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Liver surgery anesthesia

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https://www.readbyqxmd.com/read/27920414/morbidity-and-mortality-and-predictors-of-outcome-following-hepatectomy-at-a-saudi-tertiary-care-center
#1
Faisal Al-Alem, Rafif Essam Mattar, Ola Abdelmonem Fadl, Abdulsalam Alsharabi, Faisal Al-Saif, Mazen Hassanain
BACKGROUND: Hepatic resection is a major surgical procedure. Data on outcomes of hepatectomy in Saudi Arabia are scarce. OBJECTIVE: To measure morbidity and mortality and assess predictors of outcome after hepatectomy. DESIGN: Descriptive study. SETTING: Tertiary care center in Saudi Arabia with well established hepatobiliary surgery unit. PATIENTS AND METHODS: All patients undergoing liver resection in our institute during 2006-2014...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27910802/near-infrared-spectroscopy-evaluated-cerebral-oxygenation-during-anesthesia
#2
Henrik Sørensen
Likely, maintained organ and notably cerebral perfusion, secures rapid recovery following anesthesia. To secure cerebral blood flow (CBF) at least mean arterial pressure (MAP) and the arterial carbon dioxide tension (PaCO2) need to be considered. CBF is "autoregulated", i.e. stays more or less stable within a MAP of 50-150 mmHg, but the lower limit appears to depend on the central blood volume and/or cardiac output, illustrated by a decrease in CBF at a MAP of 80 mmHg with a compromised central blood volume, while CBF remains constant with a MAP < 40 mmHg, if the central blood volume is maintained...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27837084/intraoperative-diagnosis-of-intracardiac-thrombus-during-orthotopic-liver-transplantation-with-transesophageal-echocardiography-a-case-series-and-literature-review
#3
Adam A Dalia, Hisham Khan, Antolin S Flores
Anesthesia for orthotopic liver transplantation (OLT) is challenging for any anesthesiologist as the patients undergoing this procedure are among the most critically ill. Adding to the underlying complexity of OLT management is the rare complication of an intracardiac thrombus (ICT). Intracardiac thrombi can present following liver allograft reperfusion resulting in high morbidity and mortality. Currently there is no consensus treatment for ICT, and the gold standard for diagnosis is intraoperative transesophageal echocardiography (TEE); these 2 factors lead to a dangerous amalgam of the difficulty in diagnosing and treating the disease...
November 10, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27822212/systemic-hmgb1-neutralization-prevents-postoperative-neurocognitive-dysfunction-in-aged-rats
#4
Niccolò Terrando, Ting Yang, Xueqin Wang, Jiakai Fang, Mengya Cao, Ulf Andersson, Harris Helena Erlandsson, Wen Ouyang, Jianbin Tong
Postoperative neurocognitive disorders are common complications in elderly patients following surgery or critical illness. High mobility group box 1 protein (HMGB1) is rapidly released after tissue trauma and critically involved in response to sterile injury. Herein, we assessed the role of HMGB1 after liver surgery in aged rats and explored the therapeutic potential of a neutralizing anti-HMGB1 monoclonal antibody in a clinically relevant model of postoperative neurocognitive disorders. Nineteen to twenty-two months Sprague-Dawley rats were randomly assigned as: (1) control with saline; (2) surgery, a partial hepatolobectomy under sevoflurane anesthesia and analgesia, + immunoglobulin G as control antibody; (3) surgery + anti-HMGB1...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27816131/anesthesia-patients-with-concomitant-cardiac-and-hepatic-dysfunction
#5
REVIEW
Julianne Ahdout, Michael Nurok
Anesthesia and surgery in patients with hepatic and cardiac dysfunction poses a challenge for anesthesiologists. It is imperative to optimize these patients perioperatively. Cirrhosis is associated with a wide range of cardiovascular abnormalities. Cirrhotic cardiomyopathy is characterized by blunted contractile responsiveness or systolic incompetence, and/or diastolic dysfunction. In liver disease, anesthetic drug distribution, metabolism, and elimination may be altered. Among patients with liver disease, propofol is a reasonable anesthetic choice and cisatracurium is the preferred neuromuscular blocker...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27793243/anesthesia-in-pregnant-women-with-hellp-syndrome-case-report
#6
Eduardo Barbin Zuccolotto, Eugenio Pagnussatt Neto, Glínia Cavalcante Nogueira, José Roberto Nociti
BACKGROUND AND OBJECTIVES: HELLP syndrome, characterized by hemolysis, high levels of liver enzyme, and low platelet count, is an advanced clinical stage of pre-eclampsia, progressing to high maternal (24%) and perinatal (up 40%) mortality, despite childbirth care in a timely manner. The goal is to describe the anesthetic management of a case with indication to emergency cesarean. CASE REPORT: Female patient, 36 years old, gestational age of 24 weeks, with hypertensive crisis (BP 180/100mmHg) and severe headache, was admitted to the operating room for a cesarean section after diagnosis of HELLP syndrome...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27766594/prospective-survey-to-study-factors-which-could-influence-same-day-discharge-after-elective-laparoscopic-cholecystectomy-in-a-tertiary-care-hospital-of-a-developing-country
#7
Samina Ismail, Aliya Ahmed, Muhammad Qamarul Hoda, Muhammad Sohaib, Zia-Ur-Rehman
All laparoscopic cholecystectomy (LC) patients in our hospital setting are admitted overnight. This article assesses the contribution of factors like postoperative nausea and vomiting (PONV), postoperative pain and surgical complications to overnight stay after elective LC. This 1-year observational study included patients having normal liver functions undergoing elective LC before 1400 h. The collected data included patient demographics, co-morbidities, PONV, pain scores, complications, surgical time, anesthesia technique, use of prophylactic antiemetics, analgesics, patient satisfaction and desire to have this surgery as day case or in-patient procedure...
October 20, 2016: Updates in Surgery
https://www.readbyqxmd.com/read/27756208/effect-of-the-severity-of-liver-dysfunction-on-the-minimum-alveolar-concentration-of-sevoflurane-responding-to-an-electronic-stimulation-in-cirrhotic-patients
#8
Yan Yin, Hong Xiao, Jirimutuya Han, Weiyi Zhang, Jianguo Cheng, Tao Zhu
BACKGROUND: It has been observed that patients with liver dysfunction need lower dose anesthetic compared patients with normal liver function. The minimum amount of volatile anesthetic to achieve an optimal depth of anesthesia for these patients is still unclear. In this study, Minimum alveolar concentration (MAC) of the sevoflurane was determined using an electric stimulation and the effect of severity of liver dysfunction on the MAC was observed in cirrhotic patients. METHODS: Thirty patients undergoing upper abdominal surgery were divided into the following groups: group N (normal liver function), group A (Child-Pugh grade A) and group B (Child-Pugh grade B-C)...
October 18, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27742301/long-time-choledochal-clamping-in-wistar-rats-causes-biliary-obstruction-progressing-to-hepatic-fibrosis
#9
G D L Jorge, R R Tártaro, C A F Escanhoela, I D F S F Boin
BACKGROUND: Biliary complications are important causes of morbidity and mortality in patients undergoing hepatic surgery. The aim of the study was to evaluate late liver alterations after a long period of choledochal clamping in Wistar rats. METHODS: Ten male Wistar rats, weighing 304 grams, anesthetized with sodium thiopental (25 mg/kg) and xylazine (10 mg/kg) intravenously, were distributed into 2 groups: the choledochal clamping group (CCG) and the operation sham group (OSG), with 5 animals each submitted to an abdominal incision...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27742300/n-acetylcysteine-use-in-hepatic-ischemia-reperfusion-in-rats-minimizing-bowel-injury
#10
S H Lauz Medeiros, A de Oliveira Menezes, L Zogbi, E Frasson de Souza Montero
BACKGROUND: The ischemia/reperfusion (I/R) phenomenon can cause the dysfunction of some transplanted organs and other distant organs. Liver surgery success, including transplantations, may depend on the adverse effects of intestinal mucosa injury arising from temporary porta triad occlusion. The study objective was to examine I/R liver effects on the small intestine in rats after N-acetylcysteine (NAC) treatment. METHODS: Twenty-four male Wistar rats were randomly divided into 2 groups...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27613897/protective-effect-of-nicotine-on-sepsis-induced-oxidative-multi-organ-damage-role-of-neutrophils
#11
Zarife Nigâr Özdemir-Kumral, Dilek Özbeyli, Ahmet Faruk Özdemir, M Buğra Karaaslan, Kübra Kaytaz, Mustafa F Kara, Olgu Enis Tok, Feriha Ercan, Berrak Ç Yeğen
INTRODUCTION: Despite its adverse health consequences, tobacco smoking is associated with lower incidence of several neurodegenerative and inflammatory diseases. The present study is aimed to show the effects of nicotine, major tobacco constituent, on five organs targeted by sepsis. METHODS: Male Wistar albino rats received tap water with (5 mg/kg) or without nicotine for 14 days. Under ketamine anesthesia, sepsis (n=50) was induced by ligation and punction of the cecum, while sham group (n=8) had only laparotomy...
August 3, 2016: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/27595164/review-of-remote-ischemic-preconditioning-from-laboratory-studies-to-clinical-trials
#12
Vesa Anttila, Henri Haapanen, Fredrik Yannopoulos, Johanna Herajärvi, Tuomas Anttila, Tatu Juvonen
In remote ischemic preconditioning (RIPC) short periods of non-lethal ischemia followed by reperfusion of tissue or organ prepare remote tissue or organ to resist a subsequent more severe ischemia-reperfusion injury. The signaling mechanism of RIPC can be humoral communication, neuronal stimulation, systemic modification of circulating immune cells, and activation of hypoxia inducible genes. Despite promising evidence from experimental studies, the clinical effects of RIPC have been controversial. Heterogeneity of inclusion and exclusion criteria and confounding factors such as comedication, anesthesia, comorbidities, and other risk factors may have influenced the efficacy of RIPC...
September 20, 2016: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/27593591/the-significance-of-underlying-cardiac-comorbidity-on-major-adverse-cardiac-events-after-major-liver-resection
#13
Thuy B Tran, David J Worhunsky, David A Spain, Monica M Dua, Brendan C Visser, Jeffrey A Norton, George A Poultsides
BACKGROUND: The risk of postoperative adverse events in patients with underlying cardiac disease undergoing major hepatectomy remains poorly characterized. METHODS: The NSQIP database was used to identify patients undergoing hemihepatectomy and trisectionectomy. Patient characteristics and postoperative outcomes were evaluated. RESULTS: From 2005 to 2012, 5227 patients underwent major hepatectomy. Of those, 289 (5.5%) had prior major cardiac disease: 5...
September 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27583049/a-ferromagnetic-foreign-body-at-the-lateral-aspect-of-the-mandibular-ramus-in-a-medically-compromised-patient
#14
K Yamamoto, Y Nakayama, I Yamamoto, Y Matsusue, H Shimotsuji, T Kirita
A case of a ferromagnetic foreign body in a medically compromised patient was reported. The patient was a 45-year-old male who consulted our department complaining of a foreign body accidentally impacted in the right cheek. X-ray examination revealed a foreign body at the lateral aspect of the right mandibular ramus. The removal of the foreign body was scheduled, but the patient did not return for the procedure. After 8 years he revisited our department for the removal of the foreign body, because it had been found to be ferromagnetic and a barrier to MRI examination...
2016: Open Dentistry Journal
https://www.readbyqxmd.com/read/27536068/effects-of-lornoxicam-and-intravenous-ibuprofen-on-erythrocyte-deformability-and-hepatic-and-renal-blood-flow-in-rats
#15
Hande Arpacı, Faruk Metin Çomu, Ayşegül Küçük, Bahadır Kösem, Seyfi Kartal, Volkan Şıvgın, Hüseyin Cihad Turgut, Muhammed Enes Aydın, Derya Sebile Koç, Mustafa Arslan
BACKGROUND: Change in blood supply is held responsible for anesthesia-related abnormal tissue and organ perfusion. Decreased erythrocyte deformability and increased aggregation may be detected after surgery performed under general anesthesia. It was shown that nonsteroidal anti-inflammatory drugs decrease erythrocyte deformability. Lornoxicam and/or intravenous (iv) ibuprofen are commonly preferred analgesic agents for postoperative pain management. In this study, we aimed to investigate the effects of lornoxicam (2 mg/kg, iv) and ibuprofen (30 mg/kg, iv) on erythrocyte deformability, as well as hepatic and renal blood flows, in male rats...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27499322/less-invasive-surgery-using-external-fixator-for-the-treatment-of-subtrochanteric-femur-fracture-in-a-high-risk-geriatric-patient
#16
O Şahap Atik, Fatih I Can, M Selçuk Şenol, Toygun K Eren
A 90-year-old female patient was admitted to our clinic complaining of pain in her left hip which occurred due to fall from a chair. Her medical history included memory loss and mental changes associated with Alzheimer's disease and depression. Patient's cooperation and orientation were weak. Range of motion of the left hip was restricted and painful. Radiographs of the left hip demonstrated subtrochanteric comminuted fracture of femur. Laboratory tests revealed anemia and liver insufficiency. Departments of internal medicine and anesthesiology reported high risk for surgery...
August 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/27496473/factors-affecting-breathing-capacity-and-early-tracheal-extubation-after-liver-transplantation-analysis-of-506-cases
#17
B Błaszczyk, B Wrońska, M Klukowski, E Flakiewicz, M Kołacz, L Jureczko, M Pacholczyk, A Chmura, J Trzebicki
BACKGROUND: Early extubation is a standard procedure after liver transplantation (LT). METHODS: The preoperative and perioperative data of 506 adult patients undergoing LT from July 2000 to March 2015 were analyzed. The goal of this study was to determine preoperative and perioperative independent predictors of early tracheal extubation. RESULTS: Of the 506 study patients, 73.7% were extubated early after LT. Patients in this group exhibited better preoperative and perioperative outcomes...
June 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27492429/effective-evaluation-of-arterial-pulse-waveform-analysis-by-two-dimensional-stroke-volume-variation-stroke-volume-index-plots
#18
Teiji Sawa, Mao Kinoshita, Atsushi Kainuma, Koichi Akiyama, Yoshifumi Naito, Hideya Kato, Fumimasa Amaya, Keiji Shigemi
Arterial pulse waveform analysis (APWA) with a semi-invasive cardiac output monitoring device is popular in perioperative hemodynamic and fluid management. However, in APWA, evaluation of hemodynamic data is not well discussed. In this study, we analyzed how we visually interpret hemodynamic data, including stroke volume variation (SVV) and stroke volume (SV) derived from APWA. We performed arithmetic estimation of the SVV-SV relationship and applied measured values to this estimation. We then collected measured values in six anesthesia cases, including three liver transplantations and three other types of surgeries, to apply them to this SVV-SVI (stroke volume variation index) plot...
August 4, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27420728/severe-perioperative-bleeding-in-renal-cell-carcinoma-after-elective-pericardiocentesis-associated-left-ventricular-puncture-case-report
#19
Javier Lasala, Miguel Alejandro Patino, Gabriel Mena, Shital Vachhani, Teresa Moon, Thao Bui, January Tsai
In the United States during the year 2015, approximately 61,560 patients are expected to be diagnosed with kidney cancer and 14,080 to die from the disease. We present the case of a patient with renal cell carcinoma who suffered severe perioperative bleeding and coagulopathy after emergency sternotomy. We also engage in relevant aspects of perioperative anesthesia care including the considerations and management of coagulopathy, liver failure and renal failure in the oncologic patient. The case is a 49-year-old man with vena cava tumor thrombus who underwent radiologic tumor embolization, left radical nephrectomy, and inferior vena cava (IVC) thrombectomy...
2016: Medwave
https://www.readbyqxmd.com/read/27413566/symmetric-lipomatosis-arising-in-the-tongue-presenting-as-macroglossia-and-articulatory-disorder
#20
Masanori Kudoh, Ken Omura, Arata Satsukawa, Koshi Matsumoto, Takahide Taguchi, Hiroyuki Harada, Yoshimasa Ishii
Symmetric lipomatosis is definitively characterized by symmetric, tumorous lipomatous proliferation of adipose tissue that often develops in the head and neck, shoulders, and upper trunk. However, in the oral region, symmetric lipomatosis of the tongue (SLT) is an extremely rare condition related to generalized lipidosis that is often caused by chronic alcoholism. It is characterized by multiple symmetric lipomatous nodules and diffuse bilateral swelling located within the tongue. We report an extremely rare case of SLT arising in an 80-year-old man with a long history of alcoholic liver cirrhosis...
2016: Case Reports in Otolaryngology
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