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Preoperative NOT Anesthesia

Richard H Epstein, Franklin Dexter, Eric S Schwenk
Many hospitals are in the process of replacing their legacy anesthesia information management system (AIMS) with an Electronic Health Record (EHR) system, within which the AIMS is integrated. Using the legacy AIMS security access log table, we studied the extent to which anesthesia providers were accessing historical anesthesia records (January 2006 - March 2017) following implementation of an EHR (April 2017). Statistical analysis was by segmented regression. At the time of implementation of the EHR, in 44...
March 16, 2019: Journal of Medical Systems
Rebecca Y Klinger, Mary Cooter, Tiffany Bisanar, Niccolò Terrando, Miles Berger, Mihai V Podgoreanu, Mark Stafford-Smith, Mark F Newman, Joseph P Mathew, James A Blumenthal, Jorn A Karhausen, Miklos D Kertai, Vijay Krishnamoorthy, Yi-Ju Li, Madhav Swaminathan, David S Warner, Bonita L Funk, Rachele Brassard, Yanne Toulgoat-Dubois, Peter Waweru, Michael A Babyak, James A Blumenthal, Jeffrey N Browndyke, Kathleen A Welsh-Bohmer, Michael H Sketch, Ellen R Bennett, Carmelo Graffagnino, Daniel T Laskowitz, Warren J Strittmatter, Kevin Collins, Greg Smigla, Ian Shearer, Thomas A D'Amico, Mani A Daneshmand, Jeffrey G Gaca, Donald D Glower, Jack Haney, David Harpole, Mathew G Hartwig, G Chad Hughes, Jacob A Klapper, Shu S Lin, Andrew J Lodge, Carmelo A Milano, Ryan P Plichta, Jacob N Schroeder, Peter K Smith, Betty C Tong
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: Preclinical and clinical studies suggest that lidocaine might be neuroprotective, which could benefit surgical patients at risk of neurologic compromise WHAT THIS ARTICLE TELLS US THAT IS NEW: This multicenter trial of intravenous lidocaine administered during and after cardiac surgery did not show an effect on cognition at 6 weeks postoperatively BACKGROUND:: Cognitive decline after cardiac surgery occurs frequently and persists in a significant proportion of patients...
March 11, 2019: Anesthesiology
María Mercedes Aguirre C, Sebastián Mayanz S, Alonso Blanch Z, Héctor Aranibar L, Alejandro Salazar T, Gigia Roizen G, María Gabriela Álvarez N, Carlos Izquierdo A, Antonello Penna S
BACKGROUND: Perioperative cardiac arrest (PCA) is a rare but important event in the operating room. AIM: To describe PCA events at a Clinical Hospital in Santiago, Chile. MATERIAL AND METHODS: Registry of PCA that occurred in the operating room (OR) and during procedures not carried out in the OR between September 2006 and November 2017. Precipitating events, type of anesthesia and results of resuscitation maneuvers were described. RESULTS: Eighty events (five outside of the OR) during 170,431 surgical procedures were recorded, resulting in an incidence of 4...
2019: Revista Médica de Chile
Cristen Olds, Emily Spataro, Kevin Li, Cherian Kandathil, Sam P Most
Importance: Although the development of persistent opioid use after surgical procedures has garnered much attention in recent years, large-scale studies characterizing patterns of persistent opioid use among patients undergoing plastic and reconstructive surgery procedures are lacking. Objective: To assess the prevalence of immediate and long-term postoperative opioid use after plastic and reconstructive surgery procedures. Design, Setting, and Participants: In this population-based cohort study, patients who underwent 5 classes of plastic and reconstructive procedures (nasal, eye, breast, abdomen, and soft tissue reconstruction) between January 1, 2007, and December 31, 2015, were identified using IBM MarketScan Commercial and Medicare Supplemental research databases...
March 7, 2019: JAMA Facial Plastic Surgery
Osman Ilkay Ozdamar, Lokman Uzun, Gul Ozbilen Acar, Muhammet Tekin, Numan Kokten, Serdal Celik
PURPOSE: This prospective study was designed to identify risk factors for lingual nerve injury as a complication of suspension laryngoscopy. METHODS: Fifty-six adult patients (19 females and 37 males) who underwent microlaryngeal surgery (MLS) using the suspension laryngoscopy procedure under general anesthesia at our otorhinolaryngology department between January 2016 and January 2018 were enrolled in this study. All operations were performed using only a cold-steel microlaryngeal surgical set, and operations using laser and radiofrequency energy were not included...
March 6, 2019: Annals of Otology, Rhinology, and Laryngology
Michael J Marino, Amber Luong, William C Yao, Martin J Citardi
BACKGROUND: Office-based rhinologic procedures are increasingly performed to control costs and enhance patient convenience. Adequate management of pain and anxiety is essential for the technical performance of these procedures, in addition to ensuring patient comfort. Pharmacologic agents are often used to manage anxiety and pain. Nonpharmacological adjuncts may be useful for achieving these effects without oral opioids and benzodiazepines. METHODS: Charts of patients who underwent office-based rhinologic procedures with the NuCalm system (Solace Lifesciences, Inc...
March 5, 2019: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Alexandriah Alas, Ryan Hidalgo, Luis Espaillat, Hemikaa Devakumar, G Willy Davila, Eric Hurtado
INTRODUCTION AND HYPOTHESIS: Spinal anesthesia has been reported to be a risk factor for postoperative urinary retention (POUR) in various surgical specialties. We hypothesized that spinal anesthesia was a risk factor for POUR after outpatient vaginal surgery for pelvic organ prolapse (POP). METHODS: This was a retrospective review of an urogynecology database for all outpatient POP vaginal surgeries performed in 2014 to evaluate the risk of POUR after general versus spinal anesthesia...
February 27, 2019: International Urogynecology Journal
Jia Dong, Min Zeng, Nan Ji, Shuyu Hao, Yang Zhou, Zhixian Gao, Hongqiu Gu, Li Zhang, Daqing Ma, Yuming Peng, Ruquan Han
BACKGROUND: Intravenous and inhalational anesthesia might have different associations with long-term outcome in cancer patients, with reports of adverse effects of inhalation anesthesia. However, the effects of anesthesia in patients with high-grade glioma (HGG) are not known. METHODS: This study investigated 154 patients who received propofol and 140 patients who received sevoflurane for maintenance of anesthesia during HGG tumor resection. The primary outcomes were progression-free survival and overall survival...
February 21, 2019: Journal of Neurosurgical Anesthesiology
Kai-Uwe Lewandrowski
Objective: The objective of this study is to analyze incidence, estimate cost savings, and evaluate best management practices of complications resulting from outpatient transforaminal endoscopic decompression surgery for lumbar foraminal and lateral recess stenosis performed in an ambulatory surgery center. Background: Endoscopic spinal surgery is gaining popularity for the treatment of lumbar disc herniations. Recent advances in surgical techniques allow for endoscopically assisted bony decompression for neurogenic claudication symptoms due to spinal stenosis...
January 2019: International Journal of Spine Surgery
H Deng, Y Y Liu, C Tan, Y Zhao, X D Li, X Yang, J L Wang
Objective: To investigate the influence of conventional preoperative intestinal preparation and unplanned preparation on the visual field of pelvic organ prolapse repair surgery. Methods: The patients who underwent transvaginal pelvic organ prolapse repair surgery in Peking University People ' s Hospital from September 2017 to July 2018 were selected as the research objects except those who had undergone colorectal surgery and chronic constipation. The surgery doctor was blinded by intestinal preparation. There was no intestinal preparation in non intestinal preparation group and polyethylene glycol was taken orally in intestinal preparation group...
February 25, 2019: Zhonghua Fu Chan Ke za Zhi
Leslie A James, Matthew A Levin, Hung-Mo Lin, Stacie G Deiner
BACKGROUND: Frailty, a state of decreased physiological reserve, is strongly associated with perioperative mortality in older adults. However, the mechanism by which frailty is associated with mortality is not yet understood. Autonomic dysfunction in the form of decreased intraoperative hemodynamic variability has been shown to be associated with increased mortality. We aimed to see whether frail patients have less hemodynamic variability under anesthesia and whether variability mediates the relationship between frailty and 30-day mortality...
February 18, 2019: Anesthesia and Analgesia
T Ogawa, S Inoue, M Inada, M Kawaguchi
OBJECTIVE: The impact of postoperative intensive care upon patient outcomes was evaluated by retrospectively investigating the rate of poor outcomes among miscellaneous elective surgical patients with severe comorbidities. DESIGN: A retrospective cohort study was carried out. SETTING: University hospital. PATIENTS: Surgical patients with severe comorbidities. INTERVENTION: The outcomes of 1218 surgical patients treated in intensive care units (ICUs) and postsurgical wards (ICU group vs...
February 21, 2019: Medicina Intensiva
Patrick K McGlynn, Konstaninos D Arnaoutakis, Elize P Deroo, C Keith Ozaki, John P Forman, Dirk M Hentschel
OBJECTIVE: The results of preoperative ultrasound (pre-US) vein mapping for hemodialysis access creation can be affected by environmental and clinical factors, such as ambient temperature, acute illness, recent phlebotomy, and hypovolemia. These factors may inadvertently exclude otherwise viable veins as options for access creation. We hypothesized that repeating the ultrasound vein mapping immediately preoperatively after anesthesia administration (post-US) identifies additional veins not appreciated by pre-US, thereby altering the operative plan and producing more preferred accesses, particularly more forearm accesses...
March 2019: Journal of Vascular Surgery
Cristina Petrisor, Dan Dîrzu, Sebastian Trancă, Natalia Hagău, Constantin Bodolea
Airway management is one of the most important skills in everyday practice of anesthesia. Improper airway management might contribute to significant morbidity and mortality. In some patients, clinical parameters do not anticipate all difficulties related to airway management. Ultrasonography (US) might confer a potential screening tool for difficult airway. Suprahyoid and infrahyoid US measurements have been investigated for difficult airway prediction in anesthesiology. The most extensively investigated parameter was the anterior neck soft tissue thickness measured at different levels: anterior to the hyoid bone, epiglottis and vocal cords commissure...
February 17, 2019: Medical Ultrasonography
Arthelma C Tyson, Shailraj Parikh, Kuldeep Singh, Saqib Zia, Jonathan S Deitch, Jonathan A Schor
BACKGROUND: Routine laboratory testing to rule out myocardial infarction (MI) after carotid endarterectomy (CEA) is common in many centers. Its utility in this patient population has not been thoroughly investigated. We hypothesize that routine testing for MI in post-CEA patients is of low-yield and not cost-effective. METHODS: A retrospective review of 291 consecutive CEAs from February, 2011 to July, 2015 was performed. Two patients were excluded: one for postoperative non-cardiac death and one for preoperative MI...
February 12, 2019: Annals of Vascular Surgery
Sedat Akbas, Ahmet Selim Ozkan
Introduction: The effects of low-flow anesthesia on cerebral oxygenation in high-risk, morbidly obese patients are not well known. Aim: In this prospective randomized study, we compared the effects of low-flow (0.75 l/min) and normal-flow (1.5 l/min) anesthesia on regional cerebral oxygen saturation (rSO2 ) and the bispectral index (BIS) in morbidly obese patients undergoing laparoscopic bariatric surgery. Material and methods: Fifty-two morbidly obese patients undergoing laparoscopic bariatric surgery (sleeve gastrectomy) were enrolled in this study...
January 2019: Videosurgery and Other Miniinvasive Techniques
Ming-Yueh Chou, Yu-Chun Wang, Li-Ning Peng, Chih-Kuang Liang, Che-Sheng Chu, Mei-Chen Liao, Yu-Te Lin, Chien-Jen Hsu, Liang-Kung Chen
OBJECTIVES: To evaluate the roles of preoperative anemia and intra-operative blood transfusion in the development of post-operative delirium among older patients undergoing elective orthopedic surgery. METHODS: This prospective cohort study recruited subjects aged 60 years and over who were admitted for elective orthopedic surgery in a tertiary medical center during April 2011 to December 2013. Demographic data (age, gender, BMI, educational level), surgery-related factors (ASA class, type of anesthesia and surgery, intra-operative blood transfusion), results of geriatric assessment (hearing/visual impairment, cognition, depressive mood, comorbidity, malnutrition, polypharmacy, ADL, and IADL), laboratory data, length of hospital stay and the development of post-operative delirium were collected for analysis...
February 13, 2019: International Journal of Geriatric Psychiatry
Srikant S Chakravarthi, Amin B Kassam, Melanie B Fukui, Alejandro Monroy-Sosa, Nichelle Rothong, Joseph Cunningham, Jonathan E Jennings, Neil Guenther, Jeremy Connelly, Tobias Kaemmerer, Kenneth C Nash, Mark Lindsay, Janie Rissell, Juanita M Celix, Richard A Rovin
BACKGROUND: Endoscopic and microneurosurgical approaches to third ventricular lesions are commonly performed under general anesthesia. OBJECTIVE: To report our initial experience with awake transsulcal parafascicular corridor surgery (TPCS) of the third ventricle and its safety, feasibility, and limitations. METHODS: A total of 12 cases are reviewed: 6 colloid cysts, 2 central neurocytomas, 1 papillary craniopharyngioma, 1 basal ganglia glioblastoma, 1 thalamic glioblastoma, and 1 ependymal cyst...
February 12, 2019: Operative Neurosurgery (Hagerstown, Md.)
Müge Çakırca, İsa Sözen, Gülsüm Tozlu Bindal, Mustafa Baydar, Ahmet Çınar Yastı
BACKGROUND: Due to a massive increase in capillary permeability during the state of shock caused by burns, albumin and intravascular fluid rapidly move to the extravascular areas. Therefore, hypoalbuminemia is seen as an early and prolonged finding in major burns. Hypoalbuminemia leads to various problems. The aim of this study was to investigate the effect of the preoperative albumin level on perioperative morbidity and mortality in patients with major burns. METHODS: Demographic data, preoperative albumin levels, surgical records, and clinical follow-up records of a total of 61 patients who underwent surgery for major burns in our hospital for the last 2 years were examined...
January 2019: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Jason M Goldberg, Michael P Johnson, Michael J Safian
PURPOSE: Oral and maxillofacial surgeons often treat patients with both diagnosed and undiagnosed obstructive sleep apnea (OSA). Patients with OSA are at substantial risk of perioperative and postoperative complications after receiving intravenous sedation, general anesthesia, or postoperative opiate analgesia. The purpose of this study was to determine whether oral and maxillofacial surgery (OMS) providers are screening patients for perioperative and postoperative risks related to OSA before office-based ambulatory anesthesia...
January 15, 2019: Journal of Oral and Maxillofacial Surgery
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