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Stress management anesthesiologist

Kay B Leissner, Jessica L Shanahan, Peter L Bekker, Houman Amirfarzan
BACKGROUND: As part of an effort to maximize value in the perioperative setting, a paradigm shift is underway in the way that patients are cared for preoperatively, on the day of surgery, and postoperatively-a setting collectively known as the perioperative care. Enhanced Recovery After Surgery (ERAS(®)) is an evidence-based, patient-centered team approach to delivering high-quality perioperative care to surgical patients. METHODS: This review focuses on anesthesiologists, with their unique purview of perioperative setting, who are important drivers of change in the delivery of valuable perioperative care...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Htet Bo, David Avenetti, Evelina Kratunova
Moyamoya disease is a rare progressive cerebral arteriopathy associated with risk of ischemic and hemorrhagic brain complications. The dental care of affected individuals should be performed in a pain- and stress-free manner to decrease the chance of occurrence of episodes of hypocapnia, hypercapnia, hypotension, hypovolemia, and hypothermia. Dental treatment may be provided in an outpatient dental setting or in a hospital setting, but both venues require interdisciplinary collaboration to ensure safe delivery of patient care...
May 15, 2017: Journal of Dentistry for Children
Florian Raimann, Christian Senft, Jörg Honold, Kai Zacharowski, Volker Seifert, Jan Mersmann
BACKGROUND: We present a case of stress-induced cardiomyopathy (Takotsubo cardiomyopathy) caused by a venous air embolism during a craniotomy performed in the sitting position. CASE DESCRIPTION: A 69-year-old woman was admitted to the neurosurgical department and scheduled for elective resection of a cerebellar metastasis in the sitting position. After craniotomy and opening of the posterior fossa, a venous air embolism was detected via transesophageal echocardiography...
November 2017: World Neurosurgery
M Rockstroh, S Franke, M Hofer, A Will, M Kasparick, B Andersen, T Neumuth
PURPOSE: Clinical working environments have become very complex imposing many different tasks in diagnosis, medical treatment, and care procedures. During the German flagship project OR.NET, more than 50 partners developed technologies for an open integration of medical devices and IT systems in the operating room. The aim of the present work was to evaluate a large set of the proposed concepts from the perspectives of various stakeholders. METHOD: The demonstration OR is focused on interventions from the head and neck surgery and was developed in close cooperation with surgeons and numerous colleagues of the project partners...
August 2017: International Journal of Computer Assisted Radiology and Surgery
Sumitra Ganesh Bakshi, Jigeeshu Vasishtha Divatia, Sadhana Kannan, Sheila Nainan Myatra
BACKGROUND AND AIMS: Work-related stress is common among medical caregivers and concerns all perioperative care providers. Although anesthesiologists are known to experience stress, there are limited Indian data addressing this issue. This survey was conducted among Indian anesthesiologists to determine their awareness about work stress and views regarding prevention programs. MATERIAL AND METHODS: A survey questionnaire was distributed to delegates visiting the exhibits at the national anesthesiology conference in 2011...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
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...
June 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...
May 2017: 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
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