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Stress management anesthesiologist

Débora O Cumino, Joaquim E Vieira, Luciana C Lima, Livia P Stievano, Raquel A P Silva, Ligia A S T Mathias
BACKGROUND: Preoperative anxiety negatively influences children's anaesthetic and surgical experience, and results in postoperative complications, such as emergence delirium and behavioural changes. Nonpharmacological management using alternative therapies that alleviate psychological stress can be as important as pharmacological ones in reducing children's anxiety. Nevertheless, their validity as an effective anxiety-reducing strategy in children remains controversial. OBJECTIVE(S): To verify whether nonpharmacological strategies, that is, leaflet and distraction with smartphone application presented to parents/guardians and children, respectively, were effective in preventing children's anxiety during anaesthesia induction...
March 2017: European Journal of Anaesthesiology
Efrain Riveros Perez, Ricardo Riveros
The first stage of surgical treatment for hypoplastic left heart syndrome (HLHS) includes the creation of artificial systemic-to-pulmonary connections to provide pulmonary blood flow. The modified Blalock-Taussig (mBT) shunt has been the technique of choice for this procedure; however, a right ventricle-pulmonary artery (RV-PA) shunt has been introduced into clinical practice with encouraging but still conflicting outcomes when compared with the mBT shunt. The aim of this study is to explore mathematical modeling as a tool for describing physical profiles that could assist the surgical team in predicting complications related to stenosis and malfunction of grafts in an attempt to find correlations with clinical outcomes from clinical studies that compared both surgical techniques and to assist the anesthesiologist in making decisions to manage patients with this complex cardiac anatomy...
January 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
Mir W Sekandarzad, André A J van Zundert, Philipp B Lirk, Chris W Doornebal, Markus W Hollmann
This narrative review discusses the most recent up-to-date findings focused on the currently available "best clinical practice" regarding perioperative anesthesia care bundle factors and their effect on tumor progression. The main objective is to critically appraise the current literature on local anesthetics, regional outcome studies, opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs) and their ability to decrease recurrence in patients undergoing cancer surgery. A brief discussion of additional topical perioperative factors relevant to the anesthesiologist including volatile and intravenous anesthetics, perioperative stress and anxiety, nutrition, and immune stimulation is included...
November 8, 2016: Anesthesia and Analgesia
Amy E Vinson, David Zurakowski, Gail I Randel, Kathy D Schlecht
STUDY OBJECTIVE: The prevalence of anesthesiology department wellness programs is unknown. A database of wellness programs is needed as a resource for departments attempting to respond to the Accreditation Council for Graduate Medical Education Anesthesiology Milestones Project. The purpose of this study was to survey academic anesthesiology chairs on wellness issues, characterize initiatives, and establish wellness contacts for a Wellness Initiative Database (WID). DESIGN: An Internet-based survey instrument was distributed to academic anesthesiology department chairs in the United States...
November 2016: Journal of Clinical Anesthesia
Mridul Dhar, Nimisha Verma, Ram Badan Singh, Vishal Krishna Pai
INTRODUCTION: Allgrove syndrome (AS) is a rare autosomal recessive disorder characterized by achalasia cardia, alacrimia, and adrenocorticotropic hormone-resistant adrenal insufficiency which is sometimes associated with autonomic dysfunction. It has also been referred to as the triple A syndrome in view of the cardinal symptoms described above. First described by Allgrove et al in 1978, the disorder usually presents mostly during the first decade of life. These patients have the threat of adrenal crisis, shock, and hypoglycemia and are usually on steroid supplementation...
September 2016: Journal of Clinical Anesthesia
Mridul Dhar, Shashi Prakash, Vaibhav Pandey, Vishal Krishna Pai
Tumor lysis syndrome in an onco-metabolic emergency resulting from massive lysis of rapidly proliferating malignant cells seen commonly in patients with hematological malignancies such as acute lymphocytic leukemia and Burkitt's lymphoma and is quite rare in solid tumors. Spontaneous development of tumor lysis has been described among other trigger factors such as corticosteroid therapy, anesthesia, tumor manipulation during surgery and pyrexia. We describe such a case in a 5-year-old boy posted for excision and staging of a massive Wilms' tumor who developed a hyperkalemic cardiac arrest during the procedure and its subsequent intraoperative and postoperative management...
January 2016: Anesthesia, Essays and Researches
Bistra G Vlassakova, Dimitris E Emmanouil
PURPOSE OF REVIEW: Children with autism often present a challenge to the anesthesiologist. This review summarizes the current experiences and recommendations for the perioperative management of this unique group of patients. RECENT FINDINGS: Autism is the fastest growing neurodevelopmental disorder in the world. Increased recognition and public awareness of the disease is driven largely by the advances in research. A large body of evidence exists that identifies the role of genetic, environmental, biological, and developmental factors in the origin of autism...
June 2016: Current Opinion in Anaesthesiology
Rajan Verma, Brij Mohan, Joginder Pal Attri, Veena Chatrath, Anju Bala, Manjit Singh
The Anesthesiologist provides continuous medical care before, during, and after operation to permit the surgeons to perform surgeries; sometimes quite challenging that could otherwise cause substantial threats to the patient's survival. Anesthesiologists, because of their combination of skills are uniquely qualified to care for dying patients suffering from end diseases like cancer. These skills include knowledge of analgesic and sedative pharmacology for the management of pain, awareness of perceptual alterations along with well-known skills in drug titration and experience with critically ill and highly anxious, often agitated patients under stressful circumstances...
September 2015: Anesthesia, Essays and Researches
Hideki Taniguchi
In programs to enhance patient recovery after surgery, anesthesiologists play an important role. In conventional management, patients managed with the "starvation, stress, and drowning" regimen experience delays in the recovery process. In contrast, anesthesiologists in the current perioperative management scenario reduce the fasting period, maintain sufficient depth of anesthesia, and administer appropriate infusion levels. In particular, three major factors inhibiting postoperative recovery are known to be pain, gastrointestinal dysfunction, and immobility...
July 2015: Nihon Geka Gakkai Zasshi
Esra Ozayar, Handan Gulec, Merve Bayraktaroglu, Zehra Baykal Tutal, Aysun Kurtay, Munire Babayigit, Asim Ozayar, Eyup Horasanli
PURPOSE: To determine the differences among the hemodynamics, neuroendocrine stress response (NESR), and postoperative visual analogue scale (VAS) scores of pain between the procedures of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PNL) for lower pole kidney stones. PATIENTS AND METHODS: Fifty-six patients undergoing RIRS and PNL with lower puncture approach, under general anesthesia, were prospectively enrolled in our study. Perioperative blood pressure (systolic, diastolic, and mean), heart rate, and peripheral oxygen saturation (SpO2) values were recorded at intervals...
February 2016: Journal of Endourology
Chen-Shuan Chung, Tsung-Hsien Chiang, Yi-Chia Lee
An idiopathic peptic ulcer is defined as an ulcer with unknown cause or an ulcer that appears to arise spontaneously. The first step in treatment is to exclude common possible causes, including Helicobacter pylori infection, infection with other pathogens, ulcerogenic drugs, and uncommon diseases with upper gastrointestinal manifestations. When all known causes are excluded, a diagnosis of idiopathic peptic ulcer can be made. A patient whose peptic ulcer is idiopathic may have a higher risk for complicated ulcer disease, a poorer response to gastric acid suppressants, and a higher recurrence rate after treatment...
September 2015: Korean Journal of Internal Medicine
Nikhil R Nayak, Jared M Pisapia, Kalil G Abdullah, James M Schuster
Study Design Retrospective case series. Objective Ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) are two related diseases that significantly increase the risk of unstable spinal fractures from seemingly trivial trauma. Given the older age and higher surgical risk profile of most of these patients, minimally invasive (MIS) approaches to the treatment of such fractures may reduce operative risk and physiologic stress. Methods Eleven consecutive patients with hyperextension thoracolumbar injuries and a diagnosis of AS or DISH admitted to a single level I trauma center between June 2009 and June 2014 were retrospectively reviewed...
August 2015: Global Spine Journal
Antonello Bufalari, Valentina De Monte, Roberta Pecoriello, Livia Donati, Silvia Ceccarelli, Lucio Cagini, Mark Ragusa, Jacopo Vannucci
BACKGROUND: Because there is no detailed description of procedures and perioperative management of major pulmonary resections in swine, we reviewed our experience to delineate the most effective practice in performing left pneumonectomy. MATERIALS AND METHODS: Analysis of 11 consecutive left pneumonectomies. Animal data, operative reports, anesthesia records, and perioperative facts were evaluated. Follow-up information until postoperative day 60, methods of care-taking, therapy administration, and all the stabling aspects were systematically assessed...
September 2015: Journal of Surgical Research
Maiko Homma, Soshi Iwasaki, Fumiyuki Sugime, Takeshi Murouchi, Michiaki Yamakage
An 8-year-old girl of Type 1 diabetes mellitus on insulin therapy, was surgically treated for brain cavernous hemangioma. Since the hemangioma gradually became larger, the medical team including anesthesiologists, neurosurgeons, and pediatricians discussed and decided to perform craniotomy. Preoperative blood sugar level was around 40 to 300 mg x dl(-1) and appeared poorly controlled. During the surgery, opioid-based anesthesia and 1.3% glucose infusion were given to the patient to avoid surgical stress-induced hyperglycemia and to avoid starvation...
January 2015: Masui. the Japanese Journal of Anesthesiology
Jiheng Chen, Yunxiao Zhang, Chuan Huang, Keneng Chen, Mengying Fan, Zhiyi Fan
BACKGROUND: Perioperative management of pain associated with the prognosis of cancer patients. Optimization of perio-perative analgesia method, then reduce perioperative stress response, reduce opioiddosage, to reduce or even avoid systemic adverse reactions and elevated levels of tumor markers. Serum levels of tumor markers in patients with lung cancer are closely related to tumor growth. Clinical research reports on regional anesthesia effect on tumor markers for lung cancer are still very little in domesticliterature...
February 2015: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Bita A Kash, Yichen Zhang, Kayla M Cline, Terri Menser, Thomas R Miller
UNLABELLED: Policy Points: The perioperative surgical home (PSH) is complementary to the patient-centered medical home (PCMH) and defines methods for improving the patient experience and clinical outcomes, and controlling costs for the care of surgical patients. The PSH is a physician-led care delivery model that includes multi-specialty care teams and cost-efficient use of resources at all levels through a patient-centered, continuity of care delivery model with shared decision making...
December 2014: Milbank Quarterly
D Pehböck, H Dietrich, G Klima, P Paal, K H Lindner, V Wenzel
In order to extrapolate novel therapies from the bench to the bedside (translational research), animal experiments are scientifically necessary. Swine are popular laboratory animals as their cardiorespiratory physiology is very similar to humans. Every study has to be approved by the local and/or national animal ethical committees. As swine are extremely sensitive to stress the primary goal is therefore to provide a calm, stress-free environment in both housing and experimental facilities. Swine should be properly sedated for transport and normothermia needs to be ensured...
January 2015: Der Anaesthesist
Wei Wang, Yan Wang, Haibo Wu, Liming Lei, Shiqin Xu, Xiaofeng Shen, Xirong Guo, Rong Shen, Xiaoqiong Xia, Yusheng Liu, Fuzhou Wang
Postoperative cognitive dysfunction (POCD) is a subtle disorder of thought processes, which may influence isolated domains of cognition and has a significant impact on patient health. The reported incidence of POCD varies enormously due to lack of formal criteria for the assessment and diagnosis of POCD. The significant risk factors of developing POCD mainly include larger and more invasive operations, duration of anesthesia, advanced age, history of alcohol abuse, use of anticholinergic medications, and other factors...
2014: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Megan L Krause, Eric L Matteson
A multidisciplinary approach is required to care for patients with rheumatoid arthritis (RA) in the perioperative period. In preparation for surgery, patients must have a cardiovascular risk assessment performed due to the high risk of heart disease in patients with RA. Treatment of RA is with immunomodulatory medications, which present unique challenges for the perioperative period. Currently, there is no consensus on how to manage disease modifying antirheumatic drug (DMARD) therapy in the perioperative setting...
July 18, 2014: World Journal of Orthopedics
Matthias Weigl, Sophia Antoniadis, Costanza Chiapponi, Christiane Bruns, Nick Sevdalis
BACKGROUND AND AIM: Surgeons' intra-operative workload is critical for effective and safe surgical performance. Detrimental conditions in the operating room (OR) environment may add to perceived workload and jeopardize surgical performance and outcomes. This study aims to evaluate the impact of different intra-operative workflow interruptions on surgeons' capacity to manage their workload safely and efficiently. METHODS: This was an observational study of intra-operative interruptions and self-rated workload in two surgical specialties (general, orthopedic/trauma surgery)...
January 2015: Surgical Endoscopy
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