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anesthesia gynecology

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https://www.readbyqxmd.com/read/29146268/surgical-apgar-score-predicts-30-day-morbidity-in-elderly-patients-who-undergo-non-laparoscopic-gynecologic-surgery-a-retrospective-analysis
#1
Kazumi Kurata, Yoko Chino, Akiko Shinagawa, Tetsuji Kurokawa, Yoshio Yoshida
INTRODUCTION: The aim of this study was to determine whether a preoperative health status index and intraoperative data could predict perioperative morbidity and mortality in women over the age of 65 years undergoing surgery for gynecologic disorders. METHODS: The medical records of 68 female patients who were ≥65 years of age and who underwent surgery under general anesthesia in our institute from January 2014 to December 2015 were retrospectively reviewed. Preoperative data were extracted from a database and included comorbidities, American Society of Anesthesiologists physiological status classification, the Charlson Comorbidity Index, the Subjective Global Assessment 2011 revision, the subjects' risk of falling, body mass index, and age...
November 13, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29033729/use-of-rocuronium-and-sugammadex-under-neuromuscular-transmission-monitoring-in-a-patient-with-multiple-sclerosis
#2
Chryssoula Staikou, Martina Rekatsina
Multiple sclerosis (MS) is a potentially disabling disease characterized by demyelinating lesions in the central nervous system. One of the anesthetic challenges encountered in surgical patients with MS is the management of neuromuscular blockade (NMB) and its reversal. We report a case of a 31-year-old female patient suffering from MS, who underwent gynecological surgery under general anesthesia with sevoflurane, fentanyl, and rocuronium which was successfully reversed with sugammadex. Neuromuscular transmission (NMT) monitoring was used to guide the intraoperative doses of rocuronium and also the reversal of NMB by the use of sugammadex to ensure a safe tracheal extubation...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29032007/the-effect-of-sevoflurane-compared-to-propofol-maintenance-on-post-surgical-quality-of-recovery-in-patients-undergoing-an-ambulatory-gynecological-surgery-a-prospective-randomized-double-blinded-controlled-clinical-trial
#3
Gildasio S De Oliveira, Jane Bialek, Meghan E Rodes, Mark C Kendall, Robert J McCarthy
OBJECTIVE: The main objective of the current investigation was to evaluate the effect of propofol used as anesthetic maintenance compared to sevoflurane on global post-surgical quality of recovery in female patients undergoing ambulatory gynecological surgery. DESIGN: The study was a prospective randomized double blinded, controlled, clinical trial. INTERVENTIONS: Healthy female subjects were randomized to receive propofol or sevoflurane as anesthetic maintenance...
December 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29026065/urethral-diverticulum-presenting-as-a-large-vaginal-mass-complicating-pregnancy-and-delivery
#4
Everett F Magann, Lisa S Newton, Susan A Barr
BACKGROUND A case report of urethral diverticulum complicating pregnancy is presented. The diagnosis and management are challenging because of the rare nature of this condition, the varied presentations and differential diagnoses, and the possibility of misdiagnosis. CASE REPORT A 25-year-old primigravida with scheduled induction of labor at 39 weeks gestation due to gestational diabetes mellitus presented for a routine antenatal appointment at 38 weeks and four days. On digital cervical examination, she was found to have a large semi-solid anterior vaginal mass, shown by trans-vaginal ultrasound to have a nearly solid appearance of a 5×7 cm mass with septation...
October 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28975476/effects-of-indigo-carmine-intravenous-injection-on-oxygen-reserve-index-ori%C3%A2-measurement
#5
Tsuyoshi Isosu, Keisuke Yoshida, Rieko Oishi, Tsuyoshi Imaizumi, Yuzo Iseki, Norie Sanbe, Yukihiro Ikegami, Shinju Obara, Shin Kurosawa, Masahiro Murakawa
To retrospectively investigate the effects of indigo carmine intravenous injection on oxygen reserve index (ORi™) in 20 patients who underwent elective gynecologic surgery under general anesthesia. The study subjects were patients who underwent elective gynecologic surgery under general anesthesia between April 2016 and January 2017, and were administered a 5-ml intravenous injection of 0.4% indigo carmine for clinical purposes during surgery with ORi monitoring. Changes in ORi within 20 min after indigo carmine injection were observed...
October 3, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28964926/managing-postoperative-pain-after-minimally-invasive-gynecologic-surgery-in-the-era-of-the-opioid-epidemic
#6
REVIEW
Marron Wong, Stephanie Morris, Karen Wang, Khara Simpson
In this review, we examine the evidence behind nonopioid medication alternatives, peripheral nerve blocks, surgical techniques, and postoperative recovery protocols that can help minimize and effectively treat postoperative pain after minimally invasive gynecologic surgery (MIGS). Because of the depth and heterogeneity of the data, a narrative review was performed of reported interventions. A comprehensive review was performed of PubMed, Embase, and the Cochrane Database with a focus on randomized controlled trials...
September 28, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28953616/effects-of-methylprednisolone-on-the-duration-of-rocuronium-induced-neuromuscular-block-a-randomized-double-blind-trial
#7
RANDOMIZED CONTROLLED TRIAL
Weilian Geng, Yuyan Nie, Shaoqiang Huang
BACKGROUND: We aim to investigate whether intraoperative use of methylprednisolone could affect the duration of rocuronium-induced neuromuscular blockade. METHODS: A double blind, randomized, placebo-controlled trial was conducted. A total of 136 patients underwent gynecologic laparoscopic surgery were randomly divided into 3 groups: pregroup, receiving intravenous injection of methylprednisolone (40 mg) 30 minutes before induction of anesthesia; postgroup, receiving intravenous injection of methylprednisolone (40 mg) immediately after induction of anesthesia and intubation; and control group, receiving intravenous injection of normal saline...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28953124/laser-excisional-treatment-for-vaginal-intraepithelial-neoplasia-to-exclude-invasion-what-is-the-risk-of-complications
#8
Francesco Sopracordevole, Lorenzo Moriconi, Jacopo Di Giuseppe, Lara Alessandrini, Elvia Del Piero, Giorgio Giorda, Monica Buttignol, Giovanni De Piero, Vincenzo Canzonieri, Andrea Ciavattini
OBJECTIVE: We undertook a retrospective analysis of the incidence of complications of carbon dioxide (CO2) laser excision for high-grade vaginal intraepithelial neoplasia (HG-VaIN). MATERIALS AND METHODS: Retrospective large case series on 128 CO2 laser excisions for HG-VaIN in 106 women treated at the Department of Gynecologic Oncology, Oncologic Referral Center, Aviano, Italy. These procedures were performed under local anesthesia with a 20-W continuous laser beam focused to a 0...
October 2017: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/28951521/isoflurane-promotes-glucose-metabolism-through-upregulation-of-mir-21-and-suppresses-mitochondrial-oxidative-phosphorylation-of-ovarian-cancer-cells
#9
Nai-Liang Guo, Jing-Hua Tan, Jing-Ping Wu, Ying-Hua Xu
Ovarian cancer is one of the most lethal gynecologic malignancies in women. Isoflurane is one of volatile anesthetics used extensively for inhalational anesthesia and gynaecological surgery. However, the effects of isoflurane on ovarian cancer have not been fully elucidated. It is wildly studied that one of the biochemical fingerprints of cancer cells is the altered energy metabolism which is characterized by preferential dependence on glycolysis for energy production in an oxygen-independent manner. In this study, we explored the roles of isoflurane in the regulation of cellular metabolism of ovarian cancer cells...
September 26, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/28932131/spinal-anesthesia-and-spinal-anesthesia-with-subdiaphragmatic-lidocaine-in-shoulder-pain-reduction-for-gynecological-laparoscopic-surgery-a-randomized-clinical-trial
#10
Zahra Asgari, Mahroo Rezaeinejad, Reihaneh Hosseini, Masoumeh Nataj, Maryam Razavi, Mahdi Sepidarkish
OBJECTIVE: The aim of this study was to compare the effectiveness of spinal anesthesia with subdiaphragmatic lidocaine at the beginning of surgery versus spinal anesthesia in pain reduction for gynecological laparoscopic surgery. METHODS: This was a clinical trial conducted in Arash Hospital, Tehran, Iran. Eighty-four patients were randomized to either spinal anesthesia with subdiaphragmatic lidocaine, spinal anesthesia, or general anesthesia (GA). The primary outcome was patients' pain perception during surgery, 2, 4, 6, and 12 hours after surgery, and prior to discharge and was assessed by visual analogue scale (VAS)...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28928558/oral-clonidine-premedication-attenuates-hemodynamic-responses-of-ketamine-during-total-intravenous-anesthesia
#11
Pulak Tosh, Sunil Rajan, Nitu Puthenveettil, Lakshmi Kumar
BACKGROUND: The most commonly used drug for total intravenous anesthesia (TIVA) is ketamine which results in cardiovascular stimulation. AIMS: The primary aim of this study was to assess the effect of oral clonidine premedication on attenuating the hemodynamic responses following ketamine administration. SETTINGS AND DESIGNS: This was a prospective, observational, comparative study conducted in a tertiary care institution. SUBJECTS AND METHODS: A total of 40 female patients aged 18-55 years who were posted for elective short gynecological procedures under TIVA were recruited for this study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28922304/estimated-blood-loss-during-vaginal-hysterectomy-and-adnexal-surgery-described-with-an-intraoperative-pictographic-tool
#12
Nancy C Nelson, Stuart A Ostby, Amy L Weaver, Michaela E McGree, John B Gebhart, Jamie N Bakkum-Gamez
OBJECTIVE: We describe a novel way to calculate estimated blood loss (EBL) using an intraoperative pictographic tool in gynecologic surgery. METHODS: A pictographic tool to estimate sponge saturation was developed to calculate EBL during surgery. A prospective cohort of women 18 years or older undergoing benign vaginal hysterectomy with planned adnexal surgery at Mayo Clinic were consented for use of the pictographic tool. Demographic, preoperative, intraoperative, and postoperative data were abstracted...
September 15, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#13
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28894904/factors-influencing-the-outcome-of-surgery-for-pelvic-organ-prolapse
#14
Katja Stenström Bohlin, Maud Ankardal, Emil Nüssler, Håkan Lindkvist, Ian Milsom
INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) surgery is a common gynecological procedure. Our aim was to assess the influence of obesity and other risk factors on the outcome of anterior and posterior colporrhaphy with and without mesh. METHODS: Data were retrieved from the Swedish National Register for Gynecological Surgery on 18,554 women undergoing primary and repeat POP surgery without concomitant urinary incontinence (UI) surgery between 2006 and 2015...
September 11, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28818674/effects-of-electroacupuncture-administered-24hours-prior-to-surgery-on-postoperative-nausea-and-vomiting-and-pain-in-patients-undergoing-gynecologic-laparoscopic-surgery-a-feasibility-study
#15
Sha Li, Man Zheng, Wenzhong Wu, Jie Guo, Fangbin Ji, Zhen Zheng
OBJECTIVE: Our study aimed to investigate the feasibility and effectiveness of preoperative electroacupuncture (EA), delivered 24hours before surgery, on postoperative nausea and vomiting (PONV) and postoperative pain in patients undergoing gynecologic laparoscopic surgery. METHODS: In this randomized controlled trial, 40 patients scheduled for elective gynecologic laparoscopic surgery were randomly assigned to the usual care (UC) group and the EA group (n = 20 each)...
June 30, 2017: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/28818054/comparison-of-the-trapezius-and-the-adductor-pollicis-muscle-as-predictor-of-good-intubating-conditions-a-randomized-controlled-trial
#16
Stefan Soltesz, Christian Stark, Karl G Noé, Michael Anapolski, Thomas Mencke
BACKGROUND: Adequate muscle relaxation is important for ensuring optimal conditions for intubation. Although acceleromyography of the adductor pollicis muscle is commonly used to assess conditions for intubation, we hypothesized that acceleromyography of the trapezius is more indicative of optimal intubating conditions. The primary outcome was the difference between both measurement sites with regard to prediction of good or acceptable intubating conditions. METHODS: Neuromuscular blockade after injection of rocuronium 0...
August 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28802593/evaluation-of-ultrasound-guided-posterior-quadratus-lumborum-block-for-postoperative-analgesia-after-laparoscopic-gynecologic-surgery
#17
Junichi Ishio, Nobuyasu Komasawa, Haruki Kido, Toshiaki Minami
STUDY OBJECTIVE: This study aimed to determine the efficacy of ultrasound-guided posterior quadratus lumborum block (QLB) in treating postoperative pain following laparoscopic gynecologic surgery. DESIGN: Prospective randomized controlled study. PATIENTS: Seventy adult patients scheduled for elective laparoscopic gynaecological surgery under general anesthesia. INTERVENTION: This randomized controlled study involved two groups of adult females who were scheduled to undergo laparoscopic gynecologic surgery under general anesthesia...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28797517/gynecologic-anatomic-abnormalities-following-anorectal-malformations-repair
#18
Alejandra Vilanova-Sanchez, Carlos A Reck, Kate A McCracken, Victoria A Lane, Alessandra C Gasior, Richard J Wood, Marc A Levitt, Geri D Hewitt
BACKGROUND/AIM: Patients may present with gynecologic concerns after previous posterior sagittal anorectoplasty (PSARP) for repair of an anorectal malformation (ARM). Common findings include an inadequate or shortened perineal body, as well as introital stenosis, retained vaginal septum, and remnant rectovestibular fistula. An inadequate or shortened perineal body may impact fecal continence, sexual function and recommendations regarding obstetrical mode of delivery. We describe our experience with female patients referred to our center for evaluation of their previously repaired ARM, with a specific focus on perineal body anatomy and concomitant gynecologic abnormalities...
July 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28795335/encouraging-mindfulness-in-medical-house-staff-via-smartphone-app-a-pilot-study
#19
Louise Wen, Timothy E Sweeney, Lindsay Welton, Mickey Trockel, Laurence Katznelson
BACKGROUND: Stress and burnout are increasingly recognized as urgent issues among resident physicians, especially given the concerning implications of burnout on physician well-being and patient care outcomes. OBJECTIVE: The authors assessed how a mindfulness and meditation practice among residents, supported via a self-guided, smartphone-based mindfulness app, affects wellness as measured by prevalidated surveys. METHODS: Residents in the departments of general surgery, anesthesia, and obstetrics and gynecology were recruited for participation in this survey-based, four-week, single-arm study...
October 2017: Academic Psychiatry
https://www.readbyqxmd.com/read/28757921/the-impact-of-magnesium-sulfate-as-adjuvant-to-intrathecal-bupivacaine-on-intra-operative-surgeon-satisfaction-and-postoperative-analgesia-during-laparoscopic-gynecological-surgery-randomized-clinical-study
#20
Khaled Salah Mohamed, Sayed Kaoud Abd-Elshafy, Ali Mahmoud El Saman
BACKGROUND: Surgeon satisfaction and patient analgesia during the procedure of laparoscopic surgery are important issues. The aim of this work was to study if an intrathecal (IT) Bupivacaine combined with Magnesium sulfate may or may not provide good surgeon satisfaction in addition to improvement of intraoperative and postoperative analgesia. METHODS: Sixty female patients were enrolled in this prospective, randomized, double-blind controlled clinical trial study...
July 2017: Korean Journal of Pain
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