anesthesia-on-acute-postoperative-pain-in-adults-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#6
Xiuqin Wang, Naifu Liu, Jinlong Chen, Zan Xu, Fumei Wang, Chuan Ding
BACKGROUND: Dexmedetomidine has been shown to have an analgesic effect. However, no consensus was reached in previous studies. METHODS: Electronic databases such as PubMed, Embase, and Cochrane Central were searched for relevant randomized controlled trials (RCTs). The relative risk (RR) and weighted mean difference (WMD) were used to analyze the outcomes. Random-effects model was used for meta-analysis. RESULTS: Compared to the normal saline group, patients using dexmedetomidine showed a significantly decreased pain intensity within 6 hours (WMD=-0...
May 16, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29771097/-mechanical-ventilation-with-explicit-recall-a-concept-analysis
#7
Mylène Suzie Michaud, Marilou Gagnon
Mechanical ventilation in the intensive care unit requires the use of medication to reduce pain, discomfort, anxiety, and agitation. An explicit recall refers to the phenomenon where the person remembers the perceptions that occurred under sedation during mechanical ventilation. Severe psychological consequences may occur as a result of an explicit recall. This phenomenon is not well-defined and there is no common language in the literature. A conceptual analysis was carried out using Rodgers' evolutionary method in order to clarify the concept of explicit recall...
March 2018: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/29769507/a-randomized-controlled-trial-to-compare-the-efficacy-of-intravenous-dexmedetomidine-and-clonidine-as-adjuvants-to-low-dose-opioid-in-attenuation-of-hemodynamic-response-to-laryngoscopy-and-tracheal-intubation
#8
N Gupta, A Kumar, A Jain, N Hayaran, P Mishra
Increase in sympathetic activity as a result of cardiovascular stress response to laryngoscopy can be detrimental to the patient. The primary objective is to compare intravenous dexmedetomidine and clonidine as adjuvants to low dose opioid (fentanyl) for attenuation of hemodynamic response to laryngoscopy and tracheal intubation. The secondary objectives are to compare the perioperative dose requirement of fentanyl and thiopentone, to compare the duration of postoperative analgesia, and to look for side effects in all three groups...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29768487/an-observational-study-the-utility-of-perfusion-index-as-a-discharge-criterion-for-pain-assessment-in-the-postanesthesia-care-unit
#9
Chun-Lin Chu, Yi-You Huang, Ying-Hou Chen, Ling-Ping Lai, Huei-Ming Yeh
Acute post-operative pain can remain untreated if patients cannot express themselves. The perfusion index (PI) may decrease when pain activates sympathetic tone and may increase after analgesics are administered. We evaluated if the perfusion index is a feasible indicator for objectively assessing pain relief in the postanesthesia care unit (PACU) and calculated the changes in PI measurements at the time of discharge from the PACU relative to baseline PI measurements to examine if the PI is a useful criterion for discharging patients from the postanesthesia care unit...
2018: PloS One
https://www.readbyqxmd.com/read/29765268/approach-to-the-post-mohs-patient
#10
REVIEW
James F Thornton, Jourdan A Carboy
This article discusses the often unique patient presentations and management challenges of the post Mohs resection surgical patient. This includes social, economic, and health issues. Anesthesia considerations and pre- and postoperative care are also discussed in this article.
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29764631/introduction-to-surgical-and-perioperative-clinical-pharmacy-for-third-year-pharmacy-students-a-pilot-study-of-an-elective-course
#11
Eric G Johnson, Douglas R Oyler
INTRODUCTION: The objective of this study was to implement and assess an elective course that exposes pharmacy students to clinical pharmacy in the surgical and perioperative setting. METHODS: A blended-design elective that included synchronous and asynchronous learning was developed and offered to third-year pharmacy students. Students' knowledge and perception regarding clinical topics in perioperative pharmacy was assessed using pre- and post-course assessments, online quizzes, a journal club, and course assignments...
March 2018: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29742684/myocardial-injury-after-noncardiac-surgery-incidence-and-predictors-from-a-prospective-observational-cohort-study-at-an-indian-tertiary-care-centre
#12
Rubin George, Vidya P Menon, Fabia Edathadathil, Sabarish Balachandran, Merlin Moni, Dipu Sathyapalan, Preetha Prasanna, Gokuldas S, Jerry Paul, Chandrababu K K, Lakshmi Kumar, Ashok Pillai
Asymptomatic myocardial injury following noncardiac surgery (MINS) is an independent predictor of 30-day mortality and may go unrecognized based on standard diagnostic definition for myocardial infarction (MI). Given lack of published research on MINS in India, our study aims to determine incidence of MINS in patients undergoing noncardiac surgery at our tertiary care hospital, and evaluate the clinical characteristics including 30-day outcome.The prospective observational study included patients >65 years or >45 years with either hypertension (HTN), diabetes mellitus (DM), coronary artery disease (CAD), cerebrovascular accident (CVA), or peripheral arterial disease undergoing noncardiac surgery...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29737920/does-promethazine-shorten-the-length-of-stay-in-the-post-anesthesia-care-unit
#13
Jonathan P Eskander, Yury Rapoport, Elyse Cornett, Sonja Gennuso, Michael Franklin, Alan D Kaye, Charles J Fox
The combination of promethazine and opioids is known to have an opioid-sparing effect, thereby facilitating a reduction in total patient opioid consumption. In recent years, this practice has fallen out of favor in many healthcare facilities, except primarily in the post anesthesia care unit (PACU). The goal of this study was to highlight the potential of promethazine as a direct or indirect adjuvant medication in acute pain management. The present investigation was undertaken with a case series of adult female patients who underwent open total abdominal hysterectomies...
January 1, 2018: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29730078/the-efficacy-and-safety-of-intravenous-glucocorticoids-in-total-hip-arthroplasty-a-systematic-review-and-meta-analysis
#14
REVIEW
Ning An, Kang Liu, Bao-Ying Fan, Dong-Hua Ma
OBJECTIVE: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the effect and safety of intravenous glucocorticoids for reducing pain scores, postoperative nausea and vomiting (PONV) and total morphine consumption for patients prepared for total hip arthroplasty (THA). METHODS: Electronic databases: PubMed (1950-September 2016), EMBASE(1974-September 2016), the Cochrane Central Register of Controlled Trials (CENTRAL, September 2016 Issue 3) and Web of Science (1950-September 2016) were systematically searched...
May 3, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29720858/preoperative-elective-transjugular-intrahepatic-portosystemic-shunt-for-cirrhotic-patients-undergoing-abdominal-surgery
#15
REVIEW
Deepanshu Jain, Ejaz Mahmood, Maria V-Bandres, Eyob Feyssa
Despite improvements in the surgical techniques, anesthesia and intensive care, abdominal surgery in patients with cirrhosis remains a challenge. Transjugular intrahepatic portosystemic shunt (TIPS) has been used to manage complications of portal hypertension. Preoperative TIPS (prophylactic) can theoretically improve outcomes in this population. Seven original studies were identified with 24 patients who underwent prophylactic TIPS before abdominal surgery. No perioperative mortality or major abdominal bleeding attributable to portal hypertension was reported for this cohort...
May 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29719833/a-survey-of-enhanced-recovery-after-surgery-protocols-for-cesarean-delivery-in-serbia
#16
Borislava Pujic, Mirjana Kendrisic, Matthew Shotwell, Yaping Shi, Curtis L Baysinger
Enhanced recovery after surgery (ERAS) protocols have been described for patients undergoing colon surgery. Similar protocols for cesarean delivery (CD) have been developed recently. CD is one of the most commonly performed surgical procedures, and adoption of ERAS protocols following CD might benefit patients and the health-care system. We aimed to determine which Serbian hospitals reported ERAS protocols, which elements of ERAS protocols were used in CD patients, and whether ERAS and non-ERAS hospitals differed...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29707324/non-intubated-thoracoscopic-bullectomy-under-sedation-is-safe-and-comfortable-in-the-perioperative-period
#17
Jinwook Hwang, Jae Seung Shin, Joo Hyung Son, Too Jae Min
Background: Non-intubated thoracoscopic surgery can be performed under sedation using adjuvant regional anesthesia, however, the benefits of non-intubated thoracoscopic surgery under sedation have not yet been completely verified. In this study, we compare the perioperative safety and pain complaints of sedation without intubation in thoracoscopic bullectomy with that of conventional general anesthesia with double-lumen intubation and mechanical ventilation. Methods: Forty-one patients with primary spontaneous pneumothorax who were scheduled for thoracoscopic bullectomy were enrolled in this study...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29707319/perioperative-management-and-outcomes-of-minimally-invasive-esophagectomy-case-study-of-a-high-volume-tertiary-center-in-taiwan
#18
Tzu Chang, Po-Ni Hsiao, Man-Yin Tsai, Pei-Ming Huang, Ya-Jung Cheng
Background: Mortality and complication rates for surgical esophagectomy remain high despite progress in surgical techniques and perioperative care. Minimally invasive surgery and intraoperative goal-directed fluid management are gaining popularity in Taiwan; however, perioperative complications and short-term outcomes have been rarely reported. In this retrospective study, we analyzed the surgical procedures performed as well as the perioperative outcomes and treatments after esophagectomy in a high-volume medical center in Taiwan...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29703020/flumazenil-reduces-respiratory-complications-during-anesthesia-emergence-in-children-with-preoperative-upper-respiratory-tract-infections
#19
Ruiqiang Sun, Guolin Wang, Xuesong Gao, Shuzhen Wang
Despite its benignity, upper respiratory infections (URIs) 1 increase the risk of postoperative respiratory complications during the perioperative and postoperative periods. Flumazenil could improve the symptoms of respiratory obstruction.To evaluate the effect of flumazenil on the occurrence of respiratory complications during anesthesia emergence of children with preoperative URI.This was a prospective study of 164 consecutive pediatric patients who underwent strabismus surgery under general anesthesia at the Tianjin Eye Hospital between August 2016 and April 2017...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29692482/post-procedural-complications-of-cardiac-implants-done-in-a-resource-limited-setting-under-c-arm-a-single-centre-experience
#20
A Jayachandra, Vivek Aggarwal, Sandeep Kumar, I V Nagesh
Background: Cardiology interventions in peripheral hospitals is a challenging task where cardiologist have to fight against time and limited resources. Most of the sudden cardiac deaths occur due to arrhythmia and heart blocks/sinus node dysfunction. Our study is a single peripheral center experience of cardiac devices implantation using a 'C' Arm. The aim of this study was to post procedural complications of cardiac implants done in aresource limited setting under 'C' arm. Methods: This study is done at a peripheral cardiology center with no cardiac catheterization laboratory (CCL) facilities...
April 2018: Medical Journal, Armed Forces India
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