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Ambulatory surgery anesthesia

M Gaullier, T Tricard, P Mouracade, C Saussine
INTRODUCTION: The intravesical instillation of dimethyl sulfoxide (iDMSO), performed without anesthestic, is a therapeutic option for the painful bladder syndrome/interstial cystitis (PBS/IC). Some patients are against those iDMSO because of bad tolerance. Our study evaluates the tolerance and the outcome of the iDMSO under general anesthetic (GA) after the failure of the iDMSO without anesthetic. PATIENTS AND METHODS: From May 2013 to April 2016, 11 patients with a PBS, 9 women (81...
March 8, 2018: Progrès en Urologie
Johanna Olson-Kennedy, Jonathan Warus, Vivian Okonta, Marvin Belzer, Leslie F Clark
Importance: Transmasculine youth, who are assigned female at birth but have a gender identity along the masculine spectrum, often report considerable distress after breast development (chest dysphoria). Professional guidelines lack clarity regarding referring minors (defined as people younger than 18 years) for chest surgery because there are no data documenting the effect of chest surgery on minors. Objective: To examine the amount of chest dysphoria in transmasculine youth who had had chest reconstruction surgery compared with those who had not undergone this surgery...
March 5, 2018: JAMA Pediatrics
Khaled Dajani, Mohammed Almualim, Akshay Menon, Jacqueline Volpi-Abadie, Kierstin Lund
OBJECTIVES: Management of pediatric patients with neurological diagnoses can be challenging for anesthesiologists. We sought to determine whether preexisting neurologic disease could serve as an intrinsic risk factor for prolonged emergence. METHODS: Following institutional review board approval, we conducted a database search from 2012 to 2015. Included were patients aged 0 to 18 years undergoing ambulatory procedures, and carrying neurological diagnoses that profoundly affected their development...
March 2018: Southern Medical Journal
Nick Jeffery, C Elizabeth Boudreau, Megan Konarik, Travis Mays, Virginia Fajt
Background: Glyburide (also known as glibenclamide) is effective in reducing the severity of tissue destruction and improving functional outcome after experimental spinal cord injury in rodents and so has promise as a therapy in humans. There are many important differences between spinal cord injury in experimental animals and in human clinical cases, making it difficult to introduce new therapies into clinical practice. Spinal cord injury is also common in pet dogs and requires new effective therapies, meaning that they can act as a translational model for the human condition while also deriving direct benefits from such research...
2018: PeerJ
Proshad N Efune, Abu Minhajuddin, Peter Szmuk
BACKGROUND: Little is known regarding the incidence and contributing factors of postdischarge nausea and vomiting in children. AIMS: The aim of this study was to determine the incidence of postdischarge nausea and vomiting in day surgery patients and to identify demographic, intraoperative, and postoperative variables that influence the risk. METHODS: In this prospective observational study, a postdischarge questionnaire was administered to parents of ambulatory patients who received anesthesia and the electronic records were reviewed...
March 2018: Paediatric Anaesthesia
Manish B Kotwani, Anila D Malde
Background and Aims: Increasing number of pediatric ambulatory surgeries are being carried out in general anesthesia using supraglottic airways (SGAs). Literature comparing sevoflurane and desflurane for the maintenance of SGA-based anesthesia is limited. Hence, we planned this prospective randomized study to compare the maintenance, emergence and recovery characteristics of sevoflurane and desflurane for pediatric ambulatory surgery. Material and Methods: Sixty children aged 6 months to 6 years posted for short surgical procedures were enrolled into the study...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
Valeria Mossetti, Karen Boretsky, Marinella Astuto, Bruno G Locatelli, David Zurakowski, Rodolfo Lio, Roberta Nicoletti, Valter Sonzogni, Micol Maffioletti, Noemi Vicchio, Giorgio Ivani
INTRODUCTION: The prevalence of persistent postsurgical pain in children is over 20% after major surgeries; however, data are scarce on the prevalence, character, and risk factors among children undergoing common ambulatory surgeries. The primary aim of this study was to evaluate the prevalence of persistent pain following pediatric ambulatory surgery at 1, 3, and 6 months. Secondary aims were to identify risk factors and characterize the pain and consequences of persistent postsurgical pain...
January 20, 2018: Paediatric Anaesthesia
Aaron B Parrish, Sean M O'Neill, Steven R Crain, Tara A Russell, Deepak K Sonthalia, Vu T Nguyen, Armen Aboulian
BACKGROUND: Ambulatory surgery for anorectal procedures has been proven to be safe and effective. Specific perioperative pathways combining multiple interventions have been shown to optimize recovery and outcomes associated with inpatient colorectal surgery. However, there are no major studies describing and evaluating a standardized protocol for ambulatory anorectal surgery. The purpose of this study was to evaluate the outcomes of a modified enhanced recovery after surgery (ERAS) protocol for ambulatory anorectal surgery...
January 9, 2018: World Journal of Surgery
Juan Albino Mendez, Ana Leon, Ayoze Marrero, Jose M Gonzalez-Cava, Jose Antonio Reboso, Jose Ignacio Estevez, José F Gomez-Gonzalez
OBJECTIVE: The main objective of this research is the design and implementation of a new fuzzy logic tool for automatic drug delivery in patients undergoing general anesthesia. The aim is to adjust the drug dose to the real patient needs using heuristic knowledge provided by clinicians. A two-level computer decision system is proposed. The idea is to release the clinician from routine tasks so that he can focus on other variables of the patient. METHODS: The controller uses the Bispectral Index (BIS) to assess the hypnotic state of the patient...
January 5, 2018: Artificial Intelligence in Medicine
Mathew Nelson, Alexandra Reens, Lara Reda, David Lee
BACKGROUND: Interscalene brachial plexus blocks have been a routinely performed method of anesthesia for shoulder surgery that decreases the need for general anesthesia, length of stay, and recovery time. We describe a case of bupivacaine toxicity after an interscalene block. CASE REPORT: The patient was a 66-year-old man who presented to our Emergency Department by emergency medical services from an ambulatory surgery center where he had undergone rotator cuff surgery, with bradycardia and hypotension...
December 30, 2017: Journal of Emergency Medicine
Anjan Das, Hirak Biswas, Anindya Mukherjee, Sandip Roy Basunia, Subinay Chhaule, Tapobrata Mitra, Partha Sarathi Halder, Subrata Kumar Mandal
Background: Functional endoscopic sinus surgery (FESS) is the mainstay therapeutic management for nasal pathologies. We evaluated flupirtine, a centrally acting analgesic, for producing perfect perioperative conditions in FESS for adults in a day-care setting. Materials and Methods: Sixty-two patients (25-40 years) scheduled for FESS under general anesthesia were randomly divided into Group F (n = 31) receiving preoperative flupirtine (100 mg) and Group C (n = 31) receiving identical-looking placebo capsule per oral 60 min before induction of anesthesia...
October 2017: Anesthesia, Essays and Researches
Pranjali Kurhekar, Krishnagopal Vinod, J Shesha Dhiviya Krishna, M Sethuraman Raghuraman
Background: Ambulatory surgeries demand safe anesthesia with faster recovery which makes it expensive due to the cost of inhalational anesthetic agents such as sevoflurane and desflurane. Isoflurane is inexpensive agent but can cause delayed recovery. The aim of this study was to evaluate cost-benefit ratio of all three agent with respect to recovery and safety profile. Materials and Methods: Patients posted for elective ambulatory surgeries were divided into three groups...
October 2017: Anesthesia, Essays and Researches
Joginder Pal Attri, Manjit Singh, Hemchandra Bhatt, Kamal Jyoti, Harjinder Kaur
Introduction: The availability of rapid and short-acting intravenous and volatile anesthetics has facilitated early recovery that is why nowadays ambulatory surgery is becoming more common. If the criteria used to discharge patients from the Postanesthesia Care Unit (PACU) are met in the operating room (OR), it would be appropriate to consider bypassing the PACU and transferring the patient directly to the step-down unit. This process is known as "fast-tracking" after ambulatory surgery...
October 2017: Anesthesia, Essays and Researches
A Benhami, E Chuffart, N Christou, S Liva-Yonnet, M Mathonnet
The aim of this study was to evaluate the results of ambulatory parathyroid resection performed under local anesthesia (LA). MATERIAL AND METHODS: Outpatients undergoing parathyroid adenoma resection by a focused approach under LA were included. Results were evaluated by intraoperative serum parathormone levels (ioPTH) and the balance of phosphate and calcium postoperatively, at 3 months, 1 year and at the point date. The quality of ambulatory care was evaluated by the number of cancelled interventions, the number of patients hospitalized after surgery or during the first postoperative month...
December 21, 2017: Journal of Visceral Surgery
Keira P Mason, Christopher M Burkle
Over the past few years, there has been a rapid rise in office-based procedures, out of hospital and day surgery procedures, particularly as an effort to combat the escalating costs of hospital- based services. Coincident with this burgeoning demand for office based anesthesia, is the accompanying increased risk of anesthesia and sedation-related complications. In the 1990's and 2000's, the risk of mortality was higher for anesthetics and sedations performed outside of the operating theater setting. Although guidelines exist for ambulatory and office based anesthesia, they are being continuously reviewed and reconsidered...
December 13, 2017: Minerva Anestesiologica
Takaya Nishida, Takahiro Mihara, Koui Ka
PURPOSE: Recently, pediatric ambulatory surgery has become common. However, for some of these patients, unplanned admission or prolonged hospital stay is also necessary, which can increase the mental burden on these patients. The aim of this study was to identify the predictors of the incidence of increased time spent in hospitals associated with pediatric ambulatory surgery. METHODS: Data were obtained from the medical and anesthetic records of 1087 consecutive patients aged < 18 years who underwent ambulatory surgery under general anesthesia...
December 12, 2017: Journal of Anesthesia
Mark A Saxen, Richard D Urman, Juan F Yepes, Rodney A Gabriel, James E Jones
Few studies have examined the practice characteristics of dentist anesthesiologists and compared them to other anesthesia providers. Using outcomes from the National Anesthesia Clinical Outcomes Registry and the Society for Ambulatory Anesthesia Clinical Outcomes Registry for dental/oral surgery procedures, we compared 7133 predominantly office-based anesthetics by dentist anesthesiologists to 106,420 predominantly operating room anesthetics performed by physician anesthesia providers. These encounters were contrasted with 34,191 previously published encounters from the practices of oral and maxillofacial surgeons...
2017: Anesthesia Progress
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
Ana Sousa Menezes, Joana R Guimarães, Miguel Breda, Vicente Vieira, Luís Dias
INTRODUCTION: The performance of septoplasty and turbinate surgery in an outpatient basis is an increasingly established practice, although is still a controversial topic. METHODS: Retrospective analysis of 227 patients who underwent septoplasty ± inferior and/or middle turbinoplasty. Demographic, clinical, surgical, and anesthetic data were collected. Our primary outcomes were rates of perioperative complications, prolongation of hospital stay (PHS), unexpected hospital revisits (UHR), or readmissions within 30 days of surgery...
November 20, 2017: European Archives of Oto-rhino-laryngology
F Drissi, F Jurczak, J P Cossa, J F Gillion, C Baayen
BACKGROUND: Groin hernia repair (GHR) is one of the most frequent surgical interventions practiced worldwide. Outpatient surgery for GHR is known to be safe and effective. AIM: To assess the outpatient practice for GHR in France and identify predictive factors of failure. METHOD: Forty one surgeons of the French "Club Hernie" prospectively gathered data concerning successive GHR over a period of 4 years within a multicenter database. RESULTS: A total of 9330 patients were operated on during the period of the study...
October 27, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
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