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Risk assessment anesthesia

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https://www.readbyqxmd.com/read/28332236/the-mortality-rate-of-electroconvulsive-therapy-a-systematic-review-and-pooled-analysis
#1
REVIEW
N Tørring, S N Sanghani, G Petrides, C H Kellner, S D Østergaard
OBJECTIVE: Electroconvulsive therapy (ECT) remains underutilized because of fears of cognitive and medical risks, including the risk of death. In this study, we aimed to assess the mortality rate of ECT by means of a systematic review and pooled analysis. METHOD: The study was conducted in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The ECT-related mortality rate was calculated as the total number of ECT-related deaths reported in the included studies divided by the total number of ECT treatments...
March 23, 2017: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/28327900/awake-craniotomy-vs-craniotomy-under-general-anesthesia-for-perirolandic-gliomas-evaluating-perioperative-complications-and-extent-of-resection
#2
Chikezie I Eseonu, Jordina Rincon-Torroella, Karim ReFaey, Young M Lee, Jasvinder Nangiana, Tito Vivas-Buitrago, Alfredo Quiñones-Hinojosa
BACKGROUND: A craniotomy with direct cortical/subcortical stimulation either awake or under general anesthesia (GA) present 2 approaches for removing eloquent region tumors. With a reported higher prevalence of intraoperative seizures occurring during awake resections of perirolandic lesions, oftentimes, surgery under GA is chosen for these lesions. OBJECTIVE: To evaluate a single-surgeon's experience with awake craniotomies (AC) vs surgery under GA for resecting perirolandic, eloquent, motor-region gliomas...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28326467/malignant-hyperthermia-susceptibility-in-patients-with-exertional-rhabdomyolysis-a-retrospective-cohort-study-and-updated-systematic-review
#3
Natalia Kraeva, Alexander Sapa, James J Dowling, Sheila Riazi
INTRODUCTION: Two potentially fatal syndromes, malignant hyperthermia (MH), an adverse reaction to general anesthesia, and exertional rhabdomyolysis (ER) share some clinical features, including hyperthermia, muscle rigidity, tachycardia, and elevated serum creatine kinase. Some patients with ER have experienced an MH event and/or have been diagnosed as MH susceptible (MHS). In order to assess the relationship between ER and MH further, we conducted a retrospective cohort study summarizing clinical and genetic information on Canadian patients with ER who were diagnosed as MHS...
March 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28319545/systemic-lupus-erythematosus-is-associated-with-increased-adverse-postoperative-renal-outcomes-and-mortality-a-historical-cohort-study-using-administrative-health-data
#4
Rovnat Babazade, Huseyin Oguz Yilmaz, Steve M Leung, Nicole M Zimmerman, Alparslan Turan
BACKGROUND: Systemic lupus erythematosus (SLE) is a common autoimmune connective tissue disease that mainly harms kidneys, heart, lungs, and nervous system. Effects of surgical stimulus and anesthesia combined with SLE-related pathologies may increase morbidity and mortality. Therefore, we aimed to evaluate the association between SLE (versus none) and postoperative renal, cardiac, and in-hospital mortality complications among patients undergoing major surgeries. METHODS: We obtained censuses of 2009 to 2011 inpatient hospital discharges across 7 states and conducted a retrospective cohort study by using International Classification of Diseases and Injuries, Version 9, diagnosis codes, procedure codes, and present-on-admission indicators...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28306682/training-future-anesthesiologists-in-obstetric-care
#5
Mauricio Vasco Ramírez
PURPOSE OF REVIEW: In order for the obstetric anesthesiologist to become a true perioperative / peripartum physician, a change in formative programs and certification process in anesthesia are needed. RECENT FINDINGS: Anesthesia training programs are migrating to competency based medical education (CBME) worldwide. The traditional model of attending lectures, grand rounds, reading textbooks and journal papers should be complemented by virtual modalities such as massive open online courses or online teaching tools...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306681/anesthesia-in-adults-with-congenital-heart-disease
#6
Torsten Baehner, Richard K Ellerkmann
PURPOSE OF REVIEW: The current review focuses on patients with congenital heart disease (CHD) with regard to recent trends in global demographics, healthcare provision for noncardiac surgery, as well as anesthetic and perioperative care for these patients. RECENT FINDINGS: About 40 years after milestones of surgical innovation in CHD, the number of adults with CHD (ACHD) now surpasses those of children with CHD. This development leads to the fact that even patients with complex CHD managed for noncardiac surgery are not restricted to highly specialized centers...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306195/influence-of-caudal-block-on-postoperative-oliguria-in-infants-undergoing-bilateral-ureteroneocystostomy-a-retrospective-analysis
#7
Hyun Jeong Lee, Yong Seon Choi, Bon-Nyeo Koo, Sang Won Han, Young Eun Cho, Young Jae Im, Jae Hoon Lee
BACKGROUND: Caudal block has been widely used in children undergoing genitourinary surgery. However, the influence of caudal block on postoperative oliguria is unclear. AIM: The aim of this study was to assess the effect of caudal block on urinary flow through the reimplanted ureter after ureteroneocystostomy and the incidence of postoperative oliguria in infants. METHODS: This retrospective study analyzed the medical records of 121 infants aged less than 12 months who underwent bilateral ureteroneocystostomy for vesicoureteral reflux at a tertiary medical center...
March 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28301208/measures-to-prevent-air-embolism-in-transthoracic-biopsy-of-the-lung
#8
Bernhard Glodny, Elisabeth Schönherr, Martin C Freund, Melanie Haslauer, Johannes Petersen, Alexander Loizides, Astrid E Grams, Florian Augustin, Franz J Wiedermann, Rafael Rehwald
OBJECTIVE: Systemic air embolism (AE) is a rare but feared complication of transthoracic biopsy with potentially fatal consequences. The aim of the study was to assess the effect of patient positioning during transthoracic biopsy on preventing systemic AE. MATERIALS AND METHODS: We compared a historical control group of 610 patients (group 1) who underwent transthoracic biopsy before the implementation of measures to prevent systemic AE during transthoracic biopsy and a group of 1268 patients (group 2) who underwent biopsy after the measures were implemented...
March 16, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28300680/evaluation-by-mri-of-silent-brain-infarcts-in-pre-and-post-operative-asymptomatic-carotid-surgery
#9
Remy Pascot, Anne Daoudal, Alain Cardon, Gilles Godet, Antoine Lucas, Elodie Clochard, Jean-Yves Gauvrit, Yann Le Teurnier, Adrien Kaladji
OBJECTIVE: To report the prevalence of Silent Brain Infarcts (SBI) at MRI before and after surgery for asymptomatic high grade carotid stenosis. DESIGN: Single-center retrospective observational study METHODS: Asymptomatic patients who underwent carotid endarterectomy between October 2012 and October 2014 were included. The preoperative assessment included a Doppler and a CT scan dating less than 3 months. A neurological examination was performed during the anesthesia consultation and in the 15 days before surgery...
March 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28298244/frailty-related-to-anesthesia-guided-by-the-index-bispectral-frail-study-study-protocol-for-a-randomized-controlled-trial
#10
Morgan Le Guen, Marie Herr, Antoine Bizard, Caroline Bichon, Nathalie Boichut, Thierry Chazot, Ngai Liu, Joel Ankri, Marc Fischler
BACKGROUND: Currently, patients older than 60 years of age represent 25% of the population and are at an increased risk during surgery. Therefore, reducing postoperative morbidity and mortality is a major concern in medical research and practice. Dependence on caregivers and cognitive impairment represent two major risk factors in the elderly, especially in frail patients after surgery under general anesthesia. In this context, continuous monitoring of the depth of anesthesia using a bispectral index (BIS) sensor may reduce the occurrence of impairments by gaining better control of the anesthetic depth...
March 16, 2017: Trials
https://www.readbyqxmd.com/read/28293808/low-pre-operative-heart-rate-variability-and-complexity-are-associated-with-hypotension-after-anesthesia-induction-in-major-abdominal-surgery
#11
James R Padley, Erez Ben-Menachem
Significant hypotension after induction of general anesthesia is common and has the potential for serious complications. This study aimed to determine if pre-operative heart rate variability (HRV) was associated with post-induction hypotension in patients undergoing major abdominal surgery. Patients undergoing semi-elective major abdominal surgery were consecutively recruited during pre-admission clinic assessment. Exclusion criteria included cardiac conduction disease, arrhythmias or severe liver or renal disease...
March 14, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28291456/anesthesia-and-postoperative-respiratory-compromise-following-major-lower-extremity-surgery-implications-for-combat-casualties
#12
Samuel M Galvagno, Jordan Brayanov, George Williams, Edward E George
Care of military casualties requires not only assessment of patient, injury, and setting, but also the consequences of care decisions on other organ systems. In contemporary conflicts, pelviperineal and lower extremity trauma are common injuries, yet the optimal perioperative anesthetic and analgesic care remains unclear. Residual anesthesia and opioids can cause respiratory depression, specifically postoperative respiratory depression and opioid-induced respiratory depression. This observational study quantified and compared the incidences of respiratory depression following general anesthesia (GA) and spinal anesthesia (SA) for lower extremity surgery...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291437/evaluation-of-proximal-femoral-nail-antirotation-and-cemented-bipolar-hemiarthroplasty-with-calcar-replacement-in-treatment-of-intertrochanteric-femoral-fractures-in-terms-of-mortality-and-morbidity-ratios
#13
Erdinç Esen, Hakan Dur, M Baybars Ataoğlu, Tacettin Ayanoğlu, Sacit Turanlı
OBJECTIVES: This study aims to assess the mortality and morbidity rates of patients with intertrochanteric femoral fractures who were performed proximal femoral nail-antirotation (PFNA) or cemented, bipolar hemiarthroplasty with calcar replacement. PATIENTS AND METHODS: A total of 127 patients (42 males, 85 females; mean age 79.2 years; range 55 to 98 years) who were treated due to proximal femoral fracture between January 2008 and January 2011 were compared retrospectively in terms of intraoperative mortality, total mortality, and monthly distribution of mortality rates...
April 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/28291057/mild-cognitive-impairment-and-exposure-to-general-anesthesia-for-surgeries-and-procedures-a-population-based-case-control-study
#14
Juraj Sprung, Rosebud O Roberts, David S Knopman, Lauren L Price, Hunter P Schulz, Christie L Tatsuyama, Toby N Weingarten, Darrell R Schroeder, Andrew C Hanson, Ronald C Petersen, David O Warner
BACKGROUND: To examine whether exposure to general anesthesia for procedures at age ≥40 years is associated with prevalent mild cognitive impairment (MCI) in the elderly. METHODS: A case-control study nested within a population-based cohort. Olmsted County, Minnesota, residents, aged 70-91 years, underwent baseline evaluations that included the Clinical Dementia Rating scale, a neurologic evaluation, and neuropsychologic testing. Individuals identified with MCI (cases) at enrollment were matched 1:2 on age, sex, education, and apolipoprotein genotype with participants who were cognitively normal at the time of the index visit...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28290972/malignant-hyperthermia-susceptibility-and-fitness-for-duty
#15
Michael A Lee, Erin B McGlinch, Maria C McGlinch, John F Capacchione
INTRODUCTION: Malignant hyperthermia (MH) is an inherited hypermetabolic condition characterized by uncontrolled calcium release from the sarcoplasmic reticulum of skeletal muscle, usually from exposure to inhaled general anesthetics and/or the depolarizing neuromuscular blocking agent succinylcholine. Multiple case reports now reveal that crises may be precipitated by environmental factors such as exercise or high ambient temperatures. Common signs of an MH crisis include life-threatening hyperthermia, metabolic acidosis, muscle rigidity, and tachycardia...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288477/intraoperative-bleeding-and-the-risk-of-residual-cholesteatoma-a-multivariate-analysis
#16
Gavin J le Nobel, Sharon L Cushing, Blake C Papsin, Adrian L James
OBJECTIVE: Residual cholesteatoma most frequently occurs where visualization and surgical access are restricted by anatomic constraints. Other factors that compromise surgical field visualization might also increase rates of residual cholesteatoma. We evaluated whether impaired surgical field clarity from bleeding increases rates of residual cholesteatoma. STUDY DESIGN: Prospective cohort study. SETTING: Tertiary care hospital. PATIENTS: Consecutive series of children having intact canal wall surgery for cholesteatoma...
April 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28283609/intraoperative-completion-studies-local-anesthesia-and-antiplatelet-medication-are-associated-with-lower-risk-in-carotid-endarterectomy
#17
Christoph Knappich, Andreas Kuehnl, Pavlos Tsantilas, Sofie Schmid, Thorben Breitkreuz, Michael Kallmayer, Alexander Zimmermann, Hans-Henning Eckstein
BACKGROUND AND PURPOSE: In Germany, all surgical and endovascular procedures on the carotid bifurcation must be documented in a statutory nationwide quality assurance database. We aimed to analyze the association between procedural and perioperative variables and in-hospital stroke or death rates after carotid endarterectomy. METHODS: Between 2009 and 2014, overall 142 074 elective carotid endarterectomy procedures for asymptomatic or symptomatic carotid artery stenosis were documented in the database...
March 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28280904/complete-posterolateral-meniscal-root-tear-is-associated-with-high-grade-pivot-shift-phenomenon-in-noncontact-anterior-cruciate-ligament-injuries
#18
Guan-Yang Song, Hui Zhang, Xin Liu, Jin Zhang, Zhe Xue, Yi Qian, Hua Feng
PURPOSE: The purpose of this study was to investigate whether the complete posterolateral meniscal root tear (PLMRT) would be associated with high-grade pivot-shift phenomenon in noncontact anterior cruciate ligament (ACL) injuries. METHODS: From 2013 to 2015, a total of 1095 consecutive patients were diagnosed as having noncontact ACL injuries and underwent primary ACL reconstructions. Among them, 140 patients were arthroscopically verified to have concomitant PLMRTs...
March 9, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28277380/update-on-developmental-anesthesia-neurotoxicity
#19
Laszlo Vutskits, Andrew Davidson
PURPOSE OF REVIEW: Adverse long-term impact of general anesthesia on the developing brain is a widely discussed and controversial issue with potential public health relevance. The goal of this article is to give insights into the most recent experimental and clinical observations aimed to advance our understanding in this field. RECENT FINDINGS: Recent investigations demonstrate long-term behavioral consequences of early-life anesthesia exposure in nonhuman primates under experimental conditions that are translationally relevant to human clinical practice...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28268929/cardiovascular-interactions-assessed-via-conditional-joint-transfer-entropy-in-patients-developing-atrial-fibrillation-after-coronary-artery-bypass-graft-surgery
#20
Vlasta Bari, Marco Ranucci, Andrea Marchi, Beatrice De Maria, Valeria Pistuddi, Alberto Porta
Assigned the universe of knowledge Ω as composed by one target and two exogenous signals, the conditional joint transfer entropy (CJTE), assessing the amount of information jointly transferred from the two sources to the target that can be uniquely linked to one of the two sources, was found useful to study cardiovascular control. We propose the assessment of CJTE from systolic arterial pressure (SAP) and respiration (R) to heart period (HP) conditioned on R (CJTESAP, R→HP|R) along the baroreflex, and from HP and R to SAP conditioned on R (CJTEHP, R→SAP|R) along the feedforward mechanical pathway, in 134 patients undergoing coronary artery bypass graft surgery before (PRE) and after (POST) the induction of general anesthesia...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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