Anesthetic Management for Gastrointestinal Diseases

Background: Objective evaluation of the management of patients with ruptured infrarenal aortic aneurysm in emergency situations has been described rarely. Patients and methods: Fifty-two consecutive patients with ruptured infrarenal aortic aneurysm (mean age, 70.3 years; range, 56–89 years; SD 7.8) were admitted between January 1993 and March 1998. Emergency protocols, final reports, and follow-up data were analyzed retrospectively. APACHE II scores at admission and fifth postoperative day were assessed. Results: The time between the appearance of first symptoms and the referral of patients to the hospital was more than 5 hours in 37 patients (71%). Thirty-eight patients (71%) had signs of shock at time of admission. Ultrasound was performed in 81% of patients as the first diagnostic procedure. The most frequent site of aortic rupture was the left retroperitoneum (87%). Intraoperatively, acute left ventricular failure occurred in four patients, and cardiac arrest in two others. The postoperative course was complicated significantly in 34 patients. The overall mortality rate was 36.5% (n = 19). In 35 patients, APACHE II score was assessed, showing a probability of death of more than 40% in five patients and lower than 30% in 17 others. No patient showing probability of death of above 75% at the fifth postoperative day survived (n = 7). Conclusions: Ruptured aortic aneurysm demands surgical intervention. Clinical outcome is also influenced by preclinical and anesthetic management. The severity of disease as well as the patient’s prognosis can be approximated using APACHE II score. Treatment results of heterogenous patient groups can be compared.

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Successful Endovascular Repair of a Leaking Abdominal Aortic Aneurysm under Local Anesthesia

Swiss Surgery ◽

10.1024/1023-9332.7.2.86 ◽

2001 ◽

Vol 7 (2) ◽

pp. 86-89 ◽

Cited By ~ 17

Author(s):

Lachat ◽

Pfammatter ◽

Bernard ◽

Jaggy ◽

Vogt ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Ct Scan ◽

Local Anesthesia ◽

Endovascular Repair ◽

Anesthetic Management ◽

High Risk Patient ◽

Invasive Technique ◽

Chronic Obstructive ◽

Abdominal Aortic

Local anesthesia is a safe and less invasive anesthetic management for the endovascular approach to elective aortic aneurysm. We have successfully extended the indication of local anesthesia to a high-risk patient with leaking aneurysm and stable hemodynamics. Patient and methods: A 86 year old patient with renal insufficiency due to longstanding hypertension, coronary artery and chronic obstructive lung disease was transferred to our hospital with a leaking abdominal aortic aneurysm. Stable hemodynamics allowed to perform a fast CT scan, that confirmed the feasibility of endovascular repair. A bifurcated endograft (24mm x 12mm x 153mm) was implanted under local anesthesia. Results: The procedure was completed within 85 minutes without problems. The complete sealing of the aneurysm was confirmed by CT scan on the third postoperative day. Twenty months later, the patient is doing well and radiological control confirmed complete exclusion of the aneurysm. Discussion: The endoluminal treatment is a minimally invasive technique. It's feasibility can be rapidly assessed by CT scan. The transfemoral implantation can be performed under local anesthesia provided that hemodynamics are stable. This anesthetic management seems to be particularly advantageous for leaking abdominal aortic aneurysm since it doesn't change the hemodynamic situation in contrast to general anesthesia. Hemodynamic instability, abdominal distension or tenderness may indicate intraperitoneal rupture and conversion to open graft repair should be performed without delay.

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Frequency of Gastrointestinal Diseases in Patients with End-Stage Renal Disease Treated with Long Term Dialysis

Albanian Journal of Trauma and Emergency Surgery ◽

10.32391/ajtes.2018.2.2.006 ◽

2018 ◽

Vol 2 (2) ◽

pp. 105-112

Author(s):

Lutfi Zylbeari ◽

Zamira Bexheti ◽

Gazmend Zylbeari ◽

Ferizate Haxhirexha ◽

Kastriot Haxhirexha

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Gastrointestinal Diseases ◽

Stage Renal Disease ◽

End Stage

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Anesthesia for rabbits submitted to experimental surgeries: Report of a series of eight anesthesias

Panorama brasileiro de tungstênio (w) entre os anos de 2008 e 2014 ◽

10.32749/nucleodoconhecimento.com.br/health/anesthesia-for-rabbits ◽

2020 ◽

pp. 151-158

Author(s):

Rafael Antonio Caldart Bedin ◽

Maisa Schultz ◽

Antonio Bedin

Keyword(s):

Muscle Relaxation ◽

Anesthetic Management ◽

Laboratory Animals ◽

Average Weight ◽

Anesthetic Induction ◽

Anesthetic Agents ◽

Reasonable Degree ◽

Bioethical Debate ◽

Precordial Stethoscope

Anesthesia for laboratory animals is a matter of biomedical concern and one of the most present dilemmas in the current bioethical debate. The use of anesthetic agents in experimental surgery aims at analgesia and restraining the animal, in order to achieve a reasonable degree of muscle relaxation and to produce sufficient analgesia. This practice requires the use of protocols for the administration of safe and efficient doses. Eight New Zealand rabbits were submitted to laparotomies demonstrating the surgical technique discipline of the local medical course. For pre-anesthetic medication, acepromazine 1 mg.kg-1 associated with ketamine 15 mg.kg-1 was used subcutaneously. Anesthesia was maintained with isoflurane and oxygen under a laryngeal mask in a Mapleson D anesthesia system and under spontaneous breathing. Hydration was performed with 10 ml.kg-1 saline every hour. A thermal mattress was used. Precordial stethoscope, pulse oximetry and clinical parameters were used for monitoring. For euthanasia, ketamine 10 mg.kg-1 associated with potassium chloride 19.1% 1 ml.kg-1 was used intravenously. The average weight of the rabbits was 2721.25 ± 275.01 grams and the duration of the anesthetic procedure was 120 ± 87 minutes. Discussion. In long-term anesthesia, such as laparotomies, the use of pre-anesthetic medication and then anesthetic induction by the combination of agents is recommended. However, anesthetic management requires monitoring to prevent insufficient or excessive doses from occurring.

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Statistical analysis of distribution, dynamics and etiological structure of bovine diseases in Vologda region

Veterinaria Kubani ◽

10.33861/2071-8020-2020-6-3-4 ◽

2020 ◽

pp. 3-4

Author(s):

Oksana B. Badeeva ◽

Keyword(s):

Respiratory Diseases ◽

Birth Rate ◽

Statistical Data ◽

Delayed Diagnosis ◽

Specific Weight ◽

Gastrointestinal Diseases ◽

Vologda Region ◽

High Incidence ◽

Young Cattle ◽

High Level

Statistical data of livestock for 30 years is reflected in the article. Author used the materials of the state veterinary reporting. A comparative analysis of the number, incidence and death rate of adult animals and young cattle for two five-year periods (2001-2005 and 2014-2018). the data of the analysis of veterinary statistical reports for 2018 on the specific weight of the large horned cattle and age dynamics of calves in farms of the Vologda region are shown. A significant decrease in livestock of the large horned cattle by 56.3% (from 1990 to 2018) is shown in the analysis of the data. Over the five years 2014-2018, there was a decrease in the number of the large horned cattle by 31.3%, the birth rate of calves - by 26.2%, and the incidence of calves - by 12.3% and the mortality rate decreased by 3.3%. Despite the decline in the number of livestock, in 2018 there is a high incidence of animal diseases (49.6%). The highest incidence rate was observed among calves under 10 days of age 43.3%, 31.7% - from 11 to 30 days, 15.8% - from one to three months, 6.5% - from three to six months and 2.7% - from 6 to 12 months. Of the total number of sick calves in 2018, 63.2% had gastrointestinal diseases, and death for this reason is 49.6% of the total number of victims. Respiratory diseases affect 21.8% of young animals, and death due to respiratory diseases is 18.2%. Analysis of statistical data showed that, despite the complex of veterinary and sanitary measures, the incidence and death of calves remain at a high level. This can be explained by delayed diagnosis and low therapeutic effectiveness in gastrointestinal and respiratory diseases of cattle.

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Eosinophilic gastrointestinal diseases and food protein-induced enterocolitis syndrome

Nihon Shoni Arerugi Gakkaishi The Japanese Journal of Pediatric Allergy and Clinical Immunology ◽

10.3388/jspaci.30.54 ◽

2016 ◽

Vol 30 (1) ◽

pp. 54-60

Author(s):

Yoshikazu Ohtsuka

Keyword(s):

Gastrointestinal Diseases ◽

Food Protein

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Principles of Anesthetic Management in patients with Congenital Kyphoscoliosis undergoing Laparotomy

Indian Journal Of Applied Research ◽

10.15373/2249555x/sept2013/132 ◽

2011 ◽

Vol 3 (9) ◽

pp. 444-446

Author(s):

Dr. Harshad C Dongare ◽

◽

Dr. Khalid I Khatib ◽

Dr. Ajit S Baviskar

Keyword(s):

Anesthetic Management

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Probiotics in gastroenterology – from a different angle

Orvosi Hetilap ◽

10.1556/oh.2013.29547 ◽

2013 ◽

Vol 154 (8) ◽

pp. 294-304 ◽

Cited By ~ 2

Author(s):

György Miklós Buzás

Keyword(s):

Side Effects ◽

Beneficial Effect ◽

Analytical Data ◽

Well Being ◽

Gastrointestinal Diseases ◽

Convincing Evidence ◽

Probiotic Treatment ◽

History Of ◽

Irritable Bowel

After a short overview of the history of probiotics, the author presents the development of human intestinal microflora based on the newest genetic data and the microbiological features of main probiotics. The indications of probiotic administration have been defined and extended in recent years. The author reviews significant results of probiotic treatment in some gastrointestinal diseases based on meta-analytical data. Probiotics are useful in preventing and treating diarrhoea caused by antibiotics and Clostridium difficile caused diarrhoea. In the treatment of Helicobacter pylori infection, preparations containing certain Lactobacillus,Bifidobacterium strains or Saccaromyces boulardii could enhance by 5–10% the rate of successful eradication and reduce the incidence and severity of the side effects. Some symptoms of irritable bowel syndrome and thus the quality of life can be improved by probiotics. Their beneficial effect in ulcerative colitis was proven, while in Crohn’s disease has not yet been defined. The use of probiotics is not included in guidelines, with the exception of the Maastricht IV/Florence consensus. For each disease it is advisable to use probiotics containing strains only with proven beneficial effect. The efficiency of preparations containing mixed strains has not yet been properly investigated. The author reviews the rare but potentially serious side effects of probiotics. In Hungary, there are many probiotic preparations available which can be purchased in pharmacies without prescription: their use is more empirical than evidence-based. The European Food Safety Authority has recently rejected claims for probiotics to be classed as medicines given the lack of convincing evidence on the effects of probiotics on human health and well-being. Clearly, further research is needed to collect evidence which could be incorporated into the international guidelines. Orv. Hetil., 2013, 154, 294–304.

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