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Perioperative liberal drinking management promotes postoperative gastrointestinal function recovery after gynecological laparoscopic surgery: A randomized controlled trial.

STUDY OBJECTIVE: This study aims to evaluate the effect of perioperative liberal drinking management, including preoperative carbohydrate lo … y allocated in a 1:1:1 ratio into three groups, including the control, PCL, and PCL-EOF groups. The anesthetists and follow-up staff were blinded to group assignment. MEASUREMENTS: The primary outcome was the postoperative Intake, Feeling nauseated, Emesis, Examination, and Duration of symptoms (I-FEED) score (range 0 to 14, higher scores worse). Secondary ou …

Promoting major pediatric surgical care in a low-income country: a 4-year experience in Eritrea.

BACKGROUND: Access to pediatric surgical care in many sub-Saharan African countries is strongly limited by lack of medical facilities, adequate transport system, and trained medical and nursing manpower. The mortality rate for major congenital abnormalities remains extremely elevated in this area of the world. Strong efforts have been spent during the past decades to elevate the level of pediatric surgery standards in these countries through cooperation programs acting through periodical medical missions or supporting local medical teaching institutions. This is a report of a partnership betwe

Акушерская анестезия/анагезия не влияет на курс болезни при множественном склерозе: 10- Ретроспективное когортное исследование.

ЦЕЛИ: Множественный склероз (МС) часто встречается у молодых женщин, а воздействие акушерской анестезии/анагезии на болезнь плохо изучено. Ни одно из предыдущих исследований не было посвящено изучению состояния заболевания женщин, работающих в Чешской Республике. Цель этого исследования заключалась в оценке случаев или отсутствия рецидивов 6-month Послеродовый период в MS parturients с акушерской анестезией и без нее. МАТЕРИАЛЫ И МЕТОДЫ: Мы ретроспективно изучили все поставки (n = 58,455) в университетской больнице Брно 2004 в адрес 2013 и выявила женщин, имеющих ICD-10 код G35 (MS), зарегистр

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… Nevertheless, many anesthetists still believe that GA causes fewer exacerbations than neuraxial blocks, particularly spinal anesthesia (Dalmas et al., 2003 ). … Anesthetists should not automatically take all the responsibility in the case of progressive or new deficits after the procedure (Vercauteren & Heytens, 2007 ). …

Effect of hydromorphone combined with ropivacaine caudal block on immune function after hypospadias surgery in children.

BACKGROUND: This study aimed to evaluate the effects of caudal block anesthesia with hydromorphone-ropivacaine compared to ropivacaine alone on postoperative immune function and pain management in children undergoing hypospadias surgery. METHODS: A total of 100 pediatric patients were randomly assigned to two groups: the Hydromorphone-Ropivacaine (HR) group and the Ropivacaine (R) group for caudal block anesthesia, with 50 patients in each group. The R group received 0.25% ropivacaine at a dose of 1 ml/kg, while the HR group received 0.25% ropivacaine (1 ml/kg) combined with hydromorphone (10

History of pediatric liver transplantation. Where are we coming from? Where do we stand?

The history of pediatric liver transplantation cannot be dissociated from one man, Thomas E. Starzl, whose pioneer efforts contributed more … eding and ascites. Perioperatively, liver transplantation has derived benefit from the expertise of anesthetists managing babies with serious conditions and increased experience of the transplant surgeons regarding the knowledge of all the technical modalities, good strategy, technical skills and meticulous control of bleeding. It is well-recognized that child …

Bisphosphonates May Reduce Intraoperative Blood Loss in Surgery for Metastatic Spinal Disease: A Retrospective Cohort Study.

PurposeThis study was undertaken to investigate the relationship between bisphosphonate use and intraoperative blood loss following surgery for metastatic spinal disease.MethodsWe retrospectively analyzed cancer patients who were treated by metastatic spinal tumor surgery at our institution. Recorded data included intraoperative blood loss, timing and duration of bisphosphonate use, and other important confounding factors. We showed the results of crude model, minimally adjusted model, and fully adjusted model to fully observe the effects of bisphosphonates under different adjustment strategie

Improving patient care by reporting problems with medical devices.

Healthcare practitioners are the primary users of medical devices for direct patient care. As such, they are in the best position to recognize problems that result from the use of medical devices. The outcome of a device-related adverse event or product problem, as with any other medical product, can be serious and result in illness injury, or even death. The sooner that FDA learns about a problem, the sooner the agency can take action to protect patient and user safety. Healthcare practitioners are major contributors to the knowledge base related to device use and safety through astute monito

Anesthesia for an achondroplastic dwarf with bilateral vocal cord granuloma: use of a Xomed Hunsaker Mon-Jet ventilation tube.

Technological advances have greatly improved the management of the patient undergoing microlaryngeal surgery. The use of a laser, high frequency jet ventilation (HFJV), total intravenous anesthetic techniques (TIVA), and specially designed endotracheal tubes (Xomed Hunsaker Mon-Jet ventilation tube [Xomed Surgical Products, Jacksonville, FL]) are recognized as cutting edge approaches to the management of these cases. The use of high technology adjuncts requires considerable skill and knowledge from the perspective of the anesthesia provider. This case report describes an approach to anesthetic

Preventing posttraumatic pneumonia.

Between 20% and 40% of patients admitted to the hospital with multiple trauma develop bacterial pneumonias. The most immediate causes are aspiration, blunt chest trauma, and prolonged immobilization. Traumatic shock and the need for immediate head and chest surgery are contributing factors. Signs of systemic infection, infiltrates on the chest film, and microbiological evidence obtained from sputum samples are the principal diagnostic criteria. Prophylactic measures include aseptic management of the airway, tracheostomy when indicated, adequate pain relief, and early mobilization. When the inc

Eutectic mixture of local anesthetic cream--topical anesthesia for extracorporeal shock wave lithotripsy.

A 44-year-old man presented with a history of sudden onset left flank pain, accompanied by nausea and microhematuria. The diagnosis of ureteropelvic junction calculus was made and the patient was scheduled for extracorporeal shock wave lithotripsy (ESWL). ESWL uses an electrical spark to generate a shock wave that is focused on a stone in the ureter or kidney. The shock waves mechanically stress and crush the stone, eliminating the need for manipulation or open procedure. The pain of ESWL is caused by skin sensation. Eutectic mixture of local anesthetics (EMLA) cream (2.5% lidocaine and 2.5% p

Current understanding of malignant hyperthermia: genesis, prevention, and treatment.

Malignant hyperthermia (MH) is an uncommon and potentially fatal pharmacogenetic complication of anesthesia. It is commonly triggered by administration of halothane and succinylcholine. The treatment of choice is to administer dantrolene sodium while simultaneously discontinuing the triggering agent. The continued treatment of the patient will reflect the hypermetabolic state. Anesthesia can be safely administered to MH-susceptible patients. Nontriggering agents are used, and meticulous monitoring of the patient is performed. All anesthesia providers should be familiar with MH.

Utility of Ultraportable Echocardiography in the Preoperative Evaluation of Noncardiac Surgery.

BACKGROUND:: The ultraportable echocardiogram machine, with relevant portability and easiness in performing diagnoses, when in experienced hands, may contribute to the reliability of preoperative evaluation in noncardiac surgeries. OBJECTIVES:: To assess cardiac function parameters in patients aged older than 60 years, candidates of elective noncardiac surgeries, classified as ASA1 or ASA 2 according to surgical risk. METHODS:: A total of 211 patients referred for elective surgeries, without suspicion of previous heart diseases, were included in the study. Assessment of patients was conducte

[Hypoxemia after general anesthesia].

BACKGROUND: Studies conducted shortly after the implementation of pulse oximetry (PO) into clinical practice 20-25 years ago revealed that many patients breathing room air during transfer from the operating room (OR) to the post-anesthesia care unit (PACU) directly after general anesthesia (GA) had a peripheral oxygen saturation (S(p)O(2)) below 90%. Moreover, it was shown that the detection of hypoxemia by clinical criteria is extremely unreliable. Meanwhile, the use of PO has become part of the obligatory standard monitoring during GA in Germany and many other countries. Likewise, the use of

Probable succinylcholine-induced hyperkalemia in a trauma victim after recent benign anesthetics with succinylcholine.

Throughout its pharmacological history in anesthesia practice, succinylcholine has been notorious for its role in causing life-threatening hyperkalemia. Normally the serum potassium level will increase .5 to 1.0 mEq/L because of a sustained opening of the receptors in the neuromuscular junction and release of myoplasmic potassium. However, in certain patients the drug will result in a much higher level of serum potassium. The literature points out numerous conditions that predispose particular patients to this exaggerated intensification of potassium leakage from within the cell. Traumatized,