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Risk assessment anesthesia

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https://www.readbyqxmd.com/read/29232379/comparison-of-nalbuphine-and-sufentanil-for-colonoscopy-a-randomized-controlled-trial
#1
Chaoyi Deng, Xiao Wang, Qianmei Zhu, Yanming Kang, Jinlin Yang, Heng Wang
OBJECTIVES: Nalbuphine is as effective as morphine as a perioperative analgesic but has not been compared directly with sufentanil in clinical trials. The aims of this study were to compare the efficacy and safety of nalbuphine with that of sufentanil in patients undergoing colonoscopy and to determine the optimal doses of nalbuphine in this indication. METHODS: Two hundred and forty consecutive eligible patients aged 18-65 years with an American Society of Anesthesiologists classification of I-II and scheduled for colonoscopy were randomly allocated to receive sufentanil 0...
2017: PloS One
https://www.readbyqxmd.com/read/29230500/-analysis-and-options-for-optimization-of-preoperative-assessment-for-anesthesia-at-a%C3%A2-university-hospital
#2
M Kieninger, C Eissnert, M Seitz, K Judemann, T Seyfried, B Graf, B Sinner
BACKGROUND: Risk assessment prior to elective surgery is an important tool in the context of perioperative patient care; however, only a few studies have been carried out to address the processes and problems during preoperative assessment for anesthesia. AIM: Over a period of several weeks all preoperative anesthesia evaluations prior to elective surgery were prospectively recorded in order to generate a data pool with a view to identifying options for process optimization...
December 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29225156/performance-of-tci-propofol-using-the-schnider-model-for-cardiac-surgery-on-cardiopulmonary-bypass-a-pilot-study
#3
Aaron Kwang Yang Lee, Aaron Yik Hang Kong, Chee Fai Kong
OBJECTIVE: This pilot study aimed to evaluate the performance of target-controlled infusion (TCI) of propofol using the Schnider pharmacokinetic model in patients undergoing cardiac surgery requiring cardiopulmonary bypass. DESIGN: This was a prospective pharmacokinetic study. SETTING: A tertiary care hospital. PARTICIPANTS: This study is comprised of 10 patients, aged between 46 and 81, who underwent elective cardiac surgery requiring the use of cardiopulmonary bypass...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29207737/factors-affecting-post-caesarean-pain-intensity-among-women-in-the-northern-peninsular-of-malaysia
#4
Hanan Hussein Jasim, Syed Azhar Bin Syed Sulaiman, Amer Hayat Khan, Usha A/P S Rajah
Introduction: Caesarean section (CS) rate has increased considerably during the past years, accounting for 15% to 25% of births. During post-CS period, moderate to severe postoperative pain is a regularly reported problem. Ideally, the intensity of postoperative pain should be predicted so as to customize analgesia. Aim: To document the CS rate, assess the pain intensity and preoperative factors that may predict post caesarean pain among women in the Obstetric unit of a Hospital Pulau Pinang in Malaysia...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29206695/drug-induced-sleep-endoscopy-from-obscure-technique-to-diagnostic-tool-for-assessment-of-obstructive-sleep-apnea-for-surgical-interventions
#5
Joshua H Atkins, Jeff E Mandel
PURPOSE OF REVIEW: Provide a practical update on drug-induced sleep endoscopy (DISE) for anesthesia providers, which can also serve as a reference for those preparing to establish a DISE program. RECENT FINDINGS: New developments in surgical approaches to OSA and the growing global incidence of the condition have stimulated increased interest and demand for drug-induced sleep endoscopy. New techniques include transoral robotic surgery and hypoglossal nerve stimulation...
December 4, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29204425/continuous-non-invasive-arterial-pressure-assessment-during-surgery-to-improve-outcome
#6
REVIEW
Alena Stenglova, Jan Benes
Blood pressure (BP) is one of the most important variables evaluated during almost every medical examination. Most national anesthesiology societies recommend BP monitoring at least once every 5 min in anesthetized subjects undergoing surgical procedures. In most cases, BP is monitored non-invasively using oscillometric cuffs. Although the risk of arterial cannulation is not very high, the invasive BP monitoring is usually indicated only in the case of high-risk patients or in complex surgical procedures...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#7
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
December 1, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29200370/anesthesia-for-a-patient-with-excessive-supragastric-belching
#8
Michelle Wong
Excessive supragastric belching is rarely described in the anesthesia literature. Anesthesia planning of a 26-year-old patient with excessive supragastric belching, history of superior mesenteric artery syndrome (SMAS), and dental anxiety requires preoperative assessment. This case report outlines the anesthetic considerations and the management to facilitate comprehensive dentistry. Key anesthetic considerations include anxiolysis, aspiration risk reduction, total intravenous anesthesia (TIVA), and postoperative nausea and vomiting (PONV) prophylaxis...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/29197434/erbium-laser-technology-vs-traditional-drilling-for-caries-removal-a-systematic-review-with-meta-analysis
#9
REVIEW
Siying Tao, Lan Li, He Yuan, Sibei Tao, Yiming Cheng, Libang He, Jiyao Li
OBJECTIVE: The study aimed to assess the efficacy of erbium laser technology compared with traditional drilling for caries removal. METHODS: A systematic search was conducted through Medline via PubMed, Embase, Cochrane databases, CNKI till December 2016. Randomised controlled trials, quasi-randomized controlled trials, or controlled clinical trials with data comparing the efficacy of erbium laser technology versus traditional drilling for caries removal were included...
December 2017: Journal of Evidence-based Dental Practice
https://www.readbyqxmd.com/read/29195854/hypothermia-in-total-joint-arthroplasty-a-wake-up-call
#10
Jordan B Simpson, Vijai S Thomas, Sabir K Ismaily, Pavel I Muradov, Philip C Noble, Stephen J Incavo
BACKGROUND: Total joint patients are particularly vulnerable to perioperative hypothermia (PH) (combined effects of anesthesia, radiation, and convective heat loss from exposed skin surfaces and cool temperatures in the operating room). There are limited studies on PH in these patients. METHODS: In a retrospective review of 204 patients undergoing primary hip and 179 undergoing primary knee replacement surgeries, time and temperature parameters were collected from the electronic health records from preoperative and postoperative recovery room nursing assessments, intraoperative anesthesia records, and floor nursing notes...
November 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29189439/leading-causes-of-anesthesia-related-liability-claims-in-ambulatory-surgery-centers
#11
Darrell Ranum, Anair Beverly, Fred E Shapiro, Richard D Urman
OBJECTIVE: We present a contemporary analysis of patient injury, allegations, and contributing factors of anesthesia-related closed claims, which involved cases that specifically occurred in free-standing ambulatory surgery centers (ASCs). METHODS: We examined ASC-closed claims data between 2007 and 2014 from The Doctors Company, a medical malpractice insurer. Findings were coded using the Comprehensive Risk Intelligence Tool developed by CRICO Strategies. We compared coded data from ASC claims with hospital operating room (HOR) claims, in terms of injury severity category, nature of injury, nature of allegation, contributing factors identified, and contributing comorbidities and claim value...
November 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29188414/velocity-pressure-loops-for-continuous-assessment-of-ventricular-afterload-influence-of-pressure-measurement-site
#12
Jona Joachim, Fabrice Vallée, Arthur Le Gall, Joaquim Matéo, Stéphanie Lenck, Sandrine Millasseau, Emmanuel Houdart, Alexandre Mebazaa, Etienne Gayat
VPloop, the graphical representation of pressure versus velocity, and its characteristic angles, GALA and β, can be used to monitor cardiac afterload during anesthesia. Ideally VPloop should be measured from pressure and velocity obtained at the same arterial location but standard of care usually provide either radial or femoral pressure waveforms. The purpose of this study was to look at the influence of arterial sites and the use of a transfer function (TF) on VPloop and its related angles. Invasive pressure signals were recorded in 25 patients undergoing neuroradiology intervention under general anesthesia with transesophageal flow velocity monitoring...
November 29, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29188199/effects-of-25-and-30-degree-trendelenburg-positions-on-intraocular-pressure-changes-during-robot-assisted-radical-prostatectomy
#13
Masatomo Nishikawa, Hiromitsu Watanabe, Tomofumi Kurahashi
Background: The objective of this study was to assess the effects of 25-degree and 30-degree Trendelenburg positions on intraocular pressure (IOP) changes during robot-assisted radical prostatectomy (RARP). Materials and methods: This prospective study involved a total of 30 consecutive patients undergoing RARP. All participants were randomly divided into two groups: Trendelenburg position with the head down at 25 degrees or 30 degrees. In addition to representative operative outcomes, IOP was measured at six discrete time points; Time 1 (T1): before induction of general anesthesia, patients in a horizontal supine position; T2: after induction of general anesthesia, patients in a horizontal supine position; T3: 1 hour after adopting the Trendelenburg position; T4: 2 hours after adopting the Trendelenburg position; T5: after pneumoperitoneum resolution in the Trendelenburg position; T6: anesthetized before awakening in a supine position...
December 2017: Prostate International
https://www.readbyqxmd.com/read/29181580/ionizing-radiation-from-computed-tomography-versus-anesthesia-for-magnetic-resonance-imaging-in-infants-and-children-patient-safety-considerations
#14
REVIEW
Michael J Callahan, Robert D MacDougall, Sarah D Bixby, Stephan D Voss, Richard L Robertson, Joseph P Cravero
In the context of health care, risk assessment is the identification, evaluation and estimation of risk related to a particular clinical situation or intervention compared to accepted medical practice standards. The goal of risk assessment is to determine an acceptable level of risk for a given clinical treatment or intervention in association with the provided clinical circumstances for a patient or group of patients. In spite of the inherent challenges related to risk assessment in pediatric cross-sectional imaging, the potential risks of ionizing radiation and sedation/anesthesia in the pediatric population are thought to be quite small...
November 27, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29179755/fever-after-bronchoscopy-serum-procalcitonin-enables-early-diagnosis-of-post-interventional-bacterial-infection
#15
Klaus Hackner, Waltraud Riegler, Sabin Handzhiev, Rosemarie Bauer, Jan Veres, Manuela Speiser, Karin Meisinger, Peter Errhalt
BACKGROUND: The aim of this study was to differentiate unspecific and self-limiting fever after bronchoscopy from fever due to infection by using serum procalcitonin, C-reactive protein and neutrophil count. Furthermore, frequency of fever after bronchoscopy and procedures as possible risk factors were evaluated. METHODS: Three hundred and fourteen consecutive patients were included. All bronchoscopies were performed using jet-ventilation and general anesthesia...
November 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29178093/-role-of-nutrition-support-in-the-enhanced-recovery-after-surgery-for-gastrointestinal-surgery-patients
#16
Yijia Lin, Junsheng Peng
Nutrition support therapy can improve the general condition of the patient and is one of the main factors to ensure the success of the operation. Enhanced recovery after surgery (ERAS) improves the recovery following gastrointestinal surgery by reducing postoperative stress response. The application of nutrition support in ERAS includes nutrition risk assessment before surgery and preoperative nutrition treatment for malnutrition. The time to fasting and clear liquid was shortened to 6 h and 2 h before anesthesia induction...
November 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29174211/retrospective-study-of-intra-anesthetic-predictors-of-prolonged-hospitalization-increased-cost-of-care-and-mortality-for-canine-patients-at-a-veterinary-teaching-hospital
#17
Melissa D Smith, Michele Barletta, Courtni N Young, Erik H Hofmeister
OBJECTIVE: To determine the impact of intraoperative anesthetic variables on the length of hospitalization, cost of care and mortality in dogs. STUDY DESIGN: Retrospective, observational study. ANIMALS: A total of 235 dogs undergoing general anesthesia. METHODS: Medical records of dogs undergoing general anesthesia between 2007 and 2014 at the University of Georgia Veterinary Teaching Hospital were reviewed. Data collected included demographic data, American Society of Anesthesiologists (ASA) physical status, type and duration of anesthesia, hemodynamic variables, temperature, ventilation, fluid therapy and adjunctive drugs administered...
June 7, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29160244/pulmonary-aspiration-in-adjustable-gastric-banding-carriers-undergoing-a-second-surgical-procedure-considerations-on-personal-experience-and-review-of-the-literature
#18
Contardo Vergani, Marco Venturi, Sara Badiali, Barbara Chella, Enrico Mozzi
BACKGROUND: The observation of a relatively high number of pulmonary aspirations (PA) among gastric band (GB) carriers undergoing a second surgery, prompted us to modify our strategy for GB patients candidate to further operation under general anesthesia. MATERIAL OF STUDY AND RESULTS: In January 2013, following the occurrence of PA at the induction of general anesthesia in 1 GB carrier undergoing a further operation, we reviewed our Data Base between January 2005 and 2013, to explore the rate of pulmonary aspiration in patients GB carriers undergoing a second surgery...
November 7, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29159277/development-of-a-porcine-model-for-assessment-of-mucosal-repair-following-endoscopic-resection-of-the-lower-gastrointestinal-tract
#19
Nicolas Etchepare, Jérémy Bregeon, Lucille Quénéhervé, Sami Haddara, Yann Touchefeu, Michel Neunlist, Emmanuel Coron
Background and aims:  Endoscopic mucosal resection (EMR) is widely performed for the treatment of colorectal polyps. However, the pathophysiological mechanisms of mucosal repair, including in situations at high risk of post-polypectomy bleeding, remain largely unknown. The objective of our study was to develop a porcine model of EMR in the lower gastrointestinal tract to monitor mucosal wound healing over time. Methods:  Under general anesthesia, five large wounds were created in the lower gastrointestinal tract at different times, i...
October 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29157110/risk-factors-and-clinical-outcomes-of-delirium-in-osteoporotic-hip-fractures
#20
Joon Yub Kim, Jeong Hyun Yoo, Eugene Kim, Ki Bum Kwon, Byeong-Ryong Han, Yongun Cho, Jai Hyung Park
PURPOSE: This study is performed to identify risk factors for delirium in osteoporotic hip fractures and to evaluate the hospitalization cost and clinical outcomes of delirium in osteoporotic hip. METHODS: A total of 221 patients with osteoporotic hip fractures were assessed for eligibility between 2010 and 2014. Among them, 37 patients with delirium were allocated into the delirium group (group D) and 37 patients without delirium were allocated into the non-delirium group (group ND) by matching demographic factors...
September 2017: Journal of Orthopaedic Surgery
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