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Post Anesthesia Care

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https://www.readbyqxmd.com/read/28538591/intrathecal-morphine-and-oral-analgesics-provide-safe-and-effective-pain-control-after-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#1
Ying Li, Rebecca A Hong, Christopher B Robbins, Kathleen M Gibbons, Ashlee E Holman, Michelle S Caird, Frances A Farley, Matthew D Abbott, Michelle C Burke
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To demonstrate that intrathecal morphine (ITM) and oral analgesics provide effective pain control after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS), and this protocol has a low complication rate so patients can be admitted to a general care floor. SUMMARY OF BACKGROUND DATA: Previous studies have shown that ITM combined with intravenous patient-controlled analgesia or epidural infusion (EPI) provides effective pain control after PSF for AIS...
May 23, 2017: Spine
https://www.readbyqxmd.com/read/28532707/sedated-suture-adjustment-in-children-undergoing-adjustable-suture-strabismus-surgery
#2
Warachaya Phanphruk, Maan Alkharashi, Aykut Bilge, David G Hunter
PURPOSE: To study methods and adverse events of postoperative, sedated suture adjustment after strabismus surgery in the post-anesthesia care unit (PACU). METHODS: We reviewed the postoperative experience of all children ≤18 years of age undergoing adjustable suture strabismus surgery at Boston Children's Hospital over a 3-year period. Time in the hospital, adverse events, and surgical outcomes were reviewed to evaluate safety and healthcare resource utilization...
May 19, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28527544/a-prospective-study-of-nausea-and-vomiting-after-breast-cancer-surgery
#3
Susan W Wesmiller, Catherine M Bender, Yvette P Conley, Dana H Bovbjerg, Gretchen Ahrendt, Marguerite Bonaventura, Susan M Sereika
PURPOSE: Postoperative nausea and vomiting (PONV) and post-discharge nausea and vomiting (PDNV) continue to be common and disturbing complications experienced after surgery, particularly in women and especially in women undergoing breast cancer surgery. The purpose of this study was to assess the incidence and risk factors associated with PONV and PDNV from preoperative to 48 hours postoperatively in 97 women scheduled for breast cancer surgery. DESIGN: Prospective, comparative design...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28520718/retrospective-observational-evaluation-of-postoperative-oxygen-saturation-levels-and-associated-postoperative-respiratory-complications-and-hospital-resource-utilization
#4
Satya Krishna Ramachandran, Aleda Thompson, Jaideep J Pandit, Scott Devine, Amy M Shanks
INTRODUCTION: The clinical importance of postoperative episodic hypoxemia is still unclear, and therefore largely under-studied. As a result, there is limited understanding of its relationship with early postoperative respiratory complications (PRC, defined as intubation within three days of surgery) and hospital resource utilization. MATERIALS AND METHODS: This single center study was performed using a retrospective observational design. We described population based definitions of desaturation from continuous SpO2 monitoring data captured in the post anesthesia care unit (PACU), namely median SpO2 in PACU, duration of desaturation below median, nadir desaturation, and length of oxygen therapy relative to PACU duration...
2017: PloS One
https://www.readbyqxmd.com/read/28499420/continuous-femoral-nerve-blockade-and-single-shot-sciatic-nerve-block-promotes-better-analgesia-and-lower-bleeding-for-total-knee-arthroplasty-compared-to-intrathecal-morphine-a-randomized-trial
#5
Nora Elizabeth Rojas Álvarez, Rosemberg Jairo Gomez Ledesma, Adilson Hamaji, Marcelo Waldir Mian Hamaji, Joaquim Edson Vieira
BACKGROUND: Knee arthroplasty leads to postoperative pain. This study compares analgesia and postoperative bleeding achieved by intrathecal morphine with a continuous femoral plus single-shot sciatic nerve block. METHODS: A randomized non-blinded clinical trial enrolled patients aged over 18 years old, ASA I to III who underwent total knee arthroplasty. All patients underwent spinal anesthesia with isobaric bupivacaine, 20 mg. One group received 100 mcg of intrathecal morphine (M group), and the other received a femoral nerve block by continuous infusion plus a "single shot" block of the sciatic nerve at the end of the surgery (FI group)...
May 12, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28496141/a-randomized-comparison-of-the-prone-ventilation-endotracheal-tube-versus-the-traditional-endotracheal-tube-in-adult-patients-undergoing-prone-position-surgery
#6
Wangyuan Zou, Jiali Shao, Xia Liang, Lin Li, Zhenghua He, Qulian Guo
Endotracheal tube displacement or dislocation is a severe complication that can occur in patients who require prone position ventilation. We hypothesized the prone position tube (PPT) would reduce the incidence of displacement of an endotracheal tube in an adult prone operation compared to a traditional tube (TT). A total of 80 adult patients undergoing neurosurgery or spine surgery were recruited. Sixty patients with prone position ventilation were randomly divided into the traditional routine endotracheal tube group (Group TT, n = 30) and the prone position ventilation endotracheal tube group (Group PPT, n = 30)...
May 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28494898/the-effect-of-desflurane-versus-propofol-anesthesia-on-postoperative-delirium-in-elderly-obese-patients-undergoing-total-knee-replacement-a-randomized-controlled-double-blinded-clinical-trial
#7
Pedro Tanaka, Stuart Goodman, Barbara R Sommer, William Maloney, James Huddleston, Hendrikus J Lemmens
STUDY OBJECTIVE: The goal of this study was to investigate the incidence of delirium, wake-up times and early post-operative cognitive decline in one hundred obese elderly patients undergoing total knee arthroplasty. DESIGN: Prospective randomized trial. SETTINGS: Operating room, postoperative recovery area, hospital wards. PATIENTS: 100 obese patients (ASA II and III) undergoing primary total knee replacement under general anesthesia with a femoral nerve block catheter...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28494892/postoperative-analgesic-efficacy-of-single-shot-and-continuous-transversus-abdominis-plane-block-after-laparoscopic-cholecystectomy-a-randomized-controlled-clinical-trial
#8
Yun-Mi Choi, Gyeong-Jo Byeon, Soon-Ji Park, Young-Min Ok, Sang-Wook Shin, Kwangho Yang
STUDY OBJECTIVE: To compare the analgesic efficacy of ultrasound-guided single-shot and continuous transversus abdominis plane (TAP) block to that of IV-PCA in patients undergoing laparoscopic cholecystectomy. DESIGN: Prospective randomized controlled trial. SETTING: Post-anesthesia care unit and General ward. PATIENTS: 108 American Society of Anesthesiologist (ASA) physical status I-II patients undergoing laparoscopic cholecystectomy...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28489477/combined-sciatic-and-lumbar-plexus-nerve-blocks-for-the-analgesic-management-of-hip-arthroscopy-procedures-a-retrospective-review
#9
J Douglas Jaffe, Theodore Ross Morgan, Gregory B Russell
Hip arthroscopy is a minimally invasive alternative to open hip surgery. Despite its minimally invasive nature, there can still be significant reported pain following these procedures. The impact of combined sciatic and lumbar plexus nerve blocks on postoperative pain scores and opioid consumption in patients undergoing hip arthroscopy was investigated. A retrospective analysis of 176 patients revealed that compared with patients with no preoperative peripheral nerve block, significant reductions in pain scores to 24 hours were reported and decreased opioid consumption during the post anesthesia care unit (PACU) stay was recorded; no significant differences in opioid consumption out to 24 hours were discovered...
May 10, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28489162/endoscopic-sleeve-gastroplasty-for-obesity-treatment-two-years-of-experience
#10
Gontrand Lopez-Nava, M P Galvão, I Bautista-Castaño, J P Fernandez-Corbelle, M Trell, N Lopez
Background: Bariatric endoscopic techniques are minimally invasive and induce gastric volume reduction to treat obesity. Aim : To evaluate endoscopic sleeve gastroplasty (Apollo method) using a suturing method directed at the greater curvature, as well as the perioperative care, two year safety and weight loss. Method: Prospective single-center study over 154 patients (108 females) using the endoscopic sleeve gastroplasty procedure under general anesthesia with overnight inpatient observation...
January 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28477230/a-matched-case-control-comparison-of-hospital-costs-and-outcomes-for-knee-replacement-patients-admitted-postoperatively-to-acute-care-versus-rehabilitation
#11
Brian K Tse, Tessa L Walters, Steven K Howard, T Edward Kim, Stavros G Memtsoudis, Eric C Sun, Alex Kou, Lorrie Graham, Robert King, Edward R Mariano
For select total knee arthroplasty (TKA) patients, we have established an alternative pathway to bypass the acute care surgical ward and directly admit patients from the post-anesthesia care unit to on-campus rehabilitation. We retrospectively examined whether this 'fast track' pathway decreased costs and improved patient outcomes. After reviewing records of consecutive primary unilateral TKA patients over a 15-month period, each patient admitted to rehabilitation was matched with a control admitted to the acute care ward...
May 5, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28476033/dexmedetomidine-plus-sufentanil-for-pediatric-flexible-bronchoscopy-a-retrospective-clinical-trial
#12
Xiujing Dang, Weidong Hu, Zhendong Yang, Shiyu Su
Several studies have reported the use of dexmedetomidine (DEX) plus opioids for flexible bronchoscopy in both adults and children. To determine whether DEX plus sufentanil (SF) is safe for children, 142 children undergoing flexible bronchoscopy were assigned to one of three groups, each of which received the same SF loading dose and similar DEX and SF maintenance doses, but different loading doses of DEX: DS1 (DEX 0.5 μg·kg-1), DS2 (DEX 1.0 μg·kg-1), and DS3 (DEX 1.5 μg·kg-1). The Ramsay sedation scale was maintained at 3 in all groups...
April 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/28470102/oct1-genetic-variants-are-associated-with-postoperative-morphine-related-adverse-effects-in-children
#13
Rajiv Balyan, Xue Zhang, Vidya Chidambaran, Lisa J Martin, Tomoyuki Mizuno, Tsuyoshi Fukuda, Alexander A Vinks, Senthilkumar Sadhasivam
AIM: Large interindividual variability in morphine pharmacokinetics (PK) could contribute to variability in morphine analgesia and adverse events. Respiratory depression (RD) and postoperative nausea and vomiting (PONV) are significant adverse drug response of intravenous morphine in the perioperative setting limiting its efficacy in achieving adequate surgical pain relief. OCT1 is a transporter in the liver that transports morphine from the bloodstream into hepatocytes. Earlier we reported association of genetic polymorphisms in OCT1 with morphine PK, and lower morphine clearance in Caucasian children as compared with African-American (AA) children...
May 4, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28461390/propofol-sedation-exacerbates-kidney-pathology-and-dissemination-of-bacteria-during-staphylococcus-aureus-bloodstream-infections
#14
Lavanya Visvabharathy, Nancy E Freitag
Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for large numbers of post-surgical nosocomial infections across the United States and worldwide. Propofol anesthesia is widely used in surgery and in intensive care units, and recent evidence indicates that even brief exposure to propofol can substantially increase host susceptibility to microbial infection. Here we delineate the impact of propofol sedation on MRSA blood stream infections in mice in the presence and absence of prophylactic antibiotic treatment...
May 1, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28461010/effects-of-ketamine-dexmedetomidine-and-propofol-anesthesia-on-emotional-memory-consolidation-in-rats-consequences-for-the-development-of-post-traumatic-stress-disorder
#15
Maria Morena, Andrea Berardi, Andrea Peloso, Daniela Valeri, Maura Palmery, Viviana Trezza, Gustav Schelling, Patrizia Campolongo
Intensive Care Unit (ICU) or emergency care patients, exposed to traumatic events, are at increased risk for Post-Traumatic Stress Disorder (PTSD) development. Commonly used sedative/anesthetic agents can interfere with the mechanisms of memory formation, exacerbating or attenuating the memory for the traumatic event, and subsequently promote or reduce the risk of PTSD development. Here, we evaluated the effects of ketamine, dexmedetomidine and propofol on fear memory consolidation and subsequent cognitive and emotional alterations related to traumatic stress exposure...
April 28, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28459704/a-comparison-of-4-analgesic-regimens-for-acute-postoperative-pain-control-in-breast-augmentation-patients
#16
Pamela Tan, Morgan Sparks Martin, Nina Shank, Leann Myers, Emily Wolfe, John Lindsey, Stephen Metzinger
PURPOSE: Patients undergoing breast augmentation are treated with multiple combinations of medications for pain control including ketorolac, liposomal bupivacaine, bupivacaine, and intravenous and oral narcotics. There is no current consensus on the optimal combination; therefore, all are used at the discretion of the surgeon. METHODS: This was a single-center, retrospective study. The total number of patients included was 132. Comparisons were made between 4 groups: bupivacaine only (B); bupivacaine and liposomal bupivacaine (BL); bupivacaine and liposomal bupivacaine plus intraoperative ketorolac (BLKi); and bupivacaine and liposomal bupivacaine plus postoperative ketorolac (BLKp)...
June 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28455085/randomized-controlled-trial-of-intravenous-acetaminophen-for-postcesarean-delivery-pain-control
#17
Brie Altenau, Catrina C Crisp, C Ganga Devaiah, Donna S Lambers
BACKGROUND: Cesarean delivery is a common surgery in the United States, with 1.3 million performed during 2009.(1) Obstetricians must balance the growing concern with opioid abuse, dependence, and side effects with optimal postoperative pain control. Intravenous acetaminophen may represent an additional method to decrease the reliance on opioid medications and improve postoperative pain following cesarean delivery. OBJECTIVE: The objective of the study was to determine whether the administration of intravenous acetaminophen following routine scheduled cesarean delivery would decrease the need for narcotic medications to control postoperative pain...
April 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28448396/post-anesthesia-care-symptoms-diagnosis-and-management
#18
Stephen C Haskins, Jemiel A Nejim, Genewoo J Hong
No abstract text is available yet for this article.
April 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28446852/clinical-performance-of-emergency-surgical-officers-in-southern-ethiopia
#19
Abera A Gobeze, Zelalem Kebede, Yifru Berhan, Biku Ghosh
BACKGROUND: Serious shortage of gynecologists and surgeons for several decades leading to a three-year masters level training was initiated in 2009. However, systematic analysis was not done to assess the graduates' performance. The purpose of this study was to assess improvement in access to emergency surgical and obstetrical care services. METHODS: Both quantitative and qualitative methods were employed to assess the competence of emergency surgical officers (ESOs) in their decision making and surgical skills in eight hospitals between 2012 and 2014...
September 2016: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28442964/-graded-epidural-anesthesia-for-renal-transplant-in-a-patient-with-dilated-cardiomyopathy-and-severe-left-ventricle-systolic-dysfunction
#20
Rupesh Yadav, Sohan Lal Solanki
Dilated cardiomyopathy with decreased contractility of left or both ventricles impose a serious risk to patient posted for major surgery. Even after best medical optimization, careful perioperative management with risk and benefit of general and regional anesthesia should be discussed beforehand. We here reporting a case of successful management of a patient with dilated cardiomyopathy with ejection fraction of 15% posted for renal transplant surgery under graded epidural anesthesia.
April 2017: Saudi Journal of Anaesthesia
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