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Post Anesthesia Care

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https://www.readbyqxmd.com/read/29138544/early-postoperative-delirium-after-hemiarthroplasty-in-elderly-patients-aged-over-70-years-with-displaced-femoral-neck-fracture
#1
Yi-Hwa Choi, Dae-Hwan Kim, Tae-Young Kim, Tae-Wan Lim, Seok-Woo Kim, Je-Hyun Yoo
Purpose: Postoperative delirium is a risk factor for worse outcome after hip fracture surgery in elderly patients. Postoperative delirium is associated with anesthesia, postoperative pain, and patient factors. We investigated the incidence, predictors, and prognostic implications of post-operative delirium after hemiarthroplasty (HA) in elderly patients with femoral neck fracture. Patients and methods: A total of 356 consecutive patients aged >70 years who underwent HA for femoral neck fracture were enrolled...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29122625/comparison-of-intraoperative-and-early-postoperative-outcomes-of-caudal-versus-dorsal-penile-nerve-blocks-for-outpatient-penile-surgeries
#2
Katherine H Chan, Aali Shah, Elizabeth A Moser, Konrad Szymanski, Benjamin M Whittam, Rosalia Misseri, Martin Kaefer, Richard Rink, Mark P Cain
OBJECTIVE: To compare intraoperative and 1-hour postoperative outcomes in caudal versus dorsal penile nerve block (DPNB) patients undergoing penile surgeries. MATERIAL AND METHODS: We performed a retrospective cohort study of males <10 years old undergoing penile procedures (2013-2015) using the Pediatric Regional Anesthesia Network, Pediatric Health Information System databases and our medical records. The primary outcome was a maximum Faces Limbs Activity Crying Consolability pain score > 3...
November 6, 2017: Urology
https://www.readbyqxmd.com/read/29120004/nerve-traction-injury-after-subacute-revision-external-fixation-of-a-tibial-plateau-fracture
#3
Lauren E Wessel, Alexander B Christ, David Helfet, David S Wellman
Nerve traction injuries are common clinical entities that can be confused with nerve palsies secondary to alternate etiologies. Common mechanisms of nerve injury include direct laceration, crush injury, compression injury, elevated compartment pressures, or traction injury. Traction injuries commonly occur after trauma or aberrant patient positioning; however, traction injury following external fixation for lower extremity injury is rare. This case report describes a 42-year-old man who initially sustained a Schatzker VI tibial plateau fracture that required revision of external fixation for pin-site infection as soft tissues recovered from the initial trauma...
November 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/29116559/perioperative-antiemetic-therapy-for-fast-track-laparoscopic-bariatric-surgery
#4
Olumuyiwa A Bamgbade, Oluwafemi Oluwole, Rong R Khaw
BACKGROUND: Postoperative nausea and vomiting (PONV) is problematic in bariatric surgery patients and has negative impacts on perioperative outcome. Antiemetic prophylaxis may reduce PONV. Perioperative antiemetic prophylaxis or therapy is crucial and may enhance fast-track bariatric surgery. This study examined the impact of intraoperative multimodal antiemetic prophylaxis on fast-track bariatric surgery. METHODS: This prospective observational clinical study explored the perioperative data of 400 consecutive laparoscopic bariatric surgery patients, over a 6-year period...
November 7, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29112966/lengthening-of-knee-flexor-muscles-by-percutaneous-needle-tenotomy-description-of-the-technique-and-preliminary-results
#5
Alexis Schnitzler, François Genêt, Aurélie Diebold, Laurence Mailhan, Claire Jourdan, Philippe Denormandie
BACKGROUND: Knee flexion contractures occur frequently in non-ambulatory, aged persons and persons with central nervous system lesions, rendering positioning and nursing care difficult. There are often risks associated with surgical interventions. OBJECTIVE: To evaluate the effectiveness of percutaneous needle tenotomy to lengthen the knee flexor muscles and improve passive function. METHODS: This was a retrospective study of all patients who underwent percutaneous needle tenotomy between 2012 and 2014...
2017: PloS One
https://www.readbyqxmd.com/read/29108407/periprocedural-analgesic-efficacy-of-a-single-pre-emptive-administration-of-propacetamol-in-catheter-ablation-for-atrial-fibrillation-a-randomized-controlled-trial
#6
Sung Yeon Ham, Jong-Wook Song, Jae-Kwang Shim, Woo Kyung Lee, Hee-Jung Kim, Young-Lan Kwak
BACKGROUND: Anesthetic care for termination of atrial fibrillation with catheter ablation poses significant challenges due to significant pain lengthy procedure. A delicate polypharmacy combining anaesthetic agents to minimize respiratory depression and hemodynamic changes and to provide satisfactory sedation and analgesia is needed. METHODS: Ninety-eight patients were randomized into two groups receiving either two gram of propacetamol or normal saline intravenously for 20 min before anesthesia...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29106880/utility-of-screening-questionnaire-and-polysomnography-to-predict-postoperative-outcomes-in-children
#7
Hiromi Kako, Jennifer Tripi, Hina Walia, Dmitry Tumin, Mark Splaingard, Kris R Jatana, Joseph D Tobias, Vidya T Raman
INTRODUCTION: The prevalence of pediatric obstructive sleep apnea (OSA) has increased concurrently with the increasing prevalence of obesity. We have previously validated a short questionnaire predicting the occurrence of OSA on polysomnography (PSG). This follow-up study assessed the utility of the questionnaire in predicting postoperative outcomes. METHODS: Children undergoing surgery and completing a sleep study were prospectively screened for OSA using a short questionnaire...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29066932/efficiency-of-spinal-anesthesia-versus-general-anesthesia-for-lumbar-spinal-surgery-a-retrospective-analysis-of-544-patients
#8
John T Pierce, Guy Kositratna, Mark A Attiah, Michael J Kallan, Rebecca Koenigsberg, Peter Syre, David Wyler, Paul J Marcotte, W Andrew Kofke, William C Welch
BACKGROUND: Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia to general in lumbar surgery. Some studies have shown reduced surgical time, postoperative pain, time in the postanesthesia care unit (PACU), incidence of urinary retention, postoperative nausea, and more favorable cost-effectiveness with spinal anesthesia. Despite these results, the current literature has also shown contradictory results in between-group comparisons...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29065869/leading-comorbidity-associated-with-30-day-post-anesthetic-mortality-in-geriatric-surgical-patients-in-taiwan-a-retrospective-study-from-the-health-insurance-data
#9
Chun-Lin Chu, Hung-Yi Chiou, Wei-Han Chou, Po-Ya Chang, Yi-You Huang, Huei-Ming Yeh
BACKGROUND: Elderly patients with aged physical status and increased underlying disease suffered from more postoperative complication and mortality. We design this retrospective cohort study to investigate the relationship between existing comorbidity of elder patients and 30 day post-anesthetic mortality by using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) from Health Insurance Database. METHODS: Patients aged above 65 years old who received anesthesia between 2000 and 2010 were included from 1 million Longitudinal Health Insurance Database in (LHID) 2005 in Taiwan...
October 24, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29050063/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives-part-1
#10
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/29049219/risk-assessment-of-morbidly-obese-parturient-in-cesarean-section-delivery-a-prospective-cohort-single-center-study
#11
Xiaohu An, Yanhong Zhao, Ying Zhang, Qiling Yang, Yilong Wang, Weiwei Cheng, Zeyong Yang
BACKGROUND: Up to 40% of women gain excessive weight during pregnancy. Obesity complications and risks in parturient women undergoing cesarean section (CS) with different anesthetic methods remain unknown. This study aimed to assess the safety and risk of obese women undergoing CS delivery with various perioperative anesthetic methods. METHODS: Seven hundred ninety parturient women underwent CS under general anesthesia (GA), intraspinal anesthesia including epidural anesthesia (EA) and combined spinal-epidural anesthesia (CSEA)...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29046773/dexamethasone-alone-versus-in-combination-with-intra-operative-super-hydration-for-postoperative-nausea-and-vomiting-prophylaxis-in-female-patients-undergoing-laparoscopic-cholecystectomy-a-randomized-clinical-trial
#12
Eman A Ismail, Mohamed H Bakri, Sayed Kaoud Abd-Elshafy
BACKGROUND: Dexamethasone has a prophylactic effect on postoperative nausea and vomiting (PONV) and perioperative hydration is believed to play a role in PONV prophylaxis. This study was performed to examine the combined effects of pre-induction dexamethasone plus super-hydration on PONV and pain following laparoscopic cholecystectomy (LC). METHODS: A total of 100 female patients undergoing LC were enrolled and randomized equally into two groups. Group DF received 5 mg dexamethasone (pre-induction) plus 30 ml/kg Ringer's lactate (intraoperative) and group D received 5 mg dexamethasone (pre-induction) alone...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29042333/postoperative-intravenous-acetaminophen-for-craniotomy-patients-a-randomized-controlled-trial
#13
Steven Greenberg, Glenn S Murphy, Michael J Avram, Torin Shear, Jessica Benson, Kruti N Parikh, Aashka Patel, Rebecca Newmark, Vimal Patel, Julian Bailes, Joseph W Szokol
OBJECTIVE: To determine whether opioids during the first 24 postoperative hours were significantly altered when receiving intravenous (IV) acetaminophen during that time compared to those receiving placebo (normal saline). METHODS: One hundred forty patients undergoing any craniotomy were randomly assigned to receive either 1g of IV acetaminophen or placebo upon surgical closure, and every six hours thereafter, up to 18 hours postoperatively. Analgesic requirements for the first 24 hours postoperatively were recorded...
October 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29033572/role-of-heart-rate-variability-in-preoperative-assessment-of-physiological-reserves-in-patients-undergoing-major-abdominal-surgery
#14
Petr Reimer, Jan Máca, Pavel Szturz, Ondřej Jor, Roman Kula, Pavel Ševčík, Michal Burda, Milan Adamus
BACKGROUND: Major abdominal surgery (MAS) is associated with increased morbidity and mortality. The main objective of our study was to evaluate the predictive value of heart-rate variability (HRV) concerning development of postoperative complications in patients undergoing MAS. The secondary objectives were to identify the relationship of HRV and use of vasoactive drugs during anesthesia, intensive care unit length of stay (ICU-LOS), and hospital length of stay (H-LOS). PATIENTS AND METHODS: Sixty-five patients scheduled for elective MAS were enrolled in a prospective, single-center, observational study...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29029588/society-for-the-advancement-of-transplant-anesthesia-liver-transplant-anesthesia-fellowship-white-paper-advocating-measurable-proficiency-in-transplant-specialties-training
#15
Ryan M Chadha, Cara Crouch, Jeron Zerillo, Ernesto A Pretto, Raymond Planinsic, Sang Kim, Ramona Nicolau-Raducu, Dieter Adelmann, Elia Elia, Christopher L Wray, Coimbatore Srinivas, M Susan Mandell
The anesthesia community has openly debated if the care of transplant patients was generalist or specialist care ever since the publication of an opinion paper in 1999 recommended subspecialty training in the field of liver transplantation anesthesia. In the past decade, liver transplant anesthesia has become more complex with a sicker patient population and evolving evidence-based practices. Transplant training is currently not required for accreditation or certification in anesthesiology, and not all anesthesia residency programs are associated with transplant centers...
December 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29027770/bispectral-index-bis-and-non-bis-anesthetic-protocols-on-postoperative-recovery-outcomes-a-systematic-review-and-meta-analysis
#16
Min-Hsien Chiang, Shao-Chun Wu, Shih-Wei Hsu, Jo-Chi Chin
BACKGROUND: The study aimed to compare bispectral index (BIS) and non-BIS anesthetic protocols on postoperative recovery outcomes. METHODS: Medline, PubMed, Cochrane, EMBASE, and Google Scholar databases were searched until January 21, 2016. RESULTS: Twenty-six studies were included with a total of 9537 patients. BIS monitoring was significantly associated with shorter time to eye opening (P=0.001), time to extubation (P<0.001), and time to orientation (P=0...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29017364/can-patients-safely-be-admitted-to-a-ward-after-craniotomy-for-resection-of-intra-axial-brain-tumors
#17
Farhan A Mirza, Catherine Wang, Thomas Pittman
OBJECTIVE: We reviewed the safety of our practice of admitting patients who have undergone a craniotomy for resection of an intra-axial brain tumor to a floor bed instead of an ICU. We also tried to quantify the risk that patients electively admitted to the ICU would develop a problem that could not have been effectively managed on the ward. METHODS: A retrospective chart review was performed of both adult and pediatric patients who underwent craniotomy by the senior author for resection of an intra-axial brain tumor between January 2012 and December 2015...
October 11, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28972924/incidence-of-complications-in-the-post-anesthesia-care-unit-and-associated-healthcare-utilization-in-patients-undergoing-non-cardiac-surgery-requiring-neuromuscular-blockade-2005-2013-a-single-center-study
#18
Allan W Belcher, Steve Leung, Barak Cohen, Dongsheng Yang, Edward J Mascha, Alparslan Turan, Leif Saager, Kurt Ruetzler
STUDY OBJECTIVE: The use of neuromuscular blockade agents (NMBA), had been associated with significant residual post-operative paralysis and morbidity. There is a lack of clinical evidence on incidence of postoperative complications within the post-anesthesia care unit (PACU) in patients exposed to intraoperative NMBA's. This study aims to estimate the incidence of post-operative complications associated with use of NMBAs and assessing its association with healthcare resource utilization...
September 30, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28964640/a-prospective-study-of-post-cesarean-delivery-hypoxia-after-spinal-anesthesia-with-intrathecal-morphine-150%C3%AE-g
#19
Karim S Ladha, Rie Kato, Lawrence C Tsen, Brian T Bateman, Toshiyuki Okutomi
INTRODUCTION: Delayed respiratory depression is a feared complication of intrathecal morphine in patients undergoing cesarean delivery. The incidence, timing and risk factors for hypoxia in this population are not known. METHODS: Patients undergoing cesarean delivery under spinal anesthesia at a tertiary care center from October 2012 to March 2016 were included in the study. The Berlin sleep apnea Questionnaire was completed before surgery. Oxygen saturation was recorded every second for 24hours after the initiation of spinal anesthesia...
November 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28951218/reference-change-values-of-plasma-and-urine-ngal-in-cardiac-surgery-with-cardiopulmonary-bypass
#20
Aurélien Bataille, Ambre Tiepolo, Tiphaine Robert, Anne Boutten, Dan Longrois, Monique Dehoux, Sophie Provenchère
OBJECTIVE: As with any biomarker, interpretation of changes of NGAL concentration must consider its variability in a specific clinical setting. The aim of this study was to calculate the reference change value (RCV) and the index of individuality (II) of plasma and urine NGAL in the context of coronary artery bypass graft surgery with cardiopulmonary bypass, in patients without postoperative acute kidney injury. METHODS: This prospective single-center observational study included patients with a preoperative glomerular filtration rate of >30mlmin(-1) 1...
September 23, 2017: Clinical Biochemistry
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